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Paediatrics > Chapter 4: Psychological Features And Behavior Managment > Flashcards

Chapter 4: Psychological Features And Behavior Managment Flashcards

1
Q

Common features in children:

A
  • individuality
  • fear of abandonment
  • awareness of time/concept of time
  • fear of the unknown
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2
Q

Children younger than 2-3, parents should?

A

Stay in the room

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3
Q

Up until what age are children not aware of time?

A

Younger than 4 years old

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4
Q

Behavior management is necessary to?

A

Gain confidence of the child

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5
Q

Factors affecting the child behavior?

A
  • family’s attitude
  • IQ and age
  • previous experiences
  • presence of parents in the dental office during treatment
  • time and extension of the visit
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6
Q

How do we achieve effective treatments?

A

We don’t change an expected treatment to the detriment of health, based on the child’s behaviour

Ex: make an extraction instead of a pulpotomy due to bad behavior

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7
Q

how do we achieve efficient treatments?

A

To do the correct treatment in the shortest possible time

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8
Q

What does a positive attitude towards dental treatments mean?

A

The child wants to come back

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9
Q

Control behavior techniques include?

A
  • communication techniques
  • behavior modification techniques
  • movement restriction techniques
  • prohibited techniques
  • other techniques
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10
Q

What is the key to direct behavior and to creat a trusting relationship with the patient?

A

Communication

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11
Q

Communication can be?

A

Verbal or nonverbal

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12
Q

Communication techniques include:

A
  • paediatric language
  • play therapy
  • control of voice
  • tell-show-do
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13
Q

Paediatric language:

A
  • speak at the level of the child’s age without underestimating their intelligence
  • never lie
  • dont prepare the child TOO much
  • encourage their imagination and make comparisons
  • avoid silence
  • few instructions at a time
  • dont allow them to delay treatment
  • avoid words that inspire fear
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14
Q

Control of voice: the authoritarian attitude aims to

A

Reestablish communication that has been lost
We achieve that with a sudden change of tone accompanied by a facial expression, and once we recover their attention, they’ll be praised

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15
Q

What is the basic method in the educational phase of the paediatric patient, and also in any teaching technique? and what does it serve

A

Tell-show-do

Serves to familiarise the patient with the clinical environment, should be done without any interruptions and caring language, say and do immediately

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16
Q

Behavior modification technique: objective?

A

To transform inappropriate behavior into an appropriate one

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17
Q

Behavior modification techniques: types?

A
  • reinforcement
  • desensitisation
  • imitation

RID

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18
Q

Reinforcement: based on?

A

Pavlov’s laws: a rewarded behavior tends to appear frequently and a punished behavior tends to disappear

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19
Q

Reinforcement: we only apply what kind of reinforcement?

A

Positive

We dont use negative reinforcement (punishments)

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20
Q

Reinforcement: how do we deal with inappropriate behavior?

A

Ignore it

Ex: if the patient vomits, we clean it and continue

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21
Q

Reinforcements have to be?

A

Consistent and contingent

Consistent: given if they behave well and not given if wrong
Contingent: given immediately

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22
Q

Reinforcement: types? And which one works best?

A
  • social (works best): praise, smiles
  • material
  • activities
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23
Q

Desensitisation is?

A
  • a classical technique used by psychologist and psychiatrists
  • based on reducing anxiety by relaxation and doing everything systematically
  • systematically we establish a scale of difficulty of what causes anxiety and we’ll change it gradually, enter clinic-exploration-prophylaxis
  • each sequence of treatment should be individualised to each patient
24
Q

Movement restriction techniques: objectives?

A

• To protect him/her against possible injuries (prevent the child movements during anaesthesia).
• To make the treatment easier.
• To recover the child’s attention (hold the hand when distracted).
• To teach the behavior expected from him (ex: put his hand here).
• To give him/her more confidence through body contact.
• They should always be associated to behavior modification techniques and their application in
some cases is controversial.

25
Q

Movement restriction techniques: preliminary considerations?

A

• Done after conventional techniques (if they don’t work).
• If this method does not work, the next option would be the sedation or general anaesthesia.
• Never do it as a punishment.
• The aim should be to protect the patient, the dentist, and the assistant.
• Written informed consent must be obtained before.
• Peaceful environment, try to generate positive feelings.
• If correctly done it should not leave any sequel.

26
Q

Movement restriction techniques: indications:

A

• Children with physical limitations (cerebral palsy).
• Children with mental conditions that can not cooperate.
• Very young children.
• Some premeditated patients, to reduce untoward movement.
• Children with very violent tantrums: spoiled children that are normal but should be controlled sporadically—> potentially cooperative (try to avoid this techniques).
• A patient who requires urgent care and doesn’t cooperate.

27
Q

Movement restriction techniques: types:

A
  • mouth prep
  • physical control by dental team
  • physical control by parents
  • equipment: auxiliary restriction elements
28
Q

Movement restriction techniques: physical control by dental team: the physical limitation systems include?

A

Towels, sheets

29
Q

Movement restriction techniques: auxiliary restriction elements include?

A

Sheets
Towels
Seat belts
Full body stabilisation devices: papoose board, pedi wrap

30
Q

Prohibited techniques:

A

Hand over mouth: the aim was to restore communication with a child, in case he/she understood what we were going to do.

  • not indicated in children under 3 or in patients with mental conditions
31
Q

Other indications include:

A

Distraction
Relaxation
Magic
Hypnosis
Acupuncture
Child psychologists

32
Q

Distraction:

A

Music, videos, photos, games

33
Q

Profile of the non-cooperative child: 4 types are:

A
  • fearing child
  • shy child
  • rebel child
  • spoiled child
34
Q

Fearing child: characteristics:

A
  • They can not overcome their fear.
  • They react in an exaggerated way to normal stimuli.
  • Bad previous experiences.
35
Q

Fearing child: professional action

A
  • Make a practical demonstration of what is going to be done.
  • Sedation or general anaesthesia.
36
Q

Shy child: characteristics

A
  • Inability to face the situation
  • crying (not tantrums).
37
Q

Shy child: professional action

A
  • Tell-show-do.
  • Get trust and good communication.
  • Act firmly and affectionately, patience.
38
Q

Rebel child: characteristic

A
  • They show disagreement with different degrees of aggressiveness.
  • Spoiled, rebels, overprotected.
  • Rejection of authority.
39
Q

Rebel child: professional action

A

show authority and firmness.

40
Q

Spoiled child: characteristics

A

Dominant, whiners, rebels

41
Q

Spoiled child: professional action

A

Act with authority and decision

42
Q

Neurodevelopment according to the age: characteristics of a 3 month old

A

Able to smile and make sounds

43
Q

Neurodevelopment according to the age: characteristics of a 6 month old

A

They may be happy, shy, afraid
Play with baby bottle, hands, feet
Start chewing
Hold things with their hands

44
Q

Neurodevelopment according to the age: characteristics of a 12 month old:

A

Stops putting objects in their mouths
Crawl
Understands phrases, speaks 2-3 word
Angry if separated from parents
Increase motor skills

45
Q

Neurodevelopment according to the age: characteristics of a 2 year old

A
  • all teeth in mouth except 2nd TM which is erupting
  • inc motor skills
  • speaks 15-50 words
  • tantrums and negativism
  • independence
46
Q

Neurodevelopment according to the age: characteristics of a 3 year old

A

Susceptible to praise
Makes friends
1000 words

47
Q

Neurodevelopment according to the age: characteristics of a 4 year old

A

Distinguish between left and right.
Bladder/bowel control (toilet training).
Know 2000 words, 4-5 words phrases.
Great talkers and ask why.
Loss of control.
Deal better with parents separation.

48
Q

Neurodevelopment according to the age: characteristics of a 5 year old

A

Able to hop on one leg.
Says his/her age.
Distinguish between morning and afternoon. Language established, phrases 5-6 words. Mothers are the center of the world.
Respond to praise

49
Q

Neurodevelopment according to the age: characteristics of a 6 year old

A

Can not adapt, tantrums, needs to be right
Language fully established

50
Q

Neurodevelopment according to the age: characteristics of a 7-8 year old

A

Cooperators , desire approvals, great intellectual capacity
Tend to dramatise situations

51
Q

Neurodevelopment according to the age: characteristics of a 9-12 year old

A

Balanced and cooperative

52
Q

Neurodevelopment according to the age: characteristics of puberty

A

Rebellious, interest in hygiene and physical appearance

53
Q

Behavior management: 1-3 years old

A

the child doesn’t cooperate and doesn’t understand.
Most useful techniques: voice control and substitutive language.

54
Q

Behavior management: 3-6 years old

A

children cooperate but don’t understand the dental treatment.
Useful: tell-show-do, reinforcement, and imitation.

55
Q

Behavior management: older than 6 years old

A

may cooperate and understand. We must explain the treatments.
Useful: tell-show-do, reinforcement, and imitation.

Paediatrics (11 decks)

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