2 24 Nature of Developmental Psychopathology normal vs abnormal development we might look at children and adults behavior differently certain strange behaviors might be normal for children of certain ages ex tantrums or eating objects normal for 2 year olds not for 10 year olds neurodevelopmental disorders diagnosed first in infancy childhood or adolescence developmental psychopathology study of how disorders arise change with time disruption of early skills can affect later development Attention Deficit Hyperactivity Disorder ADHD DSM 5 a persistent pattern of inattn and or hyperactivity impulsivity including 1 and or 2 a 6 or more inattn symptoms b 6 or more hyperactive or impulsive symptoms b several ADHD symptoms present before age 12 c several ADHD symptoms are present in two or more settings ex home school work etc d clear evidence that symptoms interfere with social or occupational functioning e not better explained by other mental disorder ADHD Inattn Exmaples famils to give close attn to details difficulty sustaining attn does not seem to list when when spoke to directly does not follow instruction fails to finish schoolwork chores or work duties avoids tasks that require sustained mental effort easy distracted ADHD Hyperactive Impulsive Examples fidgets or taps hands or feet leaves seat when expected to remain seated runs about or climbs when inppropriate cannot play quietly excessive talking interrupts or intrudes on others difficulty waiting his or her turn Attention Deficit Hyperactivity Disorder ADHD ADHD specifiers combined presentation predominantly inattentive presentation predominantly hyperactive presentation Associated with numerous impairments behavioral acting out standing up in class speaking without raising hands impulsive cognitive distraction lack of attn concentration social problems with adults peers academic problems ADHD Psychosocial Consequences ADHD children are often viewed negatively by others constant negative feedback from peers adults peer rejection and resulting social isolation such factors foster low self esteem ADHD Facts Stastics prevalence occurs in 3 7 of school aged children symptoms are usually present around age three or four greatest frequency of diagnosis is at age 8 children with ADHD may continue to have problems as adults gender differences boys outnumber girls at least 3 1 and possibly as high as 9 1 probability of ADHD is greatest in US The Causes of ADHD Biological Contributions genetic contributions mostly unclear ADHD seems to run in families may be linked to a gene that affects the dopamine system if you have too much dopamine you are likely to have schizophrenic like symptoms so those types of too much but in ADHD it may seem like too much action etc and with schizo it s the hallucinations neurobiological contributions smaller overall brain volume linked to ADHD The Causes of ADHD Environmental Conditions role of toxins some evidence that food colors and preservatives are linked to attn problems hyperactivity maternal smoking during pregnancy increases risk again more research needed Biological Treatment of ADHD goal of biological treatments to reduce impulsivity and hyperactivity to improve attn stimulant meds reduce core symptoms in 70 of cases ex Ritalin Dexedrine etc effects of meds improve compliance in school or work and decrease negative behaviors do not affect academic performance social skills benefits are not lasting following discontinuation Behavioral and Combined Treatment of ADHD behavioral treatment reinforcement programs increase appropriate behaviors decrease inappropriate behaviors may also involve parent training combined bio psycho social treatments highly recommended superior to meds or behavioral treatments alone CH A D D children and adults with ADD non profit organization devoted to educating public about attn deficit and hyperactivity disorders Conduct Disorder DSM 5 a repetitive and persistent pattern of behaviors in which the basic rights of others or societal norms are violated including 3 of following 15 criteria in the past 12 months and one in past 6 months a 1 3 aggression to people and animals b 8 9 destruction of property c 10 12 deceitfulness or theft d 13 15 serious violation of rules b causes impairment in functioning c if 18 or older person does not meet criteria of anti social personality disorder Conduct Disorder Facts Statistics usually apparent by age 9 prevalence 1 5 3 4 times as many boys as girls a less severe diagnosis exists called Oppositional Defiant Disorder ODD appears first in almost all cases of CD Autism Spectrum Disorder considered a childhood disorder just because its usually diagnosed really early not that its just for children very quickly growing area research a persistent deficits ins ocial interactions across multiple contexts Need all 3 of 2 27 1 social emotional reciprocity 2 nonverbal communication 3 relationship deficits b restricted repetitive patterns of behavior need 2 of these 4 1 stereotyped or repetitive motor movements 2 insistence on sameness 3 highly restricted fixed interested 4 hyper more or hypo less reactivity to sensory input c symptoms must be present early in development d impairment in functioning e not due to intellectual disability have to have more than that Autism Spectrum Disorder Facts Statistics prevalence one in every 500 births but appears to be increasing 50 never acquire useful speech occurs worldwide symptoms usually develop before 36 months of age Autism Spectrum Disorder Statistics autism is associated with impairment on cognitive or intellectual tasks reliable indicators of better prognosis language ability iQ in rare cases savant skills may develop Causes of Autism current understanding of autism fundamental disturbance of the central nervous system genetic component is largely unclear early developmental factors play a role things that happen in utero or early life may play a role something happening early on prob in development but we don t really know psychosocial contributions are also unclear NOT caused by failed parenting NOT caused by vaccines andrew wakefield hoax Treatment of Autism Spectrum Disorder psychosocial behavioral treatments applied behavioral analysis ABA treatment operant and classical conditioning both reinforcement and punishment used skill building reduction of problem behaviors target communication language probelsm first person to push ivar lovaas invented this treatment in 70s to radically change