CAMHS Flashcards
What do you need for ADHD Dx
At least 2/3 for 6 months of - Hyperactivity / restless - Impulsitivity - Inattention \+ 6 other features
Must occur more than 1 setting over more than 1 activity and at a level greater than accepted for age
What symptoms suggest hyperactivity and what suggests inactivity
Hyperactivity Fidget Run inappropriately Can't play quiet Talk excessively Interrupt Can't wait turn Uncontrolled Disruptive
Inattention Short attention span Trouble concentrating Careless msitakes Can't follow instruction Easily distracted Forgetful Trouble organising
What conditions are associated with ADHD
LD Motor-coordination e.g. TICS Subtance misuse Anxiety and depression ASD Conduct disorder
How do you treat ADHD
Healthy diet and exercise Behaviour management Parenting programme Methyphindate (Ritalin) = 1st line (CNS stimulant) Atomoxetine Non-stimulant drugs
What do you monitor
Baseline ECG as cardiotoxic
Weight + height every 6 months
BP
SE - Abdo pain, nausea, dyspepsia
What is the prognosis
50% symptoms into adult
80% into teens
Symptoms will alter
What does ASD encompass
Asperger’s = mildest, normal functioning but difficulty in reading emotion etc
Pervasive development disorder
Atypical
Autism
What is ASD
What is triad of impairment
Neurodevlopment disorder Present from birth Variation in learning of language Triad of impairment in ALL 3 - Social communication + language - Social integration - Social imagination - Flexible behaviour
What is social communication
Use of speech Understanding Non-verbal Delay in language Lack of non-verbal communication Repetitive use of words
Causes high level of anxiety
What is social interaction
Social rules Don't understand emotion Rigid thinking Repetitive behaviour as don't like change Lack of smiling Lack of eye contact Difficult with friendships
What is social imagination
Lack imaginative play Do same thing over and over - repetitive movement Can't predict what will happen next Don't like new things Difficult to prepare for change Repetition is reassuring
What else do people with ASD have / usually present with this
Special interest - specific + narrow Sensory sensitivity in all 5 senses Anxiety / depression School avoidnace Aggression OCD LD
How do you Dx
History Schol report / observation Questionnaires SALT / physio ADOS / API-R
How do you RX
MDT Parenting programme Education support Autism outreach worker Teach social and functional skills
What other tests can you do
FBC, U+E, TFT, CK
Microarray – fragile X / Retts
What are co-morbid conditions
RUBELLA
TS
DOWNS
Complications of autism
High levels of anxiety / depression
What is ADHD with no hyperactivity
ADD
SE of ADHD drugs
Appetite Sleep BP HR Growth
What is 1st line ADHD
Methyphenidate - CNS stimulant
What is 2nd line
Atomoxetine - non-stimulant
What do you do before stating treatment
Watch and wait for 10 weeks
What should you ask about
Concentration Memory Impulse Sleep School
What else should you assess for
ASD
Dyslexia
LD
What is a conduct disorder
Repetitive and persistent anti-social, aggressive or defiant behaviour
>12 months
What are symptoms
Aggression
Destruction of property
Decietful
Violation of rules
What is it associated with
Adversity
How do you treat
Parent training if <12 Modify school Behaviour support Family therapy Social skills Anger management Treat co-morbid
What are complications
Violent death School exclusion Poor school Unemployment Criminal activity Poor mental health and relationships
What is Tourette’s
Development of tics persistent >1 year
What is Tics
Involuntary movement or sounds which child performs throughout the day
More prominent if under pressure or excited
What can it be associated with
OCD
ADHD
How do you Rx
Mild = reassurance and monitor
Habit reversal training
Exposure with response prevention
Medications - antipsychotic if severe
