Child psych Flashcards
play stories drawing
assess conceptualization, internal states, experiences
kaufman assessment batter for children (K-ABC)
intelligence test for ages 2.5-12
weschler intelligence scale for children revised (WISC-R)
IQ for 6-16
peabody individual achievement test (PIAT)
academic achievement
mental retardation DSM
mental retardation epi
2.5% pop. 85% mild (IQ 50-70). M>F
MR causes
most no cause. Prenatal- TORCH. Perinatal- anoxia, prematurity, birth trauma. Post natal- hypothyroidism, malnutrition, toxin exposure trauma
learning disorder DSM
achievement in math, reading or writing lower than expected for age, lvl of edu, IQ. Can’t be explained by sensory deficits, poor teaching, cultural factors. Often due to deficit in cog procressing (abn attension, mem, visual perception).
learning disorder workup
always r/o visual and hearing deficit. Cause may be genetic, abn dev, perinatal injury, neuro or med condition.
conduct D DSM
pattern of behavior that involves violation of basic rights of others or of social norms and rules. 3/4 in past y. 1) aggression toward ppl/animals 2) destruction of property 3) deceitfulness 4) serious violation of rules
conduct disorder epi
M>F. genetic and psychososcial factors. 40% risk of dev antisocial PeD. Comorbidities- ADHD, learning disorder, mood D, substance abuse, criminal behavior in adulthood
Conduct disorder tx
structure enviro with firm fules. Therapies that focus on behavior modification and problem solving skills. Adj pharmacotherapy helpful. Antipsychotics or lithium for aggression and SSRI for impulsivity, irritability, mood lability.
oppositional defiant disorder DSM
does not involve violation of basic rights of others. At least 6mo of negativistic, hostile, defiant behavior with 4/8 1) freq loss of temper, 2) arguments with adults 3) defying adult’s rules 4) deliberately annoying people 5) easily annoyed §) anger and resentment 7) spiteful 8) blaming others for mistakes or behaviors
ODD epi
20% in children >6yo. Usually begin by age 8. onset bf puberty more common in boys. Comorbid substance abuse, mood D, ADHD, remit in 25%. May –> conduct D.
ODD tx
individual psychotherapy that focuses on behavior mod and problem solving skills and parenting skills.
ADHD comorbid
2/3 have CD or ODD.
ADHD dsm
3 types: predominatly inattentive type, predominantly hyperactive imulsive type, and combined type. 1) at least 6 sx involving inattentiveness(problems listening, concentraitng, patying attention to details, organizing tasks, easily distracted, forgetful), hyperactivity (blurting out, interrupting, fidgeting, leaving seat, talking excessively) or both that persisted at least 6 mo. 2) onset bf 7 3) behavior inconsistent with age and dev.
depression children
manifest as irrtableness instead of dysphoria. Otherwise criteria is same as for adults.
ADHD tx
1) pharma- CNS stimulants - ritalin= first line. Dextroamphetamine, pemoline. SSRI/TCA -adjuct 2) indivi psychotherapy-behavior mod techniques 3) parental counseling (edu and parenting skills) 4) group therapy (improve social skills, self esteem)
pervasive develpmental disorders
social skills, language, behaviors. Autistic, asperger’s , rett’s, child disintegrative disorder
autistic D DSM
need 6 sx from folling categories. 1) social interaction prob (>2): impairment in nonverbal behaviors, failure to dev peer relationships, failure to seek sharing of interest or enjoyment iwht others, lack of social/emotional reciprocity. 2) impairment in communiation (>1): lack of delayed speech, repetitive use of language, lack of varied/ spontaenous play. 3) repetive and stereotyped patterns of behavior and activities (>1): inflexible rituals; reoccupation with parts of obj
autistic epi
.02-.05% in children under age 12. M>F. sig association with fragile C, tuberous sclerosis, mental retardation, seizures. Delay social milestones (smile), usually bf 3yo. 70% metnally retarded. 1-2% func indep as adult
autism/ asperger’s t x
no cure. Manage by remedial edu, behavioral theray, neuroleptics to cotrl aggression, hyperactivity, mood lability. SSRI ctrl stereotpyed and repetitive bahviors. Stimulatns
aspergers D DSM
normal language and cog dev. 1) impared social interaction (>2): failure to dev peer relationships; impared use of nonvebal behaviors, lack seeking to share enoyment or interests with others; lack social emational reciprocity 2) restricted or stereotyped behaviors, interests, activites (inflexible routines, reprtitive mvt, preoccupation)
Rett’s D
normal prenatal/perinator, psychomotor dev 5mo, head circumfrance. Decr rate of head growth btw age 5-48mo. Loss of previously leared purposeful hand skills 5-30mo. Dev stereotyped hand mvt (wringing hands, had washing). Early loss of social interaction –> subseq improve. problem with gait or trunc mvt. impaired language and psychomotor dev. seizure. cyanotic spells.
Rett’s D etiology, tx
MECP2 gene mut on X chromosome. Supportiv tx
childhood disintegrative D
1) normal dev in 1st 2 years. Loss of previously aquired skills in (>2): langauge, social skills, bowel or bladder ctrl, play, motor skills 3) (>2): impaired social itneraction; impaired language use; restricted/repetitive, sterotyped behaviro and interests
Rett’s D etiology, tx
MECP2 gene mut on X chromosome. Supportiv tx
childhood disintegrative D
1) normal dev in 1st 2 years. Loss of previously aquired skills in (>2): langauge, social skills, bowel or bladder ctrl, play, motor skills 3) (>2): impaired social itneraction; impaired language use; restricted/repetitive, sterotyped behaviro and interests
childhood disintegrative D etio, epi, tx
onset 2-10, M>F. rare. Unknown etio. Supportive tx ~ autism
tourette’s dsm
multiple motor and voval tics. Occur many times a day almost every day for >1y (no tic free period >3mo). Onset prior to 18yo. Distress or impairment in social/occupational func
tourrette etio
M>F, onset 7-8yo. Comorbid- OCD, ADHD. Genetic. Impaired reg of dopamine in caudate nucleus.
tourette’s tx
pharm- haloperidol, or pimozide (dop R antagonist). Supportive psychotherapy
enuresis
primary- never established urinary conteinence. 2p: manifestation occur after a period of urinary continence usualy btw 5-8. diurnal-daytime episodes. Nocturnal.
enuresis DSM
involuntary voiding after age 5. at least 2x/wk for 3mo or with marked imapirment
enuresis tx
behavior mod (buzzer wake child up when sense wetness). Pharm- antidiuretics (DDAVP) or TCA
encopresis
r/o hypothyroidism, lower GI prob (anal fissure, IBD) and dietary factor
encopresis dsm
involuntary or intentional passage of faces in inappropriate places. At least 4yo. Occur at least 1/mo for 3mo.
selective mutism
rare. F>M. onset 5-6. precede by stressful life event. Involve supportive psycho/behavioral/ family therapy
separation anxiety D
4% of school age children. F=M. parents often have anxiety D and may express excessive concern. Onset ~7yo. Tx: fx therapy, supportive psychotherapy, low dose antidepressants
child abuse dev
anxiety D, depressive D, dissociative D, substance abuse D, PTSD. Incr risk of subseq abusing own child.
