Childhood and dev Flashcards
Neurodevelopmental dx
- disruption in normal dev
Barriers to tx in kids
- stigma in kids or parents
- young kids lack lang skills
- lack consistent screening for kids
- lack coor among settings (school, PCP)
- high costs
- premature termination of tx–disagree, can’t afford
Most common neurodev dx
ADHD and mood dx (dep), then conduct dx
Factors of childhood mental illness
- long term mental dx in adults
- dec SE
- child welfare involvement
- need special ed resources
- thwarted brain dev
- conflict in fam/community
- juvenile sys involved
- phys health impaired
rf for neurodev dx
- bio: genetics, neurobio
- psych: temperament
- enviro: abuse, trauma, dec SES, parenting (maternal psych dx, controlling or emo unavail, crim hx)
Protective fx for neurodev dx
Resiliency (adapt to chx/adversity)
- inner strength
- healthy coping strat
- fxn avoid strong emo
- reach out for help
- pos attitude and poor relx
- form nurturing relx w/ other adults
- positive self-image
- fam cohesion
- pos relx w/ at least 1 parent
- temperament
- support
- academic achievement
- pos peer relx
Temperament
attitude, mood, and bx of kids used to cope with environment
PMH nurse role
- assess
- ID fam needs
- early ID is key
- promote pt rights
- s&r as last resort
NC of nurse interview
- depends on dev level (can sense when insincere)
- est tx alliance
- assess parent-child intx
Who should you consult for child’s inner symptoms?
Child
- SI, mood
Who should you consult for child’s external symptoms?
Parents
- bx, relx
Communicating w/ child with neurodev dx
- use simple, concrete phrases
- corroborate info with adult
- ask yes/no direct questions, not open-ended
- use play media
- may not be able to give accurate timeline
Preschool interview
- Probs putting feelings into words, think concretely
- use play, conduct in play room
School-grad interview
- can use constructs, provide larger explanations
- establish rapport thru competitive games
Adolescent interview
- egocentric; inc self-conscious, fear of shame
- let them know what info will be shared w/ parents if under 16
- direct, candid approach
Assessment for kids includes…
- fam fxn (parent-child relx)
- current prob: nature, severity, length, better/worse, triggers, describe bx at home
- hx: previous tx, fam hx, dev and social hx incl mother’s birth and preg hx
- mental status
- physical exam
Cognition
learning and problem solving
social and emotional dev
smiling, waving
speech and lang emo dec
ability to understand and use lang
fine motor dev
use small muscles in hands and fingers to pick up
gross motor dev
use large muscles, sit up, stand
basic principles of kids bx
- all bx has meaning
- address the need behind the bx
- kids want to bx and please those they care about
- kids with MI often can’t clearly comm needs
Basic comm for kids
- treat with respect and preserve dignity
- seek solutions, not blame
- avoid “no” and don’t” and use “do”
- instill hope: learn to comm needs clearly, manage feels, learning they are competent and worthwhile
- never give up!
bx tx for kids and adols
- reward desired bx
- bibliotherapy
- expressive arts therapy
- journal
- music therapy
- fam intx
- psychopharm
- disruptive bx management (time outs)
- play therapy
