648 CHAPTER 14
Disorders of Disruptive Behavior and Attention
In addition to Javier Enriquez’s apparent diffi culties reading, his teacher has com-
mented—not very positively—on Javier’s high energy level. He doesn’t always stay
in his chair during class, and when he’s working on a group project, other kids seem
to get annoyed at him: “He can get ‘in their face’ a bit.” Javier’s mother, Lela, and
his father, Carlos, acknowledge that Javier is a very active, energetic boy. But Carlos
says, “I was that way when I was a kid, but I grew out of it as I got older.” Javier’s
teacher recently mentioned the possibility of his having attention-defi cit/hyperactiv-
ity disorder.
In contrast, Javier’s sister, 8-year-old Pia, is defi nitely not energetic. Like her
brother, Pia is clearly bright, but her teacher says she seems to “space out” in class.
The teacher thinks that Pia is simply not applying herself, but her parents wonder
whether she’s underachieving because she’s bored and understimulated in school.
At home, Pia has defi ed her parents increasingly often—not doing her chores or
performing simple tasks they ask her to do. Lela and Carlos then get frustrated and
angry. At other times, Pia is off in her own world, “kind of like an absent-minded
professor.”
Hounding Pia to do her chores (and getting angry when she doesn’t) is not a
new pattern. For a number of years, her parents frequently had to remind Pia to
clean up her room, make her bed, and help set the table. They thought she was
intentionally defying them. Is Pia’s behavior in the normal range, or does it signal a
problem? If so, what might the problem be?
And what about Javier’s behavior—is it in the normal range? Most children are
disruptive some of the time. But in some cases, the disruptive behavior is much more
frequent and obtrusive and becomes a cause for concern. The most common reason
that children are referred to a clinician is because of disruptive behavior at home,
at school, or both (Frick & Silverthorn, 2001). The clinician’s task is to distinguish
between normal behavior and pathologically disruptive behavior and, if the behav-
ior falls outside the normal range, determine which disorder(s) might be the cause
(Christophersen & Mortweet, 2001). The disruptive behaviors may not necessarily
distress the individual who performs them. But the behaviors often distress other
people or violate social norms (Christophersen & Mortweet, 2001).
Three disorders are associated with disruptive behavior: conduct disorder, op-
positional defi ant disorder, and attention-defi cit/hyperactivity disorder (which isKey Concepts and Facts About Learning Disorders
- A learning disorder is characterized by a substantial disparity
between an individual’s performance on a standardized test
and the expected level of performance based on the individual’s
age, intelligence (assessed by an IQ test) and education level.
DSM-IV-TR includes three types of learning disorders: reading
disorder (dyslexia), mathematics disorder, and disorder of writ-
ten expression. - Genes contribute to learning disorders. Dyslexia appears to re-
sult from disruptions in brain systems that process language
and in brain systems that process visual stimuli. Motivation and
social support infl uence an individual’s ability to overcome and
compensate for a learning disorder. - Treatment for learning disorders may involve accommodations
and services mandated by the Individuals with Disabilities
Education Act (IDEA). Various cognitive techniques can help a
person learn to compensate for a learning disorder. Depending
on the specifi c learning disorder and the individual, some tech-
niques may be more effective than others.Making a Diagnosis
- Reread Case 14.4 about Nancy, and determine whether or
not her symptoms meet the criteria for a learning disorder.
Specifi cally, list which criteria apply and which do not. If you
would like more information to determine her diagnosis, what
information—specifi cally—would you want, and in what ways
would the information infl uence your decision?