childhood disorders Flashcards
externalizing problems
aka disorders of uncontrolled behaviours
- ODD and CD, ADHD
new DSM-5 category: disruptive, impulse control, conduct disorders
disruptive mood dysregulation disorder
tempertantrum dis
controversial, in dsm-5
3x or more temper outbursts/week
in prev dsm, called childhood bipolar dis
ADHD facts
not recog until research by virginia douglas
symps: diff conc, sustaining focus, follow instructions, forget daily activities
types:
- adhd combined
- adhd predominantly hyperactive
- adhd perdominantly attention deficit
prev: 5.29%, adults 4.4%
boys > girls, may be overstated
hyperactivity
constant motion, jiggle legs, fidget, talk out of turn
- cant stop moving or talking
kids w adhd have peer difficulties bcs seen as annoying
- 15-30% have learning disabilities
thomas brown ADHD model
- activation: organize, prioritze, activate to work
- focus: sustain, shift
- memory: WM and recall
4: action: monitor and relf reg
5: emotion: manage - effort: reg alertness, processing speed
executive function impaired by ADHD
thomas brown comorbidity
70% had more than 1 disorder
40% ODD, 34% anxiety,
- some CD, tics, mood disordere
genetic predisposition ADHD
75% heritable
brain diffs ADHD
frontal striatal circuity
reduced vol cerebellum and cerebrum
dec basal ganglia vol
dysfunctions NE and dopamine sys
ADHD in adults
emphasize inattention over hyperactivity
comorbid w marriage issues, subs abuse, anti-social disorders
- low SES, change jobs, dec perf
environmental toxins
mixed evidence
pesticides, lead, etc. contrib
pre and perinatal factors
maternal smoking, alc abuse, low BW, prematurity
diet
nutritional deficiencies, surpluses, IgG foods
correlation, not proven risk
psychosocial adversity
family adversity and hostility, early deprivaation
diathesis-stress theory
not research supported
hyperactivity dev when predisposition combo w authoritarian upbringing
- attention seeking
treatment ADHD
stimulants: reduce attention deficits
- rialin, methyphenidate
- lack appetite, insomnia
- may be overprescribed
psych treatment: operant conditioning and parent/classroom training
ODD
oppositional defiant disorder
main themes:
- disobedient
- irritable
- vindicative
do NOT demonstrate serious violations of norms like in CD
CD
conduct disorder
- more severe than ODD
- LACK REMOSE, vicious
comorbid w ODD and ADHD
repetitive behavs: aggression to ppl and aimals, destroy property, theft, lies, serious violations
is a criteria for anti-social personality disorder
- some will develop ASD later
bio factors CD
aggression is heritable, delinquency is not
neurpsychosocial deficits: dec verbal skills, exec funct, memory
amygdala dysfunction
psych factors CD
ineffective parenting, inconsistent discipline
learning theories: modelling and operant conditioning
biopsychosocial model
of CD
bio predisposition interacts w sociocultural context
- impacts parenting, peers, mental processes
chaotic social environ
of CD
noise lvls, crowd, unpredictable home
treating CD
address young, adulthood can progress to anti-social disorder
family interventions: parental management training
cog approaches: anger management, moral reasoning skills training
preventing CD
begin treat at 3y/o ID mothers at risk:
- post partum depression
- maternal antisocial
- young preg, smoker
- partner cruelty
dsm-5 neurodevelopment disorders list
adhd
specific learning disorders
communication disorder
motor disorders
autism spectrum disorder
intellectual disability disorder
specific learning disorders
inadequate dev in specific lang, academic, speech, motor area
- not from autism, phys disorder, lack of education
usually have avg-high intelligence
5%+ prevalence
dyslexia: cannot recog words and comp
dyscalcula: cannot align numbs, rapidly count, recall
dysgraphia: poor grammar, handwriting, diff composing written work
etiology of learning disorders
dyslexia chromosome 13
- can be heritable
dec left temporo-parietal cortex activation
treating learning disorders
special ed programs
individualized to severity
parent involvement
communication disorders
language disorder: see car but cannot communicate word
phonology/speech sound disorder: wabbit, bu
stuttering/childhood onset fluency disorder: more common boys, resolves
pragmatic communication dis: cannot interp nonverbal cues
- argued is autism
- new to dsm-5
motor disorders
developmental communication disorder: impaired motor coordination i.e. tie laces, button shirt
- only when severe
tics: motor or verbal, repetitive
tourette’s disorder: mult motor or 1+ vocal tic
intellectual disability
sig limitations intellect and adaptive behavs (perception, practical, social)
- IQ 70 or lower
- onset before 18
mild: 50-55 to 70, 85%
moderate: 35-40 to 50-55, 10%
severe: 20-25 to 35-40, 4%
profound: less than 20-25, 1-2%
etiology intellectual disability
NO IDENTIFIABLE CAUSE 30-40%
hereditary disorders: genetic or chromosomal
- i.e. fragile x syndrome
early alterations of embryonic dev: 30%
- FAS, down syndrome
measles, chickenpox, etc.
late preg and preg issues
environ: reduced stimulation, lack nutruance, low SES
- 15-20%
preventing and treating ID
enrichment programs: behav and cog interventions
- based on op conditioning
ASD
autism spectrum disorder
- many subcategories
- DSM-5 eliminated subcats bcs inconsistent distinctions…now focus on severity
4:1 boys to girls
onset infancy and early dev
comborbid w anx, dep, adhd
ASD features
deficits in social communication and interaction, trouble w changing contexts
- limited imaginative play
- repetitive and rigid behavs
- self-stim behavs i.e. arm flap
rett’s disorder
rare, only in girls
- normal dev 1-2 yrs, then head dec growth and cannot use hands meaningfully
- handwashing/wringing motion
- dec speech and walking
childhood disintegrative disorder
of ASD
v rare, norm dev 2 yrs
- lose social, play, lang, motor skills
extreme autism aloneness
rarely engage in play w others, don’t greet spontaneously
common autism deficits
echolia echo speech: repeat phrases
pronoun reversal
obsessive compulsive and ritualistic acts: upset w change, prone to stereotypic behav
etiology ASD
psych: prev though refrigerator mothers (cold, traumatize child)
genetics: 75x greater risk for siblings
- fragile x: chromosome abs, linked to freater social communication deficits
neuro factors: 30% have seizures, ab brainwave patterns
- cerebllum, amgy, corpus callosum, frontl and temp cortex
environ: mat infections, drugs, nutrition
treating ASD
early intervention to inc success
- modelling and op conditioning
EIBI: early intensive behav intervention
- works when before 5y/o and intensive (20+hrs/wk and homework for 2+yrs)
- kids w higher initial cog have best resp
disorders of overcontrolled behaviours
aka internalizing problems
now considered childhood ONSET
- social phob
- gad
- ocd
- selective mutism
- post traumatic stress
- spec phobia
- panic
- separation anx
- depression
ACEs
averse childhood experiences
- incarcerated parent, witness abuse, abused
inc poverty, MI, abnormal behav
childhood fear and anx
1/3 canadian kids rated too fearful by parents
- girls inc common
10-15% kids have anxiety disorder
- most common childhood disorder
helicopter parents: catastrophic predictions abt outside
- keep kids on edge
