IQ is 50-55 thru approx. 70; 85% of all MR cases; may not become apparent until child is school age and has difficulty meeting educational demands
Approx 10% or MR population; IQ between 35-40 and 50-55; usually develop communication skills during early childhood; can be trained to performed unskilled work under close supervision
3-4% of the MR population; IQ between 20-25 and 35-40; communicative speech usually does not develop during early childhood, although it may be acquired during the school-age years; can learn basic self-care, but need more supervision
Approx 1-2% of MR population; IQ of less than 20-25; communication skills and sensorimotor functioning are significantly impaired; need nearly constant supervision and generally benefit from a one-to-one relationship with a caregiver
WISC has high floor, or minimum score of about 50; this test cannot provide accurate assessment of the level of MR. Stanford-Binet best to assess MR because its floor is much lower (also to assess giftedness).
Causes of MR
Varied and etiology may be undetermined in approximately 30-40% of cases. Clear etiologies easier to ascertain w/severe or profound MR. Most common identifiable cause is abnormalities in embryonic development; maternal illness; maternal consumption of alcohol, maternal use of nicotine or drugs and chromosomal changes.
What is the most common form of LD?
Reading disorder (dyslexia). 80% of LDs and approx. 4% of all children.
What percentage of those with LD do not complete High School?
What percentage of children with LD have comorbid ADHD?
What are most cases of reading disorder due to?
Poor sound awareness and sound-symbol correspondence (phonological processing).
What are the two types of dyslexia?
Surface dyslexia (AKA orthogonal dyslexia: difficulty with irregular words, ex. might = mit) and deep dyslexia (probs with many words, even "regular" ones)
Dyslexia due to brain damage
What percentage of LD people struggle with significant psychosocial probs as adults?
Borderline Intellectual Functioning
IQ between 71 and 84
- Onset nearly always under 10
- approx 3:1 boy:girl ratio
- peak onset age 5.
- Often resolved by age 16, but may persist to adulthood, especially with males.
- Must cause impairment for a diagnosis.
- Rarely recommended, but Verpamil may help.
A childhood communication disorder characterized by failure to use developmentally appropriate speech sounds; when speaking, individuals with this disorder may substitute one sound for another, omit sounds, incorrectly order sounds within words of syllables, lisp, or otherwise misarticulate sounds.
Autism and Gender
Boys more likely to have AD, but when girls have it they are more likely to also have MR
What percentage of individuals with autism show MR? Have seizures?
MR - about 70%. 25% develop seizures.
What indicates good prognosis with autism?
Normal range IQ (over 70) and spoken language by age 6.
A PDD in which a child demonstrates deceleration in head growth, replacement of purposeful hand skills w/stereotyped hand movements (hand-wringing), severe psychomotor agitation, severe impairment in language development, and loss of social engagement.
Sx appear between 5 and 48 mths in age, after an apparently normal prenatal and perinatal development.
Only occurs in females.
ADHD and nuerology
Frontal lobe functioning and frontal striata pathways are implicated in symptoms
Prevalence of ADHD
- 5-8% of children and adolescents (slightly lower in adults)
- sex ratio is 3:1 male:female.
- Comorbidity with ODD/CD, anxiety disorders, mood disorders, LD
- strongly heritable (around 80%)
A disruptive behavior disorder characterized by negativistic, hostile, and defiant behavior (actively disobeying directions or parents or other caregivers, short temper, spitefulness, irritability, failure to take responsibility for one's mistakes or misbehavior, frequent arguments w/adults)
- lasting at least 6 mths.
Progresses to CD
No Aggression toward ppl/animals/property
1 - 10%
Disruptive Behavior Disorder characterized by aggression toward people or animals, destruction of property, deceitfulness, theft, and serious rule violations, childhood precursor to Antisocial Personality Disorder.
30-80% comoribid ADHD
Childhood onset < 10 = likely antisocial PD
Some normality between 18-24 mths. Regular ingetsion of non-nutritive substances, often linked to MR or PDD, can lead to serious medical complications (lead poisoning for example)
25% of these children may die as a result of malnutrition.
Repeated regurgitation and often re-chewing of food without apparent distress; may result in malnutrition or death; linked to stress in parent-child relationship, along with lack of stimulation,
Linked to ID, Autism, lack of stimulation & child neglect.
Avoidant/Restrictive Food Intake Disorder
- Causes more probs when occurring before age 2.
- Failure to eat adequately for at least one month.
- Linked w/developmental delays, sometimes child abuse or neglect, extreme stress in the family, clear failures in parental "reading" of infant/child hunger cues, or forcing food.
- Up to 25% infancts die as a result of malnutrition
- Formerly Known as: Feeding disorder of infancey or early childhood (failure to thrive)
Reactive Attachment Disorder
- Child displays significantly disturbed social relatedness, linked directly to grossly pathological care (and not MR or PDD).
- Inhibition & emotional withdrawal from caregivers
- Onset before age 5.
- Etiology: pathogenic caregiving - severe negelct
Two types of RAD
Inhibited Type: Children do not engage in many interactions, are hypervigilant, wary of letting other people come close to or make eye contact with them ("frozen watchfulness"), and often resistant toward physical affection.
Disinhibited Type: Children are indiscriminately sociable and fail to make selective attachments, act overly familiar (i.e. overly affectionate) with strangers.
Transient Tic Disorder
1+ motor or vocal tics daily for between 4 weeks and 12 months