CH 15 Childhood Disorders Flashcards
DSM-5 Criteria
Conduct Disorder
A. Repetitive & persistent pattern of violating basic rights of others or major age-appropriate societal norms for 12 months+
Aggression to people & animals
1. Bullies, threatens, or intimidates others
2. Initiates physical fights
3. Has used a weapon that can cause serious physical harm to others
4. Has been physically cruel to people
5. Has been physically cruel to animals
6. Has stolen while confronting a victim
7. Has sexually assaulted someone
Destruction of property
1. Has deliberately set a fire intending to cause serious damage
2. Has deliberately destroyed others property
Deceitfulness or theft
1. Has broken into someone else’s property
2. Often lies to obtain goods/favors/avoid obligations
3. Has stolen items of nontrivial value without confronting a victim
Serious violation or rules
1. Often stays out at night despite parental prohibitions before age 13
2. Has run away from hone overnight at least twice while living with parents
3. Often truant from school (before age 13)
B. Disturbance in behavior is clinically significant
If 18 years or older, does not meet antisocial personality disorder requirements
Enuresis
Habitual involuntary discharge of urine after the age of expected continence (5 yrs)
Usually at night
Encopresis
Children who have not learned appropriate toileting for bowel movements after age 4
Define & List examples
Neurodevelopmental disorders
Group of conditions characterized by early onset and persistent course that are (believed to be) the result of disruptions to normal brain development
ADHD & Autism Spectrum Disorder
DSM-5 Criteria
Attention Deficit/Hyperactivity Disorder
A. Persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development
1. Inattention: 6+ of the following for 6 months or longer
a. Fails to give close attention to details, makes careless mistakes in schoolwork/other activities
b. Difficulty sustaining attention in tasks or play activities
c. Doesn’t seem to listen when spoken to
d. Doesn’t follow through on instructions
e. Difficulty organizing tasks & activities
f. Avoids, dislikes, or is reluctant to engage in tasks that require lots of mental effort
g. Loses things necessary for tasks
h. Easily distracted by extraneous stimuli
i. Forgetful in daily activities
2. Hyperactivity & Impulsivity 6+ in 6 months or longer
a. Fidgets with or taps hands/feet, squirms in seat
b. Leaves seat when sitting is expected
c. Runs about when it’s inappropriate
d. Unable to play or engage in leisure activities quietly
e. “On the go”
f. Talks excessively
g. Blurts out an answer before the question’s complete
h. Difficulty waiting his or her turn
i. Interrupts or intrudes on others
B. Several of the symptoms were present prior to age 12
C. Several symptoms present in 2+ settings
D. Clear evidence that sypotoms interfere with functioning
E. Symptoms do not occur exclusively during course of a psychotic disorder/other disorder
DSM-5 Criteria
Autism Spectrum Disorder
A. Persistent deficits in social communication and interaction across multiple contexts
1. Deficits in social-emotional reciprocuty
2. Deficits in nonverbal communicative behaviors
3. Deficits in developing, maintaining, and understanding relationships
B. Restricted, repetitive patterns of behavior/interests/activities
1. Stereotyped or repetitive motor movements, use of objects, or speech
2. Insistence on sameness, infelxible adherence to routines, ritualized patterns of verbal/nonverbal behavior
3. Highly restricted, fixated interests
4. Hyper
C. Present in early developmental period
D. Symptoms cause clinically significant impairment
E. Disturbance not better explained by intellectual disability or global developmental delay
Tic
Persistent, intermittent muscle twitch or spasm
Define & List examples
Learning disorders
Delays in cognitive development in areas of language, speech, math, or motor skills that aren’t necessarily due to any demonstrable physical or neurological defect
Dyslexia
Tourette’s disorder
Extreme tic disorder, multiple tics
Intellectual Disability
Deficits in general mental abilities as defined by both intelligence and performance
LIst
ADHD Subtypes
- Inattentive
- Hyperactive & Impulsive
- Combined
Describe prevalance
ADHD
Gender, subtypes, etc.
- More common in boys (13%)
- 4% in girls
- Inattentive is most common subtype
- 50% of cases persist into adulthood
- Inattentive type is more common in girls
Describe
ADHD Testing
- Interview
- Standardized self-report
- Informant report
- Continuous performance task
- IQ Tests
Why use IQ tests when testing for ADHD?
- Rule out intellectual disability
- Test different types of skill/intelligence
- Working memory
- Processing speed
Causal factors
ADHD
- Smaller brain volume
- Slower brain maturation (3 years behind)
- Prefrontal cortex develops more slowly (attention and impulsiveness)
- Genetic and socioenvironmental factors
What medications are used to treat ADHD?
- Stimulants (Ritalin, Adderal, Vivance)
- Strattara and Wellbutrin
List
Side effects of stimulants
- Disruption of growth hormone
- Decreased blood flow to brain
- Insomnia
- Psychotic symptoms
When is Strattara used over stimulants?
- Substance abuse history
- Stims are very addictive!
Describe methods/types & benefits
Behavioral intervention for ADHD
- Teaching organizational and planning skills
- Teach parent techniques to reinforce adaptive behaviors
- Developing healthy habits & finding external aids
- One task at a time
- Scheduling, calendars, Pomodoro, mindfulness
Echolalia
Parrot-like repetition of a few words
Describe
Causal factors for Autism Spectrum Disorder
- Complex, unknown
- High genetic risk
Describe
Treatment and outcomes for ASD
- Poor prognosis
- Intensive 1-on-1 behavioral intervention (40 hrs/week, 2 years)
- Leads to improved IQ, language, adaptive behaviors, & interpersonal exchanges
- Token economy & Reinforcement
Diagnostic criteria
Intellectual Disability
Onset during developmental period that includes both intellectual and functioning deficits in conceptual, social, and practical domains
List and define
Severity levels for Intellectual Disabilities
- Mild (IQ 55-70)
- Moderate (IQ 35-55)
- Severe (IQ 20-35)
- Profound (IQ below 20-25)
Causal factors
Intellectual Disability
- Organic (birth) trauma
- Toxin exposure
- Malnutrition and low birth weight
- Genetics/chromosomes - Downs syndrome and Fragile X
Downs Syndrome
Presence of all or part of a third copy of chromosome 21
Fragile X Syndrome
- Mild-to-moderate intellectual disability
- Physical features such as long and narrow face, large ears, flexible fingers, and large testicles, and co-occurring autism
- Caused by an expansion of the FMR1 gene
