_Disorders品行障碍课件.ppt

Causes Most cases—no clear cause Only 25% known organic cause 30-40% have no id’d cause Familial risk No ID in parent, 1 ID sib—13% 1 ID parent-20% 2 ID parents—42% 2 groups of causes Organic or pathological—more commonly severe or profound Cultural-familial—mild ID Genetic and Constitutional Factors Chromosomal anomalies—Prader-Willi; Klinefelters (XXY); Turners (XO); Fragile X Fragile X—mostly males are affected—females are carriers.. Down Syndrome—1/1000 births—trisomy 21 in 95% of cases Occurrence increases with maternal age—rarely due to fathers Almond-shaped eyes that slant up Facial flatness, thick tongues, broad hands and feet, poor muscle tone, increased risk for heart and hearing problems IQ is usually moderate to profound, but occasionally higher; M around 50 Social skills are usually high Smiling is delayed—less frequent, less intense than other infants Less fear at visual cliff Developmental changes Families and Down—most families cope adequately, but worry about the future—doesn’t disrupt family life Other Organic Causes Single-gene inheritance PKU—phenylketonuria—recessive gene Prenatal and birth complications— Drugs or injury Syphilis Rubella (German measles) in first trimester Radiation in first few mos of pregnancy Age at pregnancy (over 35) Severe emotional stress throughout pregnancy Chronic alcoholism Anoxia 5/1000—20% of these are adversely affected Premature babies—associated with neurological insults Postnatal Seizures Head injury Encephalitis/meningitis Malnutrition Lead/mercury poisoning Psychosocial and Cultural Influences Severe social isolation Educationally deprived parents Parenting practices Treatment Behavioral—single most important innovation in the tx of ID Individual tx for behavior problems, also family tx Cognitive-behavioral—self-instructional training Medication—won’t change ID. Can alleviate problems that go with ID. In home vs out of home care Families are content with whatever decision they make Reasons for placemen