Disorders of ChildhoodMental RetardationIQ below 703% American Population5% institutionalizedKennedy Reorganized 1960Children may be the victims of fate, but will not be victims of neglectKennedy was for NormalizationWarehousing v. NormalizationThese people are mentally ill, just throw them in a room with a bunk & neglect themMaking the environment as normal as possibleMainstream/inclusion= we will be dealing with the mentally retarded and they will be dealing with us all their lives, so we should just put them in the public schoolThree ways to classify the Mentally Retarded Persons1) Based on measured intelligenceOld British system used Moron, Imbecile, IdiotNew system A La John KennedyMild (IQ: 50-70), Moderate (35-50), Severe (20-35), Profound (0-20)Most people institutionalized (Brenham State School) will be in moderate and severeMild will likely be let out in the publicProfoundViolent: ask the care taker questions instead of the mentally ill person2) Based on Adaptive BehaviorEducable (20% or so)Not just based on their IQ, but how they adapt5th-7th grade education by age 21Trainable (20% or so)“Self-Help” SkillsLearning to take clothes off/on at appropriate times, toilet, brush teethUn-trainable (5%)Ambulatory/Non-Ambulatory“Non-Am’s” -they don’t walkAmbulatory- mobile3) Based on Etiology (Causes (7))SocioculturalPoverty related; Causes estimated 75% of retardationFactors: Pre/Post Natal Diet deficits; lack of intellectual stimulation; no role models for learning; absence of basic vaccinations; environmental deprivationHearne & Big City Property:Head Start: created to deal with this issue, developed too lateGenetic/Chromosomal#5 Cri Du Chat SyndromePiece of # 5 is missing (chromosome)1/20,000 to 1/50,000 birthsMicrocephalyHypertelorismSimian PalmarApe line crease on hand#15 Prader-Willi Syndrome#15 chromosome, piece is missingInsatiable appetite, obesity ***Want to eat all the timeFood under lock and keyAlmond-shaped eyesUndescended testiclesLissencephalyDiagnosed prenatally/ at birth- 1/100,000May involve X chromosome #7 #17Prenatal Viral infectionPoor blood supply to brainCoach Bill O’Brian’s son#18 Edwards (trisomy 18 syndrome)Three chromosomes on #1816,000 live births, half die in utero5-10% survive first yearMicrocephaly#21 Down SyndromeTrisomy on #21Once known as mongolismOccurs in 1 in 800-1000 live births5,500 per year in USATerm coined 1887 by Dr. Langdon-Down1961 18 genetics wrote Lancet “Embarrassing Term”90% of these children are terminatedFertility unlikelyLifespan used to be age 12, now around age 60Alzheimer’s common with ageMothers age:20-24 1/150040 1/6049 1/11Theories: quality of egg theoryGeneral decline theorySperm under siege: maybe we should be doing studies on male sperm not just women’s eggsPrenatal detection (4 options but we rely on amniocentesisModerate to severe IQBiochemical/MetabolicCarbohydrate MetabolismGalactosemiaMilk, cant metabolize itVery rare 1/60,000Cant be breast fedFat MetabolismTay-SachsDevelop and look fairly normal; European JewsNo high reactions, don’t process a lot of things… but during this time they are developing tumors in the brain… 24 months: convulsions then go blindRetina dies, turns cherry redUsually die by age 3, no treatmentLOTS (late onset tay-sachs) adult version of thisProtein MetabolismPhenylketonuria (PKU)Recessive gene disorder 1/50,000Very unusual smell in the urineFollings Disease; blood test; Lofenalac… Normal IQ (if found early enough)?Phenylalanine (found in milk and etc.… cant metabolize this)Lofenalac is a protein to help with thisDietary restrictionsSugar free Kool-Aid****warning on diet drink cansIf not treated: low IQ, very aggressive, psychoticCornelia De Lange SyndromeCause Unknown #3 Chromosome1 in 10,000-30,000Mild to profound retardationMicrocephalyHirsutismSmall StatureNot detectable before birthLesch-Nyhan SyndromeOverproduction of uric acidOrange crystals in diaperRare genetic disorderNo cureSelf-Mutilation*** bite off lipsPrenatal HazardsFirst trimester are most important [spinal chord is being formed.. if disruption in that process -> Spina Bifida]High fever diseases-pregnancyDrug/Alcohol AbuseFetal Alcohol SyndromeHave to ABUSE alcohol, a drink every day won’t hurtChronis DiseasesDiabetics… can have children but calls for a close watch during pregnancySyphilisRadiationEffects of radiation, Bombs in Japan during WW2 showed us thisPsychotropic--- Thalidomide“warning” “should be taken with caution during pregnancy”If you took ____ during pregnancy= compensationAnxiety might be more harmful on a child as the medication that you’re takingThalidomide was banned in USA, but in western Europe it was used for morning sickness (typically first three months…. Back to the importance of first trimester)Phocomelia-> “Seal flippers” hands come off shoulder joints a repercussion of taking ThalidomideHazards at BirthPrematurityLess than 5 pounds 8 ouncesTotally based on body weightThe issue is really as you move away to 3 and below… that’s when you have problemsToo rapid/Prolonged LaborSoft spot on a babies head, putting pressure on the babies brain during contractions (no more than 12-18 hours in labor) longer in labor- more likely to have a problemUmbilical cord accidentsWrapped around neckTransverse/breechChild tries to be born sideways/head is not where it is supposed to beForceps injuriesPlacenta previaPlacenta is blocking the birth process, after birth detaches before the baby is bornKills the mother…lack of access to surgeryPost-Natal HazardsFalls/Near Drowning’sCarbon Monoxide PoisoningLead/Mercury PoisoningHigh Fever DiseaseEncephalitisMeningitisMiscellaneous/Unknown (look below)Brain and Skull AnomaliesMacrocephalyUnusually large head (29-30 inches)Nerve cells and Glia cells… this disease is a cancerous like issue with numerous Glia cells and it makes the skull/head largeDwarfed in stature/large headMicrocephalyExtremely small head (16-17 inches)Head comes to a conical pointIQ is… around severe… no normal in this game.Saw a lot of these disorders in Japan after we dropped bombHydrocephalyAccumulation of spinal fluid on the brain “water head”Inability to properly circulate spinal fluidProducing to much spinal fluid we would urinate it out, sweat it out, etc. But with this case, it accumulates between brain and the skull48-49 inches… head is 2/3 of her body weightThose soft spots on a babies head, the brain does not ossify