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3032 > childhood > Flashcards

childhood Flashcards

1
Q

Developmental psychopathology refers to

A

disordered behaviour that is not age appropriate for the child

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2
Q

The DSM describes ______classes of developmental disorders

A

9

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3
Q

What are the classes of developmental disorders

A 
Intellectual disabilities
Specific learning dis'd
Autism spectrum dis'd
ADHD
Motor dis'd
Communication dis'd
Feeling + eating dis'd
Anxiety dis'd
Disruptive/impulse control/conduct dis'd
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4
Q

Symptoms of externalizing dis’d

A 
outward expressions: 
aggression, 
non-compliance, 
over-activity, 
impulsiveness
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5
Q

Symptoms of internalizing dis’d

A

social withdrawal
depression
anxiety

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6
Q

anxiety and mood dis’d are examples of __________

A

Internalizing disorders

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7
Q

ADHD, oppositional defiant disorder, conduct disorder are examples of ___________

A

externalizing disorders

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8
Q

Eastern cultures are likely to express _________ symptoms, whereas Western cultures are likely to show ______ symptoms

A

internalizing; externalizing

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9
Q

Hyperactivity refers to ____________

A

A child who is constantly in motion –> tapping, fidgeting

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10
Q

Core clinical descriptions of ADHD include

A

Behaviour is extreme for developmental period

Behaviours are persistent over different settings + functional impairment

Difficulties controlling self when asked to sit still

Difficulties forming + maintaining friends due to aggression or intrusiveness

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11
Q

Vicious Cycles refer to _____________

A

ADHD children having inability to make friends due to poor social skills, aggression, self overestimation

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12
Q

All are true of ADHD EXCEPT;

Symptoms of inattention need to be present for at least 6 months

Symptoms of hyperactivity need to be present for at least 6 months

Symptoms need to be present in 2 or more settings

Symptoms need to emerge before age 7

A

Symptoms need to emerge before 7

CORRECT need to appear before 12

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13
Q

Sasha is 19 years old and thinks she has ADHD. Vicki, her younger sister is 9 years old and also suspects having this disorder. Does a clinician need to make any considerations regarding diagnosis of these clients?

A

YES - patients aged 17 + only need to exhibit 5 symptoms for 6+ months, whereas Vicki needs to show 6 symptoms for a period of 6 months

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14
Q

Prevalence of ADHD is now 8-11% compared to a prior 3-7%. Why is it suggested that ADHD prevalence has been on the rise?

A

DSM-5 changed;
-Onset of symptoms has to be before 12
(previously 7 )
-Adults only need to meet 5 criteria (previously 6)
Potentially more awareness
Potentially more people seeking treatment

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15
Q

Children with inattentive subtype ADHD are likely to have issues with____________

A

processing speed
inattention
sustained attention

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16
Q

Children with combined ADHD subtype are likely to struggle with___________

A

conduct problems
oppositional dis’d
interpersonal conflicts

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17
Q

Contrast ADHD & Conduct dis’d

A

ADHD has better-long term prognosis
ADHD associated more with odd-task behaviour school,
ADHD associated with poorer cognitive + academic outcomes

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18
Q

What are the likely outcomes of comorbid CD + ADHD?

A

Poorest outcomes
Serious antisocial behavior,
peer rejection
poor academic outcomes

***in girls, + risky sexual behaviour

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19
Q

The most common internalizing comorbidities with ADHD are ______________, their prevalence is____

A

MDD + anx; 30%

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20
Q

_______ADHD subtype is associated with nicotine, alcohol + illicit drug use. This _______ by gender

A

Hyperactive

does NOT differ

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21
Q

INCORRECT statement is;

a) Girls with ADHD more likely to be anxious or depressed
b) Girls with ADHD experience executive functioning difficulties
c) Girls with ADHD likely to have ED + conduct disorder / ODD
d) Girls with ADHD are more likely to have depression

A

D - not true

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22
Q

Genetic heritability for ADHD is ____ % and genes associated are ___________

A

70-80%
DAT1,
DRD4+DRD5, (receptors)
SNAP-25 (plasticity sequence)

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23
Q

_______ genes are associated with particular environmental factors

A

DAT1 + DRD4, prenatal exposure to nicotine / alcohol

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24
Q

DA-ergic system includes ___________. In ADHD these are ________.

A

caudate nucleus, globus pallidus, frontal lobes.

ADHD - less activation –> inhibition difficulties

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25
Q

Environmental toxins associated with ADHD__________

A 
food colourings (not anymore)
lead
nicotine 
pesticides 
chlorine
26
Q

Treatments for ADHD_________

A

Dexamphetamine
• Atomoxetine
• Methylphenidate reduces impulsivity. Interacts with DA system
Combination of ^^ and behaviour MOST effective.
Psychological tmt - based on reinforcmeent, token economy. Improves acaemic performance //social skills

27
Q

Who defines the guidelines for intellectual disabilities?

A

Association on
American Intellectual and Developmental Disabilities (AAIDD)
Australasian
Society for Intellectual Disability (ASID).

28
Q

AAIDD definition of intellectual disability incl _________

A

significant
limitations in;
intellectual functioning + adaptive behaviour expressed
in conceptual, social, practical adaptive skills

29
Q

Assumptions of ID are ________

A

Limitations of function are developmentally, culturally, appropriate.
Assessment considers cultural + linguistic diversity
Individual may have weaknesses AND strengths
Purpose of assmt is to develop necessary support
With appropriate support, improvement will follow

30
Q

ID DSM-5 criteria _________-

A

a) Have intellectual disability defined by intelligence testing + clinical testing. IQ <70
b) Experience adaptive functioning deficits relative to age in 1+ areas
c) ONSET of these deficits is during childhood development

31
Q

Describe some areas of adaptive functioning deficits associated with ADHD

A

communication, social participation, work, school, independence at home / community,
require support at school, work /independent life

32
Q

Describe the distinctive types of ID

A

NOT mild/moderate/severe

  • Conceptual (intellectual, cognitive function),
  • Social
  • Practical
33
Q

The AIDD approach to ID’s is _______________

A

identify strengths + weaknesses to cater and develop independence

34
Q

The MOST common developmental disorder is _________

A

ADHD, 7% in Au; 8-11% in US

35
Q

The three core symptoms of ADHD

A

Inattention, hyperactivity, impulsivity

36
Q

Dietary factors associated with ADHD

A

nutritional deficiencies
excessive sugar
low glyc index foods

37
Q

Down Syndrome is a type of _____________ and is associated with __________ genetic abnormality.

A

Intellectual disability; extra copy (3 total) of chromosome 21

38
Q

A side effect of atomoxetine is ____________

A

has side effects in kids with comorbid ASD

39
Q

Medications for ADHD can be prescribed for children aged above __________

A

7

40
Q

Fragile X syndrome is caused by ___________. All those with FrX have an intellectual disability (T/F)

A

Random mutation in FMR1 gene on the X chromosome.

False

41
Q

The INCORRECT answer is;

a) Williams syndrome is the rarest genetic abnormality
b) Is caused by exposure to prenatal toxins
c) Positive cases are missing the elastin gene, leading to heart problems
d) is associated with high sociability

A

B - is caused by spontaneous deletion of 26 genes in chromosome 7

42
Q

The foetus is particularly vulnerable to ID in utero because ___________

A

1st trimester - fetus has no immunological response. Vulnerable to mothers’ infectious diseases. Can effect the child’s brain post natal.

43
Q

Compare behavioural and cognitive therapies for ID

A

behavioural - target child’s level of functioning. Objectives are defined and completed in small steps. Uses operant conditioning + behaviour analysis

Cognitive - ID have issues problem solving so use Self instructional training guides i.e. take lunch order, janitor duties

44
Q

ASD is a combination of ____________ prior disorders

A

Asperger’s
pervasive developmental disorder
childhood disintegrative disorder

45
Q

clinical specifiers of ASD are based on ________

A

Severity + extent of language impairment

46
Q

Describe some social and emotional problems associated with ASD

A

RARE verbal, smiling, eye contact interaction.

spend less time looking at other people’s faces, impaired theory of mind

47
Q

Theory of mind refers to _____________

A

person’s understanding that other people have desired,
beliefs, intentions and emotions that may be different to ones own. May be unable to understand + recognize others’ emotions

48
Q

fMRI is associated with __________ neurological deficits regarding emotion in ASD

A

reduced activation of fusifrom gyrus, temporal lobes, amygdala.
Associated with face + emotion recognition

49
Q

ASD associated with a triad of symptoms which are

A
  • Social emotional disturbance
  • Communication deficits
  • Repetitive/ritualistic acts
50
Q

DSM-5 features of ASD are;

A

Deficits in social communication and social interactions
2+ Restricted repetitive behaviour patterns, interests, or activities
Onset occurs in childhood
Symptoms limit + impair functioning

51
Q

Communication defects in ASD include___________

A

-babbling slower in ASD infants
-2 yo lag behind the two-word-sentence formation
-Echolalia: when the child echoes i.e. copying TV, prevalent in ASD,
-Pronoun reversal: prefer to call self “he” or “she”
or by their name bc thats what others call them

52
Q

Ritualistic acts in ASD characterised by ________

A

Attachment to inanimate objects + extreme interest in things
Upset if routine disrupted, hysteria
Rhythmic movements - rocking, tapping

53
Q

Common comorbidities with ASD are_________

A

33% specific learning disability, anxiety, intellectual disability,

54
Q

Describe prevalence trends in ASD

A

Begins in first month of life
1 ever 68 months
5x more likely in boys
Some diagnosed at 2, DONT meet diagnostics at 9

55
Q

Genetic evidence for ASD

A
  • Heritability - 0.8
  • Risk of ASD or language delay is higher amongst siblings
  • unaffected siblings also exhibited deficits in social communication
  • Deletion on Chromosome 16 is associated with ASD
56
Q

Neuropathology associated with ASD

A

Larger brain volume - frontal temporal, cerebellar.
BIGGER amygdala - more social difficulties
SMALLER amygdala - difficulties in emotional face perception, less eye gaze

57
Q

The aim of of ASD treatment is___________

A

Reducing unusual behaviour, improve communication + social skills

58
Q

Behavioural treatments for ASD_________

A

intensive operant conditioning based program- reward omission from aggression + compliance
= increases IQ + better academic outcomes

59
Q

Drug treatments for ASD__________

A

Haloperidol - Haldol. Antipsychotic medication typical for schizophrenia. Reduce social withdrawal, stereotyped motor behavior, language
impairments
Naltrexone - reduced hyperactivity and moderated social interactions

60
Q

What is the issue with labels in developmental disorders

A

SAME symptoms can have different genetic aetiology. Becomes issue because tmt is disorder-based but ADHD child may benefit most from ASD meds

61
Q

ADHD neuropathology

A
  • Smaller DA-gic areas of the brain–> spur them to seek out activities to stimulate DA
  • Smaller grey matter + WM density
  • Reduced cortical thickness + activation, volume

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