SLD/LD/ID
3 Etiologies of Intellectual Disability
Genetics (Down syndrome, Fragile X, Recessive-gene disease/Phenylketonuria (PKU) Maternal infectious disease especially during 1st trimester (Rubella, Herpes, HIV, syphilis)
Prenatal (FAS, Maternal infections, Birth Defects, Neural tube defect)
Childhood illnesses and injuries (Hyperthyroidism, whooping cough, chickenpox, measles, bacterial infection (meningitis) TBI
Environmental (Ignored or neglected, poverty, ACEs, lead)
*30-40% of cases, cause cannot be found
Challenges with diagnosing ADHD for ages 2-3
We don't know enough
Briefly discuss common comorbidities that can accompany children with ODD and CD
ADHD comorbidity + often co-occurs with anxiety and mood disorders (ie depression)
*Internalizing disorders as preschoolers
Etiologies of specific learning disabilities
-Acquired trauma to the nervous system
-Genetic/hereditary influences
-Biochemical abnormalities
-Environmental possibilities
*1/59 LD, 4 million LD, common: dyslexia, dysgraphia, 18% drop outs
Discuss Barkley’s etiological model for ADHD + Describe each 4 executive functions.
Impairment of EF
1) Working memory - More forgetful
2) Self-regulation of affect is delayed
3) Internalization of speech is delayed
4) Reconstitution (internalization of play is delayed)
Poor goal directed persistence and following impact
1) Less able to stop a dominant, habitual response
2) Less capable of stopping an ongoing response
3) Unable to deal as well with interference, disrupting ongoing mental processing
Discuss the controversy and provide an example as to when it is appropriate to diagnose children with ODD
1) Commonly displayed in normally developing children
2) Frequently co-occurs with a host of other adjustment problems, political/family/social issues, ACEs
3) But utility in predicting as early as 3-5yrs adjustment problems (later possible development of antisocial because substance use, emotional disorders) so it's helpful to address
Example when appropriate: who's referring? what is your intention? will it help or punish? Diagnostic services purpose: to get well. ask why, what happened to you?
Specific learning disabilities are highly correlated with which other neurodevelopmental disorders
ADHD, because of the communication and attention deficits ~ academic difficulties
If a kid is not understanding the information that they are hearing then they aren't going to pay attention
Discuss conclusions of Ragnardottir article
*Gender and Age Differences in Social Skills Among Children with ADHD: Peer Problems and Prosocial Behavior, Ragnarsdottir et al. (2018)
1) ADHD more peer problems and less pro social behavior
2) ADHD Girls appeared to have greater social problems than boys
3) Teachers reported that younger girls with ADHD showed less pro social behavior than older girls with ADHD
4) Findings suggest possible different pathway for development of social skills for boys and girls with ADHD
Course/Pathway of ODD and CD
1) ODD - preschool (can be outgrown or be turn into just ADHD)
2) ODD proceeds CD
3) both impulsive and callous-unemotional subtypes
4) CD has childhood and adolescent subtypes but ODD can still be diagnosed as teen
5) Adolescent onset has a better prognosis than childhood onset
6) Callous/unemotional subtype has a worse prognosis than inattentive subtype: could lead to antisocial behavior/personality disorder in adulthood
Two main findings of the study conducted by Cen and Aytac
*Ecocultural Perspective in Learning Disability: Family Support Resources, Values, Child Problem Behaviors
1) Only perceived informational support negatively predicted internalizing problems
2) Perceived emotional and caregiving support significantly and financial support marginally predicted externalizing problems, but not after controlling for LD
Similarities in Sluggish Cognitive Tempo (SCT) and ADHD
1) Slow to complete tasks and lacks initiative/has trouble sustaining effort
2) Comorbidity
3) SCT clusters: daydreaming/sleepiness and being slow/sluggish/lethargic. low initiation/persistence may be correlated with ADHD inattention symptoms
Provide an explanation of what does Coercive Family Cycle entail
Intervention = try to break the cycle and focus on the positive, alternative, but not on incompatible behaviors such as yelling, whining, interrupting. A key focus is on obtaining compliance from the child
Differences in Sluggish Cognitive Tempo (SCT) and ADHD
1) SCT more associated with social withdrawal and peer neglect & ADHD associated with significant conflicts, aggression, bullying/victimization and rejection.
2) SCT does not seem to be as serious and pervasive of EF as ADHD
3) SCT symptoms demonstrate a far lower relationship to hyperactive-impulsive symptoms than they do to inattention symptoms
Briefly discuss protective factors for ODD not developing to CD. Provide examples!
1) External societal support systems (eg good schools)
2) Positive dispositional characteristics (eg good cognitive and socioemotional skills)
3) Nurturing family milieu (high quality relationships with parents and other adults).
Schoorl et. al (2018) discussed the impact of stress on the adaptation of adolescents with a diagnosis of oppositional defiant disorder and conduct disorder. Provide a summary of their findings
1) Results showed that boys with ODD/CD showed impaired working memory under typical testing conditions, and impairments in working memory and sustained attention under stressful conditions.
2) In contrast to controls, performance on sustained attention, cognitive flexibility, and inhibition was less influenced by stress in boys with ODD/CD
3) Results suggest that boys with ODD/CD show impairments in adaptation to the environment whereas typically developing boys show adaptive changes in executive functioning.
Discuss three etiologies (biological, psychological, and social) of conduct disorder (CD) and oppositional defiant disorder (ODD)
ODD: Familial patterns (Parental mood disorder, Maternal depression, Serious martial discord, Children of alcoholic parents)
Biological factors (Genetics, Frontal lobe involvement, Neurotransmitters)
Social and Family (Parental psychopathology, Social information processing, Psychosocial adversity, parenting style)
Psychosocial (Living in environments with high crime rates, Marital conflict and broken homes, Dysfunctional and rejecting family environments, Inconsistent and severe discipline, Physical and sexual abuse, Social learning experiences)