Abnormal Psychology
Fifth Edition
Oltmanns and Emery
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Copyright © Prentice Hall 2007
Chapter Fifteen
Mental Retardation and Pervasive
Developmental Disorders
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Chapter Outline
• Mental Retardation
• Autistic Disorder and Pervasive
Developmental Disorders
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Overview
• Mental retardation and Pervasive Developmental
Disorders (PDD) involve serious disruptions in
development.
• Both disorders are either present at birth or begin
early in life.
• Both affect many areas of intellectual, social, and
life functioning.
• Autism is the most familiar PDD, and, in fact,
professionals often use the term autistic spectrum
disorders as a synonym for PDD.
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Overview
• PDD are distinguished by dramatic, severe, and
unusual symptoms.
• Socially, the child not only lives in a world of his
own but also in a world apart.
• Many children with PDD also cannot
communicate.
• In addition, children with PDD are preoccupied
with unusual repetitive behavior, like needing to
preserve rigid routines or rocking back and forth
endlessly.
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Overview
• All people with mental retardation have
impaired intellectual abilities, but they vary
widely in academic ability, social functioning,
and life skills.
• Some people with profound retardation require
total care and live their entire lives in
institutions.
• However, most people with mental retardation
learn the self-care and vocational skills that
allow them to live in the community.
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Mental Retardation
• Much of the focus of intervention with
mental retardation is on intellectual
disability.
• Many people with mental retardation suffer
from emotional difficulties, a fact that is
overlooked all too often.
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Mental Retardation
Symptoms of Mental Retardation
• The American Association on Mental
Retardation (AAMR), the leading
organization for professionals concerned
with mental retardation, defines mental
retardation somewhat differently than DSMIV-TR.
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Mental Retardation
Symptoms of Mental Retardation
(continued)
•
However, both definitions generally agree
on the three major criteria for mental
retardation:
1) significant limitations in intellectual
functioning,
2) significant limitations in adaptive functioning,
and
3) onset before age 18 years.
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Mental Retardation
Symptoms of Mental Retardation (continued)
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•
The AAMR and DSM-IV-TR both define
subaverage intellectual functioning in terms
of a score on an individualized intelligence
test, a standardized measure for assessing
intellectual ability.
Intelligence tests yield a score called the
intelligence quotient, or IQ, the test’s rating
of an individual’s intellectual ability.
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Mental Retardation
Symptoms of Mental Retardation (continued)
•
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Defining intelligence can be controversial, and
definitions and measures of intellectual ability
have changed over the years.
Early versions of intelligence tests derived an IQ
by dividing the individual’s “mental age” by his
or her chronological age.
Mental age was determined by comparing an
individual’s test results with the average
obtained for various age groups.
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Mental Retardation
Symptoms of Mental Retardation (continued)
•
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Contemporary intelligence tests have abandoned
the concept of mental age and instead have
adopted the concept of the “deviation IQ.”
According to this theory, intellectual ability
follows the normal distribution in the
population, a bell-shaped frequency distribution.
The individual’s IQ is determined based on how
the person scores on an intelligence test relative
to the norms for his or her age group.
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Mental Retardation
Symptoms of Mental Retardation (continued)
•
•
Intelligence tests are normed to have a mean
(average) IQ score of 100 and a standard
deviation of 15.
One potential problem with the deviation IQ
is that IQ scores in the normal range are
rising across generations, a phenomenon
known as the Flynn effect (named for James
Flynn, who first noted the trend).
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Mental Retardation
Symptoms of Mental Retardation (continued)
•
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•
IQ tests are widely used, and they have
demonstrated value for predicting
performance in school.
Moreover, IQ is a trait that is stable over
time.
Despite the value of IQ tests in predicting
academic performance, a number of
important questions have been raised about
them.
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Mental Retardation
Symptoms of Mental Retardation (continued)
•
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One of the most controversial questions is
whether intelligence tests are “culture-fair.”
Culture-fair tests contain material that is
equally familiar to people who differ in their
ethnicity, native language, or immigrant status.
Tests that are culturally biased contain language,
examples, or other assumptions that favor one
ethnic group, particularly members of the
majority group, over another.
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Mental Retardation
Symptoms of Mental Retardation (continued)
•
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•
Another controversy is how well intelligence is
measured among people with mental retardation.
Many people with mental retardation have
sensory or physical disabilities that impede their
performance on standard IQ tests; thus they must
take tests that are not influenced by their
particular disability.
Despite the difficulties, evidence indicates that,
if anything, the IQ test scores of people with
mental retardation are more reliable and valid
than IQ scores in the normal range.
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Mental Retardation
Symptoms of Mental Retardation (continued)
•
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The most basic concern about intelligence tests
is the most important one: What is intelligence?
Intelligence tests measure precisely what their
original developer, Alfred Binet, intended them
to measure: potential for school achievement.
IQ tests predict school achievement fairly well.
However, school achievement is not the same as
“intelligence.”
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Mental Retardation
Symptoms of Mental Retardation
(continued)
•
•
Common sense, social sensitivity, and
“street smarts” are also part of what most
of us would consider intelligence, and
they are not measured by IQ tests.
Both the AAMR and DSM recognize that
intelligence is more than an IQ score; thus
they include adaptive behavior as a part of
their definitions of mental retardation.
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Mental Retardation
Symptoms of Mental Retardation
(continued)
•
•
The AAMR suggests that adaptive
behavior includes conceptual, social, and
practical skills.
Conceptual skills focus largely on
community self-sufficiency, and
incorporate communication, functional
academics, self-direction, and health and
safety from DSM-IV-TR.
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Mental Retardation
Symptoms of Mental Retardation
(continued)
•
•
Social skills focus on understanding how
to conduct oneself in social situations and
include social skills and leisure from the
DSM-IV-TR list.
Practical skills focus on the tasks of daily
living and include self-care, home living,
community use, health and safety, and
work from the DSM-IV-TR.
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Mental Retardation
Symptoms of Mental Retardation
(continued)
•
•
Adaptive skills are difficult to quantify.
As with the definition of IQ, the AAMR
now defines a significant limitation in
adaptive behavior as a score that is two
standard deviations below the mean on a
standardized measure of adaptive behavior
in conceptual, social, or practical skills.
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Mental Retardation
Symptoms of Mental Retardation (continued)
•
•
An argument has been made for defining
retardation solely on the basis of intelligence
testing, because current measures of adaptive
skills are imprecise.
However, the adaptive skills criterion
highlights the importance of assessing life
functioning in borderline cases, as well as the
need for services among people with mental
retardation.
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Mental Retardation
Symptoms of Mental Retardation (continued)
•
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The third criterion for defining mental
retardation is onset before 18 years of age.
This criterion excludes people whose deficits
in intellect and adaptive skills begin later in
life as a result of brain injury or disease.
People with mental retardation have not lost
skills they once had mastered, nor have they
experienced a notable change in their
condition.
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Mental Retardation
Diagnosis of Mental Retardation
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In 1866, the British physician Langdon Down
first described a subgroup of children with
mental retardation who had a characteristic
appearance.
Down’s classification helped subsequent
scientists to establish a specific etiology for what
we now know as Down syndrome.
The creation of IQ tests in the early twentieth
century also greatly furthered the classification
of mental retardation.
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Mental Retardation
Diagnosis of Mental Retardation
(continued)
•
•
Once academic potential could be
measured, controversy grew about what
IQ score cutoff should define mental
retardation.
The AAMR has set the cutoff at two
standard deviations below the mean (70).
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Mental Retardation
Diagnosis of Mental Retardation (continued)
•
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Today, mental retardation can be classified
according to two different criteria.
One criterion is based on IQ scores; the other is
according to known or presumed etiology.
The AAMR uses a multiaxial diagnosis of
mental retardation in which health, including
etiological factors, is rated on a separate axis.
A more controversial aspect of the AAMR
subclassification is the ratings of four levels of
“intensity of needed support” across nine
different areas of functioning.
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Mental Retardation
Diagnosis of Mental Retardation (continued)
•
•
The goal in rating support intensities is to
acknowledge the diversity of skills and needs
among people with mental retardation both as
people and for treatment planning.
In adopting the support intensities approach,
AAMR abandoned a long tradition still followed
in the DSM-IV-TR of dividing mental
retardation into four levels based primarily on
IQ scores: mild, moderate, severe, and profound.
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Mental Retardation
Diagnosis of Mental Retardation (continued)
•
•
Mild mental retardation is the designation
for those with IQ scores between 50–55 and
70.
People with mild mental retardation typically
have few, if any, physical impairments,
generally reach the sixth-grade level in
academic functioning, acquire vocational
skills, and typically live in the community
with or without special supports.
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Mental Retardation
Diagnosis of Mental Retardation (continued)
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People with moderate mental retardation have
IQs between 35–40 and 50–55.
They may have obvious physical abnormalities
such as the features of Down syndrome.
Academic achievement generally reaches
second-grade level, work activities require close
training and supervision, and special supervision
in families or group homes is needed for living
in the community.
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Mental Retardation
Diagnosis of Mental Retardation
(continued)
•
•
Severe mental retardation is defined by
IQ scores between 20–25 and 35–40.
At this severity level, motor development
typically is abnormal, communicative
speech is sharply limited, and close
supervision is needed for community
living.
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Mental Retardation
Diagnosis of Mental Retardation
(continued)
•
•
Profound mental retardation is
characterized by an IQ below 20–25.
Motor skills, communication, and selfcare are severely limited, and constant
supervision is required in the community
or in institutions.
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Mental Retardation
Diagnosis of Mental Retardation (continued)
•
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Because of the focus on intellectual difficulties,
professionals can overlook emotional problems
that actually are more common among people
with mental retardation than the general
population.
In order to protect against this, mental
retardation is coded along with personality
disorders on Axis II in DSM-IV-TR in order to
call attention to possible Axis I mental disorders.
The Axis II placement also reflects the fact that
significantly subaverage IQ is enduring.
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Mental Retardation
Diagnosis of Mental Retardation
(continued)
•
•
A diagnosis of mental retardation literally
might mean a difference between life and
death.
The United States Supreme Court recently
ruled that the death penalty is “cruel and
unusual punishment” for someone with
mental retardation, and therefore is
prohibited.
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Mental Retardation
Diagnosis of Mental Retardation
(continued)
•
Because of this ruling, lawyers are arguing
about the precise definition of mental
retardation—and psychologists are
evaluating whether or not accused capital
offenders have mental retardation—in
close cases throughout the country.
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Mental Retardation
Frequency of Mental Retardation
• The best estimate is that only 1 percent of the
population has mental retardation.
• Mental retardation in the United States is more
common among the poor and, as a result,
among certain ethnic groups.
• Mental retardation with a specific, known
organic cause (for example, Down syndrome)
generally has an equal prevalence among all
social classes, whereas retardation of
nonspecific etiology is more common among
families living in poverty.
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Mental Retardation
Causes of Mental Retardation
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About one-half of all cases of mental
retardation are caused by known
biological abnormalities.
The most common known biological
cause of mental retardation is the
chromosomal disorder Down syndrome.
The cause of Down syndrome is the
presence of an extra chromosome.
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Mental Retardation
Causes of Mental Retardation (continued)
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The incidence of Down syndrome is related
to maternal age.
In general, children and adults with Down
syndrome function within the moderate to
severe range of mental retardation.
By their thirties, the majority of adults with
Down syndrome develop brain pathology
similar to that found in Alzheimer’s disease.
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Mental Retardation
Causes of Mental Retardation (continued)
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Another chromosomal abnormality, fragile-X
syndrome, is the most common known genetic
cause of mental retardation.
Fragile-X syndrome is indicated by a weakening
or break on one arm of the X sex chromosomes,
and it is transmitted genetically.
Not all children with the fragile-X abnormality
have mental retardation.
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Mental Retardation
Causes of Mental Retardation
(continued)
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Several other chromosomal abnormalities
have been linked to mental retardation.
As in fragile-X syndrome, abnormalities
of the sex chromosomes are particularly
notable.
Mental retardation is known to be caused
by several recessive gene pairings.
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Mental Retardation
Causes of Mental Retardation (continued)
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Phenylketonuria, or PKU, is one of these.
PKU is caused by abnormally high levels of
the amino acid phenylalanine, usually due to
the absence of or an extreme deficiency in
phenylalanine hydroxylase, an enzyme that
metabolizes phenylalanine.
Children with PKU have normal intelligence
at birth.
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Mental Retardation
Causes of Mental Retardation (continued)
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However, as they eat foods containing
phenylalanine, the amino acid builds up in their
system.
This phenylketonuria produces brain damage
that eventually results in mental retardation.
Retardation typically progresses to the severe to
profound range.
Fortunately, PKU can be detected by blood
testing in the first several days after birth.
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Mental Retardation
Causes of Mental Retardation
(continued)
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Other relatively rare recessive-gene
disorders can also cause mental
retardation.
Mental retardation can also be caused by
various infectious diseases.
Damaging infections may be contracted
during pregnancy, at birth, or in infancy to
early childhood.
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Mental Retardation
Causes of Mental Retardation (continued)
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Rubella (German measles) is a viral infection
that may produce few symptoms in the mother
but can cause severe mental retardation and even
death in the developing fetus.
The human immunodeficiency virus (HIV) can
be transmitted from an infected mother to a
developing fetus.
The effects on the child are profound, including
mental retardation, visual and language
impairments, and eventual death.
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Mental Retardation
Causes of Mental Retardation
(continued)
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Syphilis is a bacterial disease that is
transmitted through sexual contact.
Infected mothers can pass the disease to
the fetus.
If untreated, syphilis produces a number
of physical and sensory handicaps in the
fetus, including mental retardation.
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Mental Retardation
Causes of Mental Retardation
(continued)
•
•
Another sexually transmitted disease,
genital herpes, can be transmitted to the
infant during birth and result in mental
retardation.
Two infectious diseases that occur after
birth, encephalitis and meningitis, can
cause mental retardation.
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Mental Retardation
Causes of Mental Retardation
(continued)
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Exposure to a variety of environmental
toxins can also cause mental retardation.
Both legal and illegal drugs pose a risk to
the developing fetus.
Toxins also present a potential hazard to
intellectual development after birth.
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Mental Retardation
Causes of Mental Retardation
(continued)
•
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Pregnancy and birth complications also
can cause mental retardation.
One major complication is Rh
incompatibility.
Another pregnancy and birth complication
that can cause intellectual deficits is
premature birth.
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Mental Retardation
Causes of Mental Retardation
(continued)
•
Other pregnancy and birth complications
that can cause mental retardation include
extreme difficulties in delivery,
particularly anoxia, or oxygen
deprivation; severe malnutrition; and the
seizure disorder epilepsy.
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Mental Retardation
Causes of Mental Retardation (continued)
• The tail of the normal IQ distribution involves
cases of mental retardation of unknown
etiology—what is often referred to as culturalfamilial retardation.
• As the term suggests, cultural-familial
retardation tends to run in families and is
linked with poverty.
• A controversial issue is whether this typically
mild form of mental retardation is caused
primarily by genes or by psychosocial
disadvantage.
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Mental Retardation
Causes of Mental Retardation (continued)
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Grossly abnormal environments can produce
gross abnormalities in intelligence.
Cultural-familial retardation is found far more
frequently among the poor.
Part of this is explained by the fact that lower
intelligence causes lower social status.
Impoverished environments lack the stimulation
and responsiveness required to promote
children’s intellectual and social skills
throughout their development.
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Mental Retardation
Treatment: Prevention and
Normalization
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Three major categories of intervention are
essential in the treatment of mental
retardation.
First, many cases of both organic and
cultural-familial mental retardation can be
prevented through adequate maternal and
child health care, as well as early
psychoeducational programs.
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Mental Retardation
Treatment: Prevention and
Normalization (continued)
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Second, educational, psychological, and
biomedical treatments can help people
with mental retardation to raise their
achievement levels.
Third, the lives of people with mental
retardation can be normalized through
mainstreaming in public schools and
promoting care in the community.
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Mental Retardation
Treatment: Prevention and
Normalization (continued)
•
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The availability and use of good maternal
and child health care is one major step
toward the primary prevention of many
biological causes of mental retardation.
Planning for childbearing can also help
prevent mental retardation.
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Mental Retardation
Treatment: Prevention and
Normalization (continued)
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A more controversial means of preventing
retardation is through diagnostic testing
and selective abortion.
Early social and educational interventions
can lead to the secondary prevention of
cultural-familial retardation.
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Mental Retardation
Treatment: Prevention and
Normalization (continued)
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The most important current secondary
prevention effort is Head Start, a federal
intervention program begun in 1964.
Careful assessment early in life is critical
to tertiary prevention.
Medical screening is essential for
detecting conditions like PKU.
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Mental Retardation
Treatment: Prevention and
Normalization (continued)
•
•
Accurate detection is important, because
early interventions can help.
Treatment of the social and emotional
needs of people with mental retardation
may include teaching basic self-care
skills, such as feeding, toileting, and
dressing, during the younger ages and
various “life-survival” skills at later ages.
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Mental Retardation
Treatment: Prevention and
Normalization (continued)
•
•
Medical care for physical and sensory
handicaps also is critical in the treatment
of certain types of mental retardation.
Medication is not especially helpful in
treating the intellectual or socioemotional
problems of people with mental
retardation.
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Mental Retardation
Treatment: Prevention and Normalization
(continued)
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Normalization means that people with
mental retardation are entitled to live as
much as possible like other members of
society.
The major goals of normalization include
mainstreaming children with mental
retardation into public schools and promoting
a role in the community for adults with
mental retardation.
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Mental Retardation
Treatment: Prevention and Normalization
(continued)
•
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Prior to 1975, only about half of all children
with mental retardation received an education at
public expense.
That year Congress passed the Education for All
Handicapped Children Act, which affirmed that
all handicapped children have a right to a free
and appropriate education in the “least restrictive
environment.”
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Mental Retardation
Treatment: Prevention and
Normalization (continued)
•
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Within the limits set by the handicapping
condition, services must be provided in a
setting that restricts personal liberty as
little as possible.
For many children with mental
retardation, the least restrictive
environment means mainstreaming them
into regular classrooms.
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Mental Retardation
Treatment: Prevention and
Normalization (continued)
•
•
The deinstitutionalization movement that
began in mental hospitals in the 1960s
also has normalized the lives of many
people with mental retardation.
Changing attitudes is ultimately the most
effective way to normalize the lives of
people with mental retardation and their
families.
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Autistic Disorder and Pervasive
Developmental Disorders
•
•
Pervasive developmental disorders
(PDDs) begin early in life and involve
severe impairments in a number of areas
of functioning.
People with PDD exhibit profound
disturbances in relationships, engage in
unusual behaviors, and typically have
substantial communication difficulties.
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Autistic Disorder and Pervasive
Developmental Disorders
•
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Autistic disorder (autism) is
characterized by profound indifference to
social relationships, odd, stereotypical
behaviors, and severely impaired or
nonexistent communication skills.
The disorder typically has a chronic,
unremitting course.
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Autistic Disorder and Pervasive
Developmental Disorders
Symptoms of PDD
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•
Early onset is a defining feature of autism.
Because babies with autism look normal,
the condition may not be accurately
diagnosed for a few years, as infants and
toddlers fail to reach developmental
milestones and social achievement.
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Autistic Disorder and Pervasive
Developmental Disorders
Symptoms of PDD (continued)
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Communication problems in PDD range
from few difficulties in Asperger’s
disorder to profound impairments in many
cases of autism.
According to field studies conducted for
DSM-IV, 54 percent of patients with
autism remain mute, as do 35 percent of
patients with other PDD.
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Autistic Disorder and Pervasive
Developmental Disorders
Symptoms of PDD (continued)
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Echolalia is a common problem.
Those with autism or other PDD frequently
repeat phrases that are spoken to them, or
sometimes repeatedly echo a phrase they heard
at an earlier time.
Another common language problem is pronoun
reversal, which involves confusing the pronoun
“you” with the pronoun “I.”
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Autistic Disorder and Pervasive
Developmental Disorders
Symptoms of PDD (continued)
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The speech difficulties stem from basic
disturbances in the ability to communicate
and, even more basically, in the ability to
imitate or reciprocate interactions.
Even high-functioning people with PDD
have trouble communicating or
understanding abstractions.
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Autistic Disorder and Pervasive
Developmental Disorders
Symptoms of PDD (continued)
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The inability to relate to others is another
central feature of autistic disorder.
One view is that people with autism lack a
theory of mind—that is, they fail to
appreciate that other people have a point
of reference that differs from their own.
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Autistic Disorder and Pervasive
Developmental Disorders
Symptoms of PDD (continued)
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Theory of mind has proved to be a useful,
overarching concept for understanding
social disturbances in autistic disorder, but
the problems are emotional as well as
cognitive.
Many people with PDD appear to be
missing the basic, inborn tendency to form
attachments with other people.
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Autistic Disorder and Pervasive
Developmental Disorders
Symptoms of PDD (continued)
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Another defining symptom of autism is
restricted, repetitive, and stereotyped
patterns of behavior, interests, and
activities.
These odd preoccupations and rituals
create social complications.
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Autistic Disorder and Pervasive
Developmental Disorders
Symptoms of PDD (continued)
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Rituals such as flapping a string or
spinning a top seem to serve no other
function than providing sensory feedback
or self-stimulation.
Although it is not a part of the diagnosis,
some people with PDD respond to
auditory, tactile, or visual sensations in a
highly unusual and idiosyncratic manner.
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Autistic Disorder and Pervasive
Developmental Disorders
Symptoms of PDD (continued)
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Self-injurious behavior is one of the most
bizarre and dangerous difficulties that can
accompany PDD.
One of the most intriguing characteristics
of PDD is when a child occasionally
shows savant performance—an
exceptional ability in a highly specialized
area of functioning.
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Autistic Disorder and Pervasive
Developmental Disorders
Diagnosis of Autism and PDD
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“Early infantile autism” was first described in
1943 by the psychiatrist Leo Kanner of Johns
Hopkins University.
Mental health professionals only recently
recognized that the Viennese psychiatrist Hans
Asperger identified a very similar condition at
virtually the same time as Kanner.
One important difference, however, was that
Asperger’s patients exhibited higher intellectual
functioning.
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Autistic Disorder and Pervasive
Developmental Disorders
Diagnosis of Autism and PDD (continued)
•
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The distinction between Kanner’s and
Asperger’s patients was introduced into the
formal diagnostic nomenclature in DSM-IV.
Asperger’s disorder is now listed as a subtype
of PDD.
Descriptively, it is identical to autism, with the
exception that the disorder involves no clinically
significant delay in language.
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Autistic Disorder and Pervasive
Developmental Disorders
Diagnosis of Autism and PDD (continued)
•
•
The new diagnosis for Asperger’s disorder
refers to people who show the symptoms of
autism but do not have major problems in
communication and generally function higher in
other areas as well.
Childhood disintegrative disorder refers to a
poorly understood and somewhat controversial
condition characterized by severe problems in
social interaction and communication, in
addition to stereotyped behavior.
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Autistic Disorder and Pervasive
Developmental Disorders
Diagnosis of Autism and PDD (continued)
•
Rett’s disorder is a clearly distinct condition
characterized by at least 5 months of normal
development followed by
1) a deceleration in head growth,
2) loss of purposeful hand movements,
3) loss of social engagement,
4) poor coordination, and
5) a marked delay in language.
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Copyright © Prentice Hall 2007
Autistic Disorder and Pervasive
Developmental Disorders
Frequency of Autism and PDD
•
•
•
Upper level estimates now suggest that as many
as 60 in 10,000 children suffer from autism.
Three to four times as many boys as girls suffer
from autism, suggesting a gender-linked
etiology.
Autism also is much more common among
siblings of a child with autism, suggesting
possible genetic causes.
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Autistic Disorder and Pervasive
Developmental Disorders
Causes of Autism
•
•
•
For many years, parents were blamed for
causing autism in their children.
Such bold and harmful assertions are
unsupported by evidence.
A number of findings indicate that
biological abnormalities play an important
role in the etiology of autism.
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Autistic Disorder and Pervasive
Developmental Disorders
Causes of Autism (continued)
•
•
One epidemiological study found that over
half the cases of autism were associated
with various known biological difficulties
or disorders.
Some research suggests that genetic
factors also play an important role in
many cases of autism.
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Autistic Disorder and Pervasive
Developmental Disorders
Causes of Autism (continued)
• The prevalence of autism is as much as 100
times higher among siblings of a proband
with autism, and concordance rates are
higher among MZ than DZ twins.
• Different theorists argue that autism is due
to deficits in various neurochemicals.
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Autistic Disorder and Pervasive
Developmental Disorders
Causes of Autism (continued)
• Currently, the most promising research focuses
on endorphins and neuropeptides, substances
that affect the action of neurotransmitters, as
mediators of symptoms of the disorder.
• Other research has searched for abnormalities
in brain structure, not function, among people
with autism.
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Autistic Disorder and Pervasive
Developmental Disorders
Causes of Autism (continued)
• Some research suggests that people with
autism have abnormalities in parts of the
limbic system—the area of the brain that
regulates emotions—and also in areas of the
cerebellum, where sensorimotor input is
integrated.
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Autistic Disorder and Pervasive
Developmental Disorders
Causes of Autism (continued)
• As investigators search for sites of brain
damage, one thing seems clear: Any
structural abnormalities are likely to be the
result of abnormal brain development, not
of specific damage or lesions.
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Autistic Disorder and Pervasive
Developmental Disorders
Treatment of PDD
• Unfortunately, autism is a lifelong disorder.
• In one study of 63 children with autism who were
followed into adulthood, only one person was
functioning in what could be considered the
normal range.
• Two developmental periods are especially
important to the course of autism: the early
preschool years and early adolescence.
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Autistic Disorder and Pervasive
Developmental Disorders
Treatment of PDD (continued)
• A huge variety of medications have been
used to treat autism, including antipsychotics,
antidepressants, amphetamines, psychedelics,
and megavitamins.
• Unfortunately, none of these medications is
an effective treatment for autism, and few
show much promise.
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Autistic Disorder and Pervasive
Developmental Disorders
Treatment of PDD (continued)
• Intensive behavior modification using operant
conditioning techniques called Applied Behavior
Analysis (ABA) is the most promising approach to
treating autism.
• ABA therapists focus on treating the specific
symptoms of autism, including communication
deficits, lack of self-care skills, and selfstimulatory or self-destructive behavior.
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Autistic Disorder and Pervasive
Developmental Disorders
Treatment of PDD (continued)
• Behavior therapists have been fairly
successful in teaching self-care skills and
less successful in teaching social
responsiveness.
• Despite the fact that autism apparently is
caused by neurological abnormalities, the
most effective treatment for the disorder is
highly structured and intensive ABA.
Copyright © Prentice Hall 2007