Childhood Development Flashcards
ASD
Domain 1: Social Communication and Interaction -no specific number of criteria needed. You just have to have some of these symptoms
1. ___-___reciprocity
- Back and forth conversation
- Reduced sharing of __, emotions
- Failure to initiate or respond to __ interactions
2. ___ behaviors
- Limited __ contact
- Deficits in use of ___ or other body language
- Lack of understanding or use of ___expressions
3. Developing, Maintaining, Understanding Relationships
- Can’t adjust __ to social context
- No sharing imaginative play or making friends
- Lack of interest in __
Domain 2: Repetitive Interests and Behavior - must have at least 2!
1. Stereotyped activity
- ___: Spinning, rocking, flapping, finger waving; lining up toys
- ___: scripts, echolalia (echoing someone or a script over and over again)
2. ____ with routines
3. Highly restricted, ___ interests that are abnormal in intensity or focus
- Clocks, wheels, water
Difficult to find if it is a normal hobby/obsession The intensity of the focus is what matter the most. Being hyper-interested in a certain topic like trains isn’t abnormal but if they only want to talk about trains 24/7 even when you try to change the subject that is abnormal.
4. Hyper- or hyporeactivity to __ input
- Adverse response to __ or __
- ___smelling/touching of objects
- ___ fascination with lights, movement (spinning)
Treatment:
Treatment for meds, start low and slow!
Medical:
For: Obsessive Symptoms, Anxiety, Depression
- ___ (___,___,___) (antidepressants)
- ___ __ ___
For: aggression/Irritability
- ___*
- ___*
For Insomnia
- ___
For ADHD
- ___
- ____-agonists (clonidine, guanfacine)
Non-Medical Behavioral Interventions
- applied __ analysis
- __ regulation therapy
- structured expectation and schedules
- __ skills training groups
ASD
Domain 1: Social Communication and Interaction -no specific number of criteria needed. You just have to have some of these symptoms
1. Social-emotional reciprocity
- Back and forth conversation
- Reduced sharing of interest, emotions
- Failure to initiate or respond to social interactions
2. Nonverbal behaviors
- Limited eye contact
- Deficits in use of gestures or other body language
- Lack of understanding or use of facial expressions
3. Developing, Maintaining, Understanding Relationships
- Can’t adjust behavior to social context
- No sharing imaginative play or making friends
- Lack of interest in peers
Domain 2: Repetitive Interests and Behavior - must have at least 2!
1. Stereotyped activity
- Motor: Spinning, rocking, flapping, finger waving; lining up toys
- Speech: scripts, echolalia (echoing someone or a script over and over again)
2. Inflexibility with routines
3. Highly restricted, fixated interests that are abnormal in intensity or focus
- Clocks, wheels, water
Difficult to find if it is a normal hobby/obsession The intensity of the focus is what matter the most. Being hyper-interested in a certain topic like trains isn’t abnormal but if they only want to talk about trains 24/7 even when you try to change the subject that is abnormal.
4. Hyper- or hyporeactivity to sensory input
- Adverse response to sounds, textures
- Excessive smelling/touching of objects
- Visual fascination with lights, movement (spinning)
Treatment:
Treatment for meds, start low and slow!
Medical:
For: Obsessive Symptoms, Anxiety, Depression
- SSRIs (fluoxetine, sertraline, escitalopram)
- second generation antipsychs
For: aggression/Irritability
- Risperidone* (but may have gynocomastia)
- Aripiprazole*
For Insomnia
- melatonin
For ADHD
- stimulants
- alpha-agonists (clonidine, guanfacine)
Non-Medical Behavioral Interventions
- applied behavioral analysis
- emotion regulation therapy
- structured expectation and schedules
- social skills training groups
ASD
Epidemiology
- Prevalence Data as of 2014 –> ___
- Sex breakdown = __:___ M to F
- 42 boys, 1:189 girls
Intellectual Disability
- 31% IQ equal or <___
- 23% IQ in ____ range
Risk Factors
- advanced ___ age
- assistive____ technology
- __ __ exposure in utero
- ____ exposure in utero (from retrospective data)
- ___ stress
Genetics:
- Concordance
- Monozygotic 60-70%, Dizygotic 5-10%
>100 genes identified
- __ X
- ___ Disorder
- DS (Tri. __)
- Velocardiofacial Syndrome/___ - 22q11 deletion
- TSC1 and TSC2
- PDD
Note: High functioning Autism, Asperger’s are OLD language. DSM-5 through these terms out. It is all autism
ASD
Epidemiology
- Prevalence Data as of 2014 –> 1.68
- Sex breakdown = 4:1 M to F
- 42 boys, 1:189 girls
Intellectual Disability
- 31% IQ equal or <70
- 23% IQ in 70-85 range
Risk Factors
- advanced paternal age
- assistive reproductive technology
- Valproaic acid exposure in utero
- SSRI exposure in utero (from retrospective data)
- Oxidative stress
Genetics:
- Concordance
- Monozygotic 60-70%, Dizygotic 5-10%
>100 genes identified
- Fragile X
- Rett;s Disorder
- DS (Tri. 21)
- Velocardiofacial Syndrome/DiGeorge - 22q11 deletion
- TSC1 and TSC2
- PDD
Note: High functioning Autism, Asperger’s are OLD language. DSM-5 through these terms out. It is all autism
ADHD
Epidemiology:
- 5% prev. rate
- 5-10% for children under 12
- 2.5 - 4% for adolescents
- 2.5% of adults
DSM-5 Criteria:
- Persistant symptoms interfere with__ or __ , = or > ___ mos
Common Comorbidities:
- ___ (oppositional defiant disorder)
- A___
- __ __ (25% of them have an LD, most often, something to do with reading)
- M___
- CD
- Smoking
- SUD
- Tics
ADHD
Epidemiology:
- 5% prev. rate
- 5-10% for children under 12
- 2.5 - 4% for adolescents
- 2.5% of adults
DSM-5 Criteria:
- Persistant symptoms interfere with function or development , = or > 6 mos
Common Comorbidities:
- ODD (oppositional defiant disorder)
- Anxiety
- Learning disabilities (25% of them have an LD, most often, something to do with reading)
- Memory
- CD
- Smoking
- SUD
- Tics
ADHD Risk Factors:
Genetic and Environment
- *Genetics:**
- Up to 90+% concordance in ___ twins
- 25-55% chance of having ADHD is one ___ has it
- Polygenic w/ likely epigenetic modifers
Environment:
- Pre- and peri___ risks: pre-___, low__ __, in ___ exposure to tobacco or alcohol
- __ trauma
- ___ time
- Toxins
- __ exposure, BPA?
ADHD Risk Factors:
Genetic and Environment
- *Genetics:**
- Up to 90+% concordance in monozygotic twins
- 25-55% chance of having ADHD is one parent has it
- Polygenic w/ likely epigenetic modifers
Environment:
- Pre- and perinatal risks: pre-maturity, low birth weight, in utero exposure to tobacco or alcohol
- head trauma
- time
screen- Toxins
- lead exposure, BPA?
Neurobiology of ADHD
Imbalance of __ and ___ in brain
- Prefrontal cortex is __ stimulated (decrease in working memory, planning, thinking ahead, etc.)
Can we image someone and image is they had ADHD?
You do not develop ADHD later in life. It is usually diagnosed before __ y/o.
Neurobiology
Imbalance of NE and dopamine in brain
- Prefrontal cortex is under stimulated (decrease in working memory, planning, thinking ahead, etc.)
Can we image someone and image is they had ADHD? NO
You do not develop ADHD later in life. It is usually diagnosed before 7 y/o.
Two different types of ADHD
- *___ Type**
1. Careless, rushes through work
- Can’t sustain attn/focus
- Zones out/not listening
- Disorganized
- Avoids tasks of sustained attn
- Loses things
- Easily distracted
- Doesn’t finish tasks
- Forgetful in daily activity
____ Type
- Fidgets/squirms
- Out of seat
- Runs/climbs
- Unable to play quietly
- “on the go”
- Talks excessively
- Blurts
- Difficulty waiting turn
- Interrupts/intrudes
Two different types of ADHD
- *Inattentive Type**
1. Careless, rushes through work
- Can’t sustain attn/focus
- Zones out/not listening
- Disorganized
- Avoids tasks of sustained attn
- Loses things
- Easily distracted
- Doesn’t finish tasks
- Forgetful in daily activity
Hyperactive/Impulsive Type
- Fidgets/squirms
- Out of seat
- Runs/climbs
- Unable to play quietly
- “on the go”
- Talks excessively
- Blurts
- Difficulty waiting turn
- Interrupts/intrudes
Treatment for ADHD:
- ___
- Ritalin, Concerta - ____
- Adderall, Dextroamphetamine
Pick the one based on if the kid can swallow a pill, when they need it, how long do you need it to last, etc.
Side Effects
Common:
- Decreased ___
- __ problems
Uncommon/Serious S/Es
- Increased __ or __
- Dizziness
- Hallucinations/mania
Other possible S/Es:
- ____ suppression
- Oversedation
- Stimulant dysphora
Treatment for ADHD:
- Methylphenidate
- Ritalin, Concerta - Amphetamine
- Adderall, Dextroamphetamine
Pick the one based on if the kid can swallow a pill, when they need it, how long do you need it to last, etc.
Side Effects
Common:
- Decreased appetite
- Sleep problems
Uncommon/Serious S/Es
- Increased HR or BP
- Dizziness
- Hallucinations/mania
Other possible S/Es:
- Growth suppression
- Oversedation
- Stimulant dysphora
Intellectual Disability:
Background: - most common cause is___
Epidemiology: 1-3% of population
Etiology
Genetics:
- DS
- FXS
- ___ Syndrome
- __-___
- A___
Environment
- ___ ___ syndrome
- ___ poisoning
- Infections leaing to __
Multimodal Interventions
- Physical therapy
- Occupational therapy
- Speech therapy
- Individual education plan
- Psychologist/behavoiral therapy
- Developmental pediatrician
Medications to target:
- Anxiety
- Depression
- Hyperactivity or Impulsivity
- Aggression
Intellectual Disability:
Background: - most common cause is fragile x
Epidemiology: 1-3% of population
Etiology
Genetics:
- DS
- FXS
- Williams Syndrome
- Prader-Willi
- Angelman’s
Environment
- Fetal alcohol syndrome
- Lead poisoning
- Infections leaing to encephalitis
Multimodal Interventions
- Physical therapy
- Occupational therapy
- Speech therapy
- Individual education plan
- Psychologist/behavoiral therapy
- Developmental pediatrician
Medications to target:
- Anxiety
- Depression
- Hyperactivity or Impulsivity
- Aggression
