Childhood Disorders Flashcards
How many children aged 4 to 17 experienced a mental disorder in the past year?
Almost one in seven
What are key considerations in Childhood Disorders?
Need to consider age / developmental level
Dependence of children on their parents / caregivers
Children’s internal experiences versus observable behaviours
Adults’ interpretations and reactions to children’s behaviours
What are Neurodevelopmental Disorders?
ADHD and Autism
What are Childhood Behavioural Disorders?
Separation Anxiety Disorder, Oppositional Defiant Disorder, Conduct Disorder
What are Elimination Disorders?
Enuresis and Encopresis
How is ADHD (inattention) Diagnosed?
Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
Often fails to give close attention to details, Often has difficulty sustaining attention in tasks, Often does not seem to listen when spoken to directly, Often does not follow through on instructions, Often has difficulty organizing tasks, Often dislikes tasks that require sustained mental effort, Often loses things, Is often easily distracted, Is often forgetful
How is ADHD (Hyperactivity) diagnosed?
Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
Often fidgets with or taps hands or feet or squirms in seat. Often leaves seat in situations when remaining seated is expected. Often runs about or climbs in situations where it is inappropriate. Often unable to play or engage in leisure activities quietly. Is often “on the go,” acting as if “driven by a motor” Often talks excessively. Often blurts out an answer before a question has been completed. Often has difficulty waiting his or her turn Often interrupts or intrudes on others
What is the prevalence of ADHD?
7.2 per cent across populations
ADHD was the most common disorder for children (8.2%), and the most common among boys (11%)
Within this group, 5.8% had the Inattentive Subtype of ADHD,
2.0% the Hyperactive-Impulsive Subtype
and 3.3% the Combined Subtype
What are key Psychological Treatments for ADHD?
Psychopharmacology + psychological treatments produce better outcomes than psychological treatments alone
Behavioural interventions - Behavioural parent training, School-based contingency management
How is Autism diagnosed?
Criterion A:
Deficits in social emotional reciprocity
Deficits in nonverbal communicative behaviours used for social interaction
Deficits in developing, maintaining, and understanding relationships
Criterion B:
Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history:
Stereotyped or repetitive motor movements, use of objects, or speech
Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior
Highly restricted, fixated interests that are abnormal in intensity or focus
Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment
What is the Theory of Mind?
Theory of Mind is the ability to attribute mental states—beliefs, intents, desires, emotions, knowledge, etc.—to oneself, and to others, and to understand that others have beliefs, desires, intentions, and perspectives that are different from one’s own.
What is Autism Spectrum Disorder?
Impairments in social interaction and social communication
Repetitive and restricted patterns of behaviour
How is Separation Anxiety diagnosed?
Recurrent excessive distress when anticipating or experiencing separation
Persistent and excessive worry about losing major attachment figures or about possible harm to them
Persistent and excessive worry about experiencing an event that causes separation
Persistent reluctance or refusal to go out
Persistent and excessive fear of or reluctance about being alone or without major attachment figures
Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure
Repeated nightmares involving the theme of separation
Repeated complaints of physical symptoms when separation from major attachment figures occurs or is anticipated
What is the prevalence of Separation Anxiety Disorder?
Occurs in approx. 4 per cent of children. More common in girls
Occurs most commonly in middle childhood
What a causes Separation Anxiety Disorder?
Parental anxiety may play a role
Insecure attachment and parental absence also play a role
How is Oppositional Defiant Disorder diagnosed?
A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as exhibited during interaction with at least one individual who is not a sibling.
Angry/Irritable Mood
Argumentative/Defiant
Vindictiveness
What is Oppositional Defiant Disorder?
Persistent patterns of angry/irritable mood, defiant behaviour
Difficulty regulating mood and negative affective style
Alterations in androgen (linked to aggressiveness) and differences in frontal brain activation
Traumatic brain injury and autonomic under-arousal are implicated
Parenting practices and parent-child interactions may play a role
How is Conduct Disorder diagnosed?
A repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate societal norms or rules are violated.
Aggression to People and Animals
Destruction of Property
Deceitfulness or Theft
Serious Violations of Rules
What is Conduct Disorder?
Persistent pattern of violation of rules and the rights of others
Thought to develop from oppositional defiant disorder
May be a precursor to adult criminality and antisocial personality disorder
More common in boys than girls.
What are treatments for Externalising Disorders?
Parenting interventions, such as ‘Triple P-Positive Parenting Program’ and the ‘Incredible Years’
Attachment-based approaches emphasise the quality of the parents’ relationship with the child
Child-focused approaches include cognitive-behavioural interventions and problem-solving skills training
What is Enuresis?
The involuntary emptying of the bladder in the absence of any organic cause, either at night (nocturnal enuresis) or daytime (diurnal enuresis)
Primary enuresis - never been dry
Secondary - dry for at least 6 months
What causes Enuresis?
Inherited factors are thought to play a significant role
No specific factor has been pinpointed but may be related to general developmental immaturity as well as hormonal and physical factors
Children with enuresis tend to have lower than average height and later development of milestones
Other possible factors include: hyperactivity of the parasympathetic system, dysregulation of vasopressin and abnormal sleep patterns
What is Encopresis?
Repetitive soiling in inappropriate places at least once a month for three months
Children with encopresis tend to have more: Anxiety/depressive symptoms, Attention difficulties, Greater social problems, More disruptive behaviour, Poorer school performance
Are males or females more likely to have experienced a mental disorder in childhood?
Males
What is the most common mental disorder among children and adolescents?
ADHD
What is the prevalence for anxiety in young people?
A national prevalence of 6.9%
What is the prevalence of Autism?
1%
What is the boy to girl ratio for autism?
2:1
What is the prevalence of Oppositional Defiant Disorder?
3 per cent of children
What is the prevalence for Enuresis?
Boys 15-22 per cent
Girls 7-15 per cent
How is Enuresis treated?
Conditioning approaches are most successful
Bell and pad method is the most effective intervention
What is the prevalence of Encopresis?
Diagnosed in 1.5 to 7.5 percent of children
