Child Psychiatry Flashcards
What is autism spectrum disorder?
Autism spectrum disorder (ASD) is characterised by persistent impairments in social communication, and restricted, repetitive, and stereotyped patterns of behaviours, interests, or activities
Often associated with Low IQ but not defined by low IQ
What are the features of ASD?
Reciprocal conversation Expressing emotional concern Non-verbal communication Declarative pointing Modulated eye-contact Other gesture Facial expression Mannerisms and stereotypies Obsessions, preoccupations and interests Rigid and inflexible patterns of behaviour Language delay or reversion Communication and social impairment Irritable baby Feeding difficulties as infant Increased rigidity Learning disability – mild to severe Disturbed sleep and eating habits Hyperactivity High levels of anxiety and depression Obsessional compulsive disorder School avoidance Aggression Temper tantrums Self-injury, self-harm Suicidal behaviour
What are the risk factors for ASD?
Male sex
Positive FHx
Genetic variants
Karyotype (chromosomal) abnormalities
What medications can be used in ASD?
Antipsychotics
Anti-depressants
Only to be used by specialists
What are the features of oppositional defiant disorder?
Refusal to obey adults request Often argues with adults Often loses temper Deliberately annoys people Touchy or easily annoyed by others Spiteful or vindictive Relates to temperament – irritable and ‘headstrong’ Behaviour is learned Enacted to obtain a desired result More likely to result from impaired parenting Associated with adversity
What is parent training?
Groups, individuals or self-taught
1-2hrs/wk for 8-12 weeks
Structured
Informed by social-learning theory e.g modelling behaviour.
Focus on positive reinforcement of desired behaviour and developing positive parent-child relationships
What is expressed emotion?
Expressed emotion’ is a term used in mental health to denote the intensity of expression of a range of emotions within the family context. Levels of expressed emotion may be high or low. This emotion may be considered ‘negative’ (for example hostility, anger) or ‘positive’ (for example caring concern)
What are conductive disorders?
Characterised by repetitive and persistent patterns of antisocial, aggressive or defiant behaviours which violate age-appropriate societal norms.
What is the management of conductive disorders?
Parent training programme (12 or younger) e.g. The Incredible Years
Modification of school environment eg behavioural support
Functional family therapy
Multi-systemic therapy
Child interventions: social skills, problem-solving, anger management, confidence building
Treat comorbidity
Address child protection concerns
What is ADHD?
Common childhood-onset disorder characterised by inattention, hyperactivity, and/or impulsivity demonstrated across 2 or more settings (such as home and school).
ADHD is a problem of inattention, hyperactivity, and impulsivity. This disorder is referred to as hyperkinetic disorder. ADHD is a chronic condition with symptoms that begin in early childhood but often persist into adult life. A key element of the definition is functional impairment across 2 or more domains, most often in school and at home. As a result, ADHD can limit academic, interpersonal, and occupational success and can also lead to greater risk-taking and accidents. In addition, patients with ADHD are more likely to have co-existing psychiatric disorders such as oppositional defiant disorder (ODD), conduct disorder, substance abuse, and possibly mood disorders, such as depression and mania.
What are the features of ADHD?
Inattention Careless mistakes in tasks Inability to listen Difficulty organising Can't complete tasks Loses things Easily distracted Forgetful Fidgety Excessive talking Mild mood symptoms
What is the management for ADHD?
Psychoeducation Medication – stimulants (amfetamine or methylphenidate), atomoxetine, guanfacine Behavioural interventions e.g. realistic expectations, contingency management Parent training - PinC School interventions Treat comorbidity Voluntary organisations Benefits
