Child Psych Flashcards
Applied behavior analysis is a type of treatment for what disorder? What does it comprise?
Behavior therapy for Autism, teaches basic social interactions
Functional analysis treats what aspects of Autism?
decreased problematic behavior seen in autism
- type of reinforcement- based treatment
A concerned mother brings in her child to your office because he is not developing normally in his speech. He seems to display lack of eye contact, only likes to line up his hot wheels, ignores other children, and likes to sit in the corner and rock back and forth. What is the most likely diagnosis?
Autism
- impaired social development, communication
- resticted interests ( body rocking, hand flapping)
- commonly have cognitive impairments, non-verbal
When is autism usually diagnosed? and who is more commonly affected?
Dx w/i the first 3 yrs
4x more prevalent in boys
Define autism
- abnormal/ impaired development in social interaction/ communication
- restricted repertoire of interests
- manifests very differently depending on developmental level and age
Characteristics of autism between 12 months and 24 months
- does not babble or coo by 12 mo
- does not gesture by 12 mo
- does not say single words by 16 mo.
- does not say 2 word phrases by 24 mo
- any loss of language or social skill at any age
Characteristics of autism in older children
- does not pretend play
- does not point at objects to indicate interest
- does not show interest in other children
- does not enjoy peek-a-boo or other social games
- does not bring show and tell objects to parents
T/F: children with autism can clearly express their needs
False, children with a autism have difficulty expressing needs
**they fixate on the same things, repeat words/ phrases (echolalia), prefer to be alone, inappropriately show emotion, inappropriate attachments to objects
What are three main disruptive types of behavior that autistic people display?
tantrums, self-injury, aggression
Asberger’s Disorder
impaired social interactions (eye contact, motor, posture, facial expressions), restricted range of interests, NO DELAYS IN LANGUAGE OR COGNITION, tend to have above average IQ
(DSM V says it is now part of Autism Spectrum Disorder)
Childhood Disintegrative Disorder
marked regression in multiple areas following 2 yrs of normal development (speech, play, social, adaptive behavior)
- after 2 yr lose at least 2 previously held skills
- will look like autism once regression has occurred
Disorder in which head growth rate declines after 5 mo. accompanied by lose of previous hand skills, and other social skills - ONLY SEEN IN GIRLS?
Rett’s Disorder
- prob. with social, locomotion, language
What is the best diagnostic test for autism?
NONE! Dx is based on observation of the patient:
- Autism Diagnostic Interview
- Home +/- school observation
- video analysis
- recent genetic studies
Most effective method of acquiring new behavior in autistic patients?
Discrete trial instruction (DTI) aka applied behavioral analysis
3 criteria for Dx of Mental Retardation (MR)?
1- subaverage intellectual functioning (IQ 70 or less)
2- Deficits in adaptive functioning (2+): communication, self-care, social skills, self-direction, academics, work, safety
3- Onset before 18 yo
What is the most common category of MR?
Mild MR: IQ 50/55-70
90% of MR
similar to non-MR kids in first few yrs of life
- achieve 6th grade education
- can support self with minimal supervision
Moderate MR is defined as…?
IQ 35/40-50/55
academic skills up to 2nd grade
benefit from extensive social and vocation training
can perform unskilled or semi-skilled tasks with supervision
This type of MR requires assistance for most activities and daily life with and IQ of approx. 20-40?
Severe MR
*can acquire some basic self-help skills, can count, can perform simple tasks under close supevision
An IQ below 20-25 is considered ________ MR?
Profound MR
- may have difficulty with simple tasks even under supervision
- need significant training to develop vocational, self-care and comm. skills
- function best in highly structured enviro.
T/F: A person with MR is not significantly impacted by training?
FALSE: although MR is chronic, a person with sufficient training may eventually not even meet the dx criteria for MR
How common is MR? IS it more common in men or women?
1-3% of pop.
twice as common in males
Which of the following are causes of MR: chromosomal abnormalities, environmental factors, other mental disorders, problems in pregnancy, heredity, medical conditions?
ALL of the above AND 30-40% are of UNKOWN causes
- chr. abn. 30%
- enviro./ other mental disorders 15-20%
- preg. prob. 10%
- 5% heredity
- 5% med. cond.
What type of behavior is an “essential feature” of autism (diagnostic)?
Repetitive behaviors - ex. hand flapping, body rocking, toe walking…
what types of challenging behavior is associated (but not diagnostic) with autism?
self-injury, aggression, property destruction, pica…
Negative consequences of challenging behavior (CB) include?
social isolation, impact on education/ vocational training, tissue damage, infection, blindness, self-amputation, death
Define self-injurious behavior
SIB, individual deliberately produces physical damage to his/ her own body (stereotypic mvmt disorder may include self injury)
What are the three criteria for Pica?
1- eating one+ substance not made for consumption on a persistent basis, at least 1 month
2 - eating is inappropriate for pt. age
3 - not part of culturally sanctioned practice
Destructive behavior indicates an individual that displays ________ or ________.
1- aggression (physical harm to another person
2- disruption (destruction of immediate environment)
What is the most common type of medication used for autism?
stimulants
what type of medications are used to treat repetitive behavior, rigidity, O/C sx seen in autism?
SSRI, atypical antipsychotics, valproic acid
what type of medications are used to treat hyperactivity, impulsivity, inattention seen in autism?
stimulants, A2 agonists, atomoxetine, atypical antipsychotics
what type of medications are used to treat aggression, explosive outbursts, self-injury seen in autism?
atypical antipsychotics, A2 agonists, anticonvulsants, SSRI, B-blockers
what type of medications are used to treat sleep dysfunction seen in autism?
melatonin, ramelteon, A2 agonists, mirtzapine
what type of medications are used to treat anxiety in autism?
SSRI, buspirone, mirtzapine
what type of medications are used to treat depressive phenotype in autism?
SSRI, mirtzapine
what type of medications are used to treat bipolar phenotype in autism?
anticonvulsants, atypical antipsychotics, lithium
What type of treatment for autism focuses on identifying and modifying the environmental correlates of problem behavior?
Behavioral treatment; process of functional behavior assessment
- effective but intensive and expensive, and rare
What are the following disorders classified under: ADHD, autism spectrum disorders, communication disorders, specific learning disorders and motor disorders
neurodevelopmental disorders
What are the following disorders classified under: ODD, CD, APD, pyromania and kleptomania
Disruptive, impulse control and Conduct Disorders
What type of symptoms, with regards to ADHD, are the following:
failure to pay close attention to details
difficulty sustaining attention
doesn’t listen when spoken to
fails to finish activities
difficulty with organizing
loses things for tasks
avoids tasks needing sustained mental effort
easily distracted
forgetful in daily activities
Inattention (need 6+ for 6 or more months for inattentive type dx
What type of symptoms, with regards to ADHD, are the following:
- fidgets, taps hands/feet
- leaves seat in situations where they should be sitting
- runs around or climbs inappropriately
- unable to play or work quietly
- “on the go” or “driven by a motor”
- talks excessively
- blurts out answers
- difficulty waiting turn
- interrupts or intrudes on others
Hyperactivity- 6+ for 6 or more months for hyperactive type
What other requirements are needed for an ADHD diagnosis?
sx prior to age 12
sx in 2+ settings
sx interfere with or reduce quality of life
sx aren’t better explained by another disorder
What types of behavioral therapy are used for ADHD?
direct contingency management
teacher training
parent management training
How is ODD described?
- pattern of angry/irritable mood
- argumentative/defiant behavior or vindictiveness
- for atleast 6 months
- occurs with atleast 1 person who is not a sibling
- disturbance is associated with distress in individual or in his/her social context
- behaviors are not due to something else
- *may precede development of CD**
What types of therapy are used for ODD treatment?
Parent child interaction therapy-teaches authoritative parenting
Problem solving skills training-focus on cognitive process
Parent management training
How is conduct disorder described?
- repetitive pattern of behavior in which the basic rights of others or major age-appropriate societal norms/rules are violated
- causes a clinically significant impairment in social, academic or occupational fxning
- if 18+ criteria are not met for antisocial personality disorder
What are the categories of behaviors for conduct disorder?
aggression to people and animals
destruction of property
deceitfulness or theft
serious violation of rules
When do symptoms begin showing up with childhood onset CD?
atleast 1 sx before age 10
When do symptoms begin showing up with adolescent onset CD?
no sx before age 10
When do symptoms begin showing up with unspecified onset CD?
not enough info to determine if onset was before or after age 10
What must be present in order to specify CD with limited prosocial emotions?
2+ of the following over 12 months in multiple settings:
- lack of remorse/guilt
- callous-lack of empathy
- unconcerned about performance
- shallow or deficient affect
What types of therapy are used for CD?
Multisystemic therapy Multidimensional treatment foster care Functional family therapy Anger control training PSST PMT
What is multisystemic therapy?
addresses multiple risk factors at multiple levels
focus on understanding behavior in context
What is multidimensional treatment foster care?
-Community based alternative to residential tx
child lives in foster care while parents receive PMT
