Child Psychopathology
Different views of mental retardation
Developmental course and etiology
Issues in intervention
Reading for today: Chapter 9
Social Quiz
• Why do we have “unleaded” gasoline?
• How did plumbing bring down the Roman
Empire?
• Why was the “Mad Hatter” mad?
• Why is it frowned upon to consume large
quantities of alcohol when pregnant?
• What color do we want newborn babies to be and
why?
• Why does the dentist put an apron over your body
when X-raying your teeth?
History of assessment
• Binet & Simon hired to develop a test to
determine if individuals could be educated
• Concept of “mental age” developed, which
when expressed as a ratio MA/CA = IQ
• Test became widely used, revised at
Stanford University, became “StanfordBinet” Intelligence Test
• IQ designed to predict success in school
DSM-IV Criteria
• Significantly subaverage IQ (less than 70)
• Concurrent deficits or impairments in
adaptive functioning
• Characteristics evident prior to age 18
• Ranges (and Educational Classifications):
– Mild: 50/55 to 70 (“Educable”)
– Moderate: 35/40 to 50/55 (“Trainable”)
– Severe: 20/25 to 35/40 (“Severe”)
Prevalence
• 1-3% of population, depending on cutoff
used
• those with mild mental retardation are 85%
of population, majority have idiopathic
origin (cultural-familial)
• Those with organic MR are more likely to
have genetic causes
• Slightly more males than females
• Low SES and minority groups at higher risk
Other characteristics
• Cultural-familial MR has global delays
• Organic MR has less sequential organized delays,
medical problems such as heart malformation
• Mild MR may be associated with failure, lowering
goals, and minimal success (learned helplessness)
• Comorbid developmental disabilities including
epilepsy, speech, language, behavior, sensory
• attachments develop, but signals, proximity seeking,
and even distress may be lower
• 10-40% have emotional or behavior problems (e.g.,
pica)
Biological Causes
• Heritability of IQ = 50%; “Polygenes”
• Chromosomal anomalies most common
cause of more severe forms
– Meiosis: Downs, Turners; Crossover
• Fragile X syndrome (inherited)
• Metabolism problems (PKU)
• Neurobiology: malnutrition, teratogens
(lead, mercury), fetal alcohol, perinatal
stress leading to physical damage (e.g.,
Social and psychological causes
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•
•
•
Deprived physical care
Poor emotional care
Poor social stimulation
Victor D’Avyron (feral child) was MR by
environmental causes
• These interact with biology, e.g., poor
housing may have paint chips, chips may
have leaded paint, children may eat paint
chips as they do not have toys to play with
Interventions for mental retardation
• Medications rarely, if ever, used
• Prenatal & postnatal education & screening
– Vitamins, alcohol, PKU
• Community-based placements/ living
situations: What are you aware of?
• Answers: Residential, Community-based,
supported work environment,
mainstreaming
• Variety of psychosocial interventions
Psychosocial interventions
• infant stimulation, developmental
surveillance
• behavioral approaches include shaping,
modeling, graduated guidance, both +/- beh.
• Self-regulation and metacognitive training
• Camp, other special programs (e.g.,
SMILE)
• family support: coping with parenting
demands, stress
Stephanie Rogers