Child/Adolescent Flashcards
General guidelines for assessment of Child/Adolescents
The assessment usual takes more time.
Interview child and parent separately
Fantasy vs reality
By age 4, kids have some of understanding of what’s real and what’s pretend
Memory test for school age kids
They should be able to do the 3 object recall after 5 minutes
Abstract thinking in kids (in general)
Kids under 12 are more concrete and not expected to have abstract thinking
If they don’t have abstract thinking, you can’t use proverb testing
A variety of effective treatments for kids/adolescents
Play therapy
Bibliotherapy
Orative therapy
Art therapy Behavior therapy Interpersonal Cognitive Milieu Meds
Oppositional defiant disorder
Enduring pattern of anger, arguing, defiant, vindictive behavior that lasts for at least 6 months, with at least 4 of these: Bad temper Easily annoyed Angry Argues Breaks rules Blames other Deliberately annoys others Spiteful
ODD etiology
possibly from temperament, crazy parents, trauma, unresolved conflicts
ODD prevalence and demographics
More common with parents who had ODD, conduct disorder, ADHD, antisocial personality disorder
30% will develop conduct disorder
ODD labs
There’s nothing specific, but you can do the regular panel, check for drug toxicity, and screen for illegal drugs
Meds for ODD
There’s nothing specific, and it’s not the 1st line treatment.
If you use meds, it’s to target mood or aggression.
Non pharm intervention for ODD
Therapy is the mainstay
It can be individual, family based, and problem solving skills training is an evidence based approach.
Conduct disorder
They violate the rights of others, norms and rule are violated.
They have 3 of these in the last 12 months, and 1 in the past 6 months:
-Aggression
-Destroys property
-Deceit or theft
-Serious violation of rules (staying out late or runs away from home before age 13)
-Child onset is before 10, Adolescent onset is after 10
Conduct disorder prevalence
More common when the parents are antisocial, alcoholics, mood disorders, schizophrenia
Also, if the kids has a low IQ, is abused, or rejected by the family
Conduct disorder labs
Drug screen and the regular labs
Pharm treatment of Conduct Disorder
There’s no specific meds, but you can treat symptoms with antipsychotics, mood stabilizers, SSRIs, and alpha agonists
Non pharm treatment of conduct disorder
Behavioral therapy, individual, family
ADHD etiology
Problems with executive functioning
Abnormalities in the fronto-subcoritical pathways (frontal cortex, basal ganglia)
Abnormalities of the RAS
Structural abnormalities that cause DA and NE dysfunction
ADHD incidence and demographics
5% of kids, 2.5% of adults.
More common in boys.
60% of kids persist into adulthood
ADHD risk factors
pregnancy complications including alcohol use
family conflict
low birth weight
neglect