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Child Psychopath
Exam 2
| Question | Answer |
|---|---|
| History of Schizo: 1906 | DeSanctis dementia praecoccissima |
| History of Schizo 1930s-1960s | childhood schizophrenia = autism, psychotic d/o |
| History of Schizo 1980s | infantile autism, but no COS |
| History of Schizo 1990s | autism and schizophrenia distinct |
| Epidemiology of Schizo | average age of onset: 9-12 yrs for COS, very unusual before 6-7, VEOS <13, EOS > 13, earlier onset more insidious; later more acte, prevalence: 0.19 to 1 per 10,000, gender: 2:1 to 5:1 males |
| Schizo: core symptoms | psychotic symptoms for 1+ month: hallucinations (most frequent, auditory most frequent vs visual), delusions, disorganized thoughts/formal thought disorder, grossly disorganized or catatonic bx, negative symptoms |
| Schizo: subtypes | paranoid, disorganized, catatonic, undifferentiated |
| Schizo: childhood subtypes | often not specified in children, although disorganized behavior is typically a key feature |
| Schizo: associated symptoms | depression, oppositional bx, conduct dx, suicidal |
| Schizo: negative symptoms | catatonic, reduced variability in expression, lack of social interaction |
| Schizo: phases | premorbid, prodromal, acute/active, recovery, residual |
| Schizo: phases: premorbid | early or advance abnormalities that may develop over several years |
| Schizo: phases: prodromal | functional decline immediately preceding psychotic symptoms |
| Schizo: phases: acute/active | positive symptoms and cognitive/social decline |
| Schizo: phases: recovery | decline in positive symptoms, resume normal activities, negative symptoms may predominate |
| Schizo: phases: residual | lack of positive symptoms, decline in negative, yet may remain impaired |
| Schizo: VEOS symptoms | insidious, early onset of dev delays (3-10), other premorbid symptoms (prodromal symptoms too): shyness, isolation, lack of interest, suicidal ideation, bizarre bx, agg, paranoia, compulsions, anxiety, depression |
| Schizo: differential diagnosis | very rare (r/o medical, meds, substances, trauma etc.); major depression, bipolar disorder, other psychotic disorders |
| Schizo: distinguishing from PDDs | COS rarely < age 7, autism often < age 3; COS + hallucinations & delusions; COS less impaired intellectual functioning, autism often MR (more impaired); COS acquire lang but have deviant use later, autism have prob w/ lang acq.; COS episodic, autism cont. |
| Schizo: course | acute pscyhotic phase longer in VEOS than EOS; earlier onset associated with poorer prognosis, more severe impairment; depression may follow active psychotic phase |
| Schizo: Etiological models (1) | COS is a severe and chronic form of schizophrenia with early onset reflecting more severe biological disposition to the illness |
| Schizo: Etiological models (2) | COS and AOS are different illnesses (no evidence) |
| Schizo: Etiological models (3) | Atypical early onset of schizo is associated with potentiating factors such as severe psychosocial or biological stressors |
| Schizo: Etiological models (4) | COS and AOS are the same illness with similar levels of clinical and etiological heterogeneity; COS are cases that are at the early end of the distribution of patients with schizophrenia |
| Schizo: Etiological models (Biological) | many theories, some good evidence: CNS dysfunction and structural abnormalities; genetic influence supported by twin studies and family aggregation |
| Schizo: Etiological models (Psychological) | likely influence; environmental and psychosocial stressors; family environment/expressed emotion |
| Schizo: Vulnerability Stress Model | current model; transactional (no single factor explains etiology); combination of genetic predispositions + stressful life events - vulnerabilities, stressors, protective factors; model explains variations in symptomatic bx and psychosocial functioning |
| Schizo: Vulnerability Stress Model: life events | Vulnerabilities (genetic, CNS damage, birth complications, inadequate learning, deviant family communication), Stressors (maj. life events, chronic hassels, life changes), Protective factors (intel., social support, social competence, healthy family comm. |
| LD: Plessy v. Fergusson (1896) | separate but equal |
| LD: Brown v. BOE, Topeka (1954) | equal education using equivalent resources |
| LD: PARC v. Commonwealth of Pennsylvania(1972) | all children (6-21) benefit from education |
| LD: Mills v. BOE of D.C. (1972) | funds expended equitably so no child excluded |
| LD: Larry P. v. Riles (1979) | overrepresentation of minority students in special ed. Tests biased. |
| LD: Education of All Handicapped Children Act (1975; P.L. 94-142) | free and appropriate public education for students with disabilities |
| LD: Individuals with Disabilities in Education Act (1990, 1997, 2004) | expanded types of disabilities and services |
| LD: Section 504 of the Rehabilitation Act (1973) | antidiscrimination and equal access law that protects rights of individuals with disabilities |
| LD: Mattie T. Consent Decree (1979; 2003) | class action law suit on behalf of students in MS w/ disabilities brought about by IDEA violations resulting in monitored plan for compliance by 2011 |
| Communication Disorders: 315.31 Expressive Language d/o | expressive language scores are substantially below both nonverbal IQ and receptive language |
| Communication Disorders: 315.31 Mixed Receptive-Expressive language d/o | scores of both receptive and expressive language development are substatially below those obtained from standardized measures of nonverbal intellectual capacity |
| Communication Disorders: 315.39 Phonological d/o | failure to use develop. expected speech sounds that are approp. for age and dialect (errors in sound prod., use, representation, or organ. such as, but not lim. to substitutions of 1 sound for anotother or omissions of sounds such as final consonants) |
| Communication Disorders: 307.0 Stuttering | Disturbance in norm. fluency and time patterning of speech, characterized by freq. occurrences of 1+ |
| Communication Disorders: 307.0 Stuttering list of symptoms | 1 sound/syllable rep, 2 sound prolongations, 3 interjections, 4 broken words, 5 audible/silent blocking, 6 circumiocutions, 7 word produced w/ excess physical tension, 8 monosyllabic whole-word repetitions |
| Communication Disorders list | expressive language d/o, mixed receptive-expressive language d/o, phonological d/o, stuttering, communication d/o NOS |
| Proposed DSM 5 Communication Disorders list | language disorder, speech disorder, social communication disorder |
| DSM 5 language disorder | persistent dif in acquisition/use of spoken language, written language, and other modalities of language, likely to endure into adolescence and adulthood. lang abilities below age expect. in 1 or more lang domaains evident by mult.sources of info |
| DSM 5 speech disorder | persistent dif. in speech production can affect sound production, speech fluency, voice, or resonance. speech production atypical for age or symptomatic of abnormal oral-motor structure or function. based on multiple sources of info |
| DSM 5 Social communication disorder | persistent dif in pragmatics or social uses of verbal/nonv comm. affects social reciprocity/relationships that cannot be explained by low abilities in domains of word structure/grammar. rule out ASD. results in functional limitations |
| Federal Definition of LD (specific learning disability) | disorder in one or more basic psychological processes which may manifest in an imperfect ability to listen, speak, read, write, spell, or do math calculations. can include brain injury, brain dysfunction, dyslexia, develop. aphasia. |
| DSM IV LD list | 315.00 reading disorder, 315.1 mathematics disorder, 315.2 disorder of written expression, 315.9 learning disorder, NOS |
| DSM 5 LD | specific learning disorder |
| DSM IV 315 Reading Disorder | reading achievement substatially below expected given age, measured intelligence, and education. sig. interferes w/ acad. achiev. or activity daily living that req. reading skills. if medical or sensory deficit - code on Axis 3 |
| DSM IV 315.1 Mathematics Disorder | mathematical ability substantially below expected given age, intelligence, and education. sig interferes w/acad. achievement or activities of daily living req. math ability. if medical or sensory deficit - code on Axis 3 |
| DSM IV 315.2 Disorders of Written Expression | writing skills substantially below expected given age, intelligence, and education. sig interferes w/acad. achievement or activities of daily living req. composition of written texts. if medical or sensory deficit - code on Axis 3 |
| DSM IV 315.9 Learning Disorder NOS | learning disorders that do not meet criteria for any specific LD. Problems in all 3 areas that together sig interfere with academic achievement even though test scores not substantially below that expected given age, IQ, and age-appropriate education |
| Epidemiology of LD: prevalence | 2-10%, Reading d/o 80% of LD alone or in combo with other LDs; Math other 20%; Writing LD rare in isolation |
| Epidemiology of LD: | males more common; course: Usually early elementary, but can’t diagnose until child has instruction in domain and shown evidence of poor perf.; associated features: low self esteem, social skills deficit, school drop-out, birth-related complications, GMCs |
| Epidemiology of LD: Comorbidities | ODD / CD ADHD MDD Dysthymic d/o Other LDs |
| Epidemiology of LD: differential diagnosis | Normal variations Lack of opportunity Poor teaching Cultural factors Vision, hearing impairments Mental retardation PDDs Communication d/o (can be comorbid) |
| LD models | Borne from social and educational need; Central concept: Unexpected underachievement; To be considered valid, a model of identifying LD should: -Be reliable - Distinguish poor achieving LD and non-LD on factors other than those used to create the groups |
| LD: problems related to reliability | dimensional nature of LDs; use of tests at a single point in time & cut-points; use of correlated tests & difference scores |
| LD: Validity of Discrepancy Models: 4 models list | IQ-Achievement Discrepancy; Intra-individual Discrepancy; Low Achievement; Response to Intervention |
| LD: IQ-Achievement Discrepancy | assumption - poor achiev. unexpect. due to higher IQ; no small dif on cog proc and achiev variables not related to how groups formed; no diff in reading develop or RTI, rate of growth/level of reading, genetic etiology; no evidence from neuroimaging |
| LD: Intra-Individual Discrepancy | Assump: subtest scatter is marker for unexpected underachievment; px w/ reliability (mult subtests compounds std err); discounts kids w/ flatter profiles may also have LD; major assump - cog profile lead to better targeted tx (ATI lit not well supported) |
| LD: Intra-Individual Discrepancy: it can work | intra-ind diffs can identify some kids with LD (e.g., dyslexia & px with word recognition and phonological processing) |
| LD: Low Achievement | have validity but can't separate LD from non-LD low achievv: 3 gps: typical, LAch math, LAch reading onbasis of not MR and Ach <25th%ile differ on cog correlates, neurobiological correlates, heritability RTI; fail to account for unexpect underachievement |
| LD: Response to Intervention | to be valid: combine w. low achiev model; operationalize unexp underachiev (nonresponse to instruction); problems: nature of instruction to provide, est of slope/intercept effects, decisions about cut-points, integrity of IV, etc. |
| LD: Response to Intervention: Emerging validity | responders and nonresponders differ in pre-iv ach and cog tasks; nonresponders more severe reading px pre-iv; differences in brain activation (left hem); can differentiate LD from non-LD among low achievers |
| IDEA 2004 reauthorization: added procedures for identifying SLDs | -permits IQ-Ach discrep -permits response to scientific, research based IV (RTI) -permits other alt research-based procedures (cog processes) |
| IDEA 2004 reauthorization: added criteria for determining SLDs | -must consider data demonstrating child was provided approp instruction by qualified personnel, - req data documenting repeated assessments of achievement during instruction |
| Empirical support for LD subtypes: reading disorder (3) | -word recognition/dyslexia, -reading comprehension, -reading fluency |
| Empirical support for LD subtypes: math disorder (2) | -learning/retrieving math facts (due to reading + math problem), -math calculations (math px alone) - less evidence |
| Empirical support for LD subtypes: D/o of written expression | little research |
| Etiological Models of Dyslexia (types) | psychological, biological |
| Etiological Models of Dyslexia: psychological | single-factor - phonological processing deficit |
| Etiological Models of Dyslexia: biological | genetic (runs in families, >80 MZ,~50 DZ twins), neuroanatomical dif (cerebral lateralization - no evid, cerebral asymmetry, minor cortical malformations - from abnorm cell migration), neurofunctional diff (diff patterns of activation) |
| LD:Proposed changes from DSM IV to DSM 5: only Specific Learning Disorder | looks at individual's history, psychoeducational reports of test scores and observations, and RTI; descriptive features specifiers; specify domains of academic difficulties and subskills (reading, written expression, mathematics) |
| Schizophrenia: DSM-IV criteria caveat | only one criterion A symptom required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person's behavior or thoughts, or two or more voices conversing with each other |
| Schizophrenia: DSM-IV: Criterion A: characteristic symptoms | 2 or more, present for sig. portion of time during 1-mo period (1) delusions (2) hallucinations (3)disorganized speech (4) grossly disorganized or catatonic bx (5) neg symptoms |
| Schizophrenia: DSM-IV: Criterion B: social/occupational dysfunction | for sig portion of time since onset of disturbance, 1 or more major areas of funct. (e.g., work, interpersonal relations,self-care) markedly below level achieved prior to onset |
| Schizophrenia: DSM-IV: Criterion C (duration) | disturbance persists for 6 months (must include @least 1 month of symptoms that meet Criterion A and may inc prodromal or residual symptoms |
| Schizophrenia: DSM-IV: Criterion D: schizoaffective and mood disorder (w/ psychotic features) exclusion - have been ruled out | either (1) no Major Depressive, Manic, or Mixed Episodes have occurred concurrently with the active phase symptoms; or (2) mood episodes occurred during active-phase sympt, total duration has been brief relative to the dur. of the active/residual periods |
| Schizophrenia: DSM-IV: Criterion E: substance/general medical condition exclusion | The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition. |
| Schizophrenia: DSM-IV: Criterion F: Relationship to a PDD | If there is a history of Autistic Disorder or another Pervasive Developmental Disorder, the additional diagnosis of Schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month (or less if successfully treated) |
| Schizophrenia: DSM 5 proposed changes: Criterion A | 2 or more (for 1 month): @least 1 should include 1, 2, or 3. (1) delusions, (2) hallucinations, (3) disorganized speech, (4) grossly abn psychomotor bx (inc catatonia), (5) neg symptoms |
| Schizophrenia: DSM 5 proposed changes: Criterion F: | If history of ASD or another PDD or other communication disorder of childhood onset, the additional diagnosis of Schizophrenia is made only if prominent delusions or hallucinations are also present for at least 1 month (or less if successfully treated) |
| Schizophrenia: DSM 5 proposed changes: subtypes | subtypes have all been deleted (can only specify if : With Catatonic Features |
Created by:
ironchiet
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