CAMHS Flashcards
What is attention deficit hyperactivity disorder (ADHD)
a neurodevelopmental condition incorporating features relating to inattention and/or hyperactivity/impulsivity that are persistent
Give 3 RFs for ADHD
- FHx
- Male
- low birth weight
Give inattentive features of ADHD in children
- Difficulty organising tasks and activities
- Easily distracted
- Forgetful
- Loses important things
- Doesn’t complete instructions
- Doesn’t want to engage in tasks that require sustained mental effort
- Often does not seem to listen when spoken to directly
Give hyperactive/ impulsive features of ADHD in children
- Can’t play quietly
- Continuously on the go
- Talks excessively and interrupts others
- Answers questions prematurely
- Difficulty waiting their turn
- Will spontaneously leave their seat when expected to sit
- Will run and climb in situations where it is not appropriate
Give 3 associated symptoms of ADHD in children
- Anxiety
- Difficulty with peer interactions
- Irritability and boredom
What is the diagnostic criteria for ADHD in children
- < 16 years old = child must have at least 6 criteria from either category
- > = 17 years old = child must have at least 5 criteria from either category
- Symptoms must have been present before 12 years old >6 months
- Present in more than one setting (such as home and school).
Give 3 scales that are used in the diagnosis of ADHD in children
- Conners scale
- ADHD rating scale
- DuPaul ADHD scale
How is ADHD initially managed
- Following presentation, a ten-week ‘watch and wait’ period should follow to observe whether symptoms change or resolve
- If they persist then referral to secondary care is required (paeds/ CAMHS)
Give 3 non-medical managements of ADHD in children
- Psychoeducation
- Parent training in behaviour management
- Behavioural classroom intervention
Give 3 medical treatment for ADHD in children
- 1st line: Methylphenidate - 6w trial
- Lisdexamfetamine
- Dexamfetamine
- all potentially Cardiotoxic so need baseline ECG before starting
Side effects of methylphenidate
- stunted growth
- weight loss
- insomnia
- anxiety
- nausea
- dyspepsia
What should be monitored in children taking methylphenidate
weight and height should be monitored every 6 months
What is autism spectrum disorder (ASD)
a neurodevelopmental condition characterized by qualitative impairment in social interaction and communication as well as repetitive stereotyped behaviour, interests, and activities
When are the clinical features of autism typically evident?
typically evident during early childhood, often before 2-3 years of age, but may be manifested late
What are some signs of impaired social interaction in children with autism?
- Poor eye contact
- Plays alone
- Uninterested in social interaction
- Difficulty forming close relationships
What are some signs of impaired social communication in children with autism?
- Failure to develop spoken language
- Failure to initiate conversation
- Abnormal rhythm, pitch and tone of speech
What are some examples of repetitive behaviours, interests, and activities seen in children with autism?
- Stereotyped and repetitive motor mannerisms (e.g., hand-flapping).
- Inflexible adherence to non-functional routines or rituals.
- Children may have particular ways of doing everyday activities
How is ASD diagnosed in children
Features from all 3 categories plus one of the following before aged 3:
* Lack of social attachments
* Abnormal/delayed expression
* Abnormal symbolic play
What is the goal of ASD management
- Although there is no cure for ASD, early diagnosis and early intensive treatment have the potential to affect outcomes
- The goal is to increase functional independence and quality of life
How is ASD managed
- Education and behavioural management
- family support and counselling: parental education
- SSRIs: reduce symptoms like repetitive stereotyped behaviour, anxiety, and aggression
- Methylphenidate: if there’s associated ADHD
