Child Development & Behavior

Question 1

Enuresis/Encopresis

Answer 1

If child does not achieve urine/bowel continence by age 5-6 with no underlying pathology.

Question 2

Enuresis Treatment

Answer 2

• 1st line - behavioral
  
  • Limit fluids before bed
  • wake at night to use bathroom
  • bedwetting alarms
• Medications (2nd line)
  
  • DDAVP
  • Imipramine (TCA) - last resort d/t SE and risk of OD
  • Relapse high when meds are stopped

Question 3

Encopresis Treatment

Answer 3

• 1st line - behavioral
  
  • have child sit on toilet after meals
  • avoid punishment, help clean up accident
  • Possibly underlying depression

Question 4

Common Developmental Concerns

Colic

Answer 4

• Healthy infant in first 2-3 months starts paroxysmal cry in late afternoon
• Knees drawn up, fists clenched, flatus expelled, face has pained appearance
• Reassure parents that child is not sick
• Encourage quiet environment w/o excessive handling
• Rhythmic stimulation - gentle swinging, rocking, soft music, car ride, stroller walks

Question 5

Common Developmental Concerns

Sleep Disorders

Answer 5

• BEARS to screen for sleeping problems
  
  • Bedtime resistance
  • Excessive daytime sleepiness
  • Awakening during the night
  • Regularity & duration of sleep
  • Sleep-disordered breathing

Question 6

Childhood Developmental Disorders

Answer 6

ADHD most common

Question 7

ADHD Management

Answer 7

• Education
• Behavior modification techniques
• Social skills training
• Individual counseling
• Stimulant medications

Question 8

ASD

Answer 8

• M-CHAT at 18 & 24-30 months