THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
SCHOOL OF SOCIAL WORK
COURSE NUMBER: SOWO 801, Section 001 Monday 2:00-4:50 pm
Room TTK 300
COURSE TITLE: Child and Adolescent Health & Mental Health, Fall 2008
INSTRUCTOR:
Joelle D. Powers, PhD, MSW
School of Social Work, CB#3550
University of North Carolina
Chapel Hill, NC 27599
Office: 563C
Phone: 919-843-8686
Email: jdpowers@email.unc.edu
OFFICE HOURS: Monday 12-2:00 pm or by appointment
COURSE DESCRIPTION: This course reviews theories and research that serve as a
foundation for assessing and serving children with serious health problems, physical
disabilities, and mental disorders.
EXPANDED DESCRIPTION: This is an Advanced Curriculum human behavior course
that builds on normal human development taught in the prerequisite Foundation
Curriculum human behavior course SOWO 500. Therefore, it is assumed that the student
will be able to contrast developmentally typical behaviors with atypical behaviors found
in mental disorders or that might result from a serious or chronic health condition, and to
distinguish problems of living within a normal range from the difficulties children might
experience in a physical or mental disorder. This course examines only those health and
mental disorders that typically have an onset from birth to 18 years. While mental
disorders are individually assessed, it is the perspective of this course that the impact of a
mental disorder is experienced at least within the family and community. Additionally,
there will be considerable effort throughout the course to examine how a particular
diagnosis might be misunderstood and misapplied to vulnerable populations and how to
avoid this practice. Assessing mental disorders puts clinicians in a powerful position with
clients, a position fraught with ethical issues and potential dilemmas. Therefore, specific
ethical content in this class will focus on topics related to: (a) determining whether a
child really has a mental disorder or just a developmental stage problem, (b) being sure
that if the child is different from the majority population that such difference has been
understood and appreciated rather than diagnosed, and (c) being sure that cultural content
is considered objectively in the assessment process.
COURSE OBJECTIVES: The course will cover research and theoretical issues
surrounding the psychosocial assessment and treatment of problems of health and mental
health with the goal of assisting students to:
•
Articulate a generic formulation of disability and serious illness and a
biopsychosocial perspective on disorders of childhood and adolescence.
•
Understand the advantages, limitations and ethical implications of categorical and
dimensional approaches to the diagnosis of common disorders of childhood and
adolescence, such as exemplified in the ICD, DSM and the CBCL.
•
Conceptualize the diagnosis and treatment of physical and mental disorders within a
developmental framework that also involves consideration of culture, ethnicity,
gender, sexual orientation, and socio-economic status.
•
Identify and differentiate the signs and symptoms of mental disorders that usually are
first diagnosed in infants, children, and adolescents and interpret them ethically in the
evaluation of social work clients.
•
Know the psychosocial and developmental implications of serious and life
threatening chronic illness for children, adolescents and their families.
Specific Course Objectives.
By the end of this course the student will be able to:
1. Demonstrate an understanding of the complex issues involved in defining both
mental health and mental disorders;
2. Analyze the strengths and weaknesses of using the Diagnostic and Statistical
Manual of Mental Disorders in assessment of children’s behaviors;
3. Appreciate and be able to use appropriately content on race, ethnicity, gender, age,
socioeconomic status, sexual orientation, stage of development in the assessment
of mental and emotional well-being;
4. Identify and differentiate the signs and symptoms of mental disorders that usually
are first diagnosed in infants, children, and adolescents and apply them ethically
to the evaluation of social work clients;
5. Recognize and appreciate the impact of a mental disorder not only on the life of the
child who is experiencing it, but also on the family and community in which the
child lives;
6. Recognize risk and resiliency factors associated with mental disorders; and
7. Demonstrate an understanding of the methodological basis of the genetic evidence
in health and mental health and be able to articulate the ethical issues involved in
sharing predictors with children.
REQUIRED TEXTS/READINGS:
Mash, E. J., & Barkley, R. A. (Eds.). (2003). Child psychopathology (2nd ed). New York:
Guilford Press.
The required text is available at the Health Affairs bookstore. Other required readings are
listed by the class sessions and will be available online though the Blackboard website for
the course (https://blackboard.unc.edu), or through the library. The DSM-IV-TR is
recommended, but not required, for the course.
TEACHING METHODS
A variety of teaching and assessment methods will be used to promote learning among all
students. Most class sessions will include a lecture/discussion component, case study
discussions, and one or more reinforcement or application exercises (e.g., focused
discussion, small or full group activity, video). Students are expected to attend all classes
and to be prepared to take an active roll in learning and discussions.
The course starts with a discussion of definitions and conceptions of health and mental
health. It then progresses through the most common mental health and health disorders of
childhood and adolescence. Additional topics related to well-being are also covered.
Topics covered in Weeks 2 through 13 are:
(a) Health and mental health of infants and toddlers
(b) Mental retardation (Intellectual disabilities)
(c) Pervasive developmental disorders
(d) Attention-Deficit/Hyperactivity Disorder
(e) Substance abuse
(f) Chronic physical illness
(g) Anxiety disorders; LGBT issues in schools
(h) Depressive disorders; Suicidal behavior
(i) Behavior Disorders; Physical discipline
(j) Maltreatment; Post Traumatic Stress Disorder; Alternative caregivers
(k) Eating disorders
(l) Learning and communication disorders
For each disorder covered, the course will review what is known about the
phenomenology of the disorder, its prevalence, risk factors, co-morbidity with other
disorders, etiology and developmental trajectory. DSM-IV criteria are examined for each
disorder. Themes of the course that will be discussed in relation to each disorder
include: the physical health symptoms, correlates, and consequences of mental health
disorder, and mental health symptoms, correlates, and consequences of physical health
disorder; environmental vs. individual-based aspects of etiology; developmental
influences on definitions and manifestations of disorder; cultural and gender issues in
disorder; and the impact of an individual’s disorder on the family. Although this is not a
practice or treatment course, it does address questions of how theory and assessment
provide insights for setting goals and designing programs of prevention and treatment.
GRADING
The School of Social Work uses an evaluation system of Honors (H), Pass (P), Low Pass
(L), and Fail (F). For this class, the numerical value of an H ranges from 94 - 100; a P is
80 - 93; an L is 70 - 79. The final grade will be determined as follows:
Assignment
Weekly Quizzes
Essays (2)
Case Study Presentation/Write-up
Final Examination
Total
Points Toward Final Grade
30
20 (10 points each)
25
25
100
DESCRIPTION OF CLASS ASSIGNMENTS
Weekly Quizzes. Each class session will begin with a quiz on the assigned readings for
that session and course material covered in the previous class. This is how attendance and
participation are graded for this course thus they cannot be made up at a later time.
Students can refer to class notes, handouts, and assigned readings while taking the
quizzes. Quizzes will comprise 30% of your overall grade.
Essays. Detailed instructions and a grading rubric for the essays are provided on the
course Blackboard site. The essays are worth 20 % (10 % each) of your total course grade
and will be responses to the following two readings:
•
Essay #1: Due October 6
o Stevenson, H. C., Winn, D., Walker-Barnes, C., & Coard, S. (2005). Style
matters. In V.C. McLoyd, N. E., Hill, & K. A. Dodge (Eds.), African
American family life. (pp. 311-334). New York: Guilford Press.
•
Essay #2: Due November 3
o Blanchett, W. J. (2006). Disproportionate representation of African
American students in special education. Educational Researcher, 35, 2428.
Case Study Presentation and Write Up. Each student will be responsible for presenting a
case study to the class and leading a 15 minute discussion on diagnosis of the case
according to DSM IV criteria. One week after the presentation, the write up of the case
will be due. This assignment is worth 25% of the course grade. Detailed instructions and
a grading rubric for the presentation and write up are provided on Blackboard.
Final Exam. The final is worth 25% of your total course grade and detailed directions will
be handed out in class on November 17. The final will be an open book essay/short
answer exam and is due on Wednesday, December 3 by 12pm.
POLICY ON UNEXCUSED ABSENCES
Attendance and participation points obtained through the weekly quizzes contribute
substantially to final grades. Students missing 3 classes (or more) may receive an L for
the course, because it is not possible to meet course requirements for learning objectives
with that level of absenteeism. Students are responsible for obtaining from their
classmates ALL announcements, instructional information, and handouts for class
sessions they miss.
POLICY ON INCOMPLETES AND LATE ASSIGNMENTS
All assignments are due at 2pm on the dates as listed in the syllabus. Students will lose
10% when an assignment is submitted late, and will lose an additional 10% for each 24hour period beyond the due date (including weekends).
POLICY ON ACADEMIC DISHONESTY
Academic dishonesty is contrary to the ethics of the social work profession, unfair to
other students, and will not be tolerated in any form. Students can also refer to the APA
Publication Manual (5th Ed.), the School of Social Work Manual, and the School of
Social Work Writing Guide (available on the School’s website) for information on
attribution of quotes, plagiarism and appropriate use of assistance in preparing
assignments. Hardcopy assignments should contain a signed pledge, stating, “I have
neither given nor received unauthorized aid in preparing this work.” Emailed
assignments should include the pledge in type.
POLICY ON ACCOMMODATIONS FOR STUDENTS WITH DISABILITIES
The instructor will make any necessary and appropriate accommodations for students
with disabilities. To obtain disability-related academic accommodations, students with
disabilities must contact the instructor and the Department of Disability Services as soon
as possible. The Department of Disability Services can be reached at 919-962-8300
(Voice/TDD) or http://disabilityservices.unc.edu.
READINGS AND COURSE OUTLINE
Week 1/August 25: Introduction to Health and Mental Health
Introduction to opposing approaches to health and mental health and themes of the
course.
Week 2/September 8: Heath and Mental Health of Infants & Toddlers
The developmental systems perspective. Early development and psychological
functioning; Infant mortality, Prematurity. Sleep, Feeding, and Elimination disorders;
Reactive Attachment disorder; Colic. Sign up for case study presentation dates.
Assigned Reading:
Mash, E. J. & Dozois, D.J.A. (2003). Child psychopathology: A developmental-systems
perspective. Chapter 1 (pp. 3-71) in Mash, E. J. & Barkley, R. A.
Lyons-Ruth, K., Zeanah, C. H., & Benoit. D. (2003). Disorder and risk for disorder
during infancy and toddlerhood. Chapter 13 (pp. 589-631) in Mash, E. J. &
Barkley, R. A.
Peterson, L., Reach, K., Grabe, S. (2003). Health-related disorders. Chapter 16 (pp.716—
749 in Mash, E. J. & Barkley, R. A. Read the sections on the following topics;
NOFTT, pp. 719-721; Phenylketonuria, pp. 723-724; Elimination Disorders, pp.
725-727; and Sleep Disorders, pp. 727-729)
Corresponding DSM-IV-TR Readings (optional):
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders
(4th ed.). Washington: author. Feeding and eating disorders of infancy or early childhood,
pp. 103-108.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders
(4th ed.). Washington: author. Elimination disorders, pp. 116-121.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders
(4th ed.). Washington: author. Other disorders of infancy, childhood, or adolescence, pp.
121-134.
Week 3/September 15: DSM-IV Diagnosis; Mental Retardation (Intellectual
Disabilities)
Using the DSM-IV classification system. Mental retardation. Fetal Alcohol Syndrome,
Down syndrome, Fragile-X syndrome.
Assigned Reading:
Hodapp, R. M. & Dykens, E. M. (2003). Mental retardation (Intellectual disabilities).
Chapter 11 (pp. 486-519) in Mash, E. J. & Barkley, R. A.
Cohen, W. I. (1996). Healthcare guidelines for individuals with Down syndrome. Down
Syndrome Quarterly, 1. [pages 1-14]
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental
disorders (4th ed.). Washington: author. (pp. 1-10, 27-37).
Corresponding DSM-IV-TR Readings (optional):
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders
( 4th ed.). Washington: author. Mental retardation, pp. 41-49.
Week 4/September 22: Pervasive Developmental Disorders, and School services for
children with disabilities
Autistic disorder, Rett’s disorder, Asperger’s disorder, and Childhood disintegrative
disorder.
Assigned Readings:
Klinger, L. G., Dawson, G., and Renner, P. (2003). Autistic disorder. Chapter 9 (pp. 409 454) in Mash, E. J. & Barkley, R. A.
Go to the following website: http://www.autism-society.org/ Click on “About Autism”
(at the top of the page); Read the links “What is Autism,” “Education,” and
“Living with Autism” and their sublinks.
Corresponding DSM-IV-TR Readings (optional):
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders
(4th ed.). Washington: author. Pervasive developmental disorders, pp. 69-84.
Week 5/September 29: Attention-Deficit/Hyperactivity Disorder;
Psychopharmacology
Assigned Readings:
Barkley, R. A. (2003). Attention-Deficit/Hyperactivity Disorder. Chapter 2 (pp. 75-143)
in Mash, E. J. & Barkley, R. A.
Kral, M. C., LaRosa, A., Brown, R. T., Kubiszyn, T. (2006). Pediatric
psychopharmacology. In G.. G. Bear & K. M. Minke (Eds.), Children’s needs III:
Development, prevention, and intervention. (pp. 1077-1088). Bethesda, MD:
NASP.
Corresponding DSM-IV-TR Readings (optional):
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders
(4th ed.). Washington: author. Attention deficit hyperactivity disorder, pp. 85-93.
Week 6/October 6: Substance Abuse
*Essay 1 Due
Assigned Readings:
Barkley, R. A. (2003). Adolescent substance use Disorders. Chapter 4 (pp. 199-232) in
Mash, E. J. & Barkley, R. A.
NIDA for Teens: The Science Behind Drug Abuse (2008). [Available at:
http://teens.drugabuse.gov/]. Please pay special attention to ‘Stimulants’ in the
‘Facts on Drugs’ section
.
Corresponding DSM-IV-TR Readings (optional):
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders
(4th ed.). Washington: author. Substance-Related disorders, pp. 191-209, 213-223.
Week 7/October 13: Chronic Physical Illness and its Effects on Individuals and
Families
Common chronic illnesses, obesity, chronic illness and schools
Assigned Readings:
Barbarin, O. (1990). Adjustment to serious childhood illness. In B. Lahey & A. S. Kazdin
(Eds.), Advances in Clinical Child Psychology: Volume 13, pp. 377-403. New
York: Plenum.
American Lung Association. (2003). Asthma and Children. Available at:
http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=44352 Read the links
under the heading “Asthma and Children” (except Asthma Busters).
Schwartz, M. B., & Puhl, R. (2003). Childhood obesity: A societal problem to solve.
Obesity Reviews, 4, 57-71.
CDC. (2003). National diabetes fact sheet. Department of Health and Human Services.
Retrieved January 5, 2004 from
http://www.cde.gov/diabetes/pubs/pdf/ndfs_2003.pdf
National Society for Epilepsy. (2003). Information on epilepsy: Children: a guide for
parents and carers. [Available at,
http://www.epilepsynse.org.uk/pages/info/leaflets/children.cfm? ]
National Heart Lung and Blood Institute. (2005). Cystic Fibrosis. [Available at,
http://www.nhlbi.nih.gov/health/dci/Diseases/cf/cf_what.html
Nemours Foundation. (2005). Sickle Cell Anemia. [Available at,
http://kidshealth.org/teen/diseases_conditions/genetic/sickle_cell_anemia.html
Week 8/October 20: Anxiety Disorders; LGBT Issues
Generalized anxiety disorder, OCD, specific phobia, social phobia, panic disorder
Assigned Readings:
Albano, A. M., Chorpita, B. F., & Barlow, D. H. (2003). Childhood anxiety disorders.
Chapter 6 (pp. 279-329) in Mash, E. J. & Barkley, R. A.
Mesibow, L. L. (2006). Schools’ legal obligations to gay students. Popular Government,
74, 16-23.
Jeltova, I. & Fish, M. C. (2005). Creating school environments responsive to gay, lesbian,
bisexual, and transgender families: Traditional and systemic approaches for
consultation. Journal of Educational and Psychological Consultation, 16, 17-33.
Corresponding DSM-IV-TR Readings (optional):
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders
(4th ed.). Washington: author. Anxiety disorders, especially pp. 429-430; 456-468.
Week 9/October 27: Depressive Disorders; Suicidal Behavior
Major depression, dysthymia, bipolar disorder
Assigned Readings:
Hammen, C. & Rudolph, K. D. (1996). Childhood mood disorders. Chapter 5 (pp. 233278) in Mash, E. J. & Barkley, R. A.
Corresponding DSM-IV-TR Readings (optional):
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders
(4th ed.). Washington: author. Mood Disorders, especially pp. 345-401.
Week 10/November 3: Behavior Disorders; Physical Discipline
Definitions, etiology, trajectories, comorbidity, and outcomes of behavior disorders.
*Essay 2 Due
Assigned Readings:
Hinshaw, S. P. & Lee, S. S. (2003). Conduct and oppositional defiant disorders. Chapter
3 (pp. 144 -198) in Mash, E. J. & Barkley, R. A.
Dodge, K. A., McLoyd, V. C., & Lansford, J. E. (2005). The cultural context of
physically disciplining children. In V. C. McLoyd, N. E., Hill, & K. A. Dodge
(Eds.), African American family life. (pp. 245-263). New York: Guilford Press.
Corresponding DSM-IV-TR Readings (optional):
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders
(4th ed.). Washington: author. Conduct disorder, Oppositional defiant disorder, pp. 93103.
Week 11/November 10: Maltreatment; Post Traumatic Stress Disorder; Alternative
Caregivers
Assigned readings:
Wekerle, C., & Wolfe, D. A. (2003). Child maltreatment. Chapter 14 (pp. 632-684) in
Mash, E. J. & Barkley, R. A.
Fletcher, K. E. (2003). Childhood posttraumatic stress disorder. Chapter 7 (pp. 330-371)
in Mash, E. J. & Barkley, R. A.
Pinderhughes, E. E., & Harden, B. J. (2005). Beyond the birth family: African American
children reared by alternative caregivers. In V. C. McLoyd, N. E., Hill, & K. A.
Dodge (Eds.), African American family life. (pp. 285-310). New York: Guilford
Press.
Recommended reading:
Vance, J. E. (2001). Neurobiological mechanisms of psychosocial resiliency. In J. M. Richman &
M. W. Fraser (Eds.), The context of youth violence: Resilience, risk, and protection (pp.
43-81). Westport , CT: Praeger.
Week 12/November 17: Eating Disorders
Assigned readings:
Barkley, R. A. (2003). Eating disorders. Chapter 15 (pp. 687-715) in Mash, E. J. &
Barkley, R. A.
National Eating Disorders Association (2008). [Available at:
http://www.nationaleatingdisorders.org/] (Under the Information and Resources link at
the top, please review sections on ‘Research results on eating disorders in diverse
populations’ and ‘Treatment of eating disorders’)
Week 13/November 24: NO CLASS – Happy Thanksgiving
Week 14/December 1: Learning and Communication Disorders
Reading Disorder, Disorder of Written Expression, Mathematics Disorder, Expressive
Language Disorder, Mixed Receptive-Expressive Disorder, Phonological Disorder,
Stuttering, Developmental Coordination Disorder
Assigned Reading:
Lyon, G. R., Fletcher, J. M., Barnes, M. C. (2003). Learning disabilities. Chapter 12 (pp.
520-586) in Mash, E. J. & Barkley, R. A.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental
disorders (4th ed.). Washington: author. Learning disorders, pp. 49-56.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental
disorders (4th ed.). Washington: author. Communication disorders, pp. 58-69.