Neurodevelopmental Disorders and Psychotic Disorders

Introduction
In this unit, you will learn about disorders that typically manifest early in life, often before a child enters grade school. The neurodevelopmental disorders include intellectual disabilities, autism spectrum disorder (ASD), communication disorders, attention deficit hyperactivity disorder (ADHD), specific learning disorder, and motor disorders. This unit also explores the schizophrenia spectrum and other psychotic disorders.
Neurodevelopmental Disorders
Children can be diagnosed with many of the disorders found throughout the DSM-5, including depressive disorders and anxiety disorders. However, it is necessary to use different criteria for diagnosing some of these disorders in children and adolescents. For example, in the diagnosis of a major depressive episode, a child might express irritability rather than sadness; in the diagnosis of a social anxiety disorder, the child’s fear may be expressed by crying or tantrums.
When evaluating a child, it is important to consider the larger systems that impact his or her behavior, including the family the child lives with, school and classroom environments, neighborhood or social community, and the influence of the medical system’s approach to defining and treating presenting symptoms. The child’s sociocultural background (religion, language, values, and beliefs) also plays a significant role. Factors such as adequate housing and nutrition, health, safety, and access to social services should all be considered carefully.
A child’s evaluation and diagnostic information may sometimes become part of his or her permanent medical and school records; these could have an impact on how others will view the child in the future. Therefore, it is extremely important to take the time to complete a thorough assessment of a child. Observing the child in more than one setting and obtaining permission to interview others who interact with the child on a regular basis (such as relatives, other caregivers, teachers, and physicians) can provide valuable perspectives. Treatment planning usually involves working with the child in individual or group counseling sessions but often includes counseling sessions with the child’s family as well.
Psychotic Disorders
The psychotic disorders include schizophrenia, schizoaffective disorder, schizophreniform disorder, delusional disorder, schizotypal disorder, and brief psychotic disorder. Take some time to become familiar with the key symptoms typically seen in psychotic disorders:
• The positive symptoms of schizophrenia (hallucinations, delusions (bizarre and nonbizarre), and disorganized thinking and behavior).
• The negative symptoms of schizophrenia (affective flattening, alogia, and avolition).
You will find definitions and examples of these terms on pages 817–831 in the chapter “Glossary of Technical Terms,” from the Appendix of the DSM-5.
As with the other disorders included in the DSM-5, it is important to understand a client’s unusual symptoms (such as hearing voices of spirits or having a vision of a deceased relative) within his or her own cultural and religious belief system. Strongly held beliefs seen as delusional within one sociocultural group may be thought of as normal in another. The DSM-5 includes a good discussion of this under the topic “Cultural Concepts of Distress” (starting on page 758, in the chapter “Cultural Formulation” from Section III) and in the chapter “Glossary of Cultural Concepts of Distress,” pages 833–837, from the Appendix.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
Nolen-Hoeksema, S. (2014). Abnormal psychology (6th ed.). New York, NY: McGraw-Hill.

Objectives
To successfully complete this learning unit, you will be expected to:
1. Discuss the diagnosis of mental disorders in children.
2. Develop a DSM-5 diagnosis for a child.
3. Discuss the impact of larger systems on the diagnosis and treatment planning process with children.
4. Explain the diagnosis of attention-deficit hyperactivity disorder from two theoretical models.
5. Discuss the impact of sociocultural factors on the assessment and diagnosis of childhood disorders.

Learning Activities
Unit 3 Study 1
Studies Readings
Use your Abnormal Psychology text to read pages 284–294 from Chapter 10, “Neurodevelopmental and Neurocognitive Disorders.” The other sections in this chapter are optional readings.
Use the library to read one of the following articles:
• Johnston and Mash’s 2001 article, “Families of Children With Attention-Deficit/Hyperactivity Disorder: Review and Recommendations for Future Research,” from Clinical Child and Family Psychology Review, volume 4, issue 3, pages 183–207.
• Kaslow, Broth, Smith, and Collins’s 2012 article, “Family-Based Interventions for Child and Adolescent Disorders,” from Journal of Marital and Family Therapy, volume 38, issue 1, pages 82–100.
DSM-5 Review
Review the main diagnoses for the following from Section II:
• From the chapter “Neurodevelopmental Disorders”:
o The introduction, pages 31–33.
o The ASD and ADHD diagnoses, pages 50–65.
You may optionally read the other material in this chapter.
• “Schizophrenia Spectrum and Other Psychotic Disorders,” pages 87–110. You may optionally read the other material in this chapter.
Optional – Readings
Unit 3 – Neurodevelopmental Disorders and Psychotic Disorders
Brown, R. T., Antonuccio, D. O., Dupaul, G. J., Fristad, M. A., King, C. A., Leslie, L. K., . . . Vitiello, B. (2008). Oppositional defiant and conduct disorders. In Childhood mental health disorders: Evidence base and contextual factors for psychosocial, psychopharmacological, and combined interventions (pp. 33–41). Washington, DC: American Psychological Association.
Cook–Cottone, C. (2004). Childhood posttraumatic stress disorder: Diagnosis, treatment, and school reintegration. School Psychology Review, 33(1), 127–139.
Ecklund, K., & Johnson, W. B. (2007). Toward cultural competence in child intake assessments. Professional Psychology: Research and Practice, 38(4), 356–362.
Emde, R. N. (2006). Culture, diagnostic assessment, and identity: Defining concepts. Infant Mental Health Journal, 27(6), 606–611.
Havey, J. M., Olson, J. M., McCormick, C., & Cates, G. L. (2005). Teachers’ perceptions of the incidence and management of attention deficit hyperactivity disorder. Applied Neuropsychology, 12(2), 120–127.
Pottick, K. J., Kirk, S. A., Hsieh, D. K., & Tian, X. (2007). Judging mental disorder in youths: Effects of client, clinician, and contextual differences. Journal of Consulting and Clinical Psychology, 75(1), 1–8.
Books
Robison, J. E. (2008). Look me in the eye: My life with Asperger’s. New York, NY: Three River’s Press. (Written by Augusten Burrough’s brother.)
Rogers, A. (1995). A shining affliction: A story of harm and healing in psychotherapy. New York, NY: Penguin. (Childhood trauma.)
Kottler, J. A. (2006). Divine madness: Ten stories of creative struggle. San Francisco, CA: Jossey-Bass. (Different forms of psychosis.)
Kytle, E. (1995). The voices of Robby Wilde. Athens, GA: University of Georgia Press. (Paranoid schizophrenia.)
Saks, E. R. (2008). The center cannot hold: My journey through madness. New York, NY: Hyperion. (Schizophrenia.)

Discussion 1:1 page needed with minimum of 250 words and 2 references.
Diagnosing Children
Review the media The Vignette of Marcus. Based on the information presented, address the following questions:
1. What mental disorder would you consider for Marcus? List the specific criteria from the DSM-5 that you believe Marcus meets, given the information you currently know about him. If Marcus does not meet all of the criteria needed for a diagnosis, what additional information would you need to gather?
2. What score would you document for Marcus, if Marcus’ family completed the parent- or guardian-rated Level 1 cross-cutting symptom measure? Include the specific information you included when coming up with this score.
3. What other factors (such as school system, family constellation, or medical and health care system) would you need to include when formulating a diagnosis and treatment plan for Marcus? In what way is his family system either helping him to cope at school or exacerbating the problems Marcus is having?
4. How would you explain Marcus’ symptoms from a biological perspective? How would you explain his symptoms from a psychosocial perspective?
Support your ideas with references to the course texts, articles from this learning unit, articles from the Optional Readings for Principles of Psychopathology list, or articles from peer-reviewed journals that you locate in the Capella library.

The Vignette of Marcus Below:
The Vignette of Marcus
Marcus is a 10-year-old boy who has been struggling at school. During the past year he has frequently been in fights with other students during recess. He argues with his teacher and sometimes refuses to follow her requests. He has also been in trouble for taking items belonging to other students such as lunch snacks, a sweatshirt left on the playground, and some loose change that was sitting on a desk. During class time, Marcus has difficulty following instructions and completing his work. He is easily distracted, does not pay attention to details, and frequently leaves his seat to interrupt the work of other students.
Marcus is doing better at home. He spends the weekdays with his mother and two younger brothers whose ages are 5 and 7. He helps with many of the household chores his mother cannot attend to while she is at work full time. On the weekends, Marcus lives with his father, stepmother, his 11-year-old stepsister, and his 3-year-old half-sister. He describes his father and stepmother as being very strict, but he enjoys playing with two other boys his age who live in the neighborhood.
Marcus’ teacher has met with his parents on several occasions to discuss his poor academic progress. She has expressed concern with the level of his academic skills in writing and math, as well as with his ability to get along well with others. Both the teacher and school principal have recommended counseling for Marcus, and the parents’ insurance plan will pay for 10 visits. Marcus’ pediatrician has also suggested the possibility of medication.

 

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