Child Psychiatry I & II

Question 1

To be diagnosed with ADHD, which 5 criteria must be present

Answer 1

1) persistent pattern of inattention and/or hyperactivity that interferes with functioning or development
2) several symptoms present prior to age 12
3) several symptoms present in 2+ settings
4) evidence the symptoms interfere w/ or reduce quality of social, academic, or occupational functioning
5) symptoms are not better explained by another disorder

Question 2

List and describe the 3 behavioral therapies used in ADHD

Answer 2

1) Direct contingency management: reward/reinforcement/punishment
2) teacher training
3) Parent management training -focus on parent-child interactions

Question 3

What are the 3 criteria needed for diagnosis of Oppositional Defiant Disorder?

Answer 3

1) pattern of angry/irritable mood, argumentative/defiant behavior or vindictiveness lasting at least 6 months, with at least 4 symptoms (e.g. often loses temper, often touchy, easily annoyed, often argues with authority figure, often blames others, has been spiteful vindictive)
2) the disturbance in behavior is assoc w/ distress in the individual or others in his/her immediate social contex or impacts negatively on social, educational, occupational areas
3) no other reason for acting this way

Question 4

Distinguish btw mild, moderate and severe oppositional defiant disorder

Answer 4

mild ODD -symptoms confined to one setting
moderate ODD -some symptoms present in at least 2 settings
severe ODD -some symptoms present in 3+ settings

Question 5

What are 3 behavioral treatments for oppositional defiant disorder?

Answer 5

• parent child interaction therapy -teaches authoritative parenting (nurturance, good communication, firm conrol)
• problem solving skills training focusing on cognitive processes (e.g. help kids realize that other kids/ppl are in fact not hostile)
• parent management training

Question 6

People with oppositional defiant disorder can have what condition when they’re adults?

Answer 6

passive aggressiveness

Question 7

In ADHD, oppositional defiant disorder and conduct disorder, at least how many respective symptoms need to be present for diagnosis?

Answer 7

ADHD - 6
ODD -4
CD -3

Question 8

What 3 criteria are present in conduct disorder?

Answer 8

1) a repetitive & persistent pattern of behavior in which the basic rights of others or major age-approp societal norms or rules are violated by at least 3 symptoms in the past 12 months (e.g aggression to ppl and animals, destruction of property, deceitfulness or thefts, serious violations of rules)
2) disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning
3) if the individual is 18+, not CD; instead antisocial personality disorder.

Question 9

Differentiate btw childhood onset conduct disorder, adolescent onset and unspecified onset

Answer 9

childhood onset - at least 1 symp before 10
adolescent onset -show no symptoms prior to 10
unspecified onset -not enough info to know onset of symptoms was before or after 10

Question 10

Conduct disorder with limited prosocial emotions must display 2+ of which 4 list of symptoms over at least 12 months in multiple relationships/settings?

Answer 10

• lack of remorse or guilt
• callous -lack of empathy
• unconverned abt performance
• shallow or deficient affect

Question 11

How to treat conduct disorder?

Answer 11

very hard; requires multi-disciplinary approach:

• multisystem therapy
• multidimensional treatment foster care (MTFC)
• functional family therapy
• anger control training
• parent management therapy
• problem solving skills training

Question 12

What falls under the group “pervasive developmental disorders?” What are pervasive developmental disorders?

Answer 12

Pervasive developmental disorders are neurological disorders characterized by severe and pervasive impairment in several areas of development. Examples include autism spectrum disorder, childhood disintegrative disorder and rett’s disorder.

Question 13

When is autism typically diagnosed?

Answer 13

within first three years

Question 14

Is the development of autism associated with income level, lifestyle and educational levels?

Answer 14

No

Question 15

What are some characteristics of autism?

Answer 15

-does not babble or coo by 12 months
-does not gesture (point, wave, grasp) by 12 months
-does not say single words by 16 months or 2-word phrases by 24 months
-has any loss of any language or social skill at any age
-does not display pretend play
-does not point at objects to indicate interest
-insistence on sameness
-difficulty in expressing needs
-inappropriate attachments to or engagement w/ objects
++++

Question 16

What’s Asperger’s disorder?

Answer 16

• part of autism spectrum disorder
• no delays in language or other communication problems
• tend to have above avg IQ
• restricted range of interests

Question 17

What is childhood disintegrative disorder?

Answer 17

It’s a subtype of autism manifested as marked regression in multiple areas following 2 years of normal development (normal speech, play, social and adaptive behavior); After 2 years old, lose at least 2 previously held skills (usu. lose skills in all areas); then this disorder starts resembling autism.

Question 18

What is Rett’s disorder?

Answer 18

It occurs primarily in girls
there’s a period of normal functioning following birth-5 months, but then they develop specific deficits after.

after 5 months, head growth rate decelerates, gradually lose previously acquired hand skills, and develop problems w/ social interactions, locomotion, and language

Question 19

There are no medical tests for diagnosing autism. What are some things that are evaluated to see if someone might have autism.

Answer 19

• autism diagnostic interview-r
• home and/or school observation
• video analysis of behavioral observation

Question 20

What’s the most effective way to acquire new behavior in the treatment of symptoms of autism?

Answer 20

Discrete trial instruction aka Applied behavioral analysis

Question 21

What’s the 3 criteria to diagnose mental retardation?

Answer 21

• subavg intellectural functioning (IQ at or below 70)
• deficits in adaptive functioning (2+)
• onset before age 18

Question 22

How to distinguish btw mild, moderate and severe and profound mental retardation?

Answer 22

1) Mild MR (IQ: 50-55-70)
- most ppl with mental retardation have mild
- similar to non-MR kids for first few years of life, but could only achieve to about 6th grade academic level
- can support self w/ minimal supervision

2) Moderate MR (IQ: 35-40 - 50-55)
- academic skills up to 2nd grade
- can perform unskilled or semi-skilled tasks under supervision

3) Severe MR (IQ: 20-25 - 35-40)
- can learn to count or read
- can acquire some basic self-help skills like eating
- require assistance for most activities and daily life

4) profound MR (IQ below 20-25)
- may have difficulty w/ simple tasks, even under close supervision
- need significant training to develop vocational, self-care, and communication skills
- function best in highly-structured settings

Question 23

What is challenging behavior and how is it related to autism?

Answer 23

challenging behaviors are repetitive behaviors tht are considered essential features of autism. It is an “associated” feature of autism. Examples include self-injury, aggression, property destruction, pica.

Question 24

A common type of challenging behavior is self-injurious behavior (SIB). What is it?

Answer 24

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

Question 25

What is stereotypic movement disorder?

Answer 25

motor disorder with onset in childhood involving repetitive, nonfunctional motor behavior (e.g., hand waving or head banging), that markedly interferes with normal activities or results in bodily injury

Question 26

A common type of challenging behavior is destructive behavior. What is it?

Answer 26

An individual physically harms another person (aggression) or the immediate environment (disruption).

Question 27

Compare medication use in younger kids vs older kids with autism. What about alternative med usage?

Answer 27

meds: higher in older ppl with autism

alternative med: higher in younger ppl with autism