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What's Eating Gilbert Grape

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Brittany Cox

on 1 December 2012

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Transcript of What's Eating Gilbert Grape

Brittany Cox, Ashley Duncan,
Alina Ilinskaya, Caroline Grace Merk,
Madeline Peeling, Paige Seeker What's Eating Gilbert Grape Primary Diagnosis:
Moderate Mental Retardation Treatments Prognosis Features of Mental Retardation •Needs to be constantly watched

•Enjoys the “where’s Arnie” game (essentially peek-a-boo)

•“Arnie is a big boy”

•Derives comfort from simple childhood songs

•Does not understand how climbing the water tower can put him in danger

•Likes for Gilbert to “piggy-back” him everywhere Intensive Behavior Training
10 hours/week
Antipsychotics that treat behavioral symptoms of mental retardation such as aggression, hyperactivity, agitation, irritability, and self injurious behaviors
-Aripiprazole
-Haloperidol
-Risperidone Although treatment for Arnie will not cure his MR, but rather moderate it, his prognosis is pretty good.
Will not live fully independently, but could be successful in a group home or other supervised-living facility.
With job training, could succeed in certain vocations.
Family needs to develop considerably as a unit before major improvements will be made. With possible secondary diagnosis of Autism Spectrum Disorder For Mental Retardation For Autism Structured Residential Programs
-should be personalized to each patient
-can improve challenging behaviors of those with autism therefore improving their quality of life
Intensive Behavioral Training at up to 40 per week for at least 2 to 3 years
-children with autism
-improvements in intellectual, language, and adaptive functioning skills More Treatments In Arnie's case, it is important not to treat just Arnie but also his family Is Arnie Autistic? In Favor
•Stereotyped movements
•Inability to understand and comply with social norms
•Inability to gauge emotion and respond appropriately in emotional situations
•Echolalia
•Failure to develop relationships with peers appropriate for development level
•Difficulties in communication and use of language
•Low IQ
However, did not present with enough symptoms for a diagnosis of autism, and especially did not show enough impairments in social interaction
•No stereotyped interests
•No impairments in imaginative play
•No impairments in joint social attention or social reciprocity
•Desire for social relationships and interaction
•No impairment in use of nonverbal behaviors to regulate social interactions Family
Mental Retardation Education
Stress Coping Techniques
Counseling

Momma Grape (towards the beginning of the film)
CBT
SSRIs
Weight-loss Program DSM IV-TR: Mental Retardation
evident before age 18
significantly subaverage IQ (>70)
concurrent deficits or impairments in adaptive functioning
understood in terms of severity, based on IQ: mild, moderate, severe, pervasive DSM 5: Intellectual Developmental Disorder
same as Mental Retardation, except that severity is no longer used to understand the disorder, rather
adaptive behavior functioning is. (Understood in terms of support- limited, extensive, etc). Developmental Delays Features Continued •Wears Velcro shoes (cant tie his shoes)

•doesn’t know how to use silverware correctly

•brother has to watch him take baths, tuck him in

•Cannot work, go to school, or be unsupervised Deficits in Adaptive Functioning
(ex: inability to perform basic tasks such as self care) Features Continued Examples of difficulty learning social rules
**also applicable to autism spectrum disorder (impairments in social interaction) •Inappropriate affect when talking about how “DAD’S DEAD”
•Telling boy that he is “not invited” to his party
•Stares at girls and makes involuntary noises
•AUTISM:
-Significant impairments in understanding and expressing emotion More Features Deficits in Communication •Speaks in the third person
•Mixes up words frequently: (goodbye instead of goodnight)
•Poor grammar- “I almost drowned-ed”
•AUTISM:
-Echolalia (repeats words without grasping their meaning)
-Pronoun reversals •Scrunches eyes and wipes nose
•Hand-flapping and movement
•Poor motor coordination (anomalous gait) Autism: Tics •Smashes grasshopper in mailbox and is distraught when he is dead•Does not know how to count at age 18•Water Tower continually tries to climb it even though he has been told not to over and over again Suspected Low IQ Grasshopper Scene Climbing Water Tower Scene DSM IV-TR: Pervasive Developmental Disorder- Autism
Impairments in social interaction
Impairments in communication
Restricted repetitive and stereotyped patterns of behavior, interests, and activities
Delays or abnormal functioning in social interaction, social communication, or symbolic or imaginative play prior to age 3 DSM 5- Autism Spectrum Disorders
Deficits in social communication and social interaction (must have all 3):
Deficits in social- emotional-reciprocity
Deficits in nonverbal communication used for social interaction
Deficits in developing and maintaining social relationships

Restricted, repetitive patterns of behavior, interests or activities (must have at least 2):
Stereotyped or repetitive speech, motor movements, or use of objects
Excessive adherence to routines, ritualized patterns of behavior, or excessive resistance to change
Highly restricted or fixated interests
Hyper- or hypo-reactivity to sensory input
Full transcript