Exam Questions
1. Discuss three etiological factors of intellectual disability that are mentioned in the textbook by Mash & Barkley (2014) and discussed in lecture.
Genetic factors: Down syndrome, 21 chromosomes, most common genetic form of ID. Fragile X syndrome, fragile site on the X chromosome which produce important protein for brain development and function, most common inherited form of ID.
Prenatal and perinatal factors: The most common environmental factors associated with ID (especially mild ID) are malnutrition during pregnancy, prenatal infections, fetal alcohol syndrome, exposure to other toxic compounds, premature birth, and peri-and postnatal asphyxia or other trauma. Maternal metabolic disorders, such as hypothyroidism, have also been linked with a number of risks to the fetus. Infections during pregnancy, such as toxoplasmosis, cytomegalo-virus, rubella, herpes, and group B streptococcus, likewise have the potential to alter the brain development of the fetus and can result in significantly impaired functioning.
Environmental and social risk factors: Factors that are known to have an impact on intellectual functioning in childhood include insults to the brain through significant infections, severe traumatic brain injury,vehicle accidents, sport-related trauma, assaults), and epilepsy. Lead and mercury exposures have also been consistently linked with decreases in intellectual functioning. Risk factors in children’s environments have also been linked with increased risk of ID. These include (1) biomedical factors, such as malnutrition; (2) social factors, such as impaired child–caregiver interaction, chronic illness in the family, lack of adequate stimulation, and family poverty; and (3) educational factors, such as impaired parenting, delayed diagnosis, inad-equate early intervention or special education services, and inadequate family support. Historically, research has found strong inverse relationships between socioeconomic status and the prevalence of ID, particularly mild ID. A positive association between the quality of the home learning environment and a child’s IQ has also been found.
According to Mash & Barkley (2014), a key area of controversy has been the diagnosis of ADHD in very young children (ages 2– 3 years). Although the DSM-5-TR does not forbid diagnosing a young child with ADHD, briefly discuss some of the challenges that one may encounter in doing so?
Ages 2 and 3 are naturally chaotic developmental stages. Here is when toddlers begin to interact with the world around them and see how they fit into their environments.
Toddlers are also very easily distracted. Makes it very difficult, if not impossible, to differentiate between immaturity as described above and impulsivity or inattention.
The timeline required for criteria to be met may also be too short for preschool age children.
Mash & Barkley discuss research that supports a timeline of 12 months and over be implemented for this age range specifically, instead of the 6 month timeline. This research concluded that children who were reported to have ADHD symptoms, no longer displayed those symptoms after 12 months, which would result in a lot of over diagnosing and misdiagnosing. Thus, having the timeline set to 12 months and after, is the most appropriate solution for this age group.