Child Psychiatry (16 & 17) Flashcards

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1
Q

What are the diagnostic criteria for ADHD?

A

A persistent pattern of inattention and/or hyperactivity/ impulsivity that interferes with functioning or development as characterized by inattention and/ or hyperactivity symptoms

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2
Q

Name the inattention symptoms of ADHD?

A

1- Fails to give close attention to details/ careless mistakes
2- Diffculty sustaining attention in tasks or play
2- Does not seem to listen when spoken to directly
4- Does not follow through on instructions/ fails to finish activities
5- Dislikes/ avoids tasks that need sustained mental effort
6- Loses things for tasks/ activities
7- Easily distracted
8- Forgetful in daily activities

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3
Q

How many inattentive or hyperactivity symptoms are needed for an ADHD diagnosis?

A

6 or more of each (depending on if the ADHD is combined/ inattentive/ or hyperactive type) for 6 months or more

** if the patient is older than 17, you only need 5 symptoms

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4
Q

Name the hyperactivity symptoms of ADHD?

A
1- Fidgets, taps hands/feet, squirms
2- Leaves seat in situations were supposed to sit
3- runs around or climbs inappropriately
4- Unable to play or work quietly
5- Is often "on the go"
6- Talks excessively
7- Blurts out answers
8- Difficulty waiting turn
9- Interrupts or intrudes on others
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5
Q

What age must ADHD symptoms be present at?

A

12 or younger

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6
Q

How many settings must ADHD be present in?

A

2+ settings

There must be evidence that symptoms interfere with or reduce quality of social, academic, or occupational functioning

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7
Q

What are the three types of ADHD?

A

Combined, inattentive, hyperactive/ impulsive

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8
Q

What are the behavioral treatments for ADHD?

A

1- Direct contingency management
2- Teacher training
3- Parent management Training (PMT)

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9
Q

What is Parent Management Training?

A

Focuses on parent- child interactions

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10
Q

What is ODD and what are the diagnostic criteria?

A

Patter of angry/ irritable mood, argumentative/ defiant behavior, or vindictiveness lasting at least 6 months.

Need at least 4 symptoms from any category

Must occur with individuals that are not siblings

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11
Q

Name the possible symtoms of ODD (9):

A

Angry/ Irritable Mood: Often loses temper, touchy/ easily annoyed, angry/ resentful

Argumentative/ Defiant Behavior: Often argues with authority figures, defies or refuses to comply with requests, deliberately annoys others, blames others for his/her misbehavior

Vindictiveness: has been spiteful or vindictive at least 2 x in past 6 months

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12
Q

T/F: In ODD the disturbance in behavior is associated with distress in the individual or other in his/her immediate social contact

A

True

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13
Q

What are the types of ODD and how are they defined?

A

Mild: symptoms condined to one setting

Moderate: Some symptoms present in at least 2 settings

Severe: Some symptoms present in 3+ settings

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14
Q

What are the treatments for ODD?

A

1- Parent Child Interaction Therapy (PCIT)

2- Problem solving Skills Training (PSST)

3- PMT

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15
Q

What is Conduct Disorder and what are the diagnostic criteria?

A

A repetitive and persistent pattern of behavior in which the basic rights of others of major age appropriate societal norms or rules are violated, as manifested by at least 3 symptoms in the past 12 months

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16
Q

What are the aggression to people/ animal symptoms of CD?

A

1- Often bullies/ threatens/ intmidates
2- Often initiates physical fights
3- Has used a weapon taht can cause serious injury
4- Has been physically cruel to people
5- Has been physically cruel to animals
6- Has stolen while confronting a victim
7- Has forced someone into sexual activity

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17
Q

What are the destruction of property symptoms of CD?

A

1- Has deliberately engaged in fire setting with the intention of causing damage

2- Has deliberately destroyed others property

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18
Q

What are the deceitfulness/ theft symptoms of CD?

A

1- Has broken into someone else’s house. building/ car

2- lies to obtain goods or favors/ avoid obligations

3- Has stolen items of nontrivial value without confronting a victim

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19
Q

What are the serious violation of rules symptoms of CD?

A

1- Often stays out past curfew (<13yo)

20
Q

How is CD classified?

A

By onset:

Childhood: show at least 1 symptom before 10 yo

Adolescent: show no symptoms prior to age 10

Unspecified: criteria are met, but not enough info to determine if onset was before or after age 10

21
Q

What is seen in individuals with CD and limited prosocial emotions?

A

Need 2+ of the following over at least 12 months in multiple relationships:

1- Lack of remorse or guilt
2- Callous/ lack of empathy
3- Inconcerned about performance

4- Shallow or deficient affect

22
Q

How is CD treated?

A

1- Multisystemic Therapy (MST)

2- Multidimensional Treatment Foster Care (MTFC)

3- Functinal Family Therapy (FFT)

4- Anger Control Training

5- PSST

6- PMT

23
Q

Define the autism spectrum disorders/ pervasive developmental disorders category?

A

Neurological disorders characterized by “severe and pervasive impairment in several areas of development”

24
Q

Name the autism spectrum disorders?

A

Autism, aspergers, Childhood disintegrative disorder, Rett’s disorder

25
Q

What is the definition of autism?

A

Abnormal or impaired development in social interaction and communication.

Patient has a restricted repertoire of interests

26
Q

T/F: Manifestations of Autism vary greatly depending on the developmental level and age of the individual

A

true

27
Q

When is autism typically diagnosed?

A

Before the age of 3

28
Q

What is the prevalence of autism?

A

1/88 individuals

4x more prevalent in boys than girls

29
Q

What are some characteristics of autism?

A
1- Does not babble or coo by 12 months
2- Does not gesture by 12 months
3- Does not say single words by 16 months or 2 word phrases by 24 months
4- Loss of any language/ social skills at any age
5- Does not display pretend play
6- Does not point/ indicate to objects
7- No interest in other children
8- Insistance on sameness
9- Difficulty Expressing needs
10- repeating words or phrases instead of normal language
11- Tantrum/ self injurious/ aggressive
12- prefers to be alone
30
Q

What is asperger’s disorder?

A

Impairments in social interactions with a restricted range of interests/ activities and usually has an above average IQ

31
Q

What is childhood disintegrative disorder?

A

Marked regression in multiple areas following 2 years of normal development

32
Q

What is Rett’s disorder and who is it typically seen in?

A

Development of specific deficits after a period of normal functioning following birth (usually 5mo- 30mo)

Usually see midline hand steriotomy

Seen only in females.

33
Q

How is autism assessed and diagnosed?

A

Accurate diagnosis is based on observation of the individuals communication, behavior and developmental levels

Autism Diagnostic Interview
Autism diagnositc observation scale
Home/ school observation
video analysis

34
Q

How is autism treated?

A

Discrete trial instruction

Reinforcement based treatments

Antipsychotic meds and stimulant meds

35
Q

What are the 3 diagnostic criteria of mental retardation/ intellectual disability?

A

Subaverage intellectual functioning

Deficites in adaptive functioning (in communication, self-care, social skills, self direction, academics, work, safety)–> need 2 or more

Onset before age 18

36
Q

Define Mild MR?

A

IQ: 50- 70

Similar to nonMR kids in first few years of life and can support themselves with minimal supervision
Have 6th grade academic level usually

37
Q

Define Moderate MR?

A

IQ: 35- 55

Academic skills up to 2nd grade

Benefit from extensive social and vocational training

Can perform unskilled or semi skilled tasks under supervision

38
Q

Define Severe MR?

A

IQ: 20-40

Can acquire some basic self help skills

Can perform simple tasks under close supervision

Require assistance for most activities and daily life

39
Q

Define Profound MR?

A

IQ: below 20-25

May have difficulty with simple tasks and need significant training to develop vocational, self care and communication skills

40
Q

Describe the course and prevalence of MR?

A

Usually chronic (except mild individuals can sometime test out with proper training and support)

1-3% of the population

2x more common in males

41
Q

Name some possible causes of MR?

A

Unknown etiology, chromosomal abnormalities, problems in pregnancy, heredity, medical conditions

42
Q

What are challenging behaviors?

A

Self- Injurious behaviors, Pica, Destructive behaviors

43
Q

Name some negative consequences of challenging behaviors

A

Social isolation, impact on educational/ vocation training, tissue damage, infection, blindness/ self amputation, death

44
Q

Define self destructive behavior:

A

An act in which an individual deliberately produces physical damage to his or her own body

45
Q

Define pica:

A

eating one or more nonnutritive substances on a persistent basis for a period of at least one month

46
Q

Define destructive behavior:

A

Acts in which an individual physically harms another person (aggression) or the immediate environment (disruption)