Behavior/Mental Health Flashcards
Infants who are fussy and irritable, living with mother who appears tired, what should you offer?
Supportive services to both child and mother
Early intervention and mental health services
Infants who are fussy and irritable, living with mother who appears tired, what should you offer?
Supportive services to both child and mother
Early intervention and mental health services
What does the Home Visiting Program do?
Who: serve at-risk expectant parents and families with children up through kindergarten entry
Goal: Improve family health and relationships, economic self-sufficiency, child development, and school readiness
Things they provide: case management, educational programs, family support services
What does the Women, Infants, and Children (WIC) service do?
Provide food, nutrition education, growth monitoring
What does the Early Head Start program do?
Who: Children <3 yo, pregnant women with low income
Services: prenatal/adult education. Early intervention (state run)
National helpline for info on resources in their community
211
What neurohormonal changes are seen with aggressive behavior?
Decreased serotonin, oxytocin, Y-aminobutyric acid (GABA), and increased dopamine and vasopressin
Diagnosis of bipolar disorder
at least 1 week of euphoria, out-of-control irritability with severe impairment (mania)
What do you recommend for defiant, argumentative, aggressive child (i.e. antisocial disorder)?
Parent management training
Is masturbation/self exploration common? At what ages?
normal until 5 yo, then decreases
What are concerning sexual behaviors in children
Rubbing body against others
Trying to insert tongue in mouth while kissing
Touching peer/adult genitals
Crude mimicking of movements associated with sexual acts
Sexual behaviors that are disruptive to others
Inserting objects into genitals
Asking peer/adult to engage in specific sexual act
Explicitly imitating intercourse
Touching animal genitals
Sexual behaviors that are frequently disruptive to others
Behaviors are persistent/resistant to parental distraction
What sexual behaviors in children would warrant reporting to child protective services
Any sexual behavior between kids >4y apart
Variety of sexual behaviors displayed on daily basis
Sexual behavior that results in emotional distress or physical pain
Sexual behavior associated with physically aggressive behavior
Coercion
Child becomes angry if distracted
Head-banging management
Screen for developmental disability if > 5 yo
Can be normal from 9-18 mo and resolves by 4 yo
When is applied behavioral analysis therapy used?
Children with already confirmed autism disorder
When is applied behavioral analysis therapy used?
Children with already confirmed autism disorder
According to PREP, what can be used for colicy infants?
probiotics (not FDA approved)
Prior diagnosis of ADHD is associated with what other diagnosis?
depression
Diagnosis of depression in adolescents
> 2 weeks of depressed or irritable mood +/- anhedonia, usually changes in weight
Also other SIG E CAPS sx
Evidence based psychotherapies for adolescents (2)
interpersonal psychotherapy - relationships
CBT - reframing negative thoughts and changes behaviors
In a child who had experienced violence and poverty, what type of parenting would promote resilience?
Authoritative:
clear expectations and rules, engaged by loving and responsive parents
Treatment for OCD: first step and then second
1st: CBT
Second: SSRIs if CBT doesnt work
OCD is associated with (3)
tic disorders
anxiety
ADHD
ADHD medications associated with HTN
methylphenidate
atomoxetine
Amphetamine
alpha-agonist options for ADHD
clonidine
guanfacine
Night awakenings for infants, management
If dependent on specific stimulus to sleep, use EXTINCTION (teaches self-soothe)
- limit contact at night to 1-2 minutes
FADING: moves bedtime to desired bedtime slowly over several weeks
Sleep cycles for infants are 60-90 minutes long
When are night feedings no longer necessary
6 mo
Sleep duration by age including naps
4-12 mo: 12-16 hours (+ 3-4 naps)
1-2 yo: 11-14 hrs
3-5 yo: 10-13 hrs
6-12 yo: 9-12
13-18 yo: 8-10
What screening tool can you use for sleep problems
BEARS
Bedtime problems
Excessive daytime sleepiness
Awakenings during the night
Regularity and duration of sleep
Snoring
What is a risk factor for social anxiety disorder
behavioral inhibition (withdraw from unfamiliar or new situations)
Evidence based treatment for anxiety disorders
CBT
SSRIs (though only approved for depression and OCD)
Neurotransmitters associated with anxiety
GABA
serotonin
norepinephrine
Can children with anxiety disorders qualify for Section 504 plan?
yes!
Child changing rules of games, cheating, and stealing, what’s the most common age?
6 yo
Understands rules but cannot control impulses, doesn’t know right from wrong/social conscience
Breath holding spell diagnosis and management
Age: 6 mo to 4 yo
Cause: unclear ?dysfunction of autonomic nervous system, delayed maturation in myelination of brainstem
Family history of BHS 50%
Usually provoked by injury or crying (UNLIKE SEIZURE), lasts <1 min
Cyanotic (may develop generalized motor seizure) vs. pallid (can be sleepy afterwards, bradycardic)
Management: give iron 5-6 mg/kg/day (usually iron depleted)
How do you diagnose psychogenic nonepileptic seizure disorder?
vEEG
