Abnormal Psychology

Childhood Disorders 677

Summary of

Mental Retardation

The diagnosis of mental retardation requires
both an IQ score at or below 70 and impaired
daily functioning. The four levels of mental
retardation are mild, moderate, severe, and
profound. Some people with mental retarda-
tion—particularly at the severe or profound
level—may have difficulty communicating
verbally.
Neurological factors are the primary direct
cause of most cases of mental retardation—
usually a genetic abnormality or prenatal ex-
posure to a teratogen such as alcohol. In turn,
the genetic abnormality or teratogen alters
brain structure and function.
Although mental retardation cannot be
cured, many types can be prevented, includ-
ing those due to PKU and lead poisoning.
Interventions are designed to improve the
person’s functioning by increasing his or her
communication and daily living skills. Legally,
children with mental retardation are entitled
to special education and related services, tai-
lored to their individual needs through an IEP.

Thinking like a clinician

Clare just graduated from college and started
working in a center for adults with various in-
tellectual disabilities. She is trying to get to
know each client—his or her strengths and

weaknesses. The clients with mental retarda-

tion are classifi ed in the moderate to severe

range. Based on what you’ve learned, what

can—and can’t—you assume about those cli-

ents? Why might people with mild or profound

mental retardation not be at the center?

Summary of Pervasive

Developmental Disorders

Pervasive developmental disorders involve

two types of problems: (1) signifi cant defi cits

in communication and social interaction skills,

and (2) stereotyped behaviors or narrow in-

terests. Disorders in this category are autistic

disorder, Asperger’s disorder, childhood disin-

tegrative disorder, and Rett’s disorder.

Autistic disorder (or simply, autism) is char-

acterized by significant problems with com-

munication, social interactions, and language

use. Individuals with autism are oblivious to

other people and do not pay attention to or

understand basic social rules and cues. They

may have extremely narrow interests involv-

ing repetitive play. Many people with autism

also have comorbid mental retardation when

tested with conventional intelligence tests;

on tests that do not rely on verbal abilities,

however, people with autism tend to score in

the average range or higher. In addition, some

people with autism have unique skills.

Asperger’s disorder is characterized by

problems that are similar to—though less

severe than—those associated with autism.

With Asperger’s, however, language and cog-

nitive development are in the normal range.

Neurological factors that underlie au-

tism include abnormal connections and

communication among different brain areas,

in particular, between the frontal lobe and

the rest of the brain. Genes play a role in

the development of autism and Asperger’s.

Psychological symptoms of autism include

deficits in shifting attention and in mental

fl exibility, and problems in using a theory of

mind. People with Asperger’s have less se-

vere problems with their theory of mind than

people with autism. Social symptoms include

problems in recognizing emotion in the voices

or faces of others and in understanding the

give and take of social communication.

Interventions for autism include medi-

cation for comorbid disorders or symptoms

of anxiety, agitation, and aggression. Treat-

ment for autism that targets psychological

factors includes applied behavior analysis to

modify maladaptive behaviors. Treatments

that target psychological and social factors

focus on teaching the individual to com-

municate, to recognize conventional social

cues, to read the emotional expressions of

others, and how to initiate and respond in

social situations.

SUMMING UP

Key Concepts and Facts About Other Disorders of Childhood

• Separation anxiety disorder is characterized by excessive anxi-
  ety about separation from home or from someone to whom
  the child is strongly attached. Separation anxiety disorder is
  moderately heritable and is more likely to arise in tight-knit
  families, whose members may inadvertently reinforce behaviors
  associated with separation anxiety and punish behaviors as-
  sociated with actual separation. Separation anxiety disorder is
  treated with methods used to treat other anxiety disorders: CBT
  that includes exposure and cognitive restructuring, along with
  family therapy.


• Communication disorders are characterized by problems in un-
  derstanding or using language.


• Feeding and eating disorders are characterized by problems
  with attaining or maintaining adequate weight and nutrition or
  by bizarre eating habits.
  
  
  • The elimination disorders are enuresis and encopresis, which
    are characterized, respectively, by accidental or intentional fail-
    ure to urinate and failure to defecate appropriately in a toilet.
  
  
  • Tic disorders are characterized by persistent motor or vocal tics.
    Tourette’s disorder involves recurrent motoric and vocal tics.
  
  
  
  

Making a Diagnosis

• Reread Case 14.8 about JC, and determine whether or not his
  symptoms meet the criteria for separation anxiety disorder.
  Specifically, list which criteria apply and which do not. If you
  would like more information to determine his diagnosis, what
  information—specifi cally—would you want, and in what ways
  would the information infl uence your decision?