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Transcript
CO-MORBIDITY
Learning, Disabilities, ADHD, Behavioral
Emotional Disorders
Disorders of Behavior- Arriving at a
Definition
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Normal versus Disordered Behavior
A social construct
What constitutes good mental health?
Concerns of frequency, intensity, duration
Difficult periods of childhood vs. behavior disorder
Lack of social skills vs. behavior disorder
Operationalizing such terms as pervasive, normal,
inappropriate, etc.
Student's emotional
problems vs. ability to learn. Males- in the past- propensity to rules
breaking
Behavior vs. Race and cultural bias
Girls- internalize emotional disturbance.
Other classifications
Physiological
Birth defect
TBI
Tourette’s Syndrome
Fetal Alcohol Syndrome,
Depression
Chemical and mood disorders.
Environmental
Learned behaviors
Mental illness, etc.
PTSS
Learning Disabled Students
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interact awkwardly.
interact inappropriately in social
situations.
socially imperceptive.
ATTENTION DEFICIT HYPERACTIVE
DISORDER
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tend to react to others aggressively
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are generally rejected by peers
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lose the opportunity to learn social skills
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are isolated from most social situations
(Westby, Cutler, 1994).
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victims of parents who are abusive or lacking effective parenting
skills.
(Parker, Asher 1987).
Learning Disabilities:
Typically a Disruption
in Maturational Delay
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Language skills
Motor skills
Uneven performance on IQ assessment
Visual-Motor
Incomplete or mixed dominance
Social Immaturity
Genetics
At Risk for LD
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Established risk:
identified through a medical diagnosis;
failure to develop, thrive; delay in language development.
Unknown etiology is the important term.
Biological risk:
early medical and health history indicates increased probability for
later atypical development.
(HIV, premature, injury at birth (anoxia, chemical dependency at
birth.)
Environmental risk:
biologically sound
early life experience are characterized by a profound lack of
stimulation- critical in the years birth to age five. Lack of cognitive
stimulation in the formative years; lack of nutrition, age of mother,
lack of prenatal and neonatal care.
Child can be at risk for all three, one or two.
Children with LD and Behavior Disorders
• Short Attention Span
• Low Frustration Tolerance
• Insatiability- need a significant level of intensity, often bored, need new
and novel activities, chronically restless, incredibly future oriented
• Distractibility
• Low self esteem
Continued:
• Learned helplessness
• Hyperactivity
• Sequencing deficits
• Memory deficits
• Interrogoration
• Disinhibition
• Impulsivity
Common Elements in the Definition
Common Elements in the Definitions
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Central Nervous System Dysfunction
Uneven Growth Pattern /Psychological Processing Deficits
Discrepancy Between Potential and Achievement
Exclusion of Other Causes
Symptoms of ADD/ADHD
• Severity
– Symptoms more frequent and severe than other
children
• Early onset
– Symptoms must have appeared before
age seven
• Duration
– Symptoms persist for at least 6 months
Subtypes of ADHD in DSM-IV
• ADHD-IA
• ADHD-HI
• ADHD-C
• Primarily inattentive
• Primarily
• hyperactive and impulsive
• Combined
Implications of the Law
• Children with ADD/ADHD may be eligible for special
education services under the category of “other health
impaired”
• Children with ADD/ADHD may receive services under
the legislation of Section 504 of the Rehabilitation Act of
1973
• ADD/ADHD is listed as a specific condition under “other
health impaired”
Increase in Disorders
Psychostimulant Medications for ADD/ADHD
• Ritalin
• Dexedrine
• Cylert
• 3-5 hours
• 3-5 hours
• Long-lasting
• Adderall
• 8 hours
• Concerta
• 8-12
Precursors of Learning DisabilitiesDifficulties in any of the following:
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Communication/oral language
Phonological awareness
Rapid naming skills
Knowledge of the alphabet
Visual-motor skills
Fine- and gross-motor skills
Attending abilities
Social skills
Age Span of Learning Disabilities Population
• Preschool children
• Elementary-age children
• Secondary students
• Adults
Ages that Children with LD Are Identified
Composition of Students
with Disabilities
Left-Right Brain Processing
Left Brain
Analytical
Verbal Strengths
Linear
Sequential
“Sees” parts, pieces
Precise & accurate
Detail oriented
Right Brain
Synthesizes
Visual (spatial imagery
Simultaneous
Holistic
“Sees” whole, gestalt
Makes sense of all the parts
Interpretation of
non verbal cues
Step by step learner
Organization
Ambiguity
Open ended questions
Nonverbal Learning Disabilities
• Characteristics
– Poor social perception
– High verbal intelligence
– Early reading achievement
– More evident in adolescents and adults
• Different than academic, language and cognitive
disabilities
• Asperger’s (?)Syndrome
• Video
Indicators of Social Disabilities
• Poor social perception
• Lack of judgment
• Lack of sensitivity to others
• Difficulty making friends
• Problems with family relations
• Social problems in school
Undiagnosed Syndromes
Verbal Linguistic Learning Disabilities
Difficulties in Reading
Students may:
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Have difficulty with one or more subject areas.
Have limited mastery of concepts.
Have limited fund of information.
Have limited expressive and receptive vocabulary.
Display limited knowledge of word
meanings.
• Do not understand special multiple meanings of words.
• Read significantly below level of text.
Content Area Reading
Technical Vocabulary- in the content areas carries the
conceptual load.
Students may:
Have difficulty with one or more subject areas.
Have limited mastery of area concepts.
Do not understand technical words.
Do not understand special uses of non
technical words.
Display limited knowledge of word
meanings.
Read significantly below level of text.
Causes:
• Weak listening speaking and sight vocabulary.
• Weak contextual analysis skills.
• Inability to apply same word in different contexts.
Dyslexia and the Brain
Wernicke's
Broca's area
Expressive language
area
Receptive language.
Posterior reading
system.
There are three neural pathways for reading:
•the parietal-temporal and frontal-(slower, analytical, used by beginning readers)
•the occipital-temporal (word form, experienced readers).
Recent Brain Research
Sally Shaywitz, MD
• At left, non-impaired readers
activate neural systems that are
mostly in the back of the left side of
the brain (shaded areas); at right,
dyslexic readers under activate
these reading systems in the back
of the brain and tend to over
activate frontal areas.
• In addition to their greater reliance
on Broca's area, dyslexics are also
using other auxiliary systems for
reading, ones located on the right
side as well as in the front of the
brain.
• This is evidenced by the activation
of right hemisphere parts of the
brain. (Dyslexics and slow readers
often sub-vocalize. The physical
aspect to their reading is an
attempt to compensate for the
disruption in the back of the brain.)
An Information-Processing
Model of Learning
Difficulties in Mathematics
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Sense of Body Image
Visual-motor & Visual Perceptual Abilities
Spatial Relations
Memory Abilities
Progressing from
Concrete to Abstract
•Concrete Level- Use Real Objects
•Representational Level- Use Graphic Symbols
•Abstract Level- Use Numbers
Information Processing Problems in Mathematics
•Attention
•Visual-spatial Processing
•Auditory Processing
•Memory & Retrieval
•Motor Problems
•Non Verbal LD