Childhood And Adolescent Disorders Flashcards
Attention Deficit Hyperactivity Disorder
A persistent excessive inattention (girls) and or hyperactivity/ impulsivity (boys) typically presents between 3-13. Often familial.
Hx/PE: Dx requires 5 or more symptoms from each category below for 6 or more months in at least two settings, leading to significant social and academic impairment, Symptoms must be present before 12.
Inattention: poor attention span, poor attention to detail, difficulty following instructions, forgetful, easily distracted.
Hyperactivity/impulsivity: fidgets, round around, cannot play quietly, talks excessively, does not wait for tun, interrupts others.
Treatment:
Nonpharma: behaviour modification
Pharma:
- psychostimulants: methylphenidate (s/e insomnia, irritable, LOA,)
- non-psychostimulants: A2 agonist - clonidine.
Autism spectrum disorder
Persistent impairment in socialization, communication, behaviour. Males. Possible congenital conditions (Rett Sx, tuberous sclerosis, fragile X syndrome)
Hx: Impaired social interaction and communication together with restricted activities and interests evident before age 3.
Spoken language development delayed, fail normal social behaviour, lack interest in relationships. Stereotyped speech and behaviour and restricted interests
Treatment:
Behavioural management, symptom targeted medication
Family support and counselling
Disruptive behaviour disorders includes which two disorders
Conduct Disorder and Oppositional defiant disorder
Conduct disorder
A repetitive persistent pattern of violating the basic rights of others or age-appropriate societal norms or rules for 1 year or more. Behaviour may be aggressive (rape, robbery, animal cruelty) or non-aggressive (stealing, lying, annoying others). May progress to antisocial personality disorder in adulthood.
Often seen in boys and in pt. with a history of abuse
Conduct disorder vs antisocial personality disorder
Conduct disorder is seen in Children
Antisocial personality disorder is seen in Adults
Oppositional defiant disorder
A pattern of negativistic, defiant disobedient and hostile behaviour toward authority figures (e.g. Arguing) for 6 or more months. May progress to conduct disorder
Intellectual developmental disorder
Fetal alcohol syndrome - most common avoidable cause of intellectual disability.
Assoc. with male, chromosomal abnormalities, congenital infections, teratogens, inborn errors with metabolism.
Definition: Pt have impaired intellectual functioning (IQ<70) with deficits in adaptive functioning (hygiene, social skills), onset before 18.
Mild - IQ 50-70
Moderate - IQ 35-49
Severe - IQ 20-34
Profound - IQ<20
Treatment; Family counselling and support, speech and language therapy, occupational physical therapy, behavioural intervention, social skills training
Tourette Syndrome
Common in men and boys, genetic predisposition. Assoc. with ADHD, learning disorders and OCD
Begins before 18 / multiple motor tics (blinking, grimacing) and vocal tics (grunting, coprolalia) many times per day, recurrently for >1 yr with social or occupational impairment.
Treatment: Dopamine receptor antagonist - haloperidol, pimozide or clonidine
