Child Psychiatry Flashcards
Which gender is more likely to have autism?
Boys
They are 4x more likely
75% children Male
What age does autism usually develop before?
The age of 3
What are the 3 main hallmarks of autism?
Communication impairment - Global impairment of language and communication
Interaction impairment - Impairment of social relationships
Imagination impairment - Ritualistic and compulsive phenomena
What medical conditions are associated with autism?
Fragile X syndrome
Rett syndrome
Tuberous sclerosis
What are the structural brain changes seen in children with autism?
Brain enlargement
Larger lateral and 4th ventricles
Autism is managed used a biological, psychological and social approach. What biological agents are used and why?
SSRIs - in low doses to manage repetitive behaviours
Antipsychotics - risperidone used to manage challenging behaviour
Melatonin - can be used to reduce sleep latency (the time it takes to fall asleep
Which is the only antipsychotic licensed for use in children?
Risperidone
Autism is managed used a biological, psychological and social approach. What psychosocial management is used?
CBT
Applied behavioural analysis programme
Educational psychology
Autism is managed used a biological, psychological and social approach. What social support is used?
Special teaching and schools for autistic children
Educate families and siblings
Healthcare support
What are the different autism screening tools used?
ADI-R - autism diagnosis interview revised
ADOS-2 - autism diagnostic observation schedule
DISCO - diagnostic interview for social and communication disorders
What are the 3 core symptoms of ADHD?
Inattention - easily distractible, unable to focus
Impulsivity - act without thinking, interrupting conversations, no sense of danger e.g, walking into a road
Hyperactivity - unable to sit still, climbing on things
At what age are children often diagnosed with ADHD?
Between the ages of 7-15
Younger children are often more active so its more difficult to determine in younger children
What is the diagnostic criteria for ADHD?
Symptoms must be present in multiple settings e.g, home and school
Onset of symptoms must be before 7 years of age
Symptoms must be present for at least 6 months
Must cause significant functional impairment
Not better accounted for by other disorders e.g, ASD, depression, anxiety
What questionnaire is used to assess a child with suspected ADHD?
Corners questionnaire
For parents and teachers of the child
How is ADHD managed?
1st line - psychoeducation for families and school
2nd line - methylphenidate (Ritalin)
CBT can also be useful for children with significant impairment
What are the main side effects of methylphenidate (Ritalin)?
Loss of appetite
Problems with sleep
What is oppositional defiance disorder?
Negative, hostile, disobedient and defiant behaviour
Symptoms may be present at home but not at school
Usually presents by age 8
More likely in children with ADHD
What other mental health conditions are more common in autistic children?
Depression
Bipolar affective disorder
Schizophrenia
What increases the risk of developing autism?
Genetic link - more likely if someone in family has it
What is the sally-Anne test used to assess?
Theory of mind
The sally anne test is where Anne moves the marble and sally goes to find it. The patient is asked where she will look
In order to get the correct answer of “the basket”, one must understand that sally does not know that Anne has moved the marble
85% of 5 year olds will pass the test
80% of autism children will fail the test
How is conduct disorder in children managed?
Using a multi-systemic therapy
Multi-modal, family based and social systems based approach
What is the difference between oppositional defiant disorder (ODD) and conduct disorder?
ODD is difficult behaviour at home with known adults or peers, but not at school
Conduct disorder is oppositional behaviour in all areas of life, and is extreme aggressive behaviour
