Chapter 17: Disorders of Childhood and Adolescence Flashcards

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1
Q

What is a common misconception in child clinical care?

A

That children are smaller versions of adults

  • Children are less verbal with thoughts/feelings
  • Info gathered in other nonverbal/verbal ways
  • Expectations of behaviors are different
  • If you work with children, you must work with parents
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2
Q

Childhood disorder risk factors

A
  • Parent psychopathology
  • Family discord/divorce
  • Lower socioeconomic status
  • Child temperament issues
  • Stressful experiences (abuse)
  • Early childhood physical or health problems - isolation due to illness can prevent child from going through normal developments
  • Prenatal/perinatal difficulties
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3
Q

What are neurodevelopmental disorders? Examples?

A
  • Conditions characterized by developmental deficits that can impair a range of areas
  • Autism Spectrum Disorder
  • Attention Deficit Hyperactivity Disorder
  • Tic Disorder
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4
Q

What was autism spectrum disorder originally split into?

A
  • Autistic disorder
  • Asperger’s
  • Pervasive Developmental Disorder Not Otherwise Specified
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5
Q

Prevalence of autism

A

1 in 88 children

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6
Q

Reasons for rise in prevalence

A
  • Increased awareness - “availability bias”
  • Broadening of diagnostic criteria
  • Increasing parental age - age 35 onwards is high risk
  • Other environmental toxins/factors going on
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7
Q

Characteristics of autism

A
  • Impairment in social interactions and communication skills - ranges from mutism to echolalia
  • Difficulties with perception of sensory stimuli - hypo or hyperactivity
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8
Q

Gender differences in autism

A

Rates higher in males - on higher end of spectrum

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9
Q

Treatments of autism

A

Usually using some form of operant conditioning - Lovaas method and Early Start Denver Model

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10
Q

ADHD basic symptoms

A
  • Inattention - fails to follow through on tasks, frequent shifts of attention from topic to topic
  • Hyperactivity - jumps around, cannot sit still, fidgets, talks excessively
  • Impulsivity - acts out of turn, often interrupts, engages in risky/dangerous behaviors
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11
Q

Prevalence of ADHD?

A

11% of children (4-17 yrs) in US, rates higher in boys

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12
Q

Issues of ADHD

A
  • Overdiagnosed
  • Misdiagnosed
  • Overmedicated
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13
Q

Subtypes of ADHD

A
  • Combined type: >6 sx’s for attention deficit and 6 for hyperactivity/impulsivity
  • Predominantly inattentive type: >6 for attention deficit and 6 hyperactivity/impulsivity
  • Predominantly hyperactive/impulsive type: >6 for hyperactivity/impulsivity and less than 6 inattention
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14
Q

Diagnostic criteria of ADHD

A

*DSM-IV: symptoms present

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15
Q

Possible reasons why ADHD children tend to fail in school?

A
  • Lack of focus
  • Problems with structure of school system
  • Bias of school personnel
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16
Q

Possible causes of ADHD

A
  • Metabolic - dysfunction in brain areas assoc with DA and NE (inadequate)
  • Decreased activity in areas associated with attention and movement
  • Recent study - adults who had not recovered from ADHD showed lack of synchrony in DMN functioning
  • Difficulties at birth, traumatic births
  • Higher rates in families with antisocial PD, alcoholism, depression, bipolar, anxiety
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17
Q

What are tics?

A

Involuntary sudden stereotyped motor movements

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18
Q

What are tics usually comorbid with?

A

ADHD

19
Q

Subtypes of tic disorder

A
  • Transient tic disorder: >4 wks but 1yr

* Tourette’s

20
Q

Gender differences of Tourette’s

A

More males than females

21
Q

Diagnostic criteria of Tourette’s

A

Symptoms occur before 18

22
Q

What is coprolalia?

A

Sudden uttering of obscenities

23
Q

Main issue of Tourette’s

A

Impulse control

24
Q

What are examples of externalizing disorder?

A
  • Conduct disorder
  • Oppositional Defiant Disorder
  • Disruptive Mood Dysregulation Disorder
25
Q

What is conduct disorder?

A

More serious than just pranks - behavior violates the rights of others, predictive of antisocial PD, more males

26
Q

Gender differences in conduct disorder

A
  • Males: more aggressive/confrontational behaviors

* Females: more substance abuse, truancy, prostitution, running away

27
Q

Symptoms of Oppositional Defiant Disorder

A

OFTEN:

  • Argumentative
  • Irritable
  • Defiantly negative
  • Resentful
  • Temper issues
28
Q

Onset of ODD

A

Usually before 8 years

29
Q

Gender differences by age of ODD

A

Before puberty: more male children

After puberty: rates equal

30
Q

Progression of disorder from ODD

A

ODD -> Conduct -> antisocial

31
Q

Risk factors of CD/AD/ODD

A
  • Problems with hyperactivity and inattention
  • Parental rejection or abuse
  • Having delinquent friends
32
Q

What is disruptive mood dysregulation disorder?

A
  • Marked irritability, temper issues, frequent tantrums
  • Significantly exaggerated in intensity and duration
  • Cannot be diagnosed below 6 years and not after 18
  • Symptoms more related to mood disorder/depression than ODD
33
Q

What are the internalizing disorders?

A
  • Separation anxiety disorder
  • Reactive attachment disorder
  • Fears and phobias
  • Generalized Anxiety Disorder
  • OCD
34
Q

Diagnostic criteria for fears and phobias

A

Symptoms present for at least 6 months - crying, tantrums, screaming

35
Q

Typical features of GAD in children

A
  • Anticipatory anxiety
  • Excessive worrying
  • Poor self-esteem
  • Trouble with social relations
  • Somatic problems/complaints - can manifest as unexplainable stomachaches
36
Q

Most common child compulsions

A
  • Washing
  • Checking
  • Ordering
37
Q

Prognosis of OCD in children

A

Very bad - only about ~50% recover

38
Q

Treatment of OCD in children

A

Exposure and response prevention

39
Q

OCD prevalence differences

A

Adults: equally female and male
Children: significantly higher males

40
Q

What is separation anxiety disorder?

A

Excessive anxiety when separated from familiar people

41
Q

Symptoms of separation anxiety disorder

A

Headaches, diarrhea, vomiting

42
Q

Prevalence of separation anxiety disorder

A
  • Preadolescence: more female

* Preschool age: equal between genders (male children may outgrow it as they age)

43
Q

Gender differences in manifestation of childhood depression

A
  • Males: irritability, hostility, social withdrawal, “acting out”
  • Females: body image problems, loss of appetite, dissatisfaction with life, somatic symptoms, “acting in”