Child Psychiatry Flashcards
What are the types of attachemnt?
Secure- valaues relationship anmd confident
insecure avoidant- does not value realtionships and is independent
insecure anxious- confidence dependent on others approvaal, values relationship but thinks unreliable so seek attention
iunsecure ambivaklent
disrorganised
which facotrs influence resilience
IQ- lower- lower resilience social skills temperament empathy humour parenting relationship between child and carer school achievements extra-curricular activites
What affects when a child prewent?
Age- usually presents at transistion to secondary school, i.e. bigger classes, exams, stress
frequency of the problem, impacting the family i.e. parent/carer wont go to work since child refusing
severity- self harm, sucidal thoughts
family social cirmcumstances
`
What affects when a child prewent?
Age- usually presents at transistion to secondary school, i.e. bigger classes, exams, stress
frequency of the problem, impacting the family i.e. parent/carer wont go to work since child refusing
severity- self harm, sucidal thoughts
`
fWhat aare the child mentasl health services?
Health services-
Specialist services
Universal services
Local authority-
school based services
community based services
voluntary sector
Pt referred to CAHMS who dont need it are referred back to the community.
What influecnes the interact6ion with a child?
Environmental- safe, fewer distractions (difficult in ADHD and sensitivites to sounds etc), other people in the room (ask child if they would prefer to be seen alone),
Privacy, Suitability (noisy/over-stimulating, access to toys, age approriate), intimidating i.e. in a room with several people, correct the environment for what is being assessed- ask if everything is alright with the room, is anything affecting them.
Young person related- their age, add cultural things i.e. some won’t make eye contact with a girl,
Feel safe/secure, willingness to engage (dont force them), family or carers present/not present, cognitive ability IQ/processing problems, communication/langauge problems, emotional development.
Clinican related- language adjusted to child age, other modes of communication i.e. drawing/writing, dont get distracted by time i.e. looking at the clock
Setting enough time, non-verbal communication, use of language, avoid being patronising/condescending, try not to act rehearsed
Differences between children and adult consultations
Age- can't take a full history cognitive ability emotional understanding communication problems willingness to engage what they feel comfortable saying with their parent present
Consider parent/carer expectations parental mental health family dynamics i.e. divorce engagement ability to leave the child- may feel very attached but is there anything there the parent doesnt want the child to talk about
History and observatioon
Developmental Hx- can take 2-3hrs FHx SHx School- liase with school too Observation of child with child and child with carer
Seperation anxiety
Schoolphobic vs seperation aanxiety
somatic manifestation
nightmares with seperaation themes
anxiety upon seperation from carers
what is oppositional disroder
behavioural
uncooperative, unwilling to comoly
can escalate if not maanged
What are conduct disorder?
Socialised- can develop good peer relationships, comes and goes, kess serious
Unsocialised- Are unable to form any peer realtionships, more serious, can lead to criminal beahviour
can lie, steal, truant, vioolent to people, violent to animals
RF- Clear lack of boundareis inconsisten parenting rejection- i.e. parents seperate and no contact family conflict child abuse child temperament comorbid learning/developmental difficulties
treatment- consistent care and parenting behavioural therapy school-based interventions community interventions
What is autism?
Developmental disorder characterised by the triad;
Impairment of social interaction
Impairment of communication
Restricted, stereotyped interests and behaviours
