Flashcards in Developmental disorders Deck (110):
What is the definition of 'developmental disorders'?
A group of conditions with onset in the developmental period
What conditions come under Autism Spectrum Disorders?
- asperger’s syndrome
- childhood disintegrative disorder
- pervasive developmental disorder not otherwise specified
What are the characteristics of ASD?
- deficits in social communication, interaction, and understanding what others are thinking (ToM)
- restricted repetitive behaviours, interests and activities (RRBs)
What disorder is it if no RRBs are present?
Social communication disorder
When do autistic symptoms appear?
- symptoms can appear at any age
- normally detected after 2 y/o --> must show that interaction/communication is affected but children don’t tend to talk until after 2 y/o
- often show symptoms before 2 but it isn't clear that it is autism until they start talking
What behaviours might someone with autism typically produce?
- sensory issues
- special interests
- difficulty understanding and relating to others
- difficulty reading facial expressions
- difficulty understanding common phrases/jokes/sarcasm
What is Asperger's syndrome (AS)?
- has the same criteria for autism but there is no cognitive/language delay (normal language and intelligence)
Language delay = not using single words by 2 y/o and/or phrase speech by 3 y/o
- usually clumsy
- unusual use of language
Is Asperger's syndrome more common in males or females?
More common in males
When do symptoms of Asperger's syndrome appear?
Symptoms usually aren't recognised before 3 y/o
What symptoms did Wing (1981) associate with Asperger's syndrome?
- content of speech is abnormal
- little facial expression
- limited gestures
- can’t comprehend others’ expressions/gestures
- lack understanding and the ability to follow rules that govern social behaviour
- lack empathy
- repetitive behaviour
- resistant to change
- tend to have excellent rote memory
What are Baron-Cohen's theories of autism?
- Deficit in ToM (deficit in ‘mindreading’)
- Empathising/systemising theory
What is the Empathising/systemising theory?
States that sufferers of autism have...
- weak central coherence
- executive dysfunction
What does it mean if a person has a weak central coherence?
- they see detail at the expense of the whole
- they are less susceptible to illusions that typically-developed people can see
What does it mean if a person has executive dysfunction?
- difficulties planning and organising
- can't control/plan certain behaviours that typically-developed people can
How do genetics influence autism?
The strongest evidence for autism come from twin and behavioural genetic family studies
High concordance rates between MZ twins and lower between DZ twins suggests that there is a strong genetic influence
What concordance rates between MZ and DZ twins have researchers found for autism?
Bailey et al. (1995) – MZ = 60% vs. DZ = 0%
Steffenberg et al. (2006) – MZ = 91% vs. DZ = 0%
Rosenberg et al. (2009) – MZ = 86% vs. DZ = 31%
Explain the autism continuum.
Autism and Asperger's syndrome lie on a continuum of social-communication disability, with AS as the bridge between autism and normality
What is the prevalence of autism in the population, according to Baird et al. (2006)?
Baird et al. (2006) - 100/10,000
Is autism more common in males or females?
More males have Asperger's/high-functioning autism
For moderate autism, what is the male:female ratio?
Fombonne (1999) - 4:1 overall, but varies depending on the presence/absence of ID
For severe autism, what is the male:female ratio?
For mild autism, what is the male:female ratio?
What could be the causes of the increase in the prevalence of autism in recent years?
- broadening of the concept of autism
- expansion of the diagnostic criteria
- development of services
- improved awareness of the condition
Which scales/questionnaires/interviews/tests can we use to measure autism?
- Autism Diagnostic Interview
- Autism Diagnostic Observation Schedule
- Childhood Autism Rating Scale
- Autism Spectrum Quotient
Who created the Autism Diagnostic Interview and what does it involve?
Le Couteur et al. (1989)
- score on certain criteria
What does the Autism Diagnostic Observation Schedule involve?
- score on certain criteria
- observe the person's behaviour
What is a criticism of the Autism Diagnostic Observation Schedule?
Time consuming - you must spend enough time with the child to observe all of their behaviours
Who created the Childhood Autism Rating Scale and what does it involve?
Schopler, Reichler and Renner (1986)
- the parent/caregiver fills out the scale from their perceptions of their child's behaviour
What a criticism of the Childhood Autism Rating Scale?
X can be quite brief
X not self-administered
Who created the Autism Spectrum Quotient and what does it involve?
Baron-Cohen et al. (2001)
- 50 questions
- 10 questions assess 5 skills
Which skills are assessed on the Autism Spectrum Quotient and what results do people with ASD normally obtain?
- Social skills – LOW
- Attention switching – LOW
- Attention to detail – HIGH
- Communication – LOW
- Imagination – LOW
What are some pros of the Autism Spectrum Quotient?
- short (not time consuming)
- easy to use
- easy to score
Which 2 aspects of communication are deficient in autism?
- conversational ability
- using mental state terms in speech (understanding that others have different beliefs to us)
What is 'conversational ability'?
The ability to expand, initiate and maintain conversation
Which researcher/s looked at whether teaching autistic children to pass tasks that assessed their mental state improved the children's communication?
Hadwin, Baron-Cohen, Howlin and Hill (1997)
What did Hadwin, Baron-Cohen, Howlin and Hill (1997) do in their study?
Children with autism were taught how to pass tasks that assessed emotional and belief understanding
- they were trained to have ToM abilities
What did Hadwin, Baron-Cohen, Howlin and Hill (1997) find in their study?
There was no improvement on either measure of communication (emotional understanding/belief understanding) after training
Basic logic tasks sometimes don’t require ToM abilities - what might they require instead?
Basic logic tasks sometimes don’t require ToM abilities, just the ability to be logical
How did Baron-Cohen, Leslie and Frith (1985) teach the Sally-Ann task to children with autism?
Children with autism tried to solve the task --> if they were wrong, the researcher would give them the correct answer and explain why they were wrong
- TD children pass the Sally-Ann task at 4-5 y/o
How did Fombonne (2002) define Childhood Disintegrative disorder?
Fombonne (2002) – Childhood Disintegrative disorder is a rare pervasive developmental disorder affecting 1.7/100,000 children
When does Childhood Disintegrative disorder develop?
The child has at least 2 years of normal development, followed by a loss of skills across multiple domains
- self-help skills
How does Childhood Disintegrative disorder develop?
APA (2002) - onset (i.e. the loss of skills) may be gradual or sudden
What name is sometimes given to Childhood Disintegrative disorder?
Childhood Disintegrative disorder is now called REGRESSIVE AUTISM because it is based on regression in skills
What is Pervasive Developmental Disorder Not Otherwise Specified?
- a severe and pervasive impairment in the development of reciprocal social interaction
- impairment in non-verbal/verbal communication skills
- stereotyped behaviour, interests and activities
Why is Pervasive Developmental Disorder Not Otherwise Specified not classified as other ASDs?
The individual must demonstrate impairment in social interaction/communication/RRBs but impairment is not severe or specific enough to be characterised as other ASDs
- PDDNOS has some symptoms in common with ASDs but not all
What did Juul-Dam, Townsend and Courchesne (2001) suggest might cause PDDNOS?
People with PDDNOS have a higher incidence of hyperbilirubinemia (can cause brain damage) compared to healthy people
A group of people with PDDNOS had better social skills than people with autism but worse social skills than those with intellectual disorder.
Who found this?
Njardvik, Matson and Cherr (1999)
Diagnosis of PDDNOS often gets mistaken for ADHD
- over-focusing on other children
Luteijn et al. (2000) investigated the differences between people with PDDNOS and ADHD.
What did they find?
According to parent reports, both groups (PDDNOS + ADHD) had severe problems with social behaviour but the PDDNOS group had more social problems, withdrawal problems and other PDD-specific problems
What is the definition of Intellectual Disability?
Deficits in general mental abilities...
- abstract thinking
- academic learning
- learning from experience
What impairments of adaptive functioning might people with ID experience?
- lack of personal independence (need help with their personal care)
- lack of social responsibility (unlikely to do 'normal' behaviours like care for others and have social conversations)
What was previously recommended for ID to be diagnosed, but now is deemphasised included in the ID criteria?
Previously an IQ of less than 70 was the recommended cut-off score
- no longer need
People with ID may also have a physical disability.
What ID condition includes a physical disability?
Downs syndrome - different facial structure
What tests can we use to test for ID?
- abstract reasoning tests (e.g. indicate which items fit in a logic puzzle)
- logic tests
What is the severity of ID based on?
Severity is based on the individual's adaptive functioning rather than their IQ
What is the general population prevalence of ID?
What is the general prevalence for severe ID?
Is ID more common in males or females?
ID is more common in males
When might ID be detected and how long will it last?
- delayed motor, language and social milestones may be identifiable in the first 2 years
- mild levels of ID may not be identifiable until school age when academic learning becomes important
- it is usually a lifelong disorder but the severity may change – may become better at functioning independently
What might be the causes of ID?
- inborn errors
- environmental influences
How might ID be caused by genetics?
Meffort, Batshaw and Hoffman (2012) – single-cause genes have been identified for ID syndromes
Fragile X (Downs syndrome) is caused by an extra chromosome
What sort of inborn errors might caused ID?
- brain malformations
- a maternal disease that was passed onto child prenatally
Which study investigated inborn errors in ID?
van Karnebeek and Stockler (2012) – identified 81 ‘treatable inborn errors of metabolism’ presenting with ID, incl. disorders of...
- amino acids
[identified by metabolic screening tests in the blood and urine]
Which environmental factors might influence the development of ID?
Reynolds, Zupanick and Dombeck (2013) – pre- and post-natal exposure to alcohol, drugs (nicotine, heroin, cocaine), toxins (lead, mercury, radiation) and certain infections
Foetal Alcohol Syndrome (alcohol passes through the placenta to the developing foetus’ brain) causes birth defects and ID
Which researcher/s did a meta-analysis and found that people with ID had a deficit in ToM abilities (especially on second-order tasks)?
Yirmiya et al. (1998)
In Ashcroft, Jervis and Roberts' (1999) study, what percentage of people with ID passed the Sally-Ann task?
12.5% of pps with ID passed the Sally-Ann task
In Ashcroft, Jervis and Roberts' (1999) study, what happened to the results when pps received training on ToM?
Their performance improved with training and the effect was maintained over time
What did Ashcroft, Jervis and Roberts (1999) conclude about ToM from their study?
ToM impairments are not unique to people with autism
Are false belief tasks, as a way of measuring ToM in people with ID, valid?
X people with ID can often pass false belief tasks if they have enough logic, despite a deficiency in ToM
X false belief tasks are linguistically demanding - language deficits in people with ID may make the task more difficult --> the results may reflect their language deficit rather than ToM difficulties
What conditions come under Communication Disorders?
- language disorder
- speech sound (phonological) disorder
- social (pragmatic) communication disorder
- childhood onset fluency disorder
What types of Language Disorder are there?
- mixed receptive-expressive
What do people with receptive Language Disorder have difficulty with?
Difficulty understanding what others are saying
What do people with expressive Language Disorder have difficulty with?
Difficulty expressing their thoughts and ideas
What do people with mixed receptive-expressive Language Disorder have difficulty with?
Difficulty understanding and using spoken language
When do communication disorders typically begin and how long do they last?
Communication disorders begin early in life and may have lifelong functional impairments
When does Language Disorder typically begin and how long does it last?
- diagnosed from 4 y/o (aren't speaking properly beforehand, haven’t naturally met milestones so can’t determine if the child has the disorder)
- stable over time
- persists into adulthood
When does Speech Sound Disorder typically begin?
The child keeps using immature phonological simplification processes past 3 y/o
When does Social Communication Disorder typically begin and how long does it last?
- rare in children younger than 4
- milder forms may not be identified until adolescence (when they start interacting and their deficits are discovered)
When does Childhood Onset Fluency Disorder typically begin and how long does it last?
- usually detected by 6 y/o (when they have met their language milestones)
What are the 2 symptom domains of Attention-Deficit/Hyperactivity Disorder?
What behaviours are involved in 'inattention'?
- don’t pay attention to detail
- have trouble keeping attention
- organisation difficulties
What behaviours are involved in 'hyperactivity/inattention'?
- squirms and fidgets
- runs/climbs inappropriately
- have trouble staying quiet
- appear ‘driven’
- talk excessively
What is the general population prevalence of ADHD?
NICE (2008) - 1-19%
DSM-IV - 3-5%
Is ADHD more common in males or females?
ADHD is more common in males
Male:female = 4:1
More common in adolescents
ADHD can persist into adulthood but rates do reduce. What percentage of people continue having problems in adulthood?
Is ADHD the same as conduct disorder?
ADHD is not the same as conduct disorder
Conduct disorder = the person doesn’t adhere to social standards, violate social norms, display deviant behaviour
ADHD can be comorbid with conduct disorder (25-75%)
Which INDIVIDUAL causes of ADHD have been suggested?
What evidence is there to suggest that ADHD is a genetic disorder?
Biedeman (2005) - ADHD is strongly genetic
Voeller (2004) - there is a genetic basis in 80% of cases, involving numerous genes
In 20% of cases, ADHD is the result of an acquired insult to the brain
Found high comorbidity between ADHD and learning disabilities
What evidence is there to suggest that ADHD is a neuropsychological problem?
Tannock (1998) - people with ADHD have dysfunction of the frontostriatal networks
What evidence is there to suggest that ADHD is a cognitive problem?
Barkey (1997) - people with ADHD have a deficit in behavioural inhibition
Which SOCIAL/EDUCATIONAL causes of ADHD have been suggested?
- socioeconomic disadvantage
- institutional upbringing
- educational difficulties
- peer relationship problems
What evidence is there to suggest that ADHD is influenced by institutional upbringing?
Merz and McCall (2010) – found an association between early institutional rearing and increased ADHD-related symptoms
Which possible causes of ADHD are related to the family environment/situation?
- coercive parent-child relationships
- parental depression
- alcohol abuse
What is Specific Learning Disorder?
A disorder in one or more of the basic phonological processes involved in understanding/using language (spoken/written)
Which DSM-IV diagnoses does Specific Learning Disorder combine?
SLD combines DSM-IV diagnoses of...
- reading disorder
- mathematics disorder
- disorder of written expression
- learning disorder not otherwise specified
What conditions come under Motor Disorders?
- developmental coordination disorder
- stereotypic movement disorder
- tic disorders (Tourette’s; Persistent (chronic) motor/vocal tic disorder; Provisional tic disorder; Other specified tic disorder; Unspecified tic disorder)
What is Developmental Coordination Disorder?
- acquisition and execution of coordinated motor skills is below the level that is expected for the child's age and opportunity for skill learning and use
- the child is clumsy, slow and inaccurate
What types of behaviours might Developmental Coordination Disorder interfere with?
- activities of daily living
- academic productivity
- prevocational and vocational activities
When does Developmental Coordination Disorder typically begin?
Onset is in the early developmental period
- it usually isn't diagnosed before 5 y/o because of variation in the children reaching their motor milestones
What is it important to do before a final diagnosis of Developmental Coordination Disorder is made?
It is important to measure other factors to ensure that the child's deficits aren’t the result of other disorders (e.g. intellectual/visual impairments, neurological issues)
What is the general population prevalence of Developmental Coordination Disorder?
5-6% prevalence in 5-11 y/o
What is the general population prevalence of severe Developmental Coordination Disorder?
What is the general population prevalence of probable Developmental Coordination Disorder?
Is Developmental Coordination Disorder more common in males or females?
DCD is more common in males
How does Developmental Coordination Disorder change over the lifetime?
- the individual may improve long-term
- interventions can improve symptoms
What percentage of children will still have Developmental Coordination Disorder in adolescence?
What might be the first behavioural signs of Developmental Coordination Disorder?
Delayed motor milestones may be the first sign, or when the child is starting to hold cutlery, button clothing, etc.
What is Stereotypic Movement Disorder?
- repetitive, seemingly driven and purposeless motor behaviour
What types of behaviours might Stereotypic Movement Disorder interfere with?
- social activities
- academic activities
- may result in self-injury
When does Stereotypic Movement Disorder begin?
Onset is in the early developmental period