Chapter 17: Disorders of Childhood and Adolescence Flashcards
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
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
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
4
Q
What was autism spectrum disorder originally split into?
A
- Autistic disorder
- Asperger’s
- Pervasive Developmental Disorder Not Otherwise Specified
5
Q
Prevalence of autism
A
1 in 88 children
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
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
8
Q
Gender differences in autism
A
Rates higher in males - on higher end of spectrum
9
Q
Treatments of autism
A
Usually using some form of operant conditioning - Lovaas method and Early Start Denver Model
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
11
Q
Prevalence of ADHD?
A
11% of children (4-17 yrs) in US, rates higher in boys
12
Q
Issues of ADHD
A
- Overdiagnosed
- Misdiagnosed
- Overmedicated
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
14
Q
Diagnostic criteria of ADHD
A
*DSM-IV: symptoms present
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
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
17
Q
What are tics?
A
Involuntary sudden stereotyped motor movements
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
What is conduct disorder?
More serious than just pranks - behavior violates the rights of others, predictive of antisocial PD, more males
26
Gender differences in conduct disorder
* Males: more aggressive/confrontational behaviors
| * Females: more substance abuse, truancy, prostitution, running away
27
Symptoms of Oppositional Defiant Disorder
OFTEN:
* Argumentative
* Irritable
* Defiantly negative
* Resentful
* Temper issues
28
Onset of ODD
Usually before 8 years
29
Gender differences by age of ODD
Before puberty: more male children
| After puberty: rates equal
30
Progression of disorder from ODD
ODD -> Conduct -> antisocial
31
Risk factors of CD/AD/ODD
* Problems with hyperactivity and inattention
* Parental rejection or abuse
* Having delinquent friends
32
What is disruptive mood dysregulation disorder?
* 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
What are the internalizing disorders?
* Separation anxiety disorder
* Reactive attachment disorder
* Fears and phobias
* Generalized Anxiety Disorder
* OCD
34
Diagnostic criteria for fears and phobias
Symptoms present for at least 6 months - crying, tantrums, screaming
35
Typical features of GAD in children
* Anticipatory anxiety
* Excessive worrying
* Poor self-esteem
* Trouble with social relations
* Somatic problems/complaints - can manifest as unexplainable stomachaches
36
Most common child compulsions
* Washing
* Checking
* Ordering
37
Prognosis of OCD in children
Very bad - only about ~50% recover
38
Treatment of OCD in children
Exposure and response prevention
39
OCD prevalence differences
Adults: equally female and male
Children: significantly higher males
40
What is separation anxiety disorder?
Excessive anxiety when separated from familiar people
41
Symptoms of separation anxiety disorder
Headaches, diarrhea, vomiting
42
Prevalence of separation anxiety disorder
* Preadolescence: more female
| * Preschool age: equal between genders (male children may outgrow it as they age)
43
Gender differences in manifestation of childhood depression
* Males: irritability, hostility, social withdrawal, "acting out"
* Females: body image problems, loss of appetite, dissatisfaction with life, somatic symptoms, "acting in"
