Download Disorders of Childhood

Disorders of Childhood
12/2/02
Pervasive Developmental
Disorders
• Severe childhood disorders characterized by
impairment in verbal and non-verbal
communication and social interaction
• Abnormalities occur in the developmental
process itself
• Examples: Autistic Disorder, Asperger’s
Disorder
Autistic Disorder:
3 main areas of impairment
• SOCIAL: “autistic aloneness”
• Lack of interest in interacting with others
(e.g., through eye contact, smiling, gesturing,
shared attention, playing, making friendships)
• Strong attachments to objects, but not people
• May not understand that other people have
thoughts and feelings
Autistic Disorder:
3 main areas of impairment
• COMMUNICATION (verbal and
nonverbal):
• Half of autistic children do not develop
language
• Many have speech oddities (e.g., echolalia
= echoing the words of others)
• Pronoun reversals: using “he” or “you”
instead of “I”
Autistic Disorder:
3 main areas of impairment
• ACTIVITIES / INTERESTS:
• Repetitive/self-stimulatory behaviors(e.g.,
spinning objects, hand flapping, whirling
around)
• Lack of imaginative behavior
• Obsessive-compulsive / ritualistic behaviors
(e.g., preoccupation with schedules, routines,
and sameness; lining up objects)
Autistic Disorder
• A majority of individuals with autism have
mental retardation (i.e., IQ score < 70)
• Contemporary theories stress a biological
etiology of autism, involving genetic factors
and/or organic central nervous system
impairment
Asperger’s Disorder
• Milder / higher-functioning form of autism
characterized by severe impairments in the
SOCIAL domain, some impairment in the
ACTIVITIES/INTERESTS domain, and no
significant delays in COMMUNICATION
and cognitive development
Disruptive Behavior Disorders
• Characterized by undercontrolled, or
externalizing behavior (i.e., “acting out”;
socially disruptive behavior that is
inappropriate given the age of the child
and/or setting of the behavior)
• Behavior is typically distressing and/or
annoying to those in child’s social
environment
• Examples: ADHD, ODD, Conduct Disorder
Attention Deficit /
Hyperactivity Disorder (ADHD)
• Involves attentional problems (e.g.,
distractibility, inattention, trouble
completing tasks) and/or hyperactivity (e.g.,
impulsivity, high motor activity,
interrupting)
• Symptoms occur before age 7, and in at
least 2 settings
ADHD
• Research on the etiology of ADHD
implicates biological, genetic, and
psychological factors
• A majority of kids with ADHD respond
positively to stimulant medications;
however, the benefits are only short-term.
Cognitive-behavioral parenting and selfcontrol therapies are important for longterm benefits.
Oppositional Defiant Disorder
(ODD)
• Involves noncompliance, hostility, losing
temper easily, arguing, irritability,
deliberately annoying or blaming others
• High comorbidity with ADHD
• May be a precursor to Conduct Disorder
Conduct Disorder (CD)
• Involves antisocial behaviors that violate
others’ rights (e.g., lying, stealing, fighting,
bullying, truancy, cruelty to people or
animals, criminal behaviors)
• Prognosis for child-onset CD is worse than
for adolescent-onset CD; worse for
aggressive children
Anxiety Disorders
• Characterized by overcontrolled, or
internalizing behavior (i.e., fears, worries,
shyness, nervousness, apprehensiveness)
• Example: Separation Anxiety Disorder
Separation Anxiety Disorder
• Involves excessive anxiety about separating
from parents or home (e.g., fears about
harm coming to parents, avoidance of being
alone, distress and physical complaints
when separation is anticipated; school
phobia = refusal to go to school)
Tic Disorders
• Tics are involuntary and repetitive
movements or vocalizations
• Motor tics often involve the face/head (e.g.,
eye blinking, grimacing, head jerking), but
may also involve limbs (e.g., flexing
elbows, tapping foot)
• Vocal tics: throat clearing, coughing,
sniffing, grunting, barking sounds
Tourette’s Syndrome
• Involves multiple motor and vocal tics
• Bodily sensations/urges frequently precede
tics
• Coprolalia (compulsion to shout
obscenities) is rare
• High comorbidity with ObsessiveCompulsive Disorder and/or ADHD
• Stimulant medication can bring on tics