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Do you think lower IQ scores are a risk factor for child abuse or the result of abuse and neglect, and why?
Are standardized intelligence tests like the Wechsler accurate, or is cultural bias?
Do you think undergoing therapy for PTSD like EMDR would cause an increase in IQ scores and overall level of function?

 

1.) Experience PTSD in young children was related to substantial decreases in IQ and reading achievement. Childhood trauma affected the course of IQ over time in the sense of showing less learning. 

The findings suggest that PTSD and depressed children differ in their cognitive ability, and the differences in IQ between those with PTSD and those without are not necessarily confounding variables but may be a consequence of their traumatic experience (Barrera-Valencia et al., 2017).

Childhood trauma impacts cognitive abilities and impedes learning; however, its impacts the observed cognitive alterations in psychotic disorder. 

2.) Wechsler Adult Intelligence – was developed to assess the cognitive ability of adults. This method aids in examining the relationship between intellectual function and memory.

The Wechsler Adult Intelligence Scale, fourth edition (WAIS-IV), is a commonly utilized cognitive battery across many clinical settings. However, due to various patient variables, an abbreviated assessment of intellectual abilities may be clinically advantageous to permit a more thorough assessment of other cognitive domains (Merz et al., 2021).

States that the new scale has eliminated biased items; it frequently is a variety outline of indicators and allows for the diagnosis of some mental issues, as well as an accurate depiction of a person’s intelligence.

3.) Undergoing EMDR for PTSD would cause an increase in IQ scores and overall level of function works because it specifically focuses on the brain’s memory centers, events or triggers, and any neurological associations. 

Persons with mild intellectual disabilities or borderline intellectual functioning IQs of 50-85 have a higher risk of exposure to traumatic events and developing posttraumatic stress disorder (PTSD). EMDR therapy has shown to be applicable, safe, and potentially effective for treating PTSD in individuals with IQ 50-85 (Mevissen et al., 2020)

The difference between EMDR and other therapy approaches is that EMDR works by specifically using dual attention stimuli, facilitating the decrease of a traumatic event. PTSD is the impact of common PTSD symptoms like flashbacks, triggers of sound or smell, and hypervigilance. It has a unique approach to treating PTSD by utilizing the mechanisms of the brain and facilitating the brain’s natural healing process. It also uses meth from modalities like cognitive behavioral therapy, person-centered therapy, psychodynamic therapy, somatic therapy, and behavioral therapy. So yes, this helps the overall function of the patient.

 

References

Barrera-Valencia, M., Calderón-Delgado, L., Trejos-Castillo, E., & O, B. M. (2017). Cognitive profiles of Post-traumatic Stress Disorder and depression in children and adolescents. International Journal of Clinical and Health Psychology, 17(3), 242-250. https://doi.org/10.1016/j.ijchp.2017.05.001

Merz, Z. C., Lace, J. W., Eisenstein, A. M., & Grant, A. F. (2021). Examination of Wechsler adult Intelligence Scale-Fourth Edition short-form IQ estimations in an outpatient psychoeducational sample. Applied Neuropsychology: Adult, 28(6), 707-716. https://doi.org/10.1080/23279095.2019.1687480

Mevissen, L., Ooms-Evers, M., Serra, M., de Jongh, A., & Didden, R. (2020). Feasibility and potential effectiveness of an intensive trauma-focused treatment program for families with PTSD and mild intellectual disability. European Journal of Psychotraumatology, 11(1), 1-11. https://doi.org/10.1080/20008198.2020.1777809

 

 

Discussion Questions

What questions would you ask or information would you need to diagnose the patient confidently?
What diagnosis and treatment would you choose for this patient?
What techniques do you recommend for building rapport for children with traumatic pasts who may seem hesitant to trust and share information?

1. It is crucial to know if the symptoms are new development or whether they have been there for some time. Assessing the severity of the signs is critical to inquire how they affect the child’s capacity to function at home and school. A comprehensive history and physical examination should evaluate for comorbid or other conditions that can mimic ADHD. The combination of the Diagnostic and Statistical Manual of Mental Disorders, 5th ed., criteria and validated screening tools completed by parents, teachers, or other adults can aid in establishing the diagnosis (Chang et al., 2020). It is essential to assess if the symptoms are new development or whether they have been there for some time; it is crucial to know how long the symptoms have been present. This can assist exclude other potential explanations of the symptoms and give a fuller picture of the child’s past.

2. ADHD patient has hyperactivity and inattention. Hyperactive evaluation scales require additional testing to meet the criteria. The patient may improve at home and school with treatment. Guanfacine will suppress some symptoms and may indicate another problem (Chang et al., 2020). Also recommended: counseling. The patient is hyperactive and inattentive. ADHD is 75-90% inherited. Future visits must clarify symptoms to diagnose. Although there is a substantial genetic contribution, non-inherited factors are also important (Muñoz-Solomando & Thapar, 2017). Since this child has been in several foster homes and may have suffered trauma, some symptoms could be linked to a particular event or several, adding complexity that should be investigated and dealt with over time and as trust is formed 

3. Active listening is a technique that involves listening carefully and repeating what the child says. This makes the children feel heard and builds trust. Each child responds differently to different tactics. Be flexible and explore diverse ways until you find what works for the child. Also, ensure the child’s safety. Findings underline the destructive nature of emotional maltreatment in PTSD symptomatology and treatment effectiveness. This calls for routine assessment of parental emotional abuse in the diagnostic phase, even when this is not the reason for referral (Hoeboer et al., 2021). There are many ways to create rapport with traumatized children who are cautious about trusting and sharing. Each child responds differently to different tactics. Be flexible and explore diverse ways until you find what works for the child.

References

Chang, J. G., Cimino, F. M., & Gossa, W. (2020, November 15). ADHD in Children: Common Questions and Answers. American Family Physician, 102(10), 592.

Hoeboer, C., de Roos, C., van Son, G. E., Spinhoven, P., & Elzinga, B. (2021). The effect of parental emotional abuse on the severity and treatment of PTSD symptoms in children and adolescents. Child Abuse & Neglect, 111. https://doi.org/10.1016/j.chiabu.2020.104775

Muñoz-Solomando, A., & Thapar, A. (2017). Attention deficit hyperactivity disorder. In D. Skuse, H. Bruce, & L. Dowdney (Eds.), Child psychology and psychiatry: Frameworks for clinical training and practice., 3rd ed. (pp. 203-213). Wiley Blackwell. https://doi.org/10.1002/9781119170235.ch24

 

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