Lesson 1: Common Childhood Disorders
| Site: | MoodleHUB.ca 🍁 |
| Course: | Abnormal Psychology 35 RVS |
| Book: | Lesson 1: Common Childhood Disorders |
| Printed by: | Guest user |
| Date: | Sunday, 14 September 2025, 2:06 AM |
Section/Lesson Objectives
The student will ...
• Understand and describe the three common childhood disorders discussed in the course. [This lesson]
• Discuss the possible causes of Tourette syndrome, autism, and attention deficit hyperactivity disorder. [This lesson]
• Discuss how dissociative disorders develop
• Explain the unique nature of synesthesia
• State the difference between correlation and causation
• Understand the effects of confounding factors in relationships
• Compare and contrast the various treatment methods discussed in the course
• Understand and describe the concept of perceptual blindness
• List the major mental illnesses that Albertans suffer from and state the prevalence of such illnesses in the general population
Introduction
Although certain mental illnesses are rare in children (e.g., schizophrenia, Munchausen syndrome, delusional jealousy), others are common. Some of these disorders, described in this section, are Tourette syndrome, autism, and attention deficit hyperactivity disorder.
Tourette Syndrome
Tourette syndrome is considered a disorder of childhood because the average age of onset occurs before the individual is eight years-old. The most common symptoms of this disorder are facial tics and vocal tics. These behaviours are often repeated in rapid succession for short periods. Tics are not always active in individuals, but they may reappear or worsen during times of stress or fatigue.
This disorder is inherited (genetically linked) and, although there are treatments, there is no cure. Symptoms of this neurological movement disorder may persist through an individual’s life or, as in about 25% of cases, symptoms may disappear before the individual reaches his or her 30th birthday. Tourette syndrome is not linked to a shortened lifespan, intelligence, or race/ethnicity. It is, however, more prevalent in males than females.
Table 1.1: Examples of Tics Experienced in Tourette Syndrome
|
Motor Tics |
Vocal Tics |
|
- shoulder shrugging |
- sniffling |
Video: What Makes you Tic?
Not everyone who has motor or vocal tics has Tourette syndrome. Some tics are the result of encephalitis, medication side-effects, or brain injury. If there is no evidence or history of brain trauma or encephalitis, and tests (MRI, EEG, CT, blood) do not indicate any other disorder, a diagnosis of Tourette syndrome may be made. Regarding Tourette syndrome, however, symptoms must persist for at least 12 months. In addition to tics, symptoms of Tourette syndrome may include impulsivity, obsessive behaviour, hyperactivity, and depression.
Case Study 20: Tourette Syndrome
|
Description Jonas, a middle-aged man, sought help for unrelenting tics. In his youth, the first tic developed was a eye-blinking tic, but lip-smacking, head tilting, and barking tics soon followed. In spite of these manifestations, Jonas did graduate from high school with honours. Shortly after graduation, Jonas was drafted into the US army. Although his tics were somewhat manageable during this period, he was eventually discharged from duty for medical reasons. Shortly after, Jonas found a job, got married, and started a family. By the time Jonas was 30 years-old his symptoms included head tilting, shoulder shrugging, hitting his forehead with his hands, throat clearing, spitting, and “la, la, la, hey, hey, hey” vocalizations. He even began inserting obscenities in the middle of sentences (coprolalia) when speaking. Jonas tried a variety of treatments to help alleviate his symptoms (insulin shock therapy, electroconvulsive therapy, and drug therapy), all to no avail. Eventually Jonas began to avoid public gatherings (such as church services, the movies) because his cursing and motor tics embarrassed him. He switched to the night shift at his job to reduce social embarrassment. Also, Jonas’s children stopped bringing their friends over to the house because of their discomfort surrounding his behaviour. Understandably, Jonas complained of isolation and depression. He requested a prefrontal lobotomy in the hope that the drastic measure would give him some relief from his symptoms. Although his request was denied, he was given a referral to a specialized treatment facility. |
Diagnosis Jonas met the required criteria for Tourette syndrome: the onset of his symptoms occurred before he was 21, he displayed multiple motor tics and at least one vocal tic, and the tics occurred regularly for more than one year. Although his depression might have beeen linked to a second disorder, it is better thought of as a consequence of his long-term suffering. His DSM diagnosis for Axis I is Tourette syndrome. Follow-Up Jonas was prescribed haloperidol (1mg/day) which almost completely eliminated his symptoms. His depression dissipated and he was able to participate in normal social activities again. Eighteen years later, Jonas remained almost symptom free! |
Insulin Shock Therapy
Insulin shock therapy, also known as insulin coma therapy, was first used in the early 20th century as a physiological treatment for schizophrenia. The procedure involves giving increasing amounts of insulin (a hormone used to regulate blood glucose levels) to a patient daily until the patient goes into hypoglycemic coma. The coma is caused by an acute lack of glucose in the blood.
4 - Prefrontal Lobotomy
A prefrontal lobotomy is an operation in which the frontal lobes of the brain are severed from the deeper centres beneath them. This drastic operation, once believed to be an effective treatment for schizophrenia, results in permanent brain damage. The true story movie on the life of Frances Farmer details how a lobotomy can affect an individual.
Autism
Autism, a developmental disorder, is often diagnosed in individuals before the age of four. The main symptoms include difficulties with communication, problems with social interaction, and the repetition of motor actions such as rocking back and forth. Although many individuals suffering from autism are classified as moderate intellectual disability, some attend school with other children in their age group. Also of interest, individuals suffering from autism may exhibit exceptional skill or brilliance in some limited field, such as mathematics or music. In these rare cases, such individuals are called savants. Symptoms of autism vary significantly from individual to individual.
Video: Autistic Girl Expresses Unimaginable Intelligence
Table 5.1: Symptoms of Autism
|
Area |
Symptoms |
|
Communication |
- not speaking often, if at all |
|
Social Interaction |
- not understanding the facial expressions of others |
|
Motion |
taking pleasure in repetitive motions (such as watching hands move back and forth, sniffing objects, rocking back and forth) |
Video: Temple Grandin (Grandin is an expert and spokesperson on autism....she is also autistic). Watch this clip from a movie where she is portrayed.
The cause of autism has yet to be determined. Research indicates that it can be more than one factor that causes autism. Genetics are thought to play a role in the development of the disorder. In identical twins, the chance of an identical twin having autism if their twin has it is 77%. The chance of a fraternal twin having autism if their twin has it is 31%. This could indicate that perhaps the twins had exposure to something common in the womb. The chance of a sibling having autism if their brother or sister has it is 20%. This data demonstrates that there is a genetic link. There are 200-400 genes that can cause autism which explains the broad spectrum of symptoms.
Other things that have been linked to autism are advanced paternal age, exposure to dangerous agents when the fetal brain is being developed, and mutations in the egg or sperm that occur at conception. There is a misconception that vaccines cause autism. This has been proven to be untrue.
To date, there is no cure for autism. However, early diagnosis can be instrumental in providing the child with the care they need to best manage the symptoms. Drug therapy can be used. Many individuals will spend their lives in special care homes and almost half of the people with autism will never talk. Scientists are working on improving some of the medications used to treat the symptoms, but much research has yet to be completed. What scientists have learned so far is summarized below.
|
- autistic people have larger ventricles and cerebrums (parts of the brain) than non-autistic people |
Video: Wendy Chung (what we know...and what we don't know yet)
In one case about a boy named Giulio (summarized from the Edmonton Sun - June 2003), a special diet was followed to improve symptoms of autism. When Giulio was five years old, his parents sought help from a doctor regarding his unusual behaviour. For instance, Giulio insisted on wearing the same shirt every day. When his shirt was being washed, he would wait in the laundry room until it was ready for him to wear. Giulio was also hypersensitive to loud noises, did not want to play with other children his age, and liked to watch the motion of turning wheels. Giulio was, consequently, diagnosed with autism.
While Giulio’s parents were told to focus their concentration on speech and behavioural therapy, they employed a far broader range of treatment methodologies including a diet free from gluten and casein. About two months after his parents began treating his symptoms, Giulio was able to speak in full sentences. Many other symptoms were also eliminated - Giulio’s future looks promising. Because autism is a complex disorder and because it affects people differently, using an eclectic (multi-disciplinary) approach to treatment may be most effective. Please see Case Study 21 for an additional example of autism.
Case Study 21: Autism
|
Description The parents of Heinrick, a three and a half year-old boy, consulted a doctor regarding the odd behaviour of their son. As a baby, Heinrick did not respond to social contact or “baby” games (unlike his younger sibling) and was aloof from others. Although his appearance was normal and his motor development age-appropriate, Heinrick had no interest in other children and ignored his parents. If he were in the care of an adult other than his parents, he would scream most of the time. Heinrick did not speak much, but when he did, the content was a repetition of what others had said – usually mimicking the same accent and style of speech of the original speaker. Heinrick did not use hand gestures or facial expressions when communicating. Also of interest, bright lights and rotating objects captivated Heinrick – he would stare at them and laugh, flap his hands, or dance. This behaviour was also observed when he was listening to music. The only toy that interested Heinrick was a toy car. He would hold this car in his hand constantly but did not “play” with it or any other toy. When he put a jigsaw puzzle together he would use one hand only – keeping the toy in the other hand. He could arrange the puzzle quickly, however, and it did not matter if the picture side was exposed or not. Heinrick also loved to arrange kitchen utensils in patterns over the floors in his house. If one of his parents tried to take the |
toy car away from him or remove a spatula from his patterns of utensils in the kitchen, Heinrick would throw a temper tantrum. Although the pregnancy was uneventful, Heinrick’s delivery was complicated and he required supplemental oxygen at birth. At first, it was thought that Heinrick might have a hearing disability, but this was ruled out because of his accurate echoing, his capacity to be soothed with music, and his ability to hear candy being unwrapped in another room. According to test results, Heinrick had a mental age of three in non-language skills but only one and a half years in comprehension. Diagnosis Heinrick had little interest in playing with other children. It was also obvious that he lacked skills in the area of social interaction and communication. His speech was restricted and often just repetition of what others said. Heinrick did not engage in imaginative play and the activities that he did do (jigsaw puzzles and arranging kitchen utensils) were repetitive. Also, he became extremely distressed if anyone interfered with these activities or his other routines. Heinrick’s DSM diagnosis for Axis I is Autistic Disorder. |
Attention Deficit Hyperactivity Disorder
Attention deficit hyperactivity disorder (ADHD) is a condition characterized by an unusually short attention span, problems with impulsivity and/or hyperactivity, and heightened distractibility. Although many children experience these symptoms occasionally, a child suffering from ADHD experiences these symptoms much more frequently. Because of this, individuals with ADHD often have difficulty in school as well as with social interaction in general.
It is estimated that 4-6 percent of young people between the ages of 9 to 17 have ADHD. In adults, 
approximately 2.5 percent of the population has ADHD. Boys are two to three times more likely then girls to develop ADHD. Some children with ADHD experience a reduction in symptoms later in life although others remain socially and educationally disadvantaged into adulthood.
Approximately 50% of ADHD cases can be explained by genetics. However, other causes or contributing factors could include:
- exposure to toxins (such as lead)
- injuries to the brain
- delayed brain maturation
ADHD can be classified into three types based on an analysis of the two main groups of symptoms – inattention and impulsivity/hyperactivity. Please see Table 7.1 for a analysis of the two groups, and table 7.2 for descriptions of the three types of ADHD. For a diagnosis of ADHD to be made, there must be symptoms from each of the clusters below plus a duration of six months where the individual demonstrates maladaptive behaviours and trouble functioning at a level that is that is consistent with their level of development.
Table 7.1: Cluster Symptoms of ADHD
|
Inattention Symptoms |
Impulsivity/Hyperactivity Symptoms |
|
- failure to give close attention or many careless errors in work requiring sustained attention (such as school work) |
Hyperactivity: - fidgets or squirms while seated. Impulsivity: - blurts out comments or answers to questions before he/she should |
Table 7.2: Types of ADHD
|
Types
|
Description
|
| Primarily Inattentive Type (sometimes referred to as attention deficit disorder or ADD) |
most common form of ADHD seen in schools - majority of symptoms fall into the inattentive group - daydreaming is common in children with this form of ADHD - children are not overly impulsive |
| Primarily Impulsive/ Hyperactive Type |
least common form of ADHD - this form of ADHD is characterized by excessive movement and low impulse control - inattention is not usually a problem |
| Combined Type | - most common form of ADHD observed in clinics - includes symptoms from both groupings in table 7.1. |
Video: ADHD: What is it and what's the Difference with ADD?
Symptoms of ADHD range from mild to severe, but for any diagnosis of ADHD to be made, the following questions must be answered positively (with a “yes”).
| 1. Did some of the problems begin before the age of seven and have the problems continued over time? 2. Do the symptoms and behaviours damage the child’s educational or social functioning? 3. Are the problems encountered affecting the child’s achievement in more than one setting (such as school and home)? |
In addition to general educational and social problems, individuals with ADHD may experience difficulties and behaviour problems including, but not limited to the following:
| - low self-esteem - depression - defiance of authority figures - negativism - anxiety - aggression - lying |
The cause of ADHD has not yet been determined. What has been learned, however, is that boys are more likely to have ADHD than girls. Regarding treatment, behavioural modification in conjunction with medication is recommended. Treatment is usually long-term and requires parents, teachers, and health care professionals to work together with the child. For an example of ADHD, please review Case Study 22. |
For further information on ADHD please refer to the web site below:
 |
Case Study 22: Attention Deficit Hyperactive Disorder
|
Description On the advice of a pediatrician, a distraught mother, Betty, brought her seven year-old daughter, Kayla, to a medical centre for assessment. Betty was unable to control her daughter’s behaviour. It was learned that Kayla had temper tantrums, hurled objects across the room, stole, swore, repeated what was said to her (echolalia), grunted, and “talked back” to her mother. As a baby, Kayla cried when she was picked up and, at six months of age, had a febrile seizure. By the time Kayla was three, she talked almost constantly and could not sit still. When placed in school, she was unable to remain in her seat and concentrate. She disobeyed the teacher, played pranks on the teacher, and began to lie. By the time Kayla reached grade three, she had acquired the vocal tic of grunting, was behind in her academic skills, and often had bad dreams and difficulty sleeping. Kayla did not finish what she started (at school and at home) and needed constant supervision. She was easily distracted and did not listen to instructions - often acting before thinking about the potential consequences of her behaviour. Betty did not know how to deal with Kayla. Kayla purposefully disobeyed her mother and blamed other people for her actions. It was learned that Kayla came from a very dysfunctional family. Her father was killed while attempting to murder another person, her mother had grunting tics and was poorly educated, her uncle was an alcoholic who beat his wife, |
her younger brother had vocal tics and hyperactivity, and her maternal grandfather had tics, beat his wife, and consumed alcohol excessively. Also, during childhood, Betty had been molested by her father - Kayla’s grandfather. Diagnosis Kayla exhibited many negative behaviours. Her vocal tics (grunting, echolalia) suggest Tourette syndrome, but without many motor tics, a more appropriate diagnosis is vocal tic disorder. Her swearing may be linked to this disorder. As for her other behaviour problems, the symptoms (fidgeting, distractibility, excessive talking, lack of concentration, difficulty remaining seated, inability to complete projects, difficulty focusing on instructions) suggest attention deficit hyperactivity disorder. The level of severity regarding this disorder can be considered moderate because of social and school-related difficulties. Because Kayla displayed the required minimum number of symptoms for oppositional defiant disorder (being quick to lose her temper, arguing with adults, and blaming others for her mistakes), her diagnosis also included this disorder. Kayla’s DSM summary is as follows: Axis I: Chronic Vocal Tic Disorder Attention Deficit Hyperactivity Disorder, Moderate Oppositional Defiant Disorder, Moderate |
Lesson Review
|
To summarize:
|