Disorders in Children and Elderly

• Many children experience emotional and behavioral problems as they develop
• Bullying


  • A significant concern, affecting 20% of students frequently and 50% at least once
• Some disorders are similar to adult counterparts (e.g., anxiety, depression)
• Other disorders are unique to childhood (e.g., elimination disorders)
• Enuresis (Bed-Wetting)


  Repeated involuntary or intentional bedwetting or wetting of clothes
• Encopresis (Soiling)


  Defecation into clothing
• Neurodevelopmental Disorders


  Disabilities in brain functioning that emerge at birth or early childhood, affecting behavior, memory, concentration, and learning
• Attention-Deficit/Hyperactivity Disorder (ADHD)


  • Difficulty attending to tasks, hyperactivity, impulsivity
• Co-Occurring Problems of ADHD: Learning/communication issues, poor school performance, social difficulties, misbehavior, mood or anxiety problems
• Causes of ADHD


  • Biological (dopamine activity, brain abnormalities)
  • Stress
  • Family dysfunction
• Treatment for ADHD


  Drug therapy (methylphenidate), behavioral therapy, combination approaches
• Autism Spectrum Disorder (ASD)


  • Unresponsiveness to others, uncommunicative, repetitive, rigid behaviors
• Onset of ASD: Before age 3
• Prevalence of ASD: 80% of cases in boys
• Long-Term Outcomes of ASD: Significant disability for many individuals
• Symptoms of ASD


  • Lack of responsiveness
  • Social reciprocity
  • Language/communication problems (echolalia, pronominal reversal)
• Causes of ASD


  • Sociocultural: Lack of research support for family dysfunction as a cause
  • Psychological: Theory of mind deficits
  • Biological: Genetic factors, cerebellar abnormalities
• Treatments for ASD


  • Cognitive-behavioral therapy
  • Communication training
  • Parent training
  • Community integration
  • Sometimes psychotropic drugs
• Intellectual Disability


  Significantly below-average intellectual functioning (IQ 70 or lower) and impaired adaptive behavior (communication, home living, self-direction, work, safety)
• Onset of Intellectual Disability: Before age 18
• Intelligence Tests


  Measure intellectual functioning, but validity and sociocultural bias are concerns
• Features of Intellectual Disability

  • Slow learning: Most consistent sign
  • Other difficulties: Attention, short-term memory, planning, language
• Levels of Intellectual Disability

  • Mild (IQ 50-70): Most common, improve with age
  • Moderate (IQ 35-49): Can care for themselves, benefit from vocational training
  • Severe (IQ 20-34): Need supervision, basic work skills, rarely live independently
  • Profound (IQ below 20): Require very structured environments
• Causes of Intellectual Disability

  • Biological: Primary cause of moderate, severe, and profound ID
  • Chromosomal: Down syndrome, fragile X syndrome
  • Metabolic: Phenylketonuria (PKU), Tay-Sachs disease
  • Prenatal and Birth-Related: Maternal health problems, alcohol use, birth complications
  • Childhood Problems: Poisoning, head injury, infections (meningitis, encephalitis)
• Interventions for People with Intellectual Disability


  Provide comfortable and stimulating residences, social and economic opportunities, education
• Educational Programs for Intellectual Disability: Special education vs. mainstream classrooms, teacher preparedness
• Therapy for Intellectual Disability


  Individual or group therapy, sometimes psychotropic medication for emotional/behavioral problems
• Old Age


  Over 65 years
• Population of elderly is growing, with more women than men
• Unique Challenges of Old Age

  • Pressures
  • Upsets
  • Biological changes
• Psychological Problems of the Elderly

  • Depression
  • Anxiety
  • Substance use disorders
  • Delirium
  • Mild neurocognitive disorders
  • Major neurocognitive disorders
• Normal Cognitive Changes with Age: Memory lapses, attention difficulties increase
• Neurocognitive Disorders


  Significant decline in cognitive functioning with organic roots (brain disease or injury)
• Delirium


  • Clouding of consciousness, difficulty concentrating, attention problems, misinterpretations, illusions, hallucinations
• Onset of Delirium: Rapid, hours or days
• Prevalence of Delirium: More common in the elderly, especially those over 85
• Causes of Delirium


  • Fever
  • Disease
  • Infection
  • Poor nutrition
  • Head injury
  • Stroke
  • Stress
  • Substance intoxication
• Major Neurocognitive Disorder


  • Substantial decline in cognitive functioning, interfering with independence
• Mild Neurocognitive Disorder


  • Modest decline, not affecting independence
• Alzheimer's Disease


  Most common form of neurocognitive disorder, affecting 5.8 million in the US