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Child Health > CAMHS 1 - RAD > Flashcards

CAMHS 1 - RAD Flashcards

1
Q

What is reactive attachment disorder?

A

Markedly disturbed and developmentally inappropriate social relatedness in most contexts

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2
Q

When does reactive attachment disorder normally begin?

A

Before age 5 = associated with grossly pathological care

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3
Q

What are the underlying reasons for the development of RAD?

A

Persistent disregard for the child’s physical needs and their emotional needs for comfort, stimulation and affection

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4
Q

What can individuals with RAD have difficulties doing?

A

Forming lasting, loving and intimate relationships

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5
Q

What are the medical signs of RAD?

A

Malnutrition, growth delay, evidence of physical abuse, vitamin deficiencies, infectious diseases

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6
Q

How common is RAD?

A

Estimated at 1% of all children under 5

Increased incidence in children orphaned at a young age

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7
Q

What are the subtypes of RAD?

A

Inhibited and disinhibited (disinhibited social engagement disorder)

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8
Q

What does inhibited RAD refer to?

A

Children who continually fail to initiate and respond to social interactions in a developmentally appropriate way

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9
Q

How do children with inhibited RAD approach interactions?

A

Avoidance and resisting to comforting = often hypervigilant or highly ambivalent

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10
Q

What does disinhibited RAD refer to?

A

A child who has an inability to display appropriate selective attachments (ie excessive familiarity with strangers)

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11
Q

Which subtype of RAD is more enduring over time?

A

Disinhibited RAD

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12
Q

Why is attachment important?

A

Its essential for the formation of healthy personality

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13
Q

What are aspects of a healthy personality?

A

Development of a conscience and relationships
Ability to be self-reliant and to think logically
Ability to cope with frustration and stress

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14
Q

What are potential causes of RAD?

A

Frequent changes in primary caregiver
Extended separation from primary caregiver
Frequent moves/placements in foster care/institutions
Traumatic experiences, neglect or abuse
Young/inexperienced mothers with poor parenting skills

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15
Q

What neurodevelopmental delay in particular is associated with RAD?

A

Autism spectrum disorder

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16
Q

What are red flags for RAD in very young children?

A

Persistent and medically unexplained severe colic
Poor eye contact, difficulty tracking
No reciprocal smile response
Delayed gross motor skills and poor sucking response
Difficulty being comforted and resist affection
Appear stiff, display tactile defensiveness

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17
Q

What should any of the red flags for RAD in very young children raise?

A

Safeguarding concerns

18
Q

What are common symptoms of RAD in older children and young adults?

A

Lack of self control/impulse and hyperactivity
Speech and language delays
Lack of conscience/shows no remorse
Lack of social boundaries and prefers to play alone
Hesitant in social situations and wary/on guard

19
Q

How may older children with RAD respond to physical contact?

A

May either overseek it or avoid it

May be indiscriminately affectionate with strangers

20
Q

How may aggression present in children with RAD?

A

Destructive towards self, property and others

21
Q

What food issues may children with RAD have?

A

Hording, gorging, refusing to eat, hiding food

22
Q

Why may children with RAD suffer from anger of challenging behaviour?

A

Shame-based = results from past experiences of humiliating abuses of power where they are made to feel worthless and unworthy of respect

23
Q

What do shameful past experiences cause?

A

Leave an undercurrent of rage as a result of a distorted sense of self

24
Q

What interact to change the structure of the brain and cause behavioural changes?

A

Childhood experiences and genetics

25
Q

What impact can life experiences have on the brain?

A

Dramatically alter the number of neurons, increase or decrease the dendritic branches and the number of synapses

26
Q

What can life experiences determine in the development of emotional responses?

A

How emotional centres of the brain communicate with the cortex and its higher functioning

27
Q

What are some differential diagnoses of RAD?

A

Conduct disorder, depression, autism spectrum disorder, ADHD

28
Q

How are children with conduct disorder different from children with RAD?

A

Children with CD are able to form some satisfying relationships with peers and adults

29
Q

What subtype of RAD is depression a differential for?

A

Mainly the inhibited type as children are often withdrawn

30
Q

What is the difference between depression and RAD?

A

Depressed children are able to form appropriate relationships with those who reach out to them

31
Q

What is the difference in presentation between autism spectrum disorder and RAD?

A

Children with ASD present with historical and pervasive difficulties, while children with RAD are more able to adapt based on what they get out of certain relationships

32
Q

How is ADHD different from RAD in how it presents?

A

The difficulties of ADHD are persistent and across different settings, and children are more able to initiate and maintain relationships

33
Q

How common are co-morbidities in RAD?

A

About 50% of children met criteria for one or more co-morbid disorders

34
Q

What are some co-morbid disorders of RAD?

A 
Emotional disorders (24%), behavioural disorders (21%), ADHD (19%)
13% have disorders in all of the above categories
35
Q

What are the treatments available for RAD?

A

Family therapy, individual therapy, play therapy, medication, special education interventions

36
Q

What is the aim of family therapy?

A

To help parents/caregivers and other children in the family understand symptoms and effective interventions

37
Q

How is individual therapy beneficial?

A

Helps children directly with monitoring their emotions and behaviour

38
Q

How does play therapy help children with RAD?

A

Helps child learn appropriate skills for interacting with peers and other social situations

39
Q

What does medication aim to control?

A

The symptoms of co-morbid disorders (i.e anxiety)

40
Q

What are special education interventions?

A

Specifically designed programs that can help a child learn skills required for academic and social success, while addressing behavioural and emotional difficulties

Child Health (27 decks)

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