Download Handout 51: Mental Retardation

Comer, Fundamentals of Abnormal Psychology, 4e — Chapter 14: Student Handout Answer Key
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Chapter 14 — Disorders of Childhood and Adolescence
Slides, handouts, and answers keys created by Karen Clay Rhines, Ph.D., Seton Hall University
Handout 3: Childhood and Adolescence
People often think of childhood as a carefree and happy time – yet it can also be
frightening and upsetting
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Children of all cultures typically experience at least some emotional and behavioral
problems as they encounter new people and situations
Surveys indicate that worry is a common experience
Bedwetting, nightmares, and temper tantrums are other problems experienced by many children
Handout 5: Childhood and Adolescence
Along with these common psychological difficulties, around 20% of all
children and adolescents in North America also experience a diagnosable
psychological disorder

Boys with disorders outnumber girl, even though most of the adult psychological
disorders are more common in women
Handout 6: Childhood Anxiety Disorders
As in adults, the anxiety disorders experienced by children and adolescents
include specific phobias, social phobias, generalized anxiety disorder, and
OCD
One form of anxiety listed separately in the DSM and specific to children is
separation anxiety disorder
Handout 8: Childhood Anxiety Disorders
Separation anxiety disorder sometimes takes the form of school phobia, although
most cases of school phobia have other causes
Childhood anxiety disorders are generally explained in much the same way as
adult anxiety disorders, with biological, behavioral, and cognitive factors
pointed to most often

The special features of childhood may play an important role
Handout 9: Childhood Anxiety Disorders
Psychodynamic, behavioral, cognitive, and family therapies, separately and in
combination, have been used to treat anxiety disorders in children, often with
Comer, Fundamentals of Abnormal Psychology, 4e — Chapter 14: Student Handout Answer Key
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success
Clinicians have also used drug therapy and play therapy as part of treatment
Handout 10: Childhood Depression
Children, like adults, may develop depression
Between 2 and 4% of children under 17 years of age experience major
depressive disorder

The symptoms are likely to include physical discomfort, irritability, and social
withdrawal
There appears to be no difference in the rates of depression in boys and girls
before age 11
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By age 16, girls are twice as likely as boys to be depressed
Handout 11: Childhood Depression
Explanations of childhood depression are similar to those of adult depression
Theorists have pointed to factors such as loss, learned helplessness, negative
cognitions, and low serotonin or norepinephrine activity
Handout 13: Disruptive Behavior Disorders
Children displaying extreme hostility and defiance may qualify for a diagnosis
of oppositional defiant disorder

This disorder is characterized by repeated arguments with adults, loss of temper, anger,
and resentmen

Children with this disorder ignore adult requests and rules, try to annoy people, and
blame others for their mistakes and problems

Between 2 and 16% of children will display this pattern

The disorder is more common in boys than girls before puberty but equal in both sexes
after puberty
Handout 14: Disruptive Behavior Disorders
Children displaying extreme hostility and defiance may also qualify for a
diagnosis of conduct disorder
Children with this disorder display a more extensive and severe antisocial pattern and
repeatedly violate the basic rights of others

They are often aggressive and may be physically cruel and violent

Many steal from, threaten, or harm their victims, committing such crimes as
Comer, Fundamentals of Abnormal Psychology, 4e — Chapter 14: Student Handout Answer Key
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shoplifting, vandalism, mugging, and armed robbery
Handout 15: Disruptive Behavior Disorders
Conduct disorder usually begins between 7 and 15 years of age
Between 1 and 10% of children display this pattern, boys more than girls
Children with a mild conduct disorder may improve over time, but severe cases
frequently continue into adulthood

These cases may turn into antisocial personality disorder or other psychological
problems
Handout 20: Disruptive Behavior Disorders
It may be that the greatest hope for reducing the problem of conduct disorder
lies in prevention programs that begin in early childhood

These programs try to change unfavorable social conditions before a conduct disorder
is able to develop
Handout 21: Attention-Deficit/Hyperactivity Disorder
Children who display attention-deficit/hyperactivity disorder (ADHD) have
great difficulty attending to tasks or they behave overactively and impulsively,
or both
The primary symptoms of ADHD may feed into one another, but often one of
the symptoms stands out more than the other
Handout 24: Attention-Deficit/Hyperactivity Disorder
Clinicians generally consider ADHD to have several interacting causes
including:

Biological causes

High levels of stress

Family dysfunctioning
Each of these causes has received some research support
Handout 26: Attention-Deficit/Hyperactivity Disorder
There is heated disagreement about the most effective treatment for the disorder

The most common approach has been the use of stimulant drugs such as
methylphenidate (Ritalin)

These drugs have a quieting effect on as many as 80% of children with ADHD and
Comer, Fundamentals of Abnormal Psychology, 4e — Chapter 14: Student Handout Answer Key
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sometimes increase their ability to solve problems, perform in school, and control
aggression
However, some clinicians worry about the possible long-term effects of the drugs
Handout 27: Attention-Deficit/Hyperactivity Disorder
 Behavioral therapy is also applied widely in cases of ADHD

Parents and teachers learn how to apply operant conditioning techniques to change
behavior

These treatments have often been helpful, especially when combined with drug therapy
Handout 28: Elimination Disorders
 Children with elimination disorders repeatedly urinate or pass feces in their
clothes, in bed, or on the floor
 They have already reached an age at which they are expected to control these
bodily functions

These symptoms are not caused by physical illness
Handout 29: Enuresis
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Enuresis is repeated involuntary (or in some cases intentional) bedwetting or
wetting of one’s clothes
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It typically occurs at night during sleep but may also occur during the day
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The problem may be triggered by a stressful event

Children must be at least 5 years of age to receive this diagnosis
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The prevalence of enuresis decreases with age
Handout 32: Encopresis

Encopresis – repeatedly defecating in one’s clothing – is less common than
enuresis and is less well researched

The problem:

Is usually involuntary

Seldom occurs during sleep

Starts after the age of 4

Is more common in boys than girls
Comer, Fundamentals of Abnormal Psychology, 4e — Chapter 14: Student Handout Answer Key
Handout 35: Autism

Autistic disorder, or autism, was first identified in 1943

Children with this disorder are extremely unresponsive to others,
uncommunicative, repetitive, and rigid

Symptoms appear early in life, before age 3

Only 5 of every 10,000 children are affected, and 80% are boys
Handout 36: Autism
 As many as 90% of children with autism remain severely disabled into
adulthood and are unable to lead independent lives

Even the highest-functioning adults with autism typically have problems in social
interactions and communication and have restricted interests and activities
 Several other disorders are similar to autism but differ to some degree in
symptoms or time of onset

These disorders are categorized as pervasive developmental disorders
Handout 37: What Are the Features of Autism?
 The central feature of autism is the individual’s lack of responsiveness,
including extreme aloofness and lack of interest in people
 Language and communication problems take various forms

One common speech peculiarity is echolalia, the exact echoing of phrases spoken by
others
Handout 39: What Are the Features of Autism?


The motor movements of people with autism may be unusual

Often called “self-stimulatory” behaviors; may include jumping, arm flapping, and
making faces

Children with autism may engage in self-injurious behaviors
Children may at times seem overstimulated and/or understimulated by their
environments
Handout 41: What Causes Autism?

Sociocultural causes

Theorists initially thought that family dysfunction and social stress were the primary
causes of autism (e.g., the notion of “refrigerator parents”)
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These claims had enormous influence on the public and the self-image of parents but research totally
failed to support this model
Some clinicians proposed a high degree of social and environmental stress, a theory
also unsupported by research
Handout 43: What Causes Autism?
 Biological causes

While a clear biological explanation for autism has not yet been developed, promising
leads have been uncovered

Family studies suggest a genetic factor in the disorder

Prevalence rates are higher among siblings and highest among identical twins

Chromosomal abnormalities have been discovered in 10 to 12% of people with the disorder
Handout 45: What Causes Autism?
 Biological causes

Many researchers believe that autism may have multiple biological causes

Perhaps all relevant biological factors lead to a common problem in the brain – a “final common
pathway” – that produces the features of the disorder
Handout 47: How Is Autism Treated?

Behavioral therapy

Behavioral approaches have been used in cases of autism to teach new, appropriate
behaviors, including speech, social skills, classroom skills, and self-help skills, while
reducing negative ones


Most often, therapists use modeling and operant conditioning
Therapies are ideally applied when people with autism are young
Handout 49: How Is Autism Treated?
 Parent training

Today’s treatment programs involve parents in a variety of ways

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For example, behavioral programs train parents so they can apply behavioral techniques at home
In addition, individual therapy and support groups are becoming more available to help
parents deal with their own emotions and needs
Handout 51: Mental Retardation

According to the DSM-IV, people should receive a diagnosis of mental
retardation when they display general intellectual functioning that is well
below average, in combination with poor adaptive behavior
Comer, Fundamentals of Abnormal Psychology, 4e — Chapter 14: Student Handout Answer Key
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IQ must be 70 or below
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The person must have difficulty in such areas as communication, home living, selfdirection, work, or safety
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Symptoms must appear before age 18
Handout 53: Assessing Intelligence
 Many theorists have questioned whether IQ tests are indeed valid
 Intelligence tests also appear to be socioculturally biased
 If IQ tests do not always measure intelligence accurately and objectively,
then the diagnosis of mental retardation may also be biased

That is, some people may receive the diagnosis partly because of cultural difference,
discomfort with the testing situation, or the bias of the tester
Handout 55: What Are the Characteristics of Mental Retardation?
 The most consistent sign of mental retardation is that the person learns very
slowly
 Other areas of difficulty are attention, short-term memory, planning, and
language

Those who are institutionalized with mental retardation are particularly likely to have
these limitations
Handout 56: What Are the Characteristics of Mental Retardation?
 The DSM-IV describes four levels of mental retardation:

Mild (IQ 50–70)
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Moderate (IQ 35–49)
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Severe (IQ 20–34)

Profound (IQ below 20)
Handout 57: Mild Retardation

Some 85% of all people with mental retardation fall into the category of mild
retardation (IQ 50–70)


They are sometimes called “educably retarded” because they can benefit from
schooling
People with mild retardation typically need assistance but can work in
unskilled or semiskilled jobs
Comer, Fundamentals of Abnormal Psychology, 4e — Chapter 14: Student Handout Answer Key
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Intellectual performance seems to improve with age
Handout 60: Moderate, Severe, and Profound Retardation
 Approximately 10% of persons with mental retardation function at a level of
moderate retardation (IQ 35–49)

They can care for themselves and benefit from vocational training
 About 4% of persons with mental retardation display severe retardation (IQ
20–34)

They usually require careful supervision and can perform only basic work tasks
Handout 61: Moderate, Severe, and Profound Retardation
 About 1% of persons with mental retardation fall into the category of
profound retardation

With training they may learn or improve basic skills but they need a very structured
environment
 Severe and profound levels of mental retardation often appear as part of
larger syndromes that include severe physical handicaps
Handout 63: What Are the Causes of Mental Retardation?
 Chromosomal causes

The most common chromosomal disorder leading to mental retardation is Down
syndrome
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Several types of chromosomal abnormalities may cause Down syndrome, but the most common is
trisomy 21

Fragile X syndrome is the second most common chromosomal cause of mental retardation
Handout 64: What Are the Causes of Mental Retardation?

Metabolic causes

In metabolic disorders, the body’s breakdown or production of chemicals is disturbed

The metabolic disorders that affect intelligence are typically caused by the pairing of
two defective recessive genes, one from each parent

Examples include:

Phenylketonuria (PKU)

Tay-Sachs disease
Handout 69: Interventions for People with Mental Retardation
 What is the proper residence?
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Comer, Fundamentals of Abnormal Psychology, 4e — Chapter 14: Student Handout Answer Key
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During the 1960s and 1970s, the public became more aware of these sorry conditions,
and as part of the broader deinstitutionalization movement, demanded that many
people be released from these schools
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People with mental retardation faced similar challenges by deinstitutionalization as people with
schizophrenia
Handout 70: Interventions for People with Mental Retardation
 What is the proper residence?

Since deinstitutionalization, reforms have led to the creation of small institutions that
teach self-sufficiency, devote more time to patient care, and offer education and
medical services
Residences include group homes, halfway houses, local branches of larger institutions, and
independent residences

These programs follow the principle of normalization – they try to provide living conditions similar
to those enjoyed by the rest of society
Handout 72: Interventions for People with Mental Retardation
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Which educational programs work best?

Because early intervention seems to offer such great promise, educational programs for
individuals with mental retardation may begin during the earliest years

At issue are special education versus mainstream classrooms

In special education, children with mental retardation are grouped together in a separate, specially
designed educational program

Mainstreaming places them in regular classes with nonretarded students

Neither approach seems consistently superior
Handout 74: Interventions for People with Mental Retardation
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When is therapy needed?

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People with mental retardation sometimes experience emotional and behavioral
problems

At least 10% have a diagnosable psychological disorder other than mental retardation

Some suffer from low self-esteem, interpersonal problems, and adjustment difficulties
These problems are helped to some degree with individual or group therapy

Medication is sometimes prescribed