10. Behavioural Problems (10%)

Question 1

Lorsque vous évaluez des problèmes de comportement chez les adolescents, recherchez spécifiquement quoi? (3)

Answer 1

• la consommation de substance
• les problèmes avec les pairs
• les autres facteurs de stress.

Question 2

Name medical DDX : Behavioral issues (6)

Answer 2

• Hearing/vision impairment
• CNS (head trauma, seizures)
• Metabolic (thyroid)
• Toxin (lead)
• Anemia
• Perinatal/Genetic

Question 3

Name psychosocial DDX : Behavioral issues (5)

Answer 3

• Child abuse/neglect
• Housing/food
• Substance use
• Life Stressors (eg. family/peer issues)
• Parental expectations/parenting style

Question 4

Name psych DDX : Behavioral issues (6)

Answer 4

• Mood disorder (eg. bipolar)
• Psychotic disorder
• ADHD
• Learning disorders
• Autism Spectrum Disorder
• Oppositional Defiant Disorder
• Conduct Disorder

Question 5

Describe EP : Behavioral issues

Answer 5

• Head circumference (micro/macrocephaly, increase/decreased growth velocity)
• Weight and height (growth)
• Dysmorphic features (hypertelorism, micrognathia)
• Eyes (visual acuity, strabismus, cataracts)
• Ears (hearing acuity, effusion)
• Abdomen (organomegaly)
• Skin (Cafe-au-lait spots for neurofibromatosis)
• Neuro : Tone, strength, deep tendon reflexes, primitive reflexes, Midline defects, spina bifida

Question 6

Describe approach to behavioural problems (7)

Answer 6

Use multidisciplinary approach
* Parent management therapy (encourage parents to be more positive and less harsh)
* Peer support groups for family (Autism Society)
* Behavioral interventions (positive reinforcement, charts, checklists, reachable goals, set limits and clear consequences for misbehaviour)
* Time management (schedules)
* School-based interventions (accomodations)
* Social skills / psychotherapy
* Psychometric testing

Question 7

Name sx : Oppositional Defiant Disorder

Answer 7

ODD kids “ARE BRATS”
* Annoying
* Resentful
* Easily annoyed
* Blames others
* Rule breaker
* Argues with adults
* Temper
* Spiteful/vindictive

Question 8

Describe sx : Conduct Disorder

Answer 8

TRAP
* Theft: breaking and entering, deceiving, non-confrontational stealing
* Rule breaking: running away, skipping school, out late
* Aggression: people, animals, weapons, forced sex
* Property destruction