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Develop related disorders

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Transcript

  • 1. Development-Related Disorders
  • 2. Mental Retardation General Information• Mental Retardation Is An Axis II Disorder• Wechsler Intelligence Tests – Wechsler Intelligence Scale For Children – IV – Wechsler Adult Intelligence Scale - III • Mean = 100, Standard Deviation = 15 • IQ of 70 • --Two Standard Deviations Below The Mean – 1% of the Population
  • 3. Mental Retardation Diagnostic Criteria• Low Intellectual Functioning – I.Q. Less Than Or Equal to 70• Deficits In At Least Two Domains Of Adaptive Behavior - Self Care (your awareness and ability to shower, clean your body, toilet yourself. If person has IQ 65 you look at that willingness to take care of their body) -Communication (your ability to communicate your needs and wants) - Social Skills (persons ability to follow social graces. Like move into ppl and say excuse me; when someone sneezes you say bless you. When talk to someone you make eye contact) -Use of Community Resources (use of bus system; doesn’t know how to use the bus; they are pretty slow )That’s all consistent with low IQ.
  • 4. Ranges of Mental Retardation• Mild MR• Moderate MR• Severe MR• Profound MR
  • 5. Ranges of Mental Retardation• Mild Mental Retardation – IQ:50/55-70 – Can Learn Academic Skills Up To 6th Grade – Social Learning (reading books with pics, writing- organizing little paragraphs out of sentences. 6th grade writing) (Ability to learn from observation, they can see things and do it) – Social Conformity(evidence that you have social learning skills. You see cute shoes and you want to wear those shoes, you observed it in terms of appearance and want it so you go get yourself a pair.)Evidence of to learn from their environment. – Awareness of Differences(they are aware they are not doing certain things in life like others. Aware of diff. btw themselves and more functioning others) – (for some highest academic performance might be 4th grade,5th, or 6th grade. With help they might be able to do simple balancing of a check book as long as the money is not too big. That would be highest end, might have to do it with supervision. – They have the ability to learn by observation, by simple modeling.
  • 6. Ranges of Mental Retardation• Moderate Mental Retardation – IQ: 35/40-50/55 – Can Learn Academic Skills Up To 2nd Grade – Trainable In Social and Occupational Skills (with lots of practice they can learn social and occupational skills. For ex: like stuffing envelopes. They are trainable – Independent Behavior In Familiar Environments (familiar environment to him, he’s going to have the independence to ask for a hall pass to go bathroom, go there and come back. Negative- lack of independent behavior in unfamiliar environments like for ex: taking them to Walmart and tell them go find the vacuum aisle. People with moderate MR will not be able to find it because it’s a unfamiliar place for them.)
  • 7. Ranges of Mental Retardation• Severe Mental Retardation – IQ: 20/25-35/40 – Can Learn To Talk or Communicate – Can Learn Basic Self Care (With many repetitions. Practice a hundred times a day. Johnny this is how to brush your teeth, now you do it. Now after 6 months or a year he might be able to do it right.) • Toileting • Feeding • Comb Hair • Brush Teeth
  • 8. Ranges of Mental Retardation• Profound Mental Retardation – IQ:Below 20/25 – Some Motor Development May Be Present – May Respond To Training In Self Care Skills – All in Developmental Centers. They don’t communicate verbally or even have the ability to sign for many things. They are unable to walk, follow directions. They have to be fed like a little infant.
  • 9. Mental Retardation Incidence• 1% of Population Has Mental Retardation• MR Is More Common In Males
  • 10. Origins of Mental Retardation• Down Syndrome (Trisomy 21) (they have 47 chromosomes.They have different physical look, they tend to be shorter, square face, small ears and further back, congenital problems with their hearts so shorter lives) – Mild to Moderate MR – Early Dementia (thinking skills get lower in their 30s, die from heart problems by their 50s)• Phenylketonuria (PKU)(ppl. conceived with PKU they have the inability (33:36) – Gene X Environment Interaction – Fetus/Person Unable To Use Phenylalanine, An Amino Acid in Many Foods – Increased Phenylalanine Level Causes Neural Damage/MR• Tay-Sachs Disease (higher rate in Jewish folks)• Fragile X Syndrome – Severe MR, Especially in Males
  • 11. Origins of Mental Retardation Environmental Origins• Problems During Gestation – Substances/ Toxins • Alcohol – Fetal Alcohol Syndrome » 1 In 1000 Births » Mild to Severe MR » Physical Characteristics If Mom Drank In 1st Trimester » Cognitive Deficits Possible If Mom Drank In Any Trimester • Cocaine – Increased MR Rates – Reduced Head Circumference And Reduced Birth Weight – Maternal Malnutrition During Gestation – Maternal Infection During Gestation • Rubella (German Measles) During 1st Trimester (high risk)
  • 12. Origins of Mental Retardation Environmental Origins (cont.)• Problems During Delivery – Infections – Anoxia (can result to brain damage) – Brain Injury During Birth (Forceps)• Problems During Early Development – Poor Nutrition – Poor Nurturing • “Failure To Thrive” Children – Impaired Cognitive and Physical Development In Kids Who Receive Little Nurturance
  • 13. Treatments for Mental Retardation• Education – Mainstreaming vs. Special Schooling • Mainstreaming – Including Children With Cognitive And Physical Impairments In Mainstream Classrooms – Public Law 94-142 » Passed In Early 1970s » States That Special Needs Children Must Be Educated With Their Normal Peers To the Greatest Extent Possible – Practical Limit Of Mainstreaming = 1:1 Teaching Aide – Special Schooling • Lower Student – Teacher Ratio • Only Disable Children in the Classroom
  • 14. Treatments for Mental Retardation• Behavioral Treatment – Targets • Motor Development (e.g., Button Your Coat) • Language Development (e.g., Functional Language First) • Social Development (Social Introduction, Social Perception) • Cognitive Development – Strategies • Positive Reinforcement (R+) For Desired Behaviors • Negative Punishment (P-) For Undesirable Behaviors • Parent Training (A-B-C, Task Analysis, R+, P-) • Direct Reinforcement of Other Behavior (DRO)
  • 15. Pervasive Developmental Disorders Common Features• Severe Impairments In Socialization• Severe Impairments In Communication• Unusual Behaviors, Activities, And/Or Interests
  • 16. Specific Pervasive Developmental Disorders• Rett’s Disorder – Occurs Only In females – Incidence:1 in 10,000 – Onset: 5 months- 4 years – Loss of motor skills (Handholding And Impaired Gait)- walking – Severe language Impairments
  • 17. Specific Pervasive Developmental Disorders• Childhood Disintegrative Disorder – Occurs In Males and Females – Incidence: 1 in 10,000 – Onset: 2 to 10 years old – Severely Impaired Communication* – Severely Impaired Socialization* – Unusual Behaviors, Activities, And/Or Interests* – Loss Of Bowel and Bladder Control – Impaired Motor Coordination
  • 18. Specific Pervasive Developmental Disorders• Autistic Disorder – Onset Of Symptoms Prior To Age 3 (Must see the symptoms when they are little, present prior to age 3) – Incidence: 2 to 5 in 10,000 (4 Males: 1 Female) (Mainly Men) – Severe Impairment In Socialization* (2 Or More) (Autism- to not care whats around you, be interested in yourself) • Lack Of Reciprocal Facial Gestures • Avoidance of Eye Contact • Impaired Peer Relations (Profound Asociality) (they would almost always want to do things by themselves) • Lacking Awareness of Others (Theory Of Mind) (they don’t care what others think, they would do things we would find awkward to do in public) • Lack Of Sharing Of Interests/Achievements • Lack Of Social/Emotional Reciprocity • Impaired Emotion Recognition (empathy. Do “Omg you look sad” They don’t identify emotions from facial expressions, gestures) – Severe Impairment In Communication* (1 or more) • Delayed Language • Inability To Maintain A Conversation • Stereotyped Language (Echolalia- autistic repeats back part or all of the sentence that he/she just heard), Pronoun Reversal- it goes to their lack of abstraction. Their memory skills are good, but their abstract thinking is very impaired. They take it too literally) • Lack Of Pretend Play (they don’t put thoughts and feelings into humans, you cant do pretend play unless you have theory of mind) – Unusual Behaviors, Activities, Or Interests* (1 or more) • Obsessive Preoccupations • Inflexibly Adherence To Nonfunctional Routines (Need For Sameness) (They have a need for sameness like for ex: schedule, environment. Like if mom has long hair and then cut it into a bob they say who is this person? They might identify her by her hair. • Stereotyped Motor Behaviors (Hand Flapping, Hand Gazing, Grimacing)(They are doing things to discharge their arousal)
  • 19. Specific Pervasive Developmental Disorders• Features Associated With Autism – Aggression (Some ppl with Autism will be aggressive. If don’t have skills to communicate wants and needs they will be aggressive. They just hit and their needs get met. – Self Injurious Behaviors(They may punch themselves in the face, slam their head to the floor, bite themselves so severely that sometimes to the bones. When doesn’t want to do something they’re are told you they would bite themselves. – Toileting Delays(Until age 5-7 they start urinating in the toilet. That could lead to outplacement.) – Self Stimulatory Behaviors(the stereotype behaviors. Hand flapping, Body rocking are overly stimulated.
  • 20. Specific Pervasive Developmental Disorders• Asperger’s Disorder – Severely Impaired Socialization (they have a profound deficit in social – Unusual Interests, Activities, or Behaviors – Normal Communication Skills – Better Cognitive Functioning Than Autism • 95% Of Asperger’s D/O Persons Have IQs greater or equal to 75 • 25% Of Autistic Persons Have IQS greater or equal to 75
  • 21. Biological Theories of Autism• Autism Is A Neurodevelopmental Disorder• Genetics – 92% Concordance Between Monozygotic (identical) Twins – Relatives Have Higher Rates Of Deficits In Communication, Social Skills, And Cognition• Brain Structures (Males) – Larger Ventricular Volume – Smaller Corpus Callosum (Have trouble transferring info. from one hem. to another. Have difficulty labeling emotions)
  • 22. Psychological Theories of Autism• Refrigerator Mother (Old Theory) Autism was developed in 1941.• Parent Stress – Very High – Factors • Ambiguity of Outcome (things are less clear. 40% of autism kids can be normal with lots of effort in classroom or after school program. This causes tremendous stress though- ambiguity of outcome) • High Caretaking Demand (there awareness of dangers at the age of 16 will be like for a 2 yr. old. • Extreme Therapeutic Effort (parents know if they work really hard, their child will be more normal. • Aggression • Lack Of Reciprocated Affection (she works so hard. Comes home from work tired, then trains child to be more normal. What she gets? A punch in the face, lack of affection • Duration
  • 23. Treatment of Autism• Parent Training – Functional Analysis (A-B-C)(Antecedents, Behavior, Consequences) – R+ and P-• Parent Support – Respite Care (Skilled babysitting) – Support Group• Discrete Trials Training (Lovaas)• Aversive Conditioning(Positive punishment, only used with kids you have severe dysfunctions. – Reduce Extreme Self-Injury and Aggression
  • 24. Learning Disorders (“Learning Disabilities”)Diagnostic Criteria• Academic Achievement (As Measured By Standardized Achievement Tests And Classroom Performance) Is Substantially Below Expectations Given Cognitive Development (As Measured By Intelligence Tests)• Academic Skill Performance At Least One Standard Deviation Below Expectations Given Intellectual Ability (2-3 Grade Levels below Expectations)
  • 25. Types of Learning Disorders• Mathematics Disorder – Difficulty With Math Concepts and Calculations• Disorder Of Written Expression – Poor Spelling – Errors In Grammar and Punctuation – Disorganized Paragraphs• Reading Disorder (“Dyslexia”) – Individual Omits, Distorts, Or Substitutes Words When Reading – Causes Reading To Be Slowed and Hating
  • 26. Incidence Of Learning Disorders• 5% of School Children Are Diagnosed With A Learning Disorder• Estimates Suggest That The Incidence Of Learning Disorder May Be as High as 10%• Equal Gender Distribution, But Mostly Boys Are Identified And Diagnosed Due To Their More Frequent Disruptive Behavior
  • 27. Possible Negative Consequences Of Learning Disorders• Academic Dysfunction – 40% of Persons With Learning Disorder Drop Out Of High School• Poor Self Image – Due To Multiple Academic Failures And Ridicule From Others, Many Persons With Learning Disorder Harbor Strong Feelings Of Inferiority• Impaired Socialization – Struggling Academically And Ridiculed by Peers, Adolescents With Learning Disorder Often Associate With Other Troubled Teens And May Engage In Delinquent Behavior• Underemployment – An Otherwise Intelligent Person With A Learning Disorder May Lack The Functional Reading, Writing, or Math Skills Required By Many Jobs
  • 28. Attention Deficit Hyperactivity Disorder• Diagnostic Criteria – Onset Of Sxs Prior To Age 7 – Symptoms Cause Impairment In At Least Two Settings – Duration: Minimum 6 Months – Symptoms Of Inattention (6 or more) • Careless Mistakes Or Fails To Attend To Details • Poor Sustained Attention • Does Not Listen When Spoken To • Does Not Follow Through On Instructions and Responsibilities • Difficulty In Organizing Tasks or Activities • Avoids Tasks Requiring Sustained Mental Effort • Loses Items Necessary For Tasks • Easily Distracted • Often Forgetful
  • 29. Attention Deficit Hyperactivity Disorder• Diagnostic Criteria (Cont.) – Symptoms Of Hyperactivity-Impulsivity (6 or more) • Hyperactivity – Often Fidgets or Squirms – Often Leaves Seat Inappropriately – Often Runs About or Climbs About When Inappropriate – Often Has Difficulty Playing or Engaging in Leisure Activity – Frequently “On The Go” As If “Driven By A Motor” – Often Talks Excessively • Impulsivity – Often Blurts Out Answers Before Question Has Been Completed – Often Has Difficulty Waiting His Or Her Turn – Often Interrupts Conversations Or Intrudes On Interactions
  • 30. Types of ADHD• ADHD, Predominately Inattentive Type – 6 or More Symptoms Of Inattention – Less Than 6 Symptoms Of Hyperactivity- Impulsivity• ADHD, Predominately Hyperactive- Impulsive Type – 6 Or More Symptoms Of Hyperactivity-Impulsivity – Less Than 6 Symptoms of Inattention• ADHD, Combined Type – 6 Or More Symptoms of Inattention – 6 Or More Symptoms Of Hyperactivity-Impulsivity
  • 31. ADHD Facts• Incidence Of ADHD – 5% of Children in the U.S. – Although Symptoms Are Often Present Much Earlier, Most Children Diagnosed With ADHD Are First Diagnosed After Entering the School System• Course Of ADHD – ADHD Persists Throughout Childhood, Often Into Adolescence, And Sometimes into Adulthood• Comorbidity – About 15% Of Children With ADHD Also Have A Learning Disorder
  • 32. Consequences of ADHD• Behavior Problems – According To Russell Barkley, By 5 to 8 Years Old, Between 45 And 70 % Of Kids With ADHD Have Significant Problems With • Resistance to Parental Authority • Hostility/ Aggression Toward Others • Quick- Temperedness• Social And Emotional Consequences – Social Rejection – Banished To “Bad Boy” Group (Learn “Bad Boy” Behaviors) – Higher Incidence Of Adolescent And Adult Psychopathology – Increased Legal Problems • Increased Substance Abuse Problems • Increased Interpersonal Problems
  • 33. ADHD: Biological FactorsGenetics• General Population: Incidence Rate = 5%• Parent With ADHD: Incident Rate = 50%Brain Structure And Activity• Frontal Lobes (Attention, Impulse Control) – Reduced Activity – Reduced SizeNicotine (Prenatal Exposure)• Study – 22% of Mothers’ Of ADHD Kids Smoked When Pregnant – 8% Of Mothers’ With Normal Kids Smoked When Pregnant
  • 34. ADHD: Psychological Factors• Bi-Directional Relationship – ADHD Behaviors -> Parent Behaviors – ADHD Behaviors <- Parent Behaviors – Negative Parent Behaviors (Yelling, Negativistic Statements) Decrease When Child Receives Stimulant Medication – Child ADHD Behaviors Decrease When Parent Receives Parenting Skills Training• Modeling – Parents Who Have ADHD Spectrum Behaviors Model ADHD Behaviors
  • 35. Treatment Of ADHDMedications• Stimulants (Ritalin, Cylent) – Prescribed To About 5% of All Children And About 25% of Children In Special Classrooms – Temporary Therapeutic Effects – Administration: TID Or Slow Release – Side Effects • Temporary Growth Suppression (Relieved with Drug Holidays) • Sleep Problems • Reduced Appetite – Nonadherence • Due To Parental Ambivalence, Nonadherence Rates Range From 20-70%• Antidepressants (Stratera: Norepi Reuptake Inhibitor)
  • 36. Treatment Of ADHDBehavior Therapy• Train Parents And Teachers In Operant Principles – Functional Analysis (A-B-C) – Positive Reinforcement • Catch them being good – Negative Punishment • Time Out (Time out from Reinforcement)• Token Economy (Star Chart)• Varied Settings – Classroom – Home
  • 37. Oppositional Defiant DisorderDevelopmental Considerations (Interacting with the bad kids. Whoever tries to tell them what they have to do, they won’t do it.)• Most Children And Adolescents Have Periods Of Negativistic And Defiant Behavior ; However, Youths With Oppositional Defiant Disorder Are Negativistic And Defiant Of Authority Figures Most Of The TimeDiagnostic Criteria• Impairments Due To A Pattern Of Ne Behavior That Lasts At Least 6 Months• 4 of the Following 8 Symptoms – Often Loses Temper – Often Argues With Parents – Often Defies Or Refuses To Comply With Requests And Rules Of Adults – Often Deliberately Annoys Others ( They enjoy getting on others nerves and at the same time if someone teases them they get annoyed and upset) – Often Blames Others For His/Her Mistakes Or Misbehavior – Easily Annoyed by Others – Often Angry And Resentful – Often Hateful and Vengeful
  • 38. Facts About Oppositional Defiant DisorderOnset• Generally Between 8 to 12 Years Old (Prior to puberty its more common in males, after puberty it’s a equal gender distribution)Gender Differences• More Common In Preadolescent Boys• Equally Common In Adolescent Boys And Adolescent GirlsConsequences Of Oppositional Defiant D/O• Peer Rejection (He’s going to be pushed away, that’s going to affect his self-esteem. His self-esteem is low bc of neglection and hard punishment from the parents)• Low Self Esteem (Begins in the family, he takes these obnoxious to the community• Anti- authority Attitudes (Nearly every interaction they have with their teachers is negative. The people he’s aware of they are going to be more strict with him.) – Exclusively Negative Interactions With Authority Figures
  • 39. Psychological FactorsPoor Parent-Child Relationship• Three Possible Causes – Neglect (Not being around enough; not paying attention) – Lack of Affection (not enough hugs and kisses, i love you going around) – “Unjust” Discipline (Neglect combined with extreme punishment for something the kid does all the time)Developmental Course Of Opp Def Disorder Poor Parent-Child Relationship -> Hatred of Parents (those 3 potential causes are coming together that lead to hatred of parents. Bc he cant love and respect his parents he can love and respect his teachers, others.) -> Hatred of all Authority Figures
  • 40. Treatment Of Oppositional Defiant DisorderParent Training (You work with parent, child. You look to repair emotional bonds• Train Parent(s) To Be – Be Attentive – Be Affectionate – Reinforce (Praise) Prosocial Behavior – Punish (Negative) Undesirable Behavior – Maintain A 10:1 Ratio Of Reinforcement To Punishment
  • 41. Conduct Disorder: Diagnostic CriteriaRepetitive And Persistent Pattern Of Behavior That Violates The Rights Of Others And Social Norms As Evidenced By Behaviors In At Least Three Of The Following Four Domains (3 Of 4)I. Aggression Against Humans And/Or Animals• Bullies, Threatens, Intimidates• Often Initiates Physical Fights• Has Used A Weapon• Has Been Physically Cruel to People• Has Been Physically Cruel to Animals (Has all this anger instead that looking to torture animals)• Has Stolen While Confronting A Victim (Mugging)• Has Forced Someone Into Sexual Activity (Coercive Or Physical Rape. Coercive Rape- like a blackmail. If you don’t do this then i’ll tell mom)II. Destruction Of Property• Has Set Fires To Cause Serious Damage (Fire-Setting With Intent.)• Has Destroyed Others’ Property (vandalism)
  • 42. Conduct Disorder: Diagnostic CriteriaIII. Deceitfulness Or Theft• Has Broken Into A House, Building, or Car• Often “Cons” Others By Lying In Order To Gain Goods Or Favors• Has Stolen, As in Forgery or ShopliftingIV. Serious Violations of Rules• Beginning Prior To Age 13, Stays Out All Night Despite Parental Prohibitions• Has Run Away From Home Overnight At Least Twice• Beginning Prior to Age 13, Is Often Truant From School
  • 43. Facts About Conduct DisorderOppositional Defiant Disorder -> Conduct Disorder• Most Youths With Conduct Disorder Have Histories Of Oppositional Defiant BehaviorIncidence• 6 to 16% of Males Under 18• 2 to 9% of Females Under 18Adult Outcome (1966 Study)• Followed Conduct Disorder Boys Into Adulthood• Antisocial Tendencies Are Very Stable Over Time• Very High Rates Of: – Marital Difficulties – Reduced Economic And Occupational Opportunities – Poor Social Relationships – Heavy Substance Use• Only 1/6th Of The Boys With Conduct Disorder Were Free Of Psychopathology In Adulthood• More than 25% Of The Boys Met Criteria For Antisocial Personality Disorder In Adulthood
  • 44. Conduct Disorder: Biological Factors• Genetics – Mixed Findings – Aggressive Behavior Is Clearly Heritable – Less Evidence For The Heritability Of Behaviors Such As Stealing, Running Away, And Truancy
  • 45. Conduct Disorder: Psychological FactorsImpaired Moral Development• Family Environment Lacks The Qualities That Produce Children With A Strong Sense of Morality – Parents Who Are Affectionate With Their Children And with Each Other – Parents Who Clearly Express Moral Principles And Clearly Expect That Their Children Will Uphold Them – Parents Who Punish Justly And Consistently – Parents Who Use Reasoning And Explanations As Part Of Their Parenting StyleSocial Learning Theory (Bandura)• Children Learn Aggressive Behavior From The Aggressive Behavior Modeled By Their Parents, Siblings, and MediaOperant Conditioning• Aggression Is Reinforced Because It Is Often An Effective Means of Achieving A Goal• Lack Of Negative Consequences For Aggressive Behavior
  • 46. Conduct Disorder: Psychological FactorsCoercion Theory (Gerry Patterson)• Coercive Behaviors (Whining, Complaining) Are Reinforced During Young Childhood• Aggressive Behavior Is Reinforced During Sibling Interactions As Parents Are Neglectful, Inattention, and IneffectualCognitive Theory (Ken Dodge)• Aggressive Children Make Aggressive Attributions Regarding Ambiguous Interpersonal Events• Aggressive Attributions Lead to Aggressive Behavior, Which Causes Others To Behave More Aggressively Toward Them, Further Angering The Already Aggressive Children And Continuing The Cycle Of of Rejection And Aggression (See Figure)• Cycle of Aggressive Cognitions and Behaviors• Validation of Aggressive Event• Belief System
  • 47. Treatment of Conduct DisorderParental Management Training (Gerry Patterson)• Train Parents To Modify Their Responses To The Child So That Prosocial Rather Than Antisocial Behavior Is Consistently Rewarded• Parents Are Taught Positive Reinforcement Techniques – Praising Desired Behaviors – “Catch’em Being Good”• Parents Are Taught To Use Negative Punishment Techniques In Response To Aggressive or Antisocial BehaviorAnger-Control Training• Aggressive Children Are Taught To Consider Benign Attributions To Ambiguous Interpersonal Interactions• Aggressive Children Are Taught To Self-Control Techniques (“Just Walk Away”) That Are To Be Used In Anger-Producing Situations• Training In Distraction Techniques – Serial 7s, Serial 3s• Techniques Used By Child During Role Play In Which A Peer Provokes Or Insults Him
  • 48. Separation Anxiety Disorder• Developmental Considerations – _________________________________• Diagnostic Criteria For SAD – _______________________ – ________________________________________ Concerning Separation From Home Or Primary Caretakers For At Least 4 Weeks – Three Or More Of The Following Eight Symptoms (_________) • Recurrent Excessive Distress When Separation From Home Or Caretakers Is Anticipated • ___________________________________________________ • Worry That __________________, Such As A Kidnapping, Will Cause _______________________ • ________________________________, Such As School, Because Of ______________________ From Caretakers • _________________________ Or Without The Caretakers • Reluctance Or Refusal To Go To Sleep Without Being Near Caretakers • Repeated Nightmares With Separation Theme • Repeated Complaints Of ____________________ When Separation From Attachment Figures Is Anticipated
  • 49. Theories of Separation Anxiety DisorderBiological• _____________ – The Rate Of Panic D/O In The_______________________ With SAD __________ Than The Rate Of Panic D/O In The General Population – ______________________________________________________Psychological• ________________ – _________________ Of Unexpected Separation• Modeling (_________________) – _____________ Modeled By Parents Regarding Separation• ______________________________ – ________________________ By Attachment Figures – e.g., ___________________________
  • 50. Treatment Of Separation Anxiety DisorderBehavioral Treatments• _____________________• _____________________• Modeling• Contingency Management – __________________________ – Punishment For _________________• Teach Child To React More Competently To __________________________________________Cognitive Treatments• Positive Statements ______________________ – “_________________” “I Can Sleep In My Room By Myself”• ____________________ – To Address Family Member Behaviors That May Be Maintaining The Separation Anxiety