child and adolescent - mentor & more 2 Flashcards
What is the key differential in Disinhibited Social Engagement Disorder?
ADHD
What specific behaviours distinguish Disinhibited Social Engagement Disorder?
Behaviours with unfamiliar adults
What is the association of Disinhibited Social Engagement Disorder?
A history of grossly insufficient care
What behaviours do children with Disinhibited Social Engagement Disorder often exhibit?
Inattention, general impulsivity, and hyperactivity
Are rates of ADHD elevated among children with Disinhibited Social Engagement Disorder?
Yes
Can both Disinhibited Social Engagement Disorder and ADHD be diagnosed in the same child?
Yes, if all diagnostic requirements for each are met
ICD 11 - Disinhibited social engagement disorder?
Essential features
- Disinhibited social engagement disorder (DSED) involves abnormal social behavior.
- Linked to inadequate childcare (neglect, deprivation).
- Children approach strangers indiscriminately.
- Diagnosed in children within the first 5 years.
- Not diagnosed before age 1 or with autism spectrum disorder.
What is disinhibited social engagement disorder characterised by?
Grossly abnormal social behaviour in the context of inadequate child care
This includes severe neglect or institutional deprivation.
What behaviours do children with disinhibited social engagement disorder exhibit?
Indiscriminate approach to adults and overly familiar behaviour towards strangers
This includes lacking reticence and going away with unfamiliar adults.
At what age can disinhibited social engagement disorder be diagnosed?
Cannot be diagnosed before the age of 1 year
Diagnosis requires a developmental age of at least 9 months.
What is a key feature of disinhibited social engagement disorder development?
Features develop within the first 5 years of life
Symptoms are evident before the age of 5.
What are some examples of inadequate care that can lead to disinhibited social engagement disorder?
Persistent disregard for emotional and physical needs, repeated changes of caregivers, rearing in unusual settings, maltreatment
These factors contribute to the inability to form stable selective attachments.
What is one behaviour indicative of disinhibited social engagement disorder?
Overly familiar behaviour with unfamiliar adults
This includes seeking comfort from strangers or asking inappropriate questions.
What is another behaviour associated with disinhibited social engagement disorder?
Diminished or absent checking back with an adult caregiver
This occurs even in unfamiliar settings.
True or False: Disinhibited social engagement disorder can be diagnosed in the context of Autism spectrum disorder.
False
The disorder cannot be diagnosed if Autism spectrum disorder is present.
What is a developmental milestone related to disinhibited social engagement disorder?
Capacity to form selective attachments typically develops at 1 year old
This is a crucial age for diagnosing the disorder.
Fill in the blank: Disinhibited social engagement disorder can only be diagnosed in _______.
[children]
What is the primary requirement for diagnosing disinhibited social engagement disorder?
A persistent and pervasive pattern of markedly abnormal social behaviours
This includes reduced or absent reticence in approaching unfamiliar adults.
NICE [QS133] recommend Rx for attachment disorder:
Pre-school aged children
video feedback programs
NICE [QS133] recommend Rx for attachment disorder:
primary school aged children
parental training with group play sessions for
NICE [QS133] recommend Rx for attachment disorder:
secondary school
Group-based training programs
What do NICE [NG26] guidelines state regarding children with attachment difficulties?
Children with attachment difficulties should not receive medication unless there are other mental health issues.
What is autism spectrum disorder (ASD)?
A pervasive and life-long disorder characterised by profound deficits in communication and social understanding, together with restrictive and repetitive behaviours.
How has the classification of autism and Asperger’s changed in recent diagnostic manuals?
The DSM-5 and ICD-11 group them all into one category (ASD).
What is challenging about assessing intellectual ability in people with ASD?
Intellectual ability is difficult to assess due to generally skewed profiles.
What percent of people with autism have intellectual disabilities?
33%
Austism _ dsm 5
A. Persistent deficits in social communication and interaction across contexts:
- Deficits in social-emotional reciprocity (e.g., abnormal social approach, reduced sharing of interests, failure to respond).
- Deficits in nonverbal communication (e.g., poor integration of verbal/nonverbal cues, abnormal eye contact, lack of gestures).
- Deficits in relationship understanding (e.g., difficulty in adjusting behavior, sharing play, lack of interest in peers).
B. Restricted, repetitive patterns of behavior, interests, or activities:
- Repetitive motor movements or speech (e.g., lining up toys, echolalia).
- Insistence on sameness or routines (e.g., distress at changes, rigid thinking).
- Highly restricted interests (e.g., strong attachment to unusual objects).
- Hyper/hyporeactivity to sensory input (e.g., indifference to pain, excessive interest in textures).
C. Symptoms present in early development (may not fully manifest until social demands exceed limited capacities).
D. Symptoms cause significant impairment in important areas of functioning.
E. Disturbances not better explained by intellectual disability.
Note: Both criteria A AND B must be satisfied for diagnosis.
Autism in ICD 11
Persistent deficits in social communication and interactions outside typical functioning, varying with age and intellectual level. Specific manifestations may include limitations in:
- Understanding and responding to verbal/non-verbal communication.
- Integrating spoken language with non-verbal cues (eye contact, gestures).
- Using language and sustaining conversations.
- Modulating behavior according to social context.
- Recognizing and responding to others’ emotions.
- Sharing interests and maintaining peer relationships.
Persistent repetitive behaviors, interests, or activities atypical for age, including:
- Difficulty adapting to changes, causing distress.
- Strict adherence to routines and specific timings.
- Overly rigid rules in games.
- Ritualized behaviors lacking external purpose.
- Stereotyped motor movements common in early childhood.
- Intense focus on specific interests or objects.
- Lifelong sensory sensitivities or unusual interests.
Onset typically in early childhood; symptoms can become more apparent with social demands. Symptoms lead to significant impairment in various life areas. Diagnosis remains valid even when individuals function adequately in many contexts.
