Psych Exam 3
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Psych Exam 3
Psych Exam 3
T/F: In the 19th century, state run institutions were where kids with MR went and it was socially acceptable.
What is the evolutionary degeneracy theory?
people w/ MR were throwbacks/degenerates
they cause the gene pool to deteriorate
needed to be stopped from reproducing
Who led the eugenics movement?
Sir Frances Galton
What was the eugenics movement?
a shift from the needs of people with MR to protection of society
In 1910, how were people with MR classified?
T/F: MR is the most well known childhood disorder.
What did Kennedy do for MR in 1962?
he formed the President's panel on MR
his sister had MR so he was dear to it
our current definitions come from this time
When did the grassroots movement to improve diagnosis and treatment of MR happen?
T/F: there are 2 accepted and used definitions for MR.
What are the 3 pieces to both definitions of MR?
1. patient must have sub-average intelligence
2. patient has deficits in adaptive behavior
3. must manifest during childhood
What are some important points about deficits in adaptive behavior?
child must show these deficits in every environment, not just at school
skills that would affect autonomous living like tying shoes, getting dressed
What does the AAMR classify sub-average intelligence as?
What were the old AAMR subgroups?
What does the new definition of MR focus on?
how the child is functioning in the environment, not just their IQ
What is the new definition for mild MR?
off and on support needed
for emergencies, transitions in life, crisis
what is the new definition for moderate MR?
need high level of support for a short period of time
training for a job
What is the new definition for severe MR?
daily/regular involvement in one environment
What is the new definition for profound MR?
high levels of support constantly across all environments
may have to live in a group home
What is the controversy over the new definitions that AAMR gave?
they raised the IQ from 70 to 75 so now more children are eligible for diagnosis
reliable methods for rating funtioning do not exist
how do measure the level of support needed?
T/F: the DSM supports the new AAMR definitions of MR.
T/F: adaptive functioning and IQ are moderately related with a correlation of about 0.6.
T/F: adaptive functioning and IQ are not exactly the same and should be measured separately.
What do we use to measure adaptive functioning?
Adaptive Behavior Scales
T/F: MR is equally common in both boys and girls.
What % of the population has MR?
T/F: MR is not more common in low SES and minority groups.
false; it is
T/F: in the subgroup of severe MR, social class differences disappear.
In DSM, the level of MR, reflecting a child's degree of difficulty, is based on?
the extent of cognitive impairment
Which category of MR has an overrepresentation of minority groups?
Persons with profound MR have an IQ of?
In general, kids with Down's display?
significant gains in adaptive behavior by age 6, followed by a levelling off or a decline
Kids w/ mild to moderate MR learn symbolic play by?
in much the same manner as other kids
What other diagnosis is least likely among kids with MR?
What is the gene-environment interaction also known as?
Abnormalities in facial features, growth retardation below the 10th percentile, and CNS dysfunction are all common in what disorder?
Which disorder is a severe, developmental, spectrum disorder?
With respect to attachment, most kids with autism?
prefer their caregivers over unfamiliar adults
We don't know if kids with autism ______ emotions differently.
Pragmatics is the primary language deficit of kids with_____.
Why do kids w/ autism engage in self-stimulating behavior?
they crave stimulation and self-stim excites their nervous systems
it is frequently accompanied by some sort of reinforcement
self-stim might help to block out and control the environment which could be too stimulating
Many kids with autism also have what 2 other problems?
T/F: autism is more common in boys, but it is equally common in boys and girls with those who have profound MR too.
What has been associated with autism more than any other medical condition?
Medication in combination with _______ is a good current treatment for childhood onset schizophrenia? (3 things)
educational support program
social support program
T/F: Children with a learning disability usually have average or above-average intelligence.
Awareness that sounds can be manipulated within syllables in words, recognition of the relationship between sounds and letters, and detection of rhyme and alliteration are all part of?
If a child has trouble with articulation, they will be diagnosed with?
T/F: boys are more likely to be diagnosed with communication disorders because of referral bias.
What age does stuttering peak at?
T/F: reading, writing (written expression) and math are all categories of a learning disorder.
T/F: a child with a writing disorder is likely to have problems with reading, handwriting, and eye/hand coordination.
Reading disorders have ____% heritability?
Eden et. al found that brains of adults with reading disorders have no activation in the area of the brain that detects ___?
What are the DSM subclassifications of MR?
What is the largest subgroup of MR?
What is the IQ of mild MR group?
T/F: independent living is likely for someone w/ mild MR.
T/F: those with mild MR can function autonomously
What academic level do those with mild MR reach by their teen years?
6th grade level
What is the IQ of the moderate MR group?
How many of those with MR have moderate MR?
What academic level do those w/ moderate MR reach?
2nd grade level
Which group of MR can live semi-independently?
Which group do those with Down's fall into?
What is the IQ of those in the severe MR group?
3-4% of those with MR fall into which group?
Which subgroup of MR usually suffers from one or more organic causes?
What academic level do those with severe MR reach?
4-6 years old
T/F: those with severe MR also have physical disabilities like seizures.
T/F: those with severe MR can have some communication skills by age 12.
T/F: sever MR is usually identified during infancy.
Which subgroup of MR is the smallest?
What is the typical IQ of a child with profound MR?
T/F: those with profound MR can still have rudimentary communication (I'm hungry).
What is the evidence for difference (qualitative) MR?
What is the evidence for developmental (quantitative) MR?
Which argument for MR supports the fact that the child would have slowed development but would show a similar sequence of events as a normal child? (would crawl before walking)
Which argument for MR supports the fact that even after matching for mental age, differences will still be apparent between normal children and those with MR?
Which group of MR is bigger? (cultural/familial or organic caused)
Those with MR that fall under the cultural/familial category usually have what IQ?
50-70 (mild MR)
What are some risks for cultural/familial MR?
low parent education
Is cultural/familial MR qualitative or quantitative?
T/F: early intervention can help cultural/familial MR.
How can we prevent cultural/familial MR?
stimulating, enriched environments for infancy thru pre-school
What was the Abecedarian project?
done in Appalaichan mountain region with high levels of poverty
kids maintained effects of a stimulating environment up to 10 years later
IQ was 5-10 points higher in treated group
What are the 3 main organic causes of MR?
____ _____ are caused by excess or shortages of chemicals necessary for metabolism?
___ ____ account for 3-7% of severe MR cases? (very rare)
What is the most common metabolic disorder that causes MR?
What does PKU do?
lack enzyme that converts phenylalanine to tyrosine
body accumulates phenylalanine, which turns into phenylpyruvic acid
brain damage, seizures, hyperactivity
What are some other known metabolic disorders?
maple syrup urine disease
What is the biggest risk for a chromosonal abnormality?
maternal age (mother) at pregnancy
What is the most common chromosomal abnormality disease associated with MR?
What are the 3 causes of Down's syndrome?
4% of all cases of Down's are which type?
Which is the rarest cause of Down's?
95% of all cases of Down's are which type?
Trisomy 21 is most often caused by ______ of the 21st chromosome?
______ is rearrangement of genetic material between the 14th and 21st chromosomes?
T/F: in translocation (Down's), the number of chromosomes remains the same.
T/F: in trisomy 21, the number of chromosomes remains the same.
false; one extra
T/F: it is possible for Down's to be underdiagnosed if mosaicism split occurs late in development.
T/F: mosaicism can result in differing degrees of Down's.
In _____, one cell gets three chromosomes and the other only gets one and usually dies?
Chromosomal abnormalities usually result in what type of MR?
moderate to profound
What are some physical features associated with Down's?
flat nasal bridge
large protruding tongue
short crooked 5th finger
broad square hands
almond shaped eyes
What are some features of Down's that aren't physical?
high social skills
may have muted emotions
What is the usual treatment for someone with Down's?
show life skills
Prader Willi and Angelman's are both caused by an abnormality of chromosome __?
Which one is a milder form of MR (Prader Willi or Angelman's)?
Which abnormality of chromosome 15 has moderate to severe MR?
Which disorder(s) are caused by genetic imprinting?
Angelman's and Prader Willi
If your mother's chromosome 15 is deleted, what disorder will you have?
If your father's chromosome 15 is deleted, what disorder will you have?
Which disorder is marked by an involuntary urge to eat constantly?
If someone has a short stature, incomplete sexual development, low muscle tone and is obese, what do they have?
If someone has jerky movements, seizures, flapping hands, absence of speech, and a large open-mouthed expression, what do they have?
What is thought to be a cause of Prader Willi syndrome?
maybe the hypothalamus
Which chromosomal abnormality that causes MR is X-linked and usually passed on by the mother?
Fragile X syndrome
T/F: Fragile X syndrome is present at birth.
What type of MR do those with Fragile X usually have?
mild to moderate
These kids show strengths in adaptive behavior early on, but usually behavior difficulties arise like hyperactivity, poor peer relations, etc?
Which syndrome mostly affects males, but when females have it, they have a milder form of MR?
What are some neurobiological causes of MR?
____ refers to someone who has MR but is capable of outstanding mental tasks?
T/F: the term 'savant' means wise.
T/F: savant syndrome has been found on every continent.
T/F: males and females are equally savants.
false; mostly male
What are some common savant skills?
What are talents that are unpredicted, but not at genius level called?
Who has splinter skills?
What are the 3 different categories of savants?
What are prodigious savants?
they have one specific talent that they are really really good at
only 25 in the world
can't dress themselves, do simple tasks, but might be extremely talented in one area
T/F: savant syndrome is rare even among those with MR.
How many savants with autism and MR have at least splinter skills?
1 in 10 (10%)
1 in 2000 kids with MR are also ___?
What are all of the autistic spectrum disorders?
childhood disintegrative disorder (CDD)
Pervasive developmental disorder-not otherwise specified (PDD-NOS)
T/F: across the social classes, autism is different.
How much do boys outnumber girls for autism?
3:1 or 5:1
What two disorders display equifinality?
T/F: autism has been on the rise.
What disorder was originally confused with schizophrenia?
Who argued for a separate diagnosis for kids with autism and that their disabilities were present before age 3, which was unlike schizophrenia?
What are some features of autism that were described by Kanner?
inability to relate to people
atypical cognitive potential
What was Kanner's hypothesis about autism?
the parents were intelligent, but cold and emotionally reserved "refrigerator"
the child perceives the world as a threatening place
the child withdraws into their own inner world
Which disorder is marked by a failure of the child to make eye contact or to get comfort from their parents?
25% of children with this disorder never acquire language?
What is echolalia?
a sound or word or a series of words that is repeated to soothe
found in Tourettes and autism
What is dysprosody and who has it?
inaccurate pitch and rhythm
Who has literal interpretation of language?
Who has a lack of joint attention interactions? (don't say look mommy to get attention)
Who shows an obsession for maintaining sameness with schedules, etc?
Who has ritualistic preoccupations?
Who shows self-stimulatory behavior?
What are the 3 types of self stimulatory behavior?
SIBS (self injury)
What is an example of gross motor self-stimulating behavior?
What is an example of fine motor self stimulation?
T/F: 20% of those with autism do not have MR.
How common is MR in autistic kids?
60% have it
T/F: about 20% of kids with autism have mild MR.
Impaired social interaction, impaired communication, lack of eye contact, routines, rituals, and restricted patterns of behavior and interests are all common of what disorder?
T/F: the concordance rates for identical twins for autism are pretty high.
What is the problem with autism concordance rates?
they are dealing with a very small population of subjects
If you have autism, you are also likely to have what other two disorders?
What three parts of the brain are implicated in the neuroanatomical cause of autism?
medial temporal lobe
Which cells are more densely packed and smaller in the limbic system of a person with autism?
Where would you find a loss of cells in a brain of someone with autism?
in the cerebellum
What is the abnormality that is found in the medial temporal lobe of someone with autism?
the structure and function of the amygdala is messed up
T/F: the amygdala has implications in autism.
What are three other outside factors that increase the risk of autism?
age of mother and father
maternal illness during pregnancy
lack of folic acid before and after conception
What is the best treatment for autism?
ABA (applied behavioral analysis) -- behavioral intervention
What 3 things determine a better prognosis for children with autism?
discharge to trained parents
get them to learn language before age 5
Do most insurance companies cover the cost of ABA?
T/F: there are waiting lists for ABA treatments.
T/F: there are no programs set in place yet for adults with autism.
T/F: medications are not recommended for kids with autism or aspergers.
T/F: autism is not a life-long, chronic disorder.
false; it is
T/F: complete mainstreaming is unlikely for many who have autism.
How can you teach kids with autism to use language in a meaningful way?
teach them to describe objects
teach them to follow directions (receptive language)
make them ask for things
reinforce spontaneous speech
What types of verbal responses should rewards be given for in kids with autism?
verbalizations that follow a prompt
closer approximations to the therapist's words
imitating other sounds
How do you start language and communication therapy in ABA for autistic kids?
suppress behaviors that interfere with learning language (like SIBS)
Which disorder is sometimes misdiagnosed as OCD?
Who is often awkward and poorly coordinated?
Who lacks the ability to modulate the volume of their speech and may be hard to socialize with?
T/F: childhood onset schizophrenia is very rare.
Subcategories are not useful for children in which disorder?
What is the difference in age of onset between childhood onset schizo and adult onset schizo?
: comes by age 12
: comes in late adolescence
Which disorder has positive and negative symptoms?
childhood onset schizophrenia
What are some of the positive symptoms of childhood onset schizophrenia?
hallucinations (auditory most common)
disorganized or stiff (catatonic) behavior
What are some of the negative symptoms of childhood onset shizophrenia?
flat affect (emotion) and speech
diminished goal-directed activities
How long does DSM say a child must have symptoms to be diagnosed with schizophrenia?
What are the 3 phases of childhood onset schizophrenia?
T/F: the longer the prodromal phase, the harder the schizophrenia is to treat.
A child is socially awkward, stops bathing, and shows signs of becoming schizophrenic. What phase are they in?
prodromal phase (schizophrenia)
For at least one month, a child is not aware that they are disturbed. What phase are they in?
acute phase (schizophrenia)
What are some of the similarities that CO schizophrenia shares with autism?
abnormal speech patterns
impaired social relations
What are some differences between CO schizophrenia and autism?
age of onset
intellectual functioning is still good in schizo
decline in functioning for schizo
T/F: both children and adults experience auditory hallucinations in schizophrenia.
What is the most common hallucination in kids with schizo?
T/F: children without schizo also have a very high occurrence of hallucinations.
What kind of delusions do kids with schizo usually have?
T/F: delusions that kids have are similar to those that adults with schizo have.
What are some things that are wrong with children's thoughts with schizo?
loosening of associations
low content (impoverished meaning)
neologisms (made up words)
T/F: in childhood onset schizophrenia, non psychotic symptoms typically occur first.
Is the onset of childhood schizophrenia more likely to be sudden or gradual?
T/F: the majority of kids with schizophrenia will have a poor outcome.
What things will be likely to give kids with schizophrenia a good outcome?
an acute onset vs. gradual
good functioning before the onset
and it was caused by a certain event
Childhood onset schizophrenia is thought to be a _______ disease?
T/F: most of what we know about CO schizo is from children.
false; adults w/ the disease
What is CO schizophrenia thought to be caused by?
stressful life events (Diathesis Stress Model)
a prenatal insult to the developing brain
T/F: we are all "loaded guns" until life stress comes along and if it does we could become schizophrenic
What is the neurochemical evidence for schizophrenia?
overactivity of dopamine in the frontal lobe
Is dopamine more closely tied to the negative or the positive symptoms of schizophrenia?
What are the different theories of the problems going on with dopamine in schizophrenia?
1. slow reuptake keeps the dopamine in the synapses for a long time
2. too much dopamine is released
3. neurons that receive dopaminergic input are excessively sensitive to dopamine
What endorphin is thought to be involved with schizophrenia and why?
MAO (monoamine oxidase)
it affects the body's synthesis of dopamine
What is the neuroanatomical evidence for schizophrenia?
larger ventricles in brain=negative symptoms
frontal lobe= + symptoms
evidence is mounting that (-) symptoms are caused by brain damage
What is the genetic evidence for schizophrenia?
there is no doubt it is a genetic disorder, but not entirely
the more closely related you are, the higher the risk
twin, adoption, family pedigree studies have been done
How does the environment play into schizophrenia?
environmental risk factors:
stressful life events
Which disorder displays social drift and therefore genetic drift?
T/F: CO schizophrenia is higher when the mother has birth complications.
T/F: viral infections during pregnancy can cause CO schizo.
What is the seasonality effect and which symptoms does it produce in schizophrenia?
correlation with mother getting exposed to flu virus during 2nd trimester
Is the effect of flu virus on the fetus direct or indirect?
What is the current hypothesis on flu virus and how it causes CO schizophrenia?
the virus creates an immune system reaction that changes brain chemistry or wiring at key developmental stages in fetus
the mother's immune system is attacking the baby, not the actual flu virus
How much does the flu virus increase your risk of fetus having schizophrenia?
risk goes up 3 times
What are the goals of therapy for schizophrenia?
prevent return of symptoms
minimize side effects of meds
help them function more normally in society
What does treatment for schizophrenia usually require (3 things)?
T/F: the same drugs that work for treating adults also work for treating kids with schizophrenia.
Do you see more of a decrease in the (-) or the (+) symptoms when children with schizophrenia take meds?
dec. in (+) symptoms (hallucinations/delusions)
What is the main problem with kids taking meds for schizophrenia?
they are more prone to side effects regardless of the dose or length of use
must be monitored more closely
What disease is the opposite of schizophrenia?
How many kids with schizophrenia have to stop drug treatments?
What class of drugs is used to treat schizophrenia?
How do antipsychotics work?
they block dopamine receptors in the brain
Antipsychotics have been highly successful in treating the ____ symptoms of schizophrenia?
What is the primary side effect of neuroleptics/antipsychotics?
*drag feet when walk, shuffle
*tongue hangs out
What disorder is dystonia associated with?
What disorder is tardive dyskinesia associated with?
What are some secondary complaints/side effects of antipsychotic drugs?
excessive weight gain
sexual impairment in males
What kind of drug is thorazine?
What are some antipsychotics?
Abilify (an add-on)
What is the typical compliance rate for antipsychotics?
40-60% (norm for any drug)
What is the vital compliment to medications when treating schizophrenia?
long term care
T/F: group therapy is better for treating schizophrenia.
What are the different components of therapy for schizophrenia?
psychosocial rehab and skills training
What did people use to call learning disabilities?
minimal brain damage
What is the problem with the Education for All Handicapped Children Act?
there is no exclusion or inclusion criteria
each state has their own definition
What was the old term used to describe a language disability?
What term is used to describe a language disorder now?
"specific language disorder"
What is reception?
comprehension of communications sent by others
What is expression?
production of language
What comes first, expression or reception, in language?
What are the basic components of expression?
What is the sounds of language and the rules for combining them/
What is the actual production of speech sounds?
_____ is the formation of words, including the use of prefixes and suffixes to give meaning?
_____ is the organization of words into phrases and sentences?
What is the use of language in social contexts?
What are the 3 subtypes of language disorders defined by DSM?
_____ is the failure to use age-appropriate and dialect-appropriate speech sounds?
T/F: most kids outgrow phonological disorder.
_____ is diagnosed when scores from standardized measures of expressive language are substantially below scores for nonverbal intelligence and receptive language?
____ is diagnosed when a child has a problem with both phonological language and expressive language, and are given a nonverbal IQ test to rule our intellectual problems?
Which language disorder is most severe?
T/F: Boys outnumber girls for language disorders, but not for phonological ones.
What is the prevalence of language disorders in clinical vs. regualar population?
71% clinical vs. 5% for each type in real life
T/F: most kids outgrow language disorders by 6 or 7 years old and if not then, by adolescence.
What are some potential causes of language disorders?
ear infections during the first year of life
temporal processing deficit
*differences in the way that neurons fire in response to various sounds
Wha did people used to think was the underlying cause of stuttering?
When does stuttering peak?
5 years of age
T/F: stuttering has a sudden onset.
How long does stuttering usually take to onset?
T/F: some children do not outgrow stuttering.
Is stuttering more common in boys?
T/F: stuttering only occurs in low social classes.
false; all social classes
T/F: stuttering can be genetic.
T/F: stuttering is fairly rare
true; only about 1%
What is the treatment for stuttering?
tell child to stop talking when stuttering starts
teach parents to slow their speech
teach parents to remove the pressure of speech
What are the 3 types of learning disabilities?
T/F: learning disabilities are very common in childhood
T/F: learning disabilities are lifelong problems, but they tend to get better with age.
What is the most common learning disability?
How does DSM define a learning disability?
child's ability is substantially below the expected norm (2 STDs)
they may have an average IQ but in one area they struggle
struggle to pronounce words
low comprehension of what they read
T/F: kids with learning disabilities are likely to have other problems.
What are some other problems that kids with a learning disability might have?
social skill deficits
What is the dropout rate of kids with learning disabilities?
75% (3/4) of kids with ______ still have problems by the time they reach high school?
a learning disability diagnosed in elementary school
What is the neurobiological cause of learning disabilities?
planum temporale in the brain is the same size on both right and left sides in kids with a reading LD
in normal kids, the left side is larger
When do these abnormalities in the left hemisphere occur in the brain of a child with LD?
between the 5th and 7th months of fetal development
What are the 2 types of treatment for learning disabilities?
Code Emphasis Approach
Whole Language Approach
The ______ approach to LDs focuses on decoding words and recognizing words. It works from the bottom up.
The ________ approach starts from the top down and the child learns entire words and ideas.
T/F: the best treatment for a child with an LD is to use both approaches.
What are the research supports for the Code Emphasis approach?
kids show gains in achievement
What are the research supports for the Whole Language approach?
child's attitude towards reading improves
According to DSM, what do you have to have to be diagnosed with Tourette's?
multiple motor tics
at least one vocal tic
tics may occur many times a day, everyday, for more than 1 year
T/F: both motor and vocal tics in Tourette's are involuntary.
What are the premovement potential studies?
: show a lack of neuronal activity prior to a tic
proves that tics are completely involuntary
but stress seems to increase the tics
What is the most common vocal tic?
What is palilalia?
repeating one's own last words, phrases or sentences
What is coprilalia?
saying inappropriate things
only 15% suffer this
What is echolalia?
repeating someone else's last words, phrase or sentence
T/F: the symptoms of Tourette's tend to disappear when the individual is focused.
T/F: the symptoms of Tourette's tend to wax and wane.
What disorder does Tourette's have a high comorbidity with?
What is the average age of onset for Tourette's?
7 years old
T/F: the symptoms of Tourette's might decrease in adolescence/adulthood.
T/F: it is fairly common to carry the gene for Tourette's but not display it. (1/200)
T/F: chronic tic disorder (partial expression)is more common than the complete form of Tourette's.
Is Tourette's more common in boys or girls?
T/F: Tourette's is found in all races, but not across all social classes.
false; found everywhere!
Which disorder is autosomal dominant?
What is penetrance?
30% of females with the TS gene don't show any symptoms
1% of males with the TS gene don't show any symptoms
So, we don't know what makes it penetrant into the male phenotype
What is thought to be the main cause of Tourette's?
T/F: the gene for Tourette's is found on a sex chromosome.
What is the main treatment for Tourette's?
to reduce tics:
---they don't get rid of the tics, they only dampen them
T/F: if someone has minor tics, they probably don't need any treatment.