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Psy 3240, Chapter 8

by: Katelyn Williams

Psy 3240, Chapter 8 Psy 3240

Katelyn Williams

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Abnormal child psychology
Class Notes
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This 8 page Class Notes was uploaded by Katelyn Williams on Tuesday February 9, 2016. The Class Notes belongs to Psy 3240 at Western Michigan University taught by Richardson in Winter 2016. Since its upload, it has received 17 views. For similar materials see Abnormal child psychology in Psychlogy at Western Michigan University.


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Date Created: 02/09/16
Chapter 8: ADHD Neuredeveloprnental disorders . Attention-Deficit/HyperactivityDisorder . lntellectualDisabilities . Autism Spectrum Disorder . Childhood-OnsetSchizophrenia . Communication and Learning Disorders What are neurodevelopmental disorders? . GroupofdisordersintheDSM-5thatspecificallyapplyto , a i./,,,,t,,/ a,'/oi,'t-.',i' . Firstoccur in childhood (" (,,'/'i. ,:t,i ir ")and often continue into adolescence and '! adulthood Produce impairmentsin social,,-1- academic, or occupationalfunctioning Have overlapping risksand symptoms, and oflen the same individual -Ls.-4cu.c-in Core Characteristics i'natfca /.bn 'i'r'tti'f Core Characteristics: / {..'-;'t (tA) . Difficultyfocusing on tasks orfollowing directions . Deficits in: 9t/ect:uL attention: ability to concentrate on relevant stimuli despite distractions o ,\t4.sla;?,td attention: abilityto maintain persistent focus over time ; Cofe Chafactefistics'. H,rt,raL*.t.t.t.. -'ta.,tss.-,tvt (Hl) \N-r- . !,,.., :deficit in regulating cognitive & motor behavior - o Behavioral: actingwithout {..),'. /.', .., i,,1 .'.'.':. ..,r.i "!..-1 r Emotion al reaction and regulotion :high levelof activity o o difficultytaying seated o tunn;.g t a(;nb;nJ o excessive DSM-5 Diagnostig Criteria . Atleast 6 symptoms from either lAor Hl (orbothlthat have lastedatleast . Symptoms are Onset priorto age I2 Behaviors must: occurin severalsettings o impair functioningin r-,.,.t., fi/)-r .'"./,:,*-;.,, APHD SubtvPes . Combined Type (ADHD-C) . (ADHD-Pl) Predominantly lnattentiveType . Predominantly Hyperactive-lmpulsiveType (ADHD-Hl) Combined Type (ADHD-C) . Symptoms ofinattention & hyperactivity-impulsivity . Most & unll Jl,,.J,t 1 . Most often referred for treatment Predominantly lnattentive Type (ADHD-Pl) . problem Primary is allot-t,an .. . Lesscommon than combined . Process information Jbulg o Seem "spacey" t Often have lOw A La/t n.:c arr-Aizvrtnznl o Less likelthan other subtypes to have b.Aerr, r and fl.(r _problems Predominantlv Hyperactive-lm pulsiveTvpe (ADH D-H l) t Qr^rt>-l . Primarilypreschoolers o Controversial . May not be anactualsubtype Overall... . Hyperactivity/tmpulsivityare_p6:Il_symptoms . lnattentionisa n a l,,ru symptom I o What does thismean? PreYalqnce ' 5-9% of allchildrenand adolescents ages 4-77 in NorthAmerica are currentlydiagnosed o Caauon referralproblem . Male to female ratio o 2, i :1. ( A:t inclinicalsamples)-why? o Declinesinadulthood ('1.L;L I . Found in many cultures(5.2% worldwide) Limitations ofDSM Criteria r r Developmentallyinsensitive r 6 months may be too briefforyoung children view of ADHD S- Associated Characteristics 'i ' CaJ o,;'l:vt deficits o Executive functions: integratand manage b.o, {rn.ct,.o-, underlie capacitytor srl{ rt r,/,., .. (goal-orientedbehavior) r Executive functions affect: . Focus & Su,Pt.^J attention . Planning ' Organization L(snans, )nlrtb;fp.t . lQ usuallynormal Academic delays/difficulties . Learning disorders ?-q f :,r,-of kidswith ADHD) I 'ttre, /, & 1., ,r,,,.'',, impairments(-30-60%) r Lower grades --ry t Ex-,out s,on Interpersonal Difficulties problems o Family ' ,\,s* {.r**f;i",..r,' With fUleS . conflictwith parents & siblings t ?oo lu 9.trtt.r o Peer problems r inappropriate social behavior . ----------J"!_bypeers ,iyrt/1.,,.,. and ,i Characteristics l,i,g o Sleep disturbances o POOf Laola r P-oo rol'' f|on o f f I disorders: sudden, repetitive, nonrhythmic motor movements or sounds o Accident-proneness and riskybehaviors . Other Psychological Disorders o EfiY" with comorbid condition t lleh*vl*r disorder (50%) r ( Anxiety z *^ %) ' /,tcal disorder (2O'30%l Developmental Course r lnfancy: Preschool: becomes more visible Elementary: inatftnt,b.t noticedmore o ldentification & referral o Oppositionalldefiant behaviors increase . Adolescence: aA o Symptoms continue for \ o of referred children Theories & Causes ofADHD (ant{.'c- & h eurqLliol a&,ed,f factors are central . Additional roleof €t"1Vi r41etue.q*f ; Genetislaetsrs . Strong evidence for genetic factors o Runs in families o Twin studies: concordance ratesfor MZ ( ; . %) > DZ ( :i %) o tsO %heritability o'7t"r"""tt oi't'''n ' '1 ;n tt', ,:./:*r':./t:. r:i.:r{r!}i,r., {.,t tt1.t,.t.'., a ' Neurobiological Factors . Structural abnormalitiesin the {,\r:::.:',: ::,:' circuitrybasal ganglia +prefrontal cortex) o Associated with tdtf u r t ", ,executive functioning, .Y,trrr1j:t r',{!f.,:,.:'!,&mOVement . Delay in Fr< f,ranlal Lar*'ae^ I development ' Smallervolume of C-t,c-lo.llan* & cerebral cortex Neurp!ruqnilleru . .'l Symptoms may berelated to deficie'cyn----------'1n r o Related toability to experienceeward o Need forlargerand more irupe /:a{< reinforcers . ) Dopamine transportergene L (DAT1) may be relatedtoheritability ofHD . DAT1 removes dopamine from synapticcleftesultingindecreased dopamine o DAT1 more activein thosewith ADHD o DAT1 coded forby genes -potential geneticontributionto ADHD Prenatal and EarlyDevelopment . Developmental factorsthat canimpact the function othe hr rv? us Ju s{ta relatedtoADHD: o Pregnancy and birthcomplications o Earlyneurologicalffauma o tn{,bn o Maternal prenatalsmoking orsubstance use Famjly lnfluencel o Can playa major roleindetermining the oaleo*rt & Stwr ;'1,. ofADHD o Familyconflict/parenting . Learning/modeling/imitation o Family problems associatedwith lateemergence of conduct problems gP Treatment i\ . Medication o ,, €t,'r*orta,l (e.9.MethylphenidatelRitalin,dderall) r Most common, most effectiveforHl o/o Effectivefor- 80 . of children o Increased sustained attention,impulse control,persistence inwork, improved relationswith others decrease in hyperactivity, of school-age childrentake stimulants (more than tripledsince L990) -_2__r,A lncrease ,!."{',:, availability (e.g.Concerta, Adderall) ' Rapid acting,long actingform r Potentialside effects o Non-stimulants(e.g.,Strattera) t lncreases in brain t Long acting form Parent Management Training o To assistparent in managing child'smpulsive & hyperactive behavior . lncrease f),,'t 1F1!?d'rt;,,.,",',' withchild(special time) I ,/: .L',,. gnvironment, i - r Use ofbehavior management strategies ' Praise forpositive behavior . Rewards and Punishments o -jgWdZ*"<--.--..- frequent, L 0x s i-tt"-^t . Home and school . As areminder... o Types ofpunishment: r Negative punishment: remove something lo J..r*os, behavior . Positivepunishment: or4d something to decrease a behavior o Types ofreinforcement: r reinforcement: add something to inLr<ase behavior Positive . Negative reinforcement: remove something toincrease behavior . MultimodalTreatment Study o Studiedeffectivenessof medicationversusPMT o 600,7-9 yearolds diagnosedwith ADHD randomized to: r Community care r Behavioraltreatment: PMT + summer carnp r Medication (Ritalin) Combined Beh + Med o Results:llhad decreased ADHD symptoms . Combination outcomes = ibesl . C.ry,, C 7 r.-ty't >P/vtftU,r>. (.**,.,,,,,,{.i-y. r . By 'iL months allgroups showed equalADHD symptoms completion ' Effectoftreatment drrf,-,o,:l after . Newly medicated childrengrew lessfor2 years . lntensive SummerTreatment Program (Pelham & Hoza, 1-996) o 8week day camp (ages 5-15) o Classroom & recreational activitieshlotsofstructure r Sportsinstruction ' -,>o9'ol- training 'L;/ll ' Parvr+ Management Training o Resultsshort term reductionsinbeh, social& academic problems o Long-term impact unknown


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