CHild Psychiatry II

Question 1

What are the 3 Dx criteria for Autism?

Answer 1

1. Impaired development in social interaction
2. Imparired development in communication
3. Restricted repertoire of interests

Question 1

When is autism generally Dx?

Answer 1

Within first 3 years

Question 2

What is the prevalence of autism? Between genders?

Answer 2

1/88; 4x more prevalent in boys;

Question 3

What characteristics are seen in a child within the first 12 months? 16 months? 24 months?

Answer 3

Does not babble/coo or gesture (12); Does not say single words (16); Does not say two word phrases (24)

Question 4

What are social/play behaviors that are absent in those with autism?

Answer 4

Does not pretend play (drink out of play cup), Does not point at object, Does not show interest in other children, does not enjoy peekaboo, Does not bring/show objects to parents

Question 5

What behavioral characteristics are seen in autism?

Answer 5

Insistence on sameness, Difficulty expressing needs (echalalia)

Question 7

What is Asperger’s disorder? Describe their cognitive ability

Answer 7

Impairment in social interaction (lack eye contact, motor, posture, facial expressions), restricted range of interests, no developmental delays; Tend to have above average IQ

Question 8

What is childhood disintegrative disorder?

Answer 8

Marked regression in multiple areas following 2 years of normal development; After 2 years, lose at least 2 previously held skills (language, social skills, toileting, play, motor skills); resembles autism

Question 9

What is Rett Disorder? What gender does Rett Disorder occur in?

Answer 9

Typical development followed by decreased head growth rate and lose hand skills (telltale signs); Only occurs in girls!

Question 10

What Dx test do we use for Autism?

Answer 10

There is not Dx test for autism. Dx made based on an individual’s communivation, behavior, and developmental levels

Question 11

What is the Tx of Autism Spectrum Disorders?

Answer 11

• Discrete Trial Instruction (DTI) - Applied Behavior Analysis to treat basic social interactions
• Functional Analysis - Reinforcement-based Tx are most effective for decreasing problematic behavior

Question 12

Criteria for Mental Retardation (Intellectual Disability)

Answer 12

1. IQ < 70
2. Deficits in adaptive fn (Communication, self-care, social skills, self-direction, academics, work, safety)
3. Onset before 18 yo

Question 13

Criteria for Mild MR

Answer 13

• IQ 50/55 - 70
• Most people with MR (about 90%)
• Achieve about 6th grade academic level
• Can support self w/ minimal supervision

Question 14

Criteria for moderate MR

Answer 14

• IQ 35/40 - 50/55
• Academic skills up to 2nd grade
• Benefit from extensive social and vocational training
• Can perform unskilled or semi-skilled tasks under supervision

Question 15

Criteria for severe MR

Answer 15

• IQ 20/25 - 35/40
• Can acquire some basic self-help skills (feeding)
• Can learn to count/read
• Simple tasks under close supervision
• Require assistance for most activities and daily life

Question 16

Criteria for profound MR

Answer 16

• IQ < 20/25
• May have difficulty with simple tasks even under close supervision
• Need significant training to develop vocational, self-care, and communication skills
• Function best in highly-structured settings

Question 17

What is the course of MR?

Answer 17

Chronic, lack of age-appropriate interest, twice as common in males

Question 18

What is challenging behavior?

Answer 18

Self-injurious behavior that can occur in autism

Question 19

What defines self-injurious behavior?

Answer 19

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

Question 20

Negative behavioral consequences of self-injurious behavior

Answer 20

• Social Isolation
• Impact on education/vocational training
• Tissue damage
• Infection
• Blindness
• Death

Question 21

What is the diagnostic criteria for PICA?

Answer 21

1. Persistent eating of non-nutritive substsances for period of at least 1 month
2. Eating is inappropriate for the person’s developmental level
3. Eating is not a culturally sanctioned practice

Question 22

What would your Dx be if a child eats plastic, food froma trash can and cigarette buts?

Answer 22

Pica

Question 23

What is Destructive Behavior Disorder?

Answer 23

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

Question 24

What medications are typically used to treat autism?

Answer 24

Stimulants, antipsychotics, SSRIs

Question 25

Describe the efficacy of complementary and alternative medical treatment?

Answer 25

Shit doesn’t work. Period.

Question 26

What is the best behavioral treatment for autism and related behavioral disorders?

Answer 26

Behavioral intervention and functional based treatments!