Behavioral Health -- Behavior and Stress Flashcards
1
Q
Disparities in Peds Mental Health (5)
A
- Uninsured children → higher rates of unmet need than publicly insured children
- Rates for white children were also quite high, emphasizing the general conclusion that there is a high rate of unmet need nationally for mental health care among children and adolescents
- Latino children have even greater rates of unmet need than white children
- Latino adolescents have higher rates of suicidal thoughts, depression, and anxiety symptoms
- Greater rates of dropping out of high school than white adolescents
2
Q
Mental health and primary care (3)
A
- Primary care physicians identified about 19% of all children they see with behavioral and emotional problems
- Average visit is only between 11 and 15 minutes
- Significant barriers to referral
i. Lack of available specialists
ii. Insurance restrictions
iii. Appointment delays
3
Q
Positive Mental Health (4)
A
- Successful negotiation of expected developmental achievements in cognition, social and emotional spheres including the presence of secure attachments, positive social relationships, and effective coping skills
- Mentally healthy children and adolescents
- Generally positive quality of life
- Function well at home, in school and in the community
4
Q
How to assess behavior (7)
A
Gather information using two or more methods such as:
- Interviews
- Direct observations
- Self-report inventories and rating scales
- Survey of Well Being of Young Children
- Freely-available for children under 5 years
- Answer, short, and easy to read.
- 15 minutes or less to complete and is straightforward to score and interpret
5
Q
Antecedents (4)
A
- What is triggering the behavior? – What predicts that this behavior will occur?
i. Autistic kids have difficulty making a transition from one setting to another - Include the beliefs, feelings, setting events, and acts of others that predict when a particular behavior will occur
- What triggers the behaviors
- Gather information about the antecedent event
6
Q
Behavior (6)
A
- Frequency
- Duration
- Intensity of the identified behavior
- What did the behavior look like?
- Is the problem a can’t do problem or a won’t do problem
- Kind of Behavior – Internal, cognitive or verbal
*Learning problem, reading problem, intrusive thoughts
*Overt, motor-related problem
*Hyperactivity, tics, tantrums
*Physiological problem –
Anxiety or Depression
7
Q
Modify Behavior using Positive Behavioral Principles (5)
A
- Reinforcement
- Increases behavior
- Must follow the behavior you would like to increase
- Most effective if
a. Contingent, immediate, and obvious - Positive reinfocement
a. Applies following a behavior that they want to increase
b. Social reinforcement-Praise
c. External reinforcement-Rewards`
8
Q
Parenting Skills to Teach (16)
A
- Responsive, structure, predictable
- Warm and firm
- Stress time-in before time-out
- Be clear in choices
a. Don’t ask a child to do homework. Homework time needs to be consistent and at the same time
b. Say “It is homework time” - First get the child’s attention, call them by their name and wait
- Give them warning that they will need to stop—use visuals times, clocks, sticky notes
- For older children, use checklists, calendars, phone alerts if they need to do something
- Make sure the parent gives warnings of change
- Pictures of what the room looks like clean if they ask the older child to clean their room
- Tools such as timers, checklists, schedules, calendars add predictability and lead to less fighting
- Certain children require more social reinforcement
- Practice a skill ahead of time
- Getting out in the am—Practice runs with praising of progress
- Make a game out of it
- Lists that are reasonable
- Do not over schedule the child
9
Q
Parent empathizing with child
A
Empathize with them, “I know it is hard to you to stop playing now, but we need to go to the store now.”
a. Not a question
b. No choice
c. Check to see if they understand
10
Q
Behavioral Management Investigation as a PNP (8)
A
- Empathize with family
2 What I hear you saying is - This must be tough for you.
- Find out how the family handles problems
- Teach this family to do diary of ABC pattern
- Are they consistent?
- Avoid constant punishment
11
Q
Behavioral Intervention for Simple Problems (7)
A
- Increase appropriate behavior based on principles of reinforcement
- Social reinforcers—Praise, approval, acknowledgement
- Star Charts
- Token economy—poker chips, points, stickers
- Tokens exchanged for secondary reinforcements
- Tangible reinforcement—stickers, candy, toys, TV time or video game time
- Differs from bribery since it is only used after the appropriate behavior is observed
12
Q
Ways to decrease/eliminate inappropriate behavior (3)
A
- Extinction – Withdrawal or withholding of reinforcers following the target behavior
* Ignoring the problem behavior - Time out – More effective if the child is removed from a reinforcing situation
- Loss of Privileges
13
Q
Alternatives to Physical Discipline (12)
A
- Good disciplinary practices include:
- Positive reinforcement
- Praise
- Modeling
- Structure and routine
- Setting and maintaining limits
- Realistic expectations and following through
- Verbal and non-verbal cues
- Time ins rather than time out
- Logical consequences
- Problem-solving
- Practicing
14
Q
Strategies to Improve Behavior (9)
A
- Consistency
- Creating predicable routine
- Time in: Special time
- Increasing positive attention
- Giving effective direction
- Ignoring minor problems
- Choosing battles wisely
- Time out from reinforcement
- Sensible consequences
15
Q
Common traps for parents (6)
A
- Ignoring desirable behavior
- Misbehavior is the only behavior that is noticed
- Modeling inappropriate and aggressive behavior
- Ineffective instructions
- Too many, too few, vague, given without the child’s full attention, unrealistic
- Inconsistency
