Child Psych: ADHD, Conduct, ODD, Autism

Question 1

ADHD

Answer 1

inattention, hyperactivity and impulsivity inconsistent with developmental stage
tx = stimulants #1, atomoxetine #2, a2 (guanfacine), behavioral tx

6+ inattentive sx:

1. fails to give close attention to detail/makes careless mistakes
2. difficulty sustaining attention
3. does not appear to listen
4. struggles to follow through on instructions
5. has difficulty with organization
6. avoids or dislikes tasks requiring lot of thinking
7. loses things
8. easily distracted
9. forgetful in daily activities

and/or 6+ hyperactive/impulsive sx

1. fidgets or squirms in chair
2. difficulty remaining seated
3. runs/climbs excessively in childhood or restless in adults
4. difficulty in engaging activities quietly
5. acts as if driven by a motor
6. talks excessively
7. blurts out answers before questions completed
8. difficulty waiting or taking turns
9. interrupts or intrudes upon others

> 6 months and in home and school or work, interfere with quality of functioning, onset < 12 yrs

Question 2

autism spectrum disorder

Answer 2

impairments in social communication/interaction and restrictive, repetitive behaviors and interests.

social interaction: inability to hold conversation, no eye contact, lack of interest
behavior: intense peculiar interests, inflexible adherence to rituals, stereotyped motor mannerisms, hyperactive to sensor input
begin early and causes impairment

red flag: rapid deterioration of social/language skills during 1st 2 years. auditory testing before hand

fragile X MCC

tx: early intervention, remedial education, behavioral therapy, psycho education, lo dose antipsych (risperidal/ability) for behaviors,

Question 3

Oppositional defiant disorder

Answer 3

maladaptive pattern of irritability/anger, defiance, or vindictiveness which causes dysfunction or distress in patient or those affected

1. anger/irritable mood: loses temper, easily annoyed, often angry and resentful
2. argumentative/defiant behavior: breaks rules, argues with authority, annoys others, blames others
3. vindictiveness: spiteful

child will have no problem getting along with peers but doesn’t comply with rules
often precedes conduct disorder
NO physical aggression or violating basic rights

tx: behavior modification, conflict management training, parent management training, stimulants for ADHD

Question 4

Conduct disorder

Answer 4

most serious disruptive behaviors which violate rights of humans and animals. Inflict cruelty and harm through physical and sexual violence. lack remorse for crimes and lack empathy for victims

recurrent pattern of violations of 3+ incidents over 6 mos

1. aggression to people and animals: bullies/threatens /intimidates others, initiates fights, uses weapons, cruelty to animals, steals, forces sexual activity
2. property destruction: fires, vandalism
3. deceitfulness or theft: breaking into, lied to obtain foods, stolen items
4. serious violation of rules: stays out late <13 yrs, runs away from home overnight 2x, truant from school before 13

males: higher risk of fighting, stealing, fires, vandalism
females: lying, running away, prostitution, substance use

treatment: behavioral modification, family involvement, Parent training, SSRIs and mood stabilizers and antipsychs