CHild Psychiatry II Flashcards
What are the 3 Dx criteria for Autism?
- Impaired development in social interaction
- Imparired development in communication
- Restricted repertoire of interests
When is autism generally Dx?
Within first 3 years
What is the prevalence of autism? Between genders?
1/88; 4x more prevalent in boys;
What characteristics are seen in a child within the first 12 months? 16 months? 24 months?
Does not babble/coo or gesture (12); Does not say single words (16); Does not say two word phrases (24)
What are social/play behaviors that are absent in those with autism?
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
What behavioral characteristics are seen in autism?
Insistence on sameness, Difficulty expressing needs (echalalia)
What is Asperger’s disorder? Describe their cognitive ability
Impairment in social interaction (lack eye contact, motor, posture, facial expressions), restricted range of interests, no developmental delays; Tend to have above average IQ
What is childhood disintegrative disorder?
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
What is Rett Disorder? What gender does Rett Disorder occur in?
Typical development followed by decreased head growth rate and lose hand skills (telltale signs); Only occurs in girls!
What Dx test do we use for Autism?
There is not Dx test for autism. Dx made based on an individual’s communivation, behavior, and developmental levels
What is the Tx of Autism Spectrum Disorders?
- Discrete Trial Instruction (DTI) - Applied Behavior Analysis to treat basic social interactions
- Functional Analysis - Reinforcement-based Tx are most effective for decreasing problematic behavior
Criteria for Mental Retardation (Intellectual Disability)
- IQ < 70
- Deficits in adaptive fn (Communication, self-care, social skills, self-direction, academics, work, safety)
- Onset before 18 yo
Criteria for Mild MR
- IQ 50/55 - 70
- Most people with MR (about 90%)
- Achieve about 6th grade academic level
- Can support self w/ minimal supervision
Criteria for moderate MR
- 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
Criteria for severe MR
- 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
Criteria for profound MR
- 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
What is the course of MR?
Chronic, lack of age-appropriate interest, twice as common in males
What is challenging behavior?
Self-injurious behavior that can occur in autism
What defines self-injurious behavior?
An act in which an individual deliberately produces physical damage to his or her own body
Negative behavioral consequences of self-injurious behavior
- Social Isolation
- Impact on education/vocational training
- Tissue damage
- Infection
- Blindness
- Death
What is the diagnostic criteria for PICA?
- Persistent eating of non-nutritive substsances for period of at least 1 month
- Eating is inappropriate for the person’s developmental level
- Eating is not a culturally sanctioned practice
What would your Dx be if a child eats plastic, food froma trash can and cigarette buts?
Pica
What is Destructive Behavior Disorder?
Acts in which an individual physically harms another person (aggression) or the immediate environment (disruption)
What medications are typically used to treat autism?
Stimulants, antipsychotics, SSRIs
