Behavioural and developmental issues and disorders in children Flashcards
_______ refers to the personality characteristics
you are born with—what is innate rather than
learned
Temperament
two-thirds of children can be classified into one of three categories of temparament
1
2
3
easy, 15%
difficult 15%
slow to warm up 70%
A child with a difficult temperament
will be __________
emotionally labile and have difficulty coping
with new experiences
A child with a _____ will have some difficulty coping with
new experiences, but will eventually manage after
repeated exposures
slow-to-settle
temperament
A child with an easy temperament will _____
cope easily with new experiences and will have a
calm nature.
______ is the view you have of the world based on
your own experiences; it is the ‘soup in your head
Schema
The three main ways in which attachment can go wrong are: 1 2 3
Carer not responding
Carer responding inconsistently
Carer responding inappropriately
Implications if Carer not responding
People who are
raised in this way can even develop what is called
‘learnt unresponsiveness’ and be emotionally
barren.
Implications if Carer responding inconsistently
this can lead to
uncertainty and anxiety in the child
Implications if carer responding inappropriately—such as
with aggression or anger
It creates a terrible and unsolvable paradox for children,
where the person on whom they are completely
reliant to teach them how to relate to the world is
also a threat.
The most effective forms of discipline are actually
____ and _______
praise and encouragement—of wanted behaviours
Consequences work only with children _____years of
age, and should be used solely in response to a small
fraction of a child’s behaviour, regardless of the child’s
temperament.
> 3
There are three types of consequences that work
(in decreasing order of usefulness):
Natural consequences:
Related consequences:
Losing a privilege:
________where there is a natural
flow from the misdemeanour to the consequence.
For example, if a child refuses to have dinner, he
or she goes to bed hungry
Natural consequences:
_________ where there is some link
between the unwanted behaviour and the
result. This is also sometimes called a ‘logical
consequence’. For example, if a child makes
a mess, he or she must clean it up
Related consequences:
__________ This can be a very powerful
technique as it focuses the child’s attention
but is more punitive than natural and related
consequences
Losing a privilege:
_______ are useful from 2–3 years of
age, and can take the heat out of a situation, for both
the parent and child.
It should be consistent, enforced promptly and calmly, even with empathy, and short—a good rule of thumb is a minute per year of age
Time-outs
Responses that don’t work when disciplining
children include:
screaming, constantly explaining,
repeatedly warning, threatening, pleading, arguing,
bribing and giving in, as well as smacking.
__________ are when we lose control of our feelings and
behaviour.
Tantrums
Tantrums
They are more common in toddlers (particularly
between________) because
they have not learned any or many other emotional
responses to challenging situations, such as ignoring,
negotiating, reconsidering or reframing a situation
18 months and 3 years of age
_________ from predictable tantrum
triggers, ‘scaffolding’ (giving necessary support) to
handle the event (e.g. a 5-minute warning), distraction
or active listening in the build-up to a tantrum can be
useful strategies to employ
Diverting a child
T or F
Skill-building toddlers in how to handle emotionally challenging situations (i.e. expanding their repertoire beyond tantrums) is best done either before or after (‘What else could you have done?’).
T
________ is common (around 5% of children do
so at some stage), and occurs between 6 months and
6 years (peak at age 2). While frightening to watch,
such attacks are harmless, and no treatment or action
is required.
Breath-holding
There are two types of breath holding spells:
• ______ (more common)—these happen in
response to being upset or angry. The child cries
loudly then holds his or her breath at the end of
expiration
•_______—these happen in response to pain or
a fright
blue spells
pale spells
In Mx of breath holding
T or F
They can last from 10–60 seconds, and can cause
the child to faint or, rarely, fit. They cause no harm,
and parents should be reassured. Approaches to
discipline should not change because of them
T
Head banging
They are more frequent in children with _____and ______where these behaviours may be more
pervasive through the day.
developmental disability and autism,
What are the features of head-banging
• Usually starts after 8–9 months, and is rare after
2 years of age
• Usually prior to going to sleep
• Child usually not distressed and rarely selfinjurious
_______ usually begins at age 2–4 years, as
children start to use more words and longer sentences
Stuttering
Up to 12% of children will stutter by the age ______
of 4.
Forms of stuttering
Stutters can be repetitions (of a sound, word or
phrase), prolongations of a sound (e.g. ‘aaaand’), a
block (where no sounds comes out) or combinations
of these.
The most common program used in
Australia to treat stuttering is the ________,
which is often successful and can even sometimes
stop the stutter
Lidcombe Program
There are two common types of habit cough:
1 A ________ (heard from the waiting
room) in teenage girls. There is no dyspnoea or
sputum production.
2 A_________commonly seen in boys
aged 7–10. This is related to a transient tic
disorder.
honking-type cough
throat-clearing cough
_________is a neurodevelopmental
disorder characterised by deficits in intellectual and
adaptive functioning that present before 18 years
of age
Intellectual disability (ID
The term ____________ is usually used to describe children <5 years of age who fail to meet
expected developmental milestones in several areas
of development.
‘global developmental delay’ (GDD)
MCC of developmental delay
trisomy 21
fragile X syndrome
_______is a physical disability that
affects movement and posture, and is the most
common physical disability in childhood (2 in 1000
live births).
Cerebral palsy (CP)
CP is associated with what factors?
associated with numerous antenatal and perinatal
factors, including antenatal infections (e.g. rubella,
CMV), birth defects, preterm birth, IUGR, multiple
pregnancy, perinatal hypoxia and postnatal head
trauma or cerebral infection
5 Key elements of CP
1 2 3 4 5
1 It is an umbrella term for a group of disorders.
2 It is permanent, but not unchanging.
3 It involves a disorder of movement and/or
posture and of motor function.
4 It is due to a non-progressive interference, lesion
or abnormality.
5 The interference, lesion or abnormality
originates in the immature brain.
CP is classified according to: 1 2 3 4
- severity
- topographic location
- motor function
- muscle tone
Tests to be done in CP
visual
and hearing tests, pathology tests (e.g. karyotyping,
genetic testing, urine metabolic screening) or imaging
such as a cerebral MRI.
Changes in the DSM criteria for autism
________superseded autistic disorder, pervasive
developmental disorder not otherwise specified
(PDD-NOS) and Asperger disorder,
Autism spectrum disorder (ASD)
Changes in the DSM criteria for autism:
This resulted in a change in the way autism
was diagnosed, with three domains (social deficits,
communication deficits and repetitive behaviour)
reducing to __________
two (social–communication deficits
and repetitive behaviour).
Severity criteria of autism
level 3 (very substantial support), level 2 (substantial support) and level 1 (some support)
IN autism,
In about __________f cases there
may be actual regression, with the child beginning to
say words but stopping, commonly between the ages
of 15 and 24 months.
25–30% o
A typically developing child should
smile in response to a familiar caregiver’s smile or ‘baby talk’ by _____ months.
At ______, an infant will follow a parent’s gaze, that is, look in the same direction as the parent is looking.
Children should be able to follow their parent’s point by ____ months and start pointing themselves by ____
They then begin to point to share (‘look at this’) by _______
2–4
8 months
10–12
12–14 months.
16 months
Younger children with ASD often appear to have little
desire to ________. They may have problems
imitating actions (such as clapping).
connect with others
Communication deficits in autism include deficits
in both _________
non-verbal and verbal communication, and
expressive and receptive language
____ and ______ language, including echolalia (‘parroting’ of learned phrases or scripts) is common
Stereotyped and repetitive
Children with ASD tend not to play imaginatively
(e.g. pushing the car along and saying ‘brrm’) and
instead will engage in :
unusual repetitive play, such
as lining up toys, or spinning the wheels of a car
Patients with ASD:
They frequently show little interest in social play (e.g.
peek-a-boo or pattycake) and their play is often
____________ rather than
people-focused
object-focused (e.g. computer games)
Red flags for autism
• Lack of babbling or pointing by 12 months
• No sharing of interest in objects or activities with
another person
• No single words by 16 months, or no two-word
(non-echoed) phrases by 24 months
• Any loss of language or social skills at any age
______ (from the Greek, meaning ‘disorder of
practising’) is a disorder of the planning, organising
and carrying out of motor tasks. It can affect
articulation and speech, perception and thought,
though it is not associated with decreased intelligence
Dyspraxia
other term for Dyspraxia
Another term that
is used is developmental coordination disorder (DCD
A delay in _____ and _______
can become a barrier to socialisation (e.g. not being
able to play or perform in team sports) or academic
achievement (e.g. writing) and can have flow-on
effects on self-esteem and mood
fine and gross motor skills
A _____________ is characterised by
persistent difficulties in reading, writing, arithmetic
and mathematical reasoning skills during school
years.
specific learning disorder (SLD)
______ (from the Greek, meaning ‘disorder of
words’) is an SLD of reading and spelling, while still
having otherwise normal learning abilities.
The condition was originally called ‘word blindness’.
Dyslexia
_________
is a disorder affecting attention, hyperactivity and
impulse control
Attention deficit hyperactivity disorder (ADHD)
ADHD
It is very common, affecting ____ of Australian children
3–5%
2 types of ADHD
There are 3 types: predominantly
hyperactive/impulsive; predominantly inattentive;
and mixed, with the latter being the most common
______ are the single most effective treatment
for ADHD, and became the standard treatment in the
1980s
Stimulants
Meds for ADHD
• methylphenidate (Ritalin, short acting, effect
duration 3–4 hours)
• slow-release methylphenidate (Ritalin LA 6–8
hours, Concerta 10 hours)
• dexamphetamine
• atomoxetine (Strattera)
Side effects of meds for ADHD
• Common side effects: — decreased appetite — poor weight gain • Uncommon side effects: — headache/dizziness — stomach aches — insomnia — irritable, withdrawn or highly emotional
• Sometimes suggested for ADHD, but research
is unclear about existence of and/or extent of
benefit
• Contains high amounts of omega-3 fatty acids
• May help improve symptoms in some children
Fish oil
____________ is defined as
an ongoing pattern of anger-guided disobedience
and hostile and defiant behaviour towards authority
figures that goes beyond the bounds of normal
childhood behavior
Oppositional defiant disorder (ODD)
3 types of ODD
- angry/irritable mood,
- argumentative/defiant behaviour
- vindictiveness
ODD is common (with an incidence estimated
at 5–10%) 21 and often undiagnosed, and has a large
incidence of co-diagnosis with ______
ADHD,
ODD
The onset is usually gradual, becoming
evident before the age of _________
8
ODD is caused by a combination of ____ and______
difficult temperament traits and environmental factors
ODD cab progress to what conditions
- Disruptive mood dysregulation disorder (DMDD
* Conduct disorder
characterised by severe and recurrent temper
outbursts greatly out of proportion in intensity
or duration to the situation >3/week for
>12 months
Disruptive mood dysregulation disorder (DMDD)
where there is behaviour that
violates the rights of others or societal norms,
such as aggression directed towards people,
animals or property, often with a callous manner
and lack of empathy
Conduct disorder
_______ are sudden, rapid, recurrent involuntary
vocalisations or movements usually appearing in
bouts that wax and wane in intensity, frequency and
type
Tics
Tic disorders are classified into
1
2
3
- Tourette syndrome
- persistent motor or vocal tic disorder
- provisional tic disorder
• \_\_\_\_\_\_\_\_\_ —motor and vocal tics for >1 year •\_\_\_\_\_\_\_\_\_\_—motor or vocal tics for >1 year • \_\_\_\_\_\_\_\_—motor and/or vocal tics for <1 year
Tourette syndrome
persistent motor or vocal tic disorder
provisional tic disorder
Tic disorder
• average of _______ from onset to diagnosis
5 years
Difference of complex tic vs compulsions of OCD
they are not cognitive,
preplanned or anxiety reducing
Examples of complex tics
— \_\_\_\_\_\_\_ (making obscene gestures) — \_\_\_\_\_ (copying others) — wounding oneself — echolalia (repeating others) —\_\_\_\_\_\_ (repeating oneself) — \_\_\_\_\_\_\_ (uttering obscenities)
copropraxia
echopraxia
palilalia
coprolalia
