Developmental Psychology Lecture Notes PDF

# Developmental Psychology Lecture Nine - Atypical Development - Neurodevelopmental Disorders ## Learning Objectives - Explain classification of developmental psychopathology, with reference to DSM-5 - Explain the general diagnostic approach to neurodevelopmental disorders - List the key diagnost...

# Developmental Psychology Lecture Nine - Atypical Development - Neurodevelopmental Disorders ## Learning Objectives - Explain classification of developmental psychopathology, with reference to DSM-5 - Explain the general diagnostic approach to neurodevelopmental disorders - List the key diagnostic features of ASD, ADHD, SLD, and DCD ## Typical Development - Has a child developed by a certain age? - How proficient are they at a certain skill for their age? > A representative sample of 7-year-olds rank-ordered score (out of 100) on a test of Arithmetic ability - if a child's score ranks them above the 50% centile e.g. 16 (i.e. they're outperforming 5 out of 10 of their peers) ## Atypical Development - Has a child developed by a certain age? - How proficient are they at a certain skill for their age? > A representative sample of 7-year-olds ranked-order score (out of 100) on a test of Arithmetic ability - if a child's score ranks them below the 10% centile e.g. 3 (i.e. a score below a threshold that at least 1 in 10 of their peers can meet) ## Critique of the Notion Typical/Atypical Development - Contemporary view that acknowledges that childhood is not fixed and is not universal, but instead mobile and shifting (Walkerdine, 2004) - Traditionally developmental psychology has focused on individual development as a natural progress towards adulthood - This 'natural progress' is conceived as the same for all children regardless of class, race, or gender - This is a traditional, Western view of childhood development, but is then applied to children all over the world - Over 95% of literature originates from the US (Fawcett, 2000) - Much is written by men or from a male perspective - Walkerdine (1993) argues that so-called 'scientific psychological truths' about child development need to be understood in terms of the historical circumstances in which the knowledge was generated ## Alternative Views on Child Development - Movement towards seeing childhood as an adult construction that changes over time and place - Child development seen not as a fact, but as a cultural construction (MacNaughton, 2003) - Dahlberg et al. (2007) argue that when we describe a child's development, we are describing our cultural understandings and biases, and not what exists in fact - It can be argued that traditional child development theory has contributed to the oppression and exploitation of children - Due to the process of judging 'atypical development' as inadequacies or weaknesses, rather than as 'alternative ways of knowing' ## Atypical Development Due to Delay or Disorder - Environmental factors (context) - Neurobiological factors that make a child vulnerable to finding certain aspects of their development more challenging (e.g. genetic, neurological) ## When Does Atypical Development Constitute a 'Disorder' Exactly? > "Any condition characterised by cognitive and emotional disturbances, abnormal behaviours, impaired functioning, or any combination of these. Such disorders cannot be accounted for solely by environmental circumstances and may involve physiological, genetic, chemical, social, and other factors. Specific classifications of mental disorders are elaborated in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) ..." - APA Dictionary ## What Is DSM-5? - The taxonomic and diagnostic tool published by the American Psychiatric Association - Serves as the principal authority for psychiatric diagnoses - Treatment recommendations are often determined by DSM classifications - The first edition was from 1952 - Currently on the fifth edition (2013) ## Common Features of Neurodevelopmental Disorders Within DSM-5 1. They are 'developmental' disorders, and are first evident in childhood 2. They result in impairments in activities of daily living (behaviours create difficulties educationally/socially) 3. Difficulties persist over time and contexts (difficulties aren't better explained by external environmental factors) ## DSM-5 - Developmental Disorders - Genetic factors are thought to play a role in the aetiology (the cause) of all neurodevelopmental disorders, but these are diagnosed according to behavioural profile > Genotype → Neurological Development → Cognitive Development → Behavioural Phenotype ## Developmental Disorders - Can be broadly categorized into three groups - Learning difficulties - Autism - Attention deficit/hyperactivity disorder (ADHD) ## Learning Difficulties Aka General Learning Disability - Refers to conditions where the defining characteristic is one of significant impairment of intellectual functioning - There's been a shift in terminology over the decades away from prejudice-laden terms - Typically refers to developmental disorders where the onset occurs before 18 years old - excludes onset caused by trauma or neurological illness - Refers to individuals who experience general difficulties in acquiring new skills - knowledge associated with an IQ of below 70 - IQ is seen as a marker of the potential to learn, as well as cognitive ability - E.g. down's syndrome; foetal alcohol spectrum disorder; and fragile x syndrome ## Specific Learning Difficulties (SpLD) - Demonstrates variable ability to learn with good to high scores on many skills, but marked deficits in specific areas (e.g. reading and writing) - If already diagnosed with a learning difficulty, then a SpLD cannot also be diagnosed ## DSM-5 Recognizes Four Specifiers for SpLD  - Reading - Spelling - Writing - Mathematics - Specifiers encompass what were previously discrete diagnoses in DSM-IV - Dyslexia primarily affects word reading and spelling - Dysgraphia affects written expression - Dyscalculia affects maths learning ## Autism Spectrum Disorder - DSM-5 combined multiple previous diagnoses with ASD - Asperger's Syndrome - 'Classic' autism - DSM-5 also organized a 'Triad of Impairments' that were previously proposed in DSM-IV ### DSM-IV TR - Required Deficits in 3 Areas - Social interaction - Communication - Restricted and repetitive stereotyped behaviour ### DSM-5 - Characterized by deficits in 2 Domains  - Social communication and interaction (each of three areas) - Restricted and repetitive behaviour, interest, and activities (two of four areas) - And acknowledged sensory differences as a behaviour within the second domain ## Treatment and Support - Within DSM-5 three functional levels are identified for ASD - Level 1 - requiring support - Difficulty initiating social interactions - Organisation and planning problems can hamper independence - Level 2 - requiring substantial support - Social interactions limited to narrow special interests - Frequent restricted/repetitive behaviours - Level 3 - requiring very substantial support - Severe difficulties in verbal and non-verbal social communication skills - Great distress/difficulty changing actions or focus - Diagnosis at levels 1 and 2 is more difficult, which can delay support - A more 'joined-up' approach from health and education professionals may aid earlier diagnosis though ## Attention Deficit Hyperactivity Disorder - In DSM-5 ADHD is assessed across two behavioural dimensions - Hyperactivity and impulsivity - Inattention - Which defines three specifiers at diagnosis (but these are not sub-types of ADHD) - DSM-5 was the first time ADHD was classified as a neurodevelopmental disorder - This separated ADHD, for the first time, from Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD), which were classified under "Disruptive, Impulse Control and Conduct Disorders" ## Treatment and Support for ADHD - Psychostimulant medications - methylphenidate (and others) are suggested to be capable of - Reducing disruptive behaviour - Reducing aggression - Improving interaction with parents, teachers, and peers - Improving goal-directed behaviour and concentration - Behaviour therapy - parental training and/or classroom management programmes - That reinforce appropriate behaviours - Adapt activities for individuals (e.g. more breaks, brief assignments) - Alternative therapies? - Combined treatment  ## Early Intervention - It is increasingly recognized that the earlier support is available to children and families, the greater the positive benefit they will derive - Early intervention can come from health services, education, or other areas - A lot of work was done in the 2000s to create joined-up services connecting these areas - children's centres were built as 'one-stop shops' - Much of this was dismantled by the Conservative government in the 2010s - Leeds ADHD clinic now has a 10-year waiting list ## Summary - We've debated what is ‘atypical development' and considered its limitations as a concept - Looked at the difference between Learning Difficulties and Specific Learning Difficulties - Discussed how DSM-5 categorises and diagnoses SpLDs, ASD, and ADHS, and examined how these have been reclassified and organised over time