PSY240: - L7

Reading §

• Identify variables that need to be measured when evaluating community integration and inclusion. Explain varying prevalence rates for autism spectrum disorders
  • The deinstitutionalization and mainstreaming movements have emphasized the importance of community integration. However they have also highlighted the potential risks of vulnerability and exploitation in community inclusion. Evaluation of community-based care and quality of life has become an important area of work for psychologists
  • Systematic intensive early intervention programs applying operant conditioning principles have been found effective in developing language and social skills and in managing challenging behaviour. A specific learning disorder according to DMS-5 includes four essential diagnostic features: persistent difficulties learning and using key academic skills despite the provision of interventions that target those difficulties; performance of academic skills that are well below average for chronological age; appearance of the learning difficulties in the school years; and a recognition that learning difficulties are not attributable to other neurological conditions or intellectual disabilities.
• Explain the cognitive impairments that are the defining features of specific learning disorders
  • Autism spectrum disorder is characterized by deficits in the areas of social communication and behavioural interests exhibited by a lack of social responsiveness or reciprocity, unusual sensory responses to the environment, absent or unusual expressive language and restrictive or repetitive behaviours. Higher-functioning individuals with higher intelligence, more expressive language, and fewer other symptoms are often categorized as having Asperger’s disorder.
    • Neurobiological and genetic factors are currently considered to play important roles in the development of autism, although the causal processes are still not clearly understood.
  • According to the LDAO definition, learning disabilities are a neurologically based disorder that affects one or more ways in which a person takes in, stores, or uses information. Individuals with learning disorders experience specific impairments in one or more of the cognitive processes related to learning
    • Cognitive processes include phonological processing, working memory, processing speed, language processing, visual-spatial processing, executive functions, and visualmotor processing.
    • Learning disorders can impede academic achievement in the areas of reading, writing, or mathematics. They can also impact daily life, such as having difficulty with problem solving, organization, following multi-step instructions, or, sometimes, understanding sarcasm
  • Persons with learning disabilities are two to three times more likely to experience mental health challenges, including anxiety, and difficulties with social competence
    • Early identification by means of a comprehensive psychological assessment, academic remediation and accommodations in the school setting, and support or therapeutic intervention where appropriate, is vital for enabling individuals with LD to accomplish goals and to engage in fulfilling and productive lives

Lecture §

• PDF:
• Autism spectrum disorder
  • Discovered by 1943, Leo Kanner, described as innate as a genetic disorder
  • Symptoms: What are the 3 most important symptoms in communication?
    1. Deficits in social-emotional reciprocity
       • Use protoimperative gestures rather than protodeclarative gestures: inconsistent use of early preverbal communication
       • Protoimperative: point to desirable object
       • Protodeclarative: eye-contact and joined Attention
    2. Deficits in nonverbal communicative behaviors
       • Gap in the verbal vs. non-verbal skills
    3. Deficits in developing, maintaining and understanding relationship
       • Social: More sensitive to environment; thus tend to isolate themselves to avoid overwhelming
       • Neurology Stress can contribute, but the root cause is social interaction comprehension
    • Qualitative
      • Pronoun reversals (hard time to use “I”)
      • Echolalia (repeat words)
      • Perseverative speech (not communicative speak)
      • Impairments in pragmatics (language interpretation)
  • Diagnostic: What are the identifying feature of autism
    • The most identifying feature for autism is communication impairment due to dysfunction in social cue interpretation
    • IQ Test
      • Most of those with ASD have IQ scores that are below average, though not necessarily in the range for intellectual disability
    • How are Asperger’s Disorder consolidated in ASD
      • Severity: level 3
    • What are the 5 categories that diagnosis ASD?
      • Diagnostic
  • Gender Biases: What is the 2 theories explaining lesser diagnosis rate in girls in Level 1?
    • Level 1 females diagnosis difficulty
    • Harder to trigger in girls
      • Girls’ threshold for genetic mutation is harder
    • Phenotype
      • Girls with autism will have a greater functionality than boys
      • The mutations manifest differently in girls
      • Girls show less repetitive behaviour
  • Etiology: Gene + Environment
    • Genetic influences genetic disorder
      • Fragile X syndrome co-occur in $2-3\%$
      • a $5\%$ elevated risk for chromosomal anomalies
      • About $25\%$ of children with tuberous sclerosis have ASD
    • Problem in early development
      • Experience more health problems during pregnancy, at birth, or immediately following birth
      • Prenatal complications: parental age
    • Family and Twin Studies
      • Broader autism phenotype: $15-20\%$ of siblings of individuals with ASD have the disorder
      • Concordance rates: $70-90\%$ in identical twins
    • Molecular Genetics
      • Implicated but not a direct cause
      • Expression of ASD genes may be influenced by environmental factors occurring primarily during fetal brain development
      • Epigenetic dysregulation may be a facto
    • Brain abnormalities
    • Disorder of risk and adaptation
  • Treatment: What are the (2) common treatment methods?
    • Psychological interventions
      • Minimize core difficulties
      • Maximize independence and quality of life
      • Help the child and family cope more effectively with the disorder
      • Applied behaviour analysis: Ex. Operant Conditioning
    • Medications and Nutritional Supplements
      • Reduce aggression, repetitive behaviors, distractibility with medication (antidepressants, anti-psychotic medication, Ritalin)
      • Limited controlled research on their effectiveness of nutritional supplements
• Learning Disabilities
  • Symptoms: What are the 6 functions impaired?
    • Impairments in one or more processes related preceiving, thinking, remembering or learning
    1. Oral language (listening, speaking, understanding)
    2. Reading (decoding, phonetic knowledge, word recognition, comprehension)
    3. Written language (spelling & written expression)
    4. Mathematics (computation, problem solving)
    5. Organization
    6. Social skills
  • Diagnostic:
    • What are the 4 essential features of the diagnosis
      1. Persistent difficulties learning and using key academic skills despite the provision of interventions that target those difficulties
      2. Performance of academic skills that is well below average for chronological age
      3. Appearance of the learning difficulties in the school years
      4. A determination that the learning difficulties are not attributable to, or better explained by another neurological condition or intellectual disabilities
    • Impairment in Reading (What is the word used for this and its identifying features?)
      • Dyslexia: an impairment in phonological processing
      • Difficulties with reading fluency (Phonemes - letters)
      • Phonological awareness
    • Impairment in Math (What is the word used for this and its identifying features?)
      • Dyscalculia: deficits in the processing of numerical quantities, problems with working memory
      • Number sense hypothesis vs core deficits in Working Memory
      • Difficult to identify and diagnose
    • Impairment in Written Expression (What is the word used for this and its identifying features?)
      • Dysgraphia : Impairment in spelling, writing fluency, and written expression
      • The least well understood
      • It may reflect deficits in a number of neuropsychological domains
      • Processing speed, working memory, executive functioning
  • Etiology: To what percentage can this be explained by genetics
    • $50-60\%$ of the variance is explained by genetics
    • Environmental changes in the form of specific reading instruction can influence neural systems in the brain
  • Treatment:
    • Evidence-based reading interventions target phonemic awareness, vocabulary development, reading fluency, and reading comprehension strategies
    • Response-to-intervention approach
      • Lower intensity intervention is first delivered to children at risk of a reading disorder; those who continue to experience significant difficulty with reading then go onto receive more intensive intervention