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Module 5 > Child And Adolescent Disorders > Flashcards

Child And Adolescent Disorders Flashcards

1
Q

Autism spectrum disorders

A

Spectrum disorder
Severe autism - high functioning

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2
Q

Severe autism

A

May have trouble getting themselves dressed

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3
Q

High functioning autism

A

A high end fully verbal group
“Savants” excel in particular areas music, art memory math or perceptual skills such as puzzle building

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4
Q

ASD manifest at which ages

A

Early child hood / toddler years primarily 18-36 mo
Parent may start seeing things they notice is different

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5
Q

Why is autism increasing now

A

Increased awareness and better screening

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6
Q

Clinical manifestations of ASD demonstrate in

A

Social interaction
Communication
Behavior

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7
Q

Social differences in ASD

A

Doesn’t make eye contact or makes very little contact*
Doesn’t respond to a parents smile or other facial expression
Doesn’t look at objects a parent is looking at or pointing to
Doesnt point to objects to get a parent to look at them
Doesnt bring objects of interest to show a parent
Doesn’t have appropriate facial expressions *
Unable to perceive what others might be thinking or feeling by looking at their facial expressions
Does not show concern or empathy for others
Unable to make friends or uninterested in making friends

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8
Q

Communication impairments common sign in ASD?

A

Range from absent to delayed speech
May lose language or other social milestones (regression)

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9
Q

If someone comes in with delayed speech what is done next

A

Hearing and speech is avaluated if a delay or regression in noted

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10
Q

Echolalia

A

Repeats exactly what others say without understanding the meaning (parroting or echoing) immediate or delayed

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11
Q

Stereotypic behavior or stimming

A

Rocks ,spins away , twirls fingers, walks on toes for a long time or flaps hands

The behaviors often involve repetitive movements or sounds

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12
Q

What may someone with ASD be sensitive to?

A

Smells, sounds, lights, textures and touch

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13
Q

T o F
someone with ASD hardly has tantrums

A

False
They may have intense temper tantrums or show aggression

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14
Q

When is standardized screening done at?

A

At well visits

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15
Q

What gets screened at 9 mo

A

Developmental screening
Are they where they should be at 9 months

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16
Q

What is screened at 18 mo

A

Developmental and autism screening MCHAT

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17
Q

Screening for 24- 30 mo

A

Developmental and autism again MCHAT

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18
Q

MCHAT

A

Modified check list for autism in toddlers

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19
Q

Gold standard for diagnosing ASD

A

Autism diagnostic observation schedule (ADOS)

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20
Q

Purpose of behavior modification programs

A

We are trying to modify behaviors so we are trying to give positive rewards for positive behaviors

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21
Q

Applied behavior analysis (ABA)

A

Teach reinforces and maintains new skills and desirable behaviors
In
Communication
Social interactions
Reading& academics
Motor skills
Hygiene and grooming

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22
Q

What problematic behaviors can ABA help extinguish?

A

Self injury like banging head on wall
and aggression toward others

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23
Q

What kind of problems do we run into with ABA

A

Intensive therapy and it requires a minimum of 25 hours a wk for it to work so time wise is hard on parents who have to work
Also expensive

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24
Q

If someone w autism is diagnosed and we refer them to local state dept of mental health and developmental disabilities - why is this?

A

Because they have access to social workers and resources that will be helpful for them
They can be able to access programs that they qualify for

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25
Q

early childhood intervention (ECI)

A

Birth to 3 years
We refer to this program as soon as autism is SUSPECTED
If caught during this time frame for autism the child can have home visits, PT, OT , speech therapy

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26
Q

Individualized education programs (IEP)

A

Pre school program (3-5 yrs) autism
What do they need to be successful in school?

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27
Q

Special education

A

5-21 yrs
Into regular school IEP
Here is what they need to be successful

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28
Q

Hippotherapy

A

Therapeutic horseback riding

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29
Q

Hippotherapy

A

Complimentary therapies /alternative medicine
Therapeutic horseback riding
Strategy used by PT, OT and speech pathologist

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30
Q

Diet/supplements for ASD ?

A

Gluten free*
Casein-free diets (protein present in dairy) *
Vitamin and omega 3 supplementation
High fat and low carb diet (keto)

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31
Q

Anti-psychotic meds for ASD and what is it used for

A

Resperidone (risperdal)
Apripazole (abilifly)

Aggressive behavior
Deliberate self injury
Temper tantrums

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32
Q

What is used in sleep issues for ASD?

A

Melatonin along with a weighted blanket

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33
Q

As far as nursing care, how can we decrease stimulation for someone with ASD?

A

Private room , avoid extraneous auditory and visual distractions

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34
Q

Nursing care for an autistic child

A

Decrease stimulation
Minimal holding touch and eye contact
Organize care so we are not in there all the time

35
Q

ADHD

A

Inattention
Impulsiveness
Hyperactivity

36
Q

How long does some one experiencing ADHD symptoms have to be experiencing them before diagnosed

A

6 months

Have to be careful when diagnosing because it can be developmental instead of ADHD

37
Q

At how many settings and what settings are symptoms of ADHD that must be present to get a confirmed diagnosis

A

In 2 or more settings
At school (academic)
At home
Social setting

38
Q

3 sub types of ADHD

A

*Combined type (most common)
*Predominantly inattentive
* Predominantly hyperactive impulsive type

39
Q

Diagnostic - Maladaptive with ADHD

A

Is it causing some kind of problem in ther life
(Stops them form adapting to new or difficult situations ) and inconsistent w their developmental age

40
Q

Two diagnostic test for adhd

A

Psychological testing
Behavioral check list

41
Q

Psychological testing

A

ADHD
Projective testing and IQ & achievement levels

42
Q

Behavioral checklist

A

For ADHD
Parents and teachers can fill out
Do you see this behavior and how often?

43
Q

Multimodal treatment

A

For adhd
Pharmacotherapy
Behavioral intervention
ADHD coaching

44
Q

ADHD coaching

A

Teaches the individuals to manage their inattention, hyperactivity and impulsivity by by developing self awareness and strategies

45
Q

What is medication determined by for adhd

A

Age
Usually wait till 5 years and older to give medications

46
Q

Psychostimulants

A

For adhd
Start small dose initially
Gradually increase till we get the desired response

47
Q

Jornay PM

A

ADHD psychostimulant
Type of Ritalin extend and release
First and only medication dosed at night

48
Q

Methylphenidate hydrochloride

A

ADHD
Ritalin
Most commonly used

49
Q

Dextroamphetamine sulfate

A

Dexedrine
ADHD
Not commonly used

50
Q

Lisdexamfetmine (Vyvanse)

A

ADHD
Psycho stimulant
If Ritalin is not working this is the next line drug

51
Q

Dextroamphetamine -amphetamine (adder-all)

A

Psychostimulant
ADHD

52
Q

Side effects of stimulant meds (adhd)

A

Loss of apetite (weight loss)
Abdominal pain (n&v)
Suppression of growth
Sleeplessness
Headaches
Crying and irritability
Cardiovascular stimulation (hypertension)

53
Q

Atomoxetine ( strattera)

A

Non stimulant medication
Suicidal thoughts is side effect
Teach parents change in mood or signs of depression

54
Q

Adjunct therapy
Selective adrenergic agonist
ADHD

A

Clonidine (catapres) extend and release

55
Q

Meds for adjunct therapy
Tricyclic antidepressants
ADHD

A

Notriptyline( pamelor)
Imipramine( tofranil)
Desipramine( norpramin)

Side effect- increase in the incidence of dental caries

56
Q

Adjunct therapy meds for adhd

A

Selective adrenergic agonist
Tricyclic antidepressant

57
Q

Environment changes that can help with adhd

A

Organizational charts *
Families and teacher- same goal
High structured environment
Parents, school, pediatrician working together
Decrease distractions*
Show parents how to monitor positive behavior

58
Q

What is important to teach about caffeine and stimulants ?

A

Caffeine decreases the efficacy of stimulant medications

59
Q

What would we teach parents who’s child is having issues with weight loss due to side effect of stimulant adhd

A

Nutritious snacks in evening when effects of med is decreasing
Serve frequent small meals and healthy on the go snacks(cheese sticks fruits)

60
Q

If child on a stimulant is having trouble sleeping what can we do to help?

A

Change the dosing

61
Q

What are children with adhd AT RISK FOR

A

Increased risk for accidents and unintentional injuries due to impulsivity
And decrease judgement of dangerous activities

62
Q

When is stimulant methylphenidate , dextroamphetamine medication used for ODD

A

Only used if they have ADHD too. Will not use alone for ODD.

63
Q

When are antidepressant (fluoxetine, setraline)meds used in ODD?

A

When behavior management is only achieving lemonade, results and hostile and aggressive behaviors are on going

64
Q

If ODD is untreated what can progress to

A

Conduct disorder . And if that isn’t handled it can turn to anti social or personality disorder

65
Q

Hallmark signs of conduct disorder

A

Aggressive behavior

66
Q

In conduct disorder what do they lack regarding aggressive actions to people or property

A

Remorse

67
Q

What is the best treatment for conduct disorder

A

Prevention - catch at ODD

68
Q

What medications are used for conduct disorder

A

Antipsychotics and mood stabilizers

69
Q

Gender dysophoria diagnostic criteria in children

A

A noticeable in congruence between ones experienced / expressed gender and signed gender
At least 6 mo duration
Manifested by at least 6 of criterion

70
Q

Diagnostics criteria for gender dysphoria

A

Is it causing distress in their life?

71
Q

Biological sex

A

Assigned gender

72
Q

Gender expression

A

What they identify as
Identity

73
Q

Hormonal suppressors

A

Puberty blockers
Fully reversible
Give child more time to make. Dont know long term effects

74
Q

Regular cross sex Hormone therapy

A

Longer they are on this the less reversible they are
As they develop secondary charecteristics can’t reverse

75
Q

Meds for childhood depression

A

Tricyclic antidepressants
Selective serotonin reuptake inhibitors (SSRI)

76
Q

SSRIs for depression

A

Fluxetine (Prozac)
Escitalopram (lexapro)
Sertaline (Zoloft)

77
Q

With antidepressants how long does it take for them to work

A

2-4 weeks

78
Q

Adverse effect of antidepressant

A

Increased suicidal thinking in pediatric pt (black box warning) teach parents to report change in behavior

79
Q

Suicide risk assessment

A

Presence of suicide ideation
Specific plans for self injury
History of actual self harm or threats or gestures

80
Q

Suicide

A

The deliberate act of self injury with the intent that ine injury results in death

81
Q

Suicide ideation

A

Involves a preoccupation with thoughts about committing sucicide (may be a precursor to suicide)

Just thinking about

82
Q

Suicide attempt

A

Attempted to accuse injury or death

83
Q

With previous suicide attempts its important to know

A

They are at high risk for doing it again so monitor closely

84
Q

Meds for conduct disorder

A

Antipsychotics, mood stabilizer

Module 5 (39 decks)

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