Child Psychopathology Potential Question 1. Definition of a clinical disorder 2. Positive/negative predictive power 3. Be able to complete a clinical disorder table for the following disorders: a. Intellectual Disabilities (previously Mental Retardation) b. Autism c. Aspergers’ Disorder d. ADHD – combined subtype e. Oppositional Defiant Disorder f. Conduct Disorder 1. What is a clinical disorder? A constellation of symptoms that significantly impairs an individual’s ability to function and is characterized by a particular symptom picture with a specifiable onset, course, duration, outcome, and response to treatment, and associated familial, psychosocial, and biological correlates 2. Which is more important to clinicians, Positive Predictive Power or Sensitivity? What is PPP, and why is it more important to a practicing clinician? [note: there are 3 separate pieces to address] Positive Predictive Power is more important because it represents the proportion of children with a specific symptom who meet diagnostic criteria for a specific disorder. Clinicians usually are uncertain of a child’s diagnostic when they are brought to a clinic for an evaluation and/or treatment. They discover which symptoms a child has by means of clinical interviews (parent/child/teacher) and standardized rating scales, and the presence of certain symptoms (PPP) makes a particular diagnosis more likely to be accurate. 3. Why is Intellectual disability not diagnosed on IQ alone? Intellectual disability is not diagnosed based on IQ alone because a child could have an IQ below 70 due to a substandard environment yet show no impairment in their ability to function adaptively in their environment. 4. Describe the primary subtypes of Intellectual Disability: a. Mild mental retardation- minimal deficits, achieves adult skills for self-support, may need assistance often successful. b. Moderate mental retardation-assisted/community living, can perform unskilled/semi-skilled work. c. Severe mental retardation-that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility. d. Profound mental retardation-simple supervised tasks. 5. Explain the difference between organic mental retardation and cultural-familial mental retardation. Provide an example of each. Organic – Results from a known a genetic disorder or biological abnormalities and is present at birth. Frequently occurs in families where everyone else has normal intellectual functioning. The cause of the MR is known. Examples: Down’s Syndrome, Fragile X Syndrome, Trisomy 21 Cultural–Familial – Thought to result from a combination of environmental deprivation and genetic disposition towards low intelligence. The exact cause of MR is not known. Example: A child who isn’t stimulated enough at a young age, is raised in an impoverished environment, and doesn’t develop properly 6. What three areas must a child show severe and pervasive impairment in to be diagnosed with Autism? Describe the impairment that children with Autism typically show in each area. a. Impairment in social functioning- Avoids eye contact, is uninterested in social interactions, shows little interest in others’ behavior, and doesn’t respond to signs of affection. b. Impairment in communication- marked delays in language, may be mute, shows echolalia, pronoun reversal, abnormal prosody, and problems with pragmatics. c. Stereotyped patterns of behavior- hand flapping, toe walking, rocking, insists on following elaborate routines 7. Explain how the IQ-Achievement discrepancy is used to diagnose learning disorders and why it may not be the best way to diagnose children with learning disorders. Children are administered an IQ test and a standardized academic achievement test; a significant discrepancy between the two scores must exist to meet diagnostic criteria for a learning disability or learning disorder. This approach may not be optimal because a child could barely miss the cutoff discrepancy score but still show significant impairment and need intervention to avoid failure. 8. Provide three possible explanations for self-injurious behaviors in children with Intellectual Disability. a. They serve a particular function such as: gaining attention, food or specific items, providing stimulation or enjoyment, or escaping a chore, activity or social interaction they dislike. b. SIB may reflect hypersensitivity to the neurotransmitter dopamine. c. Children who exhibit SIBs may have high levels of endogenous opioids that raise their pain tolerance. 9. Describe the two primary subtypes of ADHD. Combined type – shows significant inattentive and hyperactive-impulsive symptoms. Children with this subtype are usually described as inattentive, impulsive, and exhibit excessive motor activity. They also experience significant difficulties interacting with peers and do poorly in school. Predominantly inattentive type – Children with this subtype exhibit slow information processing, tend to be uncoordinated, and are described as daydreamers, in a fog, confused, staring into space, and forgetful. 10. How does incidence rate differ from prevalence rate? Incidence rate refers to the occurrence of new cases during a particular time interval (e.g., within the past year). Prevalence rate refers the number of existing cases within a particular time frame (e.g., within the past year). 11. What are callous unemotional traits and what role do they play in children diagnosed with conduct disorder (i.e., is the behavior and/or outcomes different for children with conduct disorder with and without CU traits?).