Attachment Disorders Flashcards
what is RAD?
reactive attachment disorder
significant disturbance to child development and inappropriate social relatedness before the age of 5
individuals have difficulty forming lasting, loving relationships
what 3 things can cause RAD?
persistent disregard for childs emotional needs
persistent disregard for physical needs
repeated change of caregiver
what are the 2 main types of RAD?
inhibited
- children fail to initiate and respond to social interactions (e.g children don’t seek comfort from care giver when distressed)
disinhibited
- children are unable to display selective attachment (e.g child is too familiar with strangers)
describe the healthy vs alien self theory
alien self = children who develop RAD because the parent is not reciprocal with the child (does not respond to their emotions so child thinks they aren’t worth that sort of care)
this affects self esteem leading to an alien self (sense of self which is not real, just in response to neglect)
what can cause anger issues in children?
anger in RAD children can be shame based
can originate from humiliating abuses of power where they are made to feel worthless
shameful experiences can leave undercurrent of rage
name 4 conditions which can be mistaken for RAD?
conduct disorder
depression
ADHD
ASD
what is conduct disorder?
persistent behaviour where age appropriate norms or rules are consistently broken
still able to form meaningful relationships
how does conduct disorder present?
aggression towards people or animals destruction of property theft serious rule violation commonly associated with ADHD
what are the types of conduct disorder?
mild-moderate = restricted to family environment
severe
- unsocialised = get caught by the law
- socialised = good at getting away with it
how is conduct disorder managed?
parent or child training
medication
- risperidone (antipsychotic)
- treat co-morbidities
how does depression differ to RAD?
sufferers of depression can form relationships with those who reach out to them
how does ASD differ to RAD?
ASD causes pervasive problems, RAD kids are more able to adapt their behaviour depending on what they get out of the relationship
how does ADHD differ to RAD?
ADHD difficulties are persistent, more able to initiate and maintain relationships
how does ADHD present (triad)?
inattention
hyperactivity
impulsivity
long standing from age 5
what causes ADHD?
genetics + environment
how is ADHD managed?
stimulant medication
how is a growth chart used?
take childs height and weight
plot it against their past height and weights
compare with average for their age and sex
what are centile lines?
cross sections of normal growth curve
spaced at 2/3 of a standard deviation between each line
what is SD?
measure of distance from the mean
what is Z score?
number of SDs from the mean
how is height recorded?
remove shoes
measure on expiration
record height to nearest mm with one decimal place
what is PVH and when does this occur in boys and girls?
peak height velocity
girls = 12
boys = 14
average height difference between men and women? what causes this?
12.5-14cm
due to boys reaching their PVH later than girls
what is growth dependant on in infants, children and adolescents?
infants = insulin + nutrition children = GH adolescents = sex hormones
BMI is the best indicator of thinness/fatness after what age?
2 years
normal centiles for weight?
normal = 25th-7th centile
what centile is overweight?
> 91st centile
when does puberty usually begin in girls?
11
what defines precocious puberty in girls and boys?
girls = breast development before 8 boys = before 9
what are the 3 stages of puberty in girls?
thelarche = breast budding/enlargement adrenarche = pubic/axillary hair growth and sweat/odour menarche = first period (should happen around 2 years after thelarche, marks last stage of puberty)
what defines pubertal delay in boys and girls?
boys = no testicular development by 14 girls = no breast development by 13
when does puberty usually complete in girls and boys?
girls = 16 boys = 17
when does puberty begin in boys?
6 months later than girls (anything after 9 is normal)
what is the first sign of puberty in boys?
testicular volume >4
what 3 things occur in male puberty?
deepening voice
pubic/axillary/chest hair growth
enlarged penis/testes
what are the 3 signs of post-puberty in boys?
fully broken voice
facial hair
adult sized penis
how does weight affect growth in children and why?
obesity = faster growth
increase in number of fat cells increases the amount of leptin in the body
leptin can initiate puberty quicker
in what direction does development occur in children?
cephalocaudal
what is global delay?
delay in all 4 fields
- gross motor
- vision and fine motor
- language and hearing
- social and play
how many fields are affected in specific delay?
only 1
describe development at pre-school, primary school and adolescence stages?
pre-school = pre-operational
primary school = operational
adolescence = formal operational
