Child Psych Flashcards
When gathering information in child psychiatry it is important to?
consult multiple sources ( child, parent/caregiver, teacher and coaches, pediatrician, child welfare or juvenile justice system (if relevant))
What is the Kaufman Assessment Battery for Children?
Intelligence test for ages 2-12
Wechsler Intelligence Scale for Children-Revised is what for ages?
6-16
Criteria for diagnosis of Intellectual Disability? (IQ? AGE?, ETC.)
Subaverage intellectual functioning with an IQ of less then or equal to 70, deficits in adaptive skills appropriate for the age group and the onset must be before age 18
Prenatal causes of intellectual disability
TORCH (Toxoplasmosis, Other (syphilis, AIDS, alcohol/illicit drugs), Rubella, CMV, Herpes simplex)
Perinatal causes of intellectual disability
Anoxia, prematurity, birth trauma, MENINGITIS, hyperbilirubinemia
Postnatal causes of intellectual disability
hypothyroidism, malnutrition, toxin exposure, trauma, psychosocial causes
Intellectual disability, obesity, hypogonadism, almond shaped eyes
Prader-Willi Syndrome
Autistic Characteristics, delayed speech, motor delay and sensory deficits. If male have large testicles
Fragile X syndrome
Most common learning disorder
Reading disorder
What do you always have to rule out before diagnosing learning disorders?
Sensory deficits
At least 6 months of negativistic, hostile and defiant behavior during which at least 4 of the following have been present:
Frequent loss of temper, arguments with adults, defying adults’ rules, deliberately annoying people, easily annoyed, anger and resentment, spitefulness, blaming others for mistakes or misbehaviors
Oppositional Defiant Disorder
How is oppositional defiant disorder different from conduct disorder?
Unlike conduct disorder, ODD does NOT involve physical aggression or violation of the basic rights of others
ODD has increased incidence with what?
comorbid substance abuse, mood disorders, ADHD
Cruelty to animals may be a hint at?
conduct disorder
A very persistent pattern of behavior in which the basic rights of others or social norms are violated as evidenced by the presence of at least 3 out of 15 described behaviors in the past year. The behaviors are grouped within the following categories: Aggression toward people and animals, destruction of property, deceitfulness or theft, serious violations of rules
Conduct Disorder
Children with Conduct Disorder have a higher risk of what?
Substance abuse and making suicidal gestures and attempts
Conduct disorder has a high incidence with what other condition?
ADHD
Criteria for ADHD diagnosis?
at least 6 sx of either inattentiveness, hyperactivity, or both, that have presisted for at least 6 months, are present at a degree that is maladaptive and have an onset prior to age 7
in evaluating a toddler who shows no interest or does not speak unless spoken to directly, it is important to do what before making a diagnosis of autism?
order a hearing test
Autism is associated with?
fragile x, tuberous sclerosis and seizures
How do autism and asperger differ?
Children with asperger disorder have normal language acquisition and cognitive development
Asperger disorder social interaction is often characterized by?
a “professional” or “pedantic” style
cognitive development never progresses beyond that of the first year of life
Rett Disorder
Onset of Rett
between age 5 and 48 months
Gender Rett is seen predominately in?
Girls
Rett is associated with which gene?
MECP2 gene mutation on x chromosome
What are Rett pts at increased risk for?
sudden death
Children with hand wringing, hand washing, impaired language, psychomotor retardation, problems with gait and trunk movements
Rett Disorder
Characterized by normal physical and psychomotor development during the first 5 months after birth, followed by a decreasing rate of head growth and loss of perviously learned purposeful hand skills between 5 and 30 months
Rett Disorder
Onset of Rett Disorder
Between 5 and 48 months
which gender is Rett disorder seen predominately in
Females (boys have variable phenotype and it is most likely lethal in utero)
Rett Disorder Tx
Supportive
normal development in the first 2 years of life but there is loss of previously acquired skills before age 10 years in at least 2 of these areas: language, social skills, bowel or bladder control, play, motor skills, and at least 2 of these areas: impaired social interactions, impaired communication, restricted, repetitive, sterotyped behaviors, and interests
Childhood Disintegrative Disorder
Childhood Disintegrative Disorder must show up before what age?
10 years old
Childhood Disintegrative disorder is more common in which gender
4-8x more in boys
Characterized by multiple daily motor and one or more vocal tics (both must be present during illness but not necessarily concurrently) with onset BEFORE AGE 18
Tourette Disorder
Repetitive speaking of obscene words
Coprolalia
Exact repetition of words
Echolalia
Tourette Disorder criteria for tics
occur many times a day almost every day for greater then a year and no tic free period greater then 3 months
Tx of choice for Tourette disorder
Psychopharmacology (risperidone, clonidine, guanfacine, haloperidol, pimozide)
Urinary continence is usually established before what age?
Age 4
Involuntary voiding of urine after age 5. AT least TWICE a week for at least 3 consecutive months
Enuresis
Involuntary or intentional passage of feces in inappropriate places by age 4 at least once a month for at least 3 months
Encopresis
Separation anxiety is usually diagnosed after what age?
6 years old (from 7 months to 6 years old it is normal)
Neurochemical Etiology associated with Tourette
Impaired regulation of dopamine
Postinfectious Autoimmune Factor associated with development of Tourette and OCD
Group A beta hemolytic Strep (s. pyogens) infection
