Child psychology Flashcards
Development Infancy: Explain From delivery to 2yrs
- Premature infants (<34wks) are at increased risk of Dyslexia, behavioural problems, developmentally delayed, mental retardation and child abuse. (Also their parents are at risk for PTSD)
- By the end of Infancy these basic areas have developed intention
Development Infancy: Explain Reflexes
Rooting, Grasp, Babinski (up), patellar, Moro (Startle), and Tonic Neck.
- Grasp, startle, and tonic neck tend to disappear by 4mo
- Babinski is down by 12mo.
Survival Systems work, but needs more external input for neurophysiological functions
Development Infancy: Explain Language and thinking
Guttural or babbling will emerge around 8wks (especially for mom)
Development Infancy: Explain Emotional/Social development
- By 3wks they imitate adults, may be precursors to further emotional life
- Smiling - endogenous with in 2wks, exogenous with in 4mo.
- Temperament (Chess and Thomas)
- some aspects persist into adult life (calm), others extinguish.
- Activity Level, Distractibility, Adaptability, Attention Span, Intensity, Responsiveness, Quality of mood, Rhythmicity, Approach/Withdrawal.
Development Infancy: Explain Attachment
- Bonding: relationship mother develops towards baby
- Attachment: relationship baby develops towards mom
- Harry Harlow: Effects of social isolation in monkeys
- John Bowlby: defined attachment as maintenance of physical contact when infant is hungry, frightened or in distress.
- Mary Ainsworth: The Strange Situation Three major Attachment styles
- Secure
- Babies go off and explore, mom is a “secure base”. Get distressed when mom-leaves or becomes unresponsive, easily and quickly comforted when mom is back, then return to play. Tend to show fewer adjustment problems.
- Insecure-Anxious/Avoidant/Resistant
- Babies tend to cling to mom, less likely to explore. Get distressed when mom leaves/becomes unresponsive, are angry/hard to comfort when mom returns. Parents are likely to become rejecting.
- Insecure- Ambivalent/Avoidant
- Babies explore ignoring presence of mom, do not check in with her. Not distressed with mom-leaves or becomes unresponsive, and do not particularly require comforting. Do seek mom with stranger, or fear and are inconsolable.
- Attachment decreases anxiety, and transitional object may serve as a secure base.
- With progressively more children attachment for older children is lessened.
- Secure
- Spitz: Deprivation and neglect causes mental retardation
- Stranger Anxiety:26wks-32wks. Separation Anxiety: 10-18 mo.
- Parental Fit, and “Good Enough Mothering”
- 40% of infants are “easy”, 10% are hyper alert, 50% are a mix of both these traits. If parenting style does not fit everyone is distressed.
- Mom’s don’t have to be perfect, but should respond to the babies Needs.
Development Toddlers and Preschool: Explain Language and Cognitive
Start with 2 word sentences, end with real sentences. Memory improves, limited use of logic.
Toddlers start to listen to explanations, and start to tolerate delay, varied capacity for Self Regulation,
Pre-schoolers start using sentences, and thinking symbolically. However still very ego-centric
Development Toddlers and Preschool: Explain Emotional and Social
Toddlers start to copy others in how to respond to new events. They are exploring and excitable!
Pre-schoolers feelings are driven by somatic changes, but can tolerate anxiety more. Responses to environment less emotions themselves
By the end of pre-school tend to have stable emotions, and develop empathy, can feel guilty.
PLAY
- Toddlers play independently, not often with others.
- Pre-schoolers engage in Parallel play, then associative play
- By age 4 begin cooperative play.
Imaginary Friends
- Appear in preschool, usually friendly humans. Can be things.
- Up to 50% between age 3-10 will have them at one time.
- Usually disappears by age 12.
Development Toddlers and Preschool: Explain Sexual and Genital
- Toddlers begin to manifest Gender identity at age 18mo, usually fixed by 30mo.
- Gender Role describes behaviour and is not correlated with identity.
- However, starts to be applied to children immediately. Moms talk to girls more, etc..
- Toilet Training: Control of urination in day time b 2.5yrs, in night by age 4. Bowel control by age 4.
- Between age 3-6 start noticing differences in bodies of different sexes, play doctor.
- Age 3-6 have preoccupation with bodies in general and is often called the “band aid phase”
Development “The Middle Years” Age 6- Puberty: Explain Language and Cognitive Development
In school and demands for academic learning become determinants of personality
- Language and Cognitive Development
- Increased self regulation, by age 9-10 can voluntarily concentrate (This does require practice)
- Maturational changes in brain leads to increased independence, learning, socialization, moral development.
- Start to identify with adults in their lives regarding gender roles
- Peer interaction becomes more important, but prefer same sex interaction.
- Sex play/ comparisons are common especially in boys
- Best Friend by age 10, usually same sex
- School refusal: Separation anxiety, transference related to mom (from mom separating from kid)
Development “The Middle Years” Age 6- Puberty: Explain Sexual Role Development
There are currently many changing social rules/expectations. This can be hard for children without clear guidelines or support.
Development “The Middle Years” Age 6- Puberty: Explain Dreams/Sleep
- Age 4: understand dreams are individual
- Disturbing dreams peak at 3,6, and 10 (transitions)
- Age 5: realize that dreams are not real.
- Age 2 need 30 min to fall asleep.
- Disorders with sleep are usually related to dreaming, and need rituals to protect themselves.
Development Family Factors: Explain Parenting Styles (Rutter)
- Authoritarian- Strict inflexible rules, may cause low self-esteem, and social withdrawal. (strict rules, less level of support)
- Indulgent-Permissive- little to no limit setting, unpredictable parental harshness. Low self-reliance, poor impulse control, aggression. (low rules and level of support)
- Indulgent- Neglectful- non-involvement in child’s life/ rearing. Child may develop low self-esteem, poor self control, aggression.
- Authoritative Reciprocal- firm rules and shared decision making in loving environment. Results in self reliance, and social responsibility.
Development Family Factors: Explain Divorce (30%-50% of kids live in single parent households)
- Infants- Don’t notice
- 3-6yrs- don’t understand, or assume its their fault (egocentric)
- Older children understand, (especially adolescents)
- May believe they could have prevented the divorce
- May be supportive of divorce- especially if teenager
- Adaptation takes several years.
- Demographically at risk for many poor outcomes (historically)
- Types of Stepfamilies
- Neo-Traditional: absent parent included sometimes, discipline is discussed openly, taking sides is avoided.
- Romantic: expect to be “Traditional” immediately, absent parent is criticized, difficulty with step parent, few open discussions.
- Matriarchal: Run by a competent mom, companion follows. Companion is “buddy” for kids, not a parent, birth of step-sibling causes problems.
Explain Development Adolescense (5 Stages / Year Groups)
- “Normality” describes amount of adaptation achieved while navigating hurdles and milestones.
- Role confusion (Erikson)
- Integration of past with current changes and expectations.
- Identity Crisis is Normal, bonding with peers and experimenting is common.
- Early Adolescence (12-14yrs)
- Initial physical changes (Growth Spurts) embarrassment about body
- Start to criticise family, spending time with family and less supervision.
- Increased interest in opposite Sex
- Middle Adolescence (14-16yrs)
- Continue to try being more independent from family
- Sexual behaviour increases
- Self-esteem is critical to modulate risk taking.
- Sense of Omnipotence
- Late Adolescence (17-19yrs)
- Continued exploration of academic and artistic tastes
- Greater definition of self and belonging to groups
- Cognitive Maturation (into late 20s)
- Transition from concrete to more abstract. Increased awareness of self.
- Omnipotence transitions to strategies to promote ones strengths and compensate for weaknesses
- Morality develops as cognition matures.
What are the Normal Milestones?
What are the Development Theories? (In Review)
Which Genetic Disorder is this?
Trisomy 21, 15/10000 of live births (very common question)
Physiology- Slanted eyes, epicanthal folds, flat nose
Etiology- Nondisjunction during meiosis, nondisjunction in fertilization, translocations
Down Syndrome
Which Genetic Disorder is this?
Mutation at fragile site, 1/1000 males (very common question)
Physiology- large head and ears, short stature, hyper extensible joints, post-pubertal macroorchidism
High rate of ADHD, learning disorders, ASD, Relatively strong skills in communication and socialization
Some asymptomatic males, female carriers.
Fragile X
Which Genetic Disorder is this?
deletion on chromosome 15 1/10000 births
Compulsive eating, obesity, intellectual disability, hypogonadism, hypotonic, small hands and feet.
Prader-Willi Syndrome
Which Genetic Disorder is this?
Deletion on chromosome 5,
Severe mental disability, microcephaly, low set ears, oblique palpebral fissures, micrognathia
Characteristic cat like cry 2/2 laryngeal abnormalities that they grow out of
Cat’s Cry Syndrome (Cri-du-Chat)
Which Genetic Disorder is this?
Autosomal Recessive, inborn error of metabolism, 1/10-15K births.
Severe disability, ECZEMA, vomiting, convulsions, temper tantrums, twisting of hands
Treat with low phenylalanine diet ASAP. If before 3mo can have normal intelligence.
Phenylketonuria (PKU)
Which Genetic Disorder is this?
degenerative, dominate X gene, only affects females.
At 1yr age, Ataxia, grimacing, teeth grinding, loss of speech. Progressive motor and cerebral degeneration as well and eventual death
Rett Syndrome
Which Genetic Disorder is this?
Chromosome 17 1/5000
Cafe Au Lait spots, neurofibromatosis, optic gliomas, acoustic neuromas. Causing seizure and learning disorders.
Neurofibromatosis 1
Which Genetic Disorder is this?
Autosomal Dominant 1/15000
Seizures with adenomas sebaceym and ash leaf sports
Tuberous Sclerosis
Which Genetic Disorder is this?
X Linked
Deficiency in Purine Metabolism, diet helps
Compulsive self mutilation via biting
Lesch-Nyhan Syndrome
What are the classifications of Intellectual Disabilities?
Formally known as Mental retardation, caused by a variety of things leading to social and cognitive impairments characterized by impaired functioning.
- Classifications
- Mild (85% of intellectually disabled, 50% with no clear cause, IQ is 50-70)
- 0-5yrs- Develops social and communication skills needed, minimal retardation noted
- 6-20yrs- Learns academic skills up to 6th grade of regular school by late teens, can be guided to social conformity
- 21+yrs- Usually achieves social and vocational skills for self-support, may need guidance when under more stress.
- Moderate (10% of intellectually disabled, IQ is 35-50)
- 0-5yrs- Can talk/learn to communicate, can be managed with moderate supervision
- 6-20yrs- Benefits from training in social and occupational skills, unlikely to progress pass regular 2nd grade academically. Can learn to travel alone to familiar places.
- 21+yrs- May achieve self-maintenance in unskilled/semi-skilled work under sheltered conditions.
- Severe (4% of intellectually disabled, IQ is 20-35)
- 0-5yrs- poor motor development, speech is minimal, cannot benefit from training
- 6-20yrs- can talk or learn to communicate, trained in elemental health habits
- 21+yrs- may contribute partially to self care, can develop self protection skills, do well in group homes.
- Profound (1% of intellectually disabled, IQ is less than 20)
- 0-5yrs- gross disability, cannot function, needs constant nursing care and supervision
- 6-20yrs- some motor development, may respond to minimal training in self help
- 21+yrs- Some motor and speech, needs nursing care.
Special Facts:
- Epidemiology is difficult because many with mild disability are not recognized until middle childhood.
- Schools are required by law to provide appropriate and necessary services to children with disabilities.
- Special Education has changed over the years.
- Present verbally as younger than their age, may be acquired or developmental/congenital
- NO comprehension difficulty in pure expressive
- May be associated with ASD, often requires testing or full diagnosis.
- Limited vocabulary, simple grammar, variable articulation, “inner language” refers to appropriate use of toys, objects.
- Tend to use filler words “stuff… things”, usually recognized by 18mo when child has ZERO words
- Learning and Communication DO: Explain Expressive Language Deficits
- Impaired Sound discrimination, impaired auditory processing, or poor memory for sound sequences
- Lack of understanding questions/directions, inability to follow conversation,
- May be perceived as behavioural rather than a deficit.
- May be due to genetics, brain abnormalities, environment, or neurological processes
- Usually present before age 4, mild may present around age 7
- Learning and Communication DO: Explain Mixed Receptive and Expressive Deficits
- h Sound Disorder
- Difficulty producing sounds, or atypical sound (Omitting the last sounds of a word, substituting one sound for another)
- Diagnose by comparing abilities to expectations.
- 3yrs can articulate: m, n, ng, b, p, h, t, k, q, and d
- 4yrs can articulate: f, y,,ch, sh, and z
- 5yrs can articulate: th, s, and r
- Not related to cerebral palsy, deafness, hearing loss, TBI, or neurological deficits.
- Learning and Communication DO: Explain Speech Sound Disorder
- Begins in the first years of life, peaks at age 2, 3.5, 5-7
- Disruptions in fluency, sound/syllable repetitions, sound prolongations, dysrhythmic phonations, or pauses. Can be physical
- Learning and Communication DO: Explain Child Onset Fluency Disorder
Deficits in verbal and non-verbal communication for social purposes in absence of restricted repetitive interests/behaviours.
Learning and Communication DO: Explain Social/Pragmatic Communication DO
Autism Spectrum DO- includes Aspbergers
Explain the Biological Influences
Prevalence is about 8/10k, but can be diagnosed later, and more diagnoses lately, Men>Woman (more social)
- Definitely heritable, but multifactorial genetics, can be coordinated with fragile X, tuberous Sclerosis, chromosomes 2, 7
- Biomarkers: 5-HT expression on platelets, mTOR synaptic plasticity system, alterations in GABA inhibition
- Prenatal immune incompatibility damaging early neuronal circuits, as well as other prenatal complications
- Advanced age of parents, maternal gestational bleeding, gestational diabetes, first baby
- Perinatal: Umbilical cord complications, birth trauma, fetal distress, low birth weight, low 5min Apgar score, congenital malformation.
- Neurological disorders: 32% have seizures, 25% have ventricular enlargement,
- NO differences in parental rearing
- Persistent deficits in social interaction across multiple contexts (social reciprocity, nonverbal communication, relationships)
- Restricted/repetitive patterns of behaviour
- Stereotypes or repetitive motor movements, Rigidity, restricted/fixed interests (trains, computers), or hypo/hyper reactivity to sensory inputs
- Severity based on social communication impairments and restricted repetitive patterns of behaviour
- Present in early development but not clear until social demands increase, cause impairment,
- Not other mental disorder/ intellectual disability
- +/- intellectual impairment, language impairment, genetic condition, neurodevelopmental conditions, catatonia
- Autism Spectrum DO- includes Aspbergers
Explain the Clinical Features (DSM-V Criteria)
Autism Spectrum DO- includes Aspbergers
Explain DiDX
- Social Pragmatic Communication Disorder
- Childhood Onset Schizophrenia (Rare in children less than 12)
- Intellectual Disability with Behavioural Symptoms
- Language Disorder
- Psychosocial Deprivation- raised by wolves
What is the etiology of Substance Use, Abuse and Addiction?
Combination of genetics and environment
Family studies suggest that 40-60% of an individual’s risk comes from their genetic makeup
What are the Substance Use Risk Factors?
What is the neurobiology of substance use and abuse?
What is it considered a disease of?
How does affect us?
- Substance use disorders are NOT disorders of self-control (initial choice is based on impulse control)
- Considered a brain disease – drugs change the structure and function of the brain
- Changes to prefrontal cortex seen – particularly damaging in adolescents where prefrontal cortex is still maturing!
Changes to the prefrontal cortex affect executive function, attention, and memory
- Short term memory loss
- Impaired abstraction
- Loss of impulse control
- Impaired decision making ability
- Personality changes
- Increased dopamine activates the reward circuit
- Drugs can release 2-10x more dopamine than eating or sex, which can occur immediately via injecting or inhaling
- With long term substance abuse, the brain adjusts to exogenous dopamine flooding by reducing endogenous dopamine (downregulation)
- Causes continued use of drugs in an attempt to normalize dopamine levels
Explain the timing of Alcohol Withdrawal Symptoms
What is CIWA protocl for alcohol withdrawal?
What is the Opioid-free treatment of Opioid Withdrawal?
Don’t need to do if methodone
