Child Psychiatry (16 & 17) Flashcards
What are the diagnostic criteria for ADHD?
A persistent pattern of inattention and/or hyperactivity/ impulsivity that interferes with functioning or development as characterized by inattention and/ or hyperactivity symptoms
Name the inattention symptoms of ADHD?
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
How many inattentive or hyperactivity symptoms are needed for an ADHD diagnosis?
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
Name the hyperactivity symptoms of ADHD?
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
What age must ADHD symptoms be present at?
12 or younger
How many settings must ADHD be present in?
2+ settings
There must be evidence that symptoms interfere with or reduce quality of social, academic, or occupational functioning
What are the three types of ADHD?
Combined, inattentive, hyperactive/ impulsive
What are the behavioral treatments for ADHD?
1- Direct contingency management
2- Teacher training
3- Parent management Training (PMT)
What is Parent Management Training?
Focuses on parent- child interactions
What is ODD and what are the diagnostic criteria?
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
Name the possible symtoms of ODD (9):
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
T/F: In ODD the disturbance in behavior is associated with distress in the individual or other in his/her immediate social contact
True
What are the types of ODD and how are they defined?
Mild: symptoms condined to one setting
Moderate: Some symptoms present in at least 2 settings
Severe: Some symptoms present in 3+ settings
What are the treatments for ODD?
1- Parent Child Interaction Therapy (PCIT)
2- Problem solving Skills Training (PSST)
3- PMT
What is Conduct Disorder and what are the diagnostic criteria?
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
What are the aggression to people/ animal symptoms of CD?
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
What are the destruction of property symptoms of CD?
1- Has deliberately engaged in fire setting with the intention of causing damage
2- Has deliberately destroyed others property
What are the deceitfulness/ theft symptoms of CD?
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
What are the serious violation of rules symptoms of CD?
1- Often stays out past curfew (<13yo)
How is CD classified?
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
What is seen in individuals with CD and limited prosocial emotions?
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
How is CD treated?
1- Multisystemic Therapy (MST)
2- Multidimensional Treatment Foster Care (MTFC)
3- Functinal Family Therapy (FFT)
4- Anger Control Training
5- PSST
6- PMT
Define the autism spectrum disorders/ pervasive developmental disorders category?
Neurological disorders characterized by “severe and pervasive impairment in several areas of development”
Name the autism spectrum disorders?
Autism, aspergers, Childhood disintegrative disorder, Rett’s disorder
What is the definition of autism?
Abnormal or impaired development in social interaction and communication.
Patient has a restricted repertoire of interests
T/F: Manifestations of Autism vary greatly depending on the developmental level and age of the individual
true
When is autism typically diagnosed?
Before the age of 3
What is the prevalence of autism?
1/88 individuals
4x more prevalent in boys than girls
What are some characteristics of autism?
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
What is asperger’s disorder?
Impairments in social interactions with a restricted range of interests/ activities and usually has an above average IQ
What is childhood disintegrative disorder?
Marked regression in multiple areas following 2 years of normal development
What is Rett’s disorder and who is it typically seen in?
Development of specific deficits after a period of normal functioning following birth (usually 5mo- 30mo)
Usually see midline hand steriotomy
Seen only in females.
How is autism assessed and diagnosed?
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
How is autism treated?
Discrete trial instruction
Reinforcement based treatments
Antipsychotic meds and stimulant meds
What are the 3 diagnostic criteria of mental retardation/ intellectual disability?
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
Define Mild MR?
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
Define Moderate MR?
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
Define Severe MR?
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
Define Profound MR?
IQ: below 20-25
May have difficulty with simple tasks and need significant training to develop vocational, self care and communication skills
Describe the course and prevalence of MR?
Usually chronic (except mild individuals can sometime test out with proper training and support)
1-3% of the population
2x more common in males
Name some possible causes of MR?
Unknown etiology, chromosomal abnormalities, problems in pregnancy, heredity, medical conditions
What are challenging behaviors?
Self- Injurious behaviors, Pica, Destructive behaviors
Name some negative consequences of challenging behaviors
Social isolation, impact on educational/ vocation training, tissue damage, infection, blindness/ self amputation, death
Define self destructive behavior:
An act in which an individual deliberately produces physical damage to his or her own body
Define pica:
eating one or more nonnutritive substances on a persistent basis for a period of at least one month
Define destructive behavior:
Acts in which an individual physically harms another person (aggression) or the immediate environment (disruption)
