2/14: Child Psychiatry Flashcards
differences b/w adult and child psychiatry
consideration of developmental level, techniques of assessment, involvement of family, inc role of non-physicians in the health care team, freq occurrence of psychiatric comorbidity
Intellectual disability
significantly sub-avg intellectual fxing (IQ)
- signif limitations in adaptive fxing: communication, self-care, life skills, health and safety skills
- have to have limitations in both intellectual and adaptive
- affects 1-2% of population
- MC males
mild intellectual disability
55-70
- educable w/special ed assistance
- read, write, simple math
- concrete thinker
- expect to be able to hold a job and live indep
- 85% of ID pts
- MC in lower SES
- no identifiable cause
moderate intellectual disability
40-55
- talk, recogn name, basic hygiene, do laundry, handle small change
- minimal academic progress
- live w/family or in supervised group home
- cannot live independently
- part of supervised activities, sheltered work
- 10% of ID pts
severe intellectual disability
25-40
- unable to complete self-help
- will need care in institutionalized setting
profound intellectual disability
<40
- unable to complete self-help
- will need care in institutionalized setting
avg IQ
85-115
below 2SDs= intellectual disability
MC Intellectual disability
fetal alcohol syndrome
MC chromosomal cause
Down syndrome
MC heritable form of mental retardation
Fragile X syndrome
Intellectual disability: prenatal factors
substance abuse/use, maternal malnutr and illness, mutagen exposure
Intellectual disability: perinatal and early postnatal factors
traumatic delivery/brain injury, infx, heady injury, exposure to toxins, malnutrition
Intellectual disability: tx
cannot “cure” it:
tx problematic beh, comorbid conditions, independent living skills, provide special education assistance
learning disorder
inability to achieve in a particular academic area at the level predicted by an individual’s cognitive abilities
-generally borderline IQ or above
learning disorder: dx
requires standardized IQ (2SD below in that area) and achievement testing,
tx=special ed services
learning disorder: types
reading, math, written expression
MC in males, 2-8% of kids
learning disorder: comorbidities
ADHD, mood disorder, truancy, school refusal, substance abuse
communication disorders
- expressive lang DO
- mixed receptive-expressive language DO
- phonological DO
- stuttering DO
- communication disorders NOS
language disorders
impairment in the comprehension and/or use of spoken, written, or other verbal symbol system
- receptive=taking info in
- expressive= getting info out
phonological DO
poor articulation or pronunciation
-substitution (wight–>right), distortions (crat–>cat), omissions (oke–> joke), additions
stuttering DO
reptition and prolongation of sound, syllables or words, that interrupt the flow of speech,
occasional 2˚ characteristics or tics, such as stamping foot or throwing the head out to get the sound out
assessment issues in speech
concomitant retardation or learning disability, dialect, regionalism, facial structure (e.g. cleft palate)
autistic disorder
qualitative impairment in social intrx and communication,
- restrictive repetitive and stereotyped patterns of behavior, interests, activities
- delays or abnormal fxing in at least one of the following areas: social intrx, language as used in social communication, symbolic or imaginative play
- onset prior to age 3
- dont response to cuddling, smile, no eye contact, no language dev`
autistic disorder epid
25% have comorbid seizure DO, MC in males, universal screening at 18 m.
