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Psychology and Law


Joe Wheeler Dixon PhD JD HSP-P
Clinical and Forensic Psychologist
 

Clinical Topics Relating to Children and Families

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Child Custody  |  Autism  |  Asperger's Disorder  |  Attentional Deficits

Family Therapy  |  Psychological Evaluation  |  Memory  |  Learning

Special Education  |  Child as Eyewitness  | Infantile Amnesia

Frontal Lobes  |  Metacognition  |  Learning Disabilities

Shopping  |  Learning Styles  |  Insomnia  |  Brain Functions  |  Brain Training

Childhood Schizophrenia  |  Depression  |  Time-Out  |  Anger  |  Temper Tantrums


 

Child Custody: Child custody disputes during divorce proceedings are common. Psychologists do have a positive and valid role to play.  Importantly, the psychological make-up of the child can be delineated for the judge -- emotional status, intellectual status, academic progress, etc. all of which may have a bearing on the judge's decisions. While there is no crystal ball that will tell the judge who would be the better parent, the psychologist can help the judge by identifying parents with mental disorders who would have difficulty in raising a child. In the vast majority of cases, however, both parents are equally qualified psychologically to raise their children following divorce. Thus, in the vast majority of cases, the judge is correct to place great weight on non-psychological factors in making his or her decision.  The APA guidelines on child custody evaluations can be viewed here.

Autism:  Autism is a complex neuro-biological (brain) disorder that is present at birth and lasts the lifetime.  Today, 1 in approximately 150 children are diagnosed with autism, making it more common than pediatric cancer, diabetes, and AIDS combined.  We do not know what causes Autism, although very recent research has discovered a link between SSRI medications used to treat depression and Autism.  In a recent study (2014) at Johns Hopkins of nearly 1,000 mother-child pairs, prenatal exposure to SSRI medications, i.e., pregnant women who took SSRIs for depression, male children had an incident rate of almost three times (3x) higher to develop Autism than male children whose mothers did not take SSRIs during pregnancy. Greater risk was associated with the SSRIs taken in the first trimester for Autism and Development Delays if taken during the third trimester. SSRIs are used to treat depression, anxiety, and other conditions on a wide scale basis in the United States. Pregnant women should exercise extreme caution before undertaking this SSRI treatment regime. There are effective behavioral alternatives for women with depression and anxiety; consult your physician or a psychologist.

    Medical treatments for Autism focus on medications to assist with mood and behavioral features, but the primary treatment for the Autism itself is behavioral. With proper and consistent behavioral training, autistic children can and do learn better communication and social skills, which are the two main deficit areas. Autism interferes with the brain's ability to learn and profit from normal exposure to language and social interaction. The disorder is first observed in early childhood, and the earlier the diagnosis is made and behavioral interventions begin the better is the prognostic outcome.  Autism occurs in all racial, ethnic, and social groups, and it is four times more likely to occur in boys than girls. Autistic children often manifest rigid behavioral routines, and repetitive motor behaviors, and they fail to understand subtle social cues such as reading another's facial expressions. They are visual learners much more so than auditory learners. Symptoms can range from moderate to quite severe. Parents need to seek out a pediatrician or child psychologist who has special training and experience with Autism, because it often goes undiagnosed until school begins at age five or six. Severe deficits seen in Autism will greatly interfere with learning academic subjects in school.



Asperger's Disorder:  Aspergerís Disorder is a complex neuro-behavioral disorder first manifest in childhood, and it is similar in clinical presentation to Autism Disorder, although in many respects Asperger's is less severe. Some clinicians even refer to Asperger's as High Functioning Autism and speak of a continuum of disorders referred to as Autistic Spectrum Disorders.  A key distinction between Autism and Asperger's is the much better language development observed in Asperger's children. The essential clinical features of Asperger's include qualitative deficits in social skills, restricted, repetitive, and stereotyped behaviors and interests, and qualitative differences in use of language. Importantly, language does develop without delays, however Asperger's children use language in odd and idiosyncratic ways. Intelligence develops normally, and they manifest a normal curiosity about many aspects of their world, unlike Autistic children.  In fact, Asperger's children typically develop normally during the first three years of life, unlike Autistic children.  As with Autistic children, Asperger's Disorder is often misdiagnosed by pediatricians and psychologists who lack special training and experience with Autistic or Asperger's Disorder children. Asperger's Disorder occurs in all races and ethnic populations, and Asperger's is more often seen in boys than girls.  Symptoms range from moderate to severe, and medical treatments are limited to medications for mood features and behavioral dyscontrol. In fact, a common misdiagnosis is a "severe case of ADHD," and this error occurs because the behavioral components are so similar. To arrive at a correct diagnosis with Autism or Asperger's a carefully selected cognitive and affective battery of psychological tests is necessary, together with a detailed clinical, social, and academic history. The primary effective treatment for Asperger's Disorder is behavioral interventions. Parents are the primary change agents, and they work under the training and supervision of skilled behavior analysts, who are usually child clinical psychologists.


Attentional Deficits:
 The key features of ADHD are inability to sustain attention or vigilance to a task, impulsivity, and/or restless or over-active motor behavior. A child, or an adult, can manifest the attentional deficits and the impulsivity without the over-active motor behavior, and this latter syndrome is more often seen in females than males. This diagnosis is likely the most over-diagnosed condition in modern medicine today. There are available neuropsychological tests than can verify the presence of ADHD, but rarely do teachers, pediatricians, or parents know of these or make an appropriate referral to a child psychologist trained with these instruments.

    It is important to keep in mind that children are active, and their attention wanders, and they can be easily distracted by novel stimuli in the environment, but unless and until these signs and symptoms significantly interfere with daily activities, such as learning in school, the diagnosis should not be made and certainly no psychostimulant medications should be prescribed or taken. We do not know the long term effects of children taking psychostimulant medications on their cognitive, behavioral, or emotional development. And as in the case with many childhood disorders, there are effective behavioral treatments that can reduce or eliminate many of the features of ADHD. 

    Interestingly, a recently completed study at Tel Aviv University (2013) found a clear link between rates of breastfeeding and the likelihood of developing Attention Deficit/Hyperactivity Disorder (ADHD), even when typical risk factors were taken into consideration.

Infantile Amnesia:  At approximately the age of three to four years of age, all autobiographical memories of the young child begin to become  permanently erased. That is, all personal memories are lost forever. This seems at odds with our experiences, because most people do have 'memories' of events that occurred before the age of three or four years of age. However, the 'memories' we recall of events before the onset on infantile amnesia are actually secondary or false memories, that is, recall of events told to us, typically by family members, after our personal memories are erased due to infantile amnesia. We come to believe that these secondary memories are our true recollections, but actually we are recalling what someone has told us or we overheard. Thus, these memories are not direct, true memories.

    This is a little known but well documented medical fact that usually has little or no implication for most people. However, in cases of child abuse or molestation that occurred before the onset of infantile amnesia, and the child is now older and asked to recall the event, say at a trial, the child is not actually relying upon their direct memory, but of the event as it was told and described to them by another person, i.e., hearsay. This can have serious implications in the matter of child eyewitness identification of a molester.

   
Recently published research (2013) by the Canadian Association for Neuroscience shows that formation of new neurons in the hippocampus -- a brain region known for its importance in learning and remembering -- could cause forgetting of prior memories through reorganization of existing brain circuits, i.e., of memories formed in the first three or so years of life. Researchers argue this reorganization could have the positive effect of clearing old memories, reducing interference and thereby increasing capacity for new learning. This is likely the most plausible explanation to date for infantile amnesia. This is akin to a computer over-writing material stored on its hard drive. This phenomenon has been shown to occur in all people, but when you tell people this, most won't believe you!

    Although infants use their own memories to learn new information, few adults can remember events in their lives that happened prior to the age of three. Psychologists have now documented that age seven is when these earliest memories tend to fully fade into oblivion, i.e., total and complete infantile amnesia, also referred to as childhood amnesia.  A Emory Health Sciences Study (2014) was the first empirical demonstration of the age of onset and period duration, e.g.. ages three to about seven, of childhood amnesia, and involved interviewing over 80 children about past events in their lives and following them for several years periodically assessing their personal or autobiographical memories.

 


More to be added soon ...

 

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