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XIO > childhood impulse control > Flashcards

childhood impulse control Flashcards

1
Q

disorders - Look for behavioral manifestations that

A

are not age appropriate
deviate from cultural norms in an UNHEALTHY way
Always involve families in the assessment and treatment as well.

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2
Q

Intellectual Development Disorders (IDD)

A

IQ < 70 w/ resulting impairment in function; age of onset < 18 yo

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3
Q

mild IDD - and what level of reading and writing

A

IQ 50-70 (85% of all persons w/ MR) - usually pretty high functioning, most need a little support, can live on their own sometimes. maximum expectation is reading and writing at 6th grade level

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4
Q

moderate IDD - expected reading and writing level

A

IQ 35-50 - maximum expectation is reading and writing at 2nd grade level

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5
Q

severe IDD - IQ - and what about speech?

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IQ 20-35 - lives in a group home, limited speech.3-4% of ppl with DD.

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6
Q

profound IDD

A

: IQ < 20 - usually secondary to neurological disorder, like cerebral palsy. total care.

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7
Q

IDD - causes

A

genetic, medical and/or environmental factors, birth injuries - cord wrapped around neck, lead poisoning, mold, mercury

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8
Q

IDD - comorbities

A

Common comorbid dxs: ADHD, Mood D/O, ASD (autism spectrum disorder), Szs, Motor pxs

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9
Q

tx for IDD - what type of therapy (think of children)

A

Assess strengths to encourage independence
Use behavior modification
Referrals to community resources (e.g. JPC = Pomeroy center)

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10
Q

Autism Spectrum Disorder (ASD) - what age?

A

sxs usually appear early (as an infant) usually diagnosed between 1 1/2 and 3 yrs old. can appear as early as 6-8 weeks old - eye movements
multiple theories on etiology of ASD

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11
Q

autism now affects

A

1 in every 36 children in the US (1 in 23 boys) and the incidence is growing (in 2000, the rate was 1 in every 150 kids). The older a man is, the more likely the child will be autistic.

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12
Q

autism - developmental deficits in social skills and language***

A

difficulty reading other peoples’ faces
sing song voice, movie quotes over and over again
poor non-verbal and verbal communication

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13
Q

autism - over half

A

have some degree of IDD (IQ<70)

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14
Q

autism - males vs. females

A

males 4X> than females, but females have historically been underdiagnosed

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15
Q

autism interventions - what is the therapy called? (aba teaches autism)

A

early intevention is crucial. Applied Behavior Analysis (ABA)– behavioral therapy to teach communication skills, improve social interaction - give a star or sticker if they respond appropriately.

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16
Q

autism - diet

A

diet and complementary therapies are controversial; mixed results - inflammatory foods. corn, gluten, soy. might result in symptom reduction, but not cure. autism have higher heavy metals in system - so chelation may be used but can be very dangerous.

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17
Q

regressive autism

A

at 1 or 2, they stop functioning suddenly. these kids usually respond to alternative interventions.

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18
Q

meds for autism (zach is crazy)

A

no cure available, but Abilify and Risperdal have been FDA-approved for tx of tantrums, aggression, SIB; SSRIs for depression and anxiety sxs

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19
Q

autism prognosis

A

generally poor prognosis (better w/ higher IQ/language skills)

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20
Q

Attention Deficit Hyperactivity Disorder (ADHD)

A

characterized by poor attention span, distractibility, hyperactivity and impulsivity. the daydreamer, not absorbing material, disorganized, careless mistakes on homework. they can hyper focus on something they’re really interested in though.

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21
Q

ADHD - hyperactive symptoms - sleep?

A

interrupting, risk for injury nanda, ppl w/ adhd usually sleep well.

22
Q

ADHD - causes - what about birth weight

A

genetics, brain injury, lead exposure, alcohol and tobacco use during pregnancy, low birth weight, premature delivery

23
Q

autism - boys vs. girls

A

males 4X> than females, but females have historically been underdiagnosed

24
Q

ADHD meds (Dex has ADHD)

A

ppl w/ ADHD are dopamine seeking*
CNS stimulants e.g. Ritalin (methylphenidate**), Dexedrine, Adderall

25
Q

ADHD meds cont

A

atomoxetine (Strattera) - a norepinephrine reuptake inhibitor: less chance for abuse

26
Q

ADHD meds cont (antidepressants)

A

Antidepressants e.g. SSRIs, buproprion (increases dopamine and norepinephrine)

27
Q

ADHD meds cont

A

Alpha agonists e.g. clonidine and guanfacine (for aggression, impulsivity, hyperactivity)

28
Q

nursing action - ADHD

A

Establish clear limits, regular routine - they need external structure
Decrease stimuli (2/2 difficulty “filtering out” extraneous stimuli) OR use of music can help some kids focus
Behavior modification
Protect from injury (2/2 impulsivity, risk-taking bx)

29
Q

Oppositional Defiant Disorder (ODD)

A

just a difficult kid. can develop into conduct disorder. low serotonin.

30
Q

ODD characteristics

A

disobedience, argumentativeness, angry outbursts, poor frustration tolerance, tendency to blame others rather than take responsibility for actions

31
Q

ODD - high comorbidity w/

A

ADHD, learning disabilities, mood d/os and PSA

32
Q

ODD - risk factors (odd was neglected)

A

harsh, inconsistent or neglectful parenting
parental conflict, divorce
parents w/ PSA, Mood d/o; Personality d/o
early institutional living (e.g. group home)
need structure, limits

33
Q

Conduct Disorder (CD) - what neurotransmitter is low?

A

low serotonin

34
Q

CD - characteristics (conduct your substance abuse)

A

serious violation of societal norms (e.g. aggression towards people and/or animals, destruction of property) fires. substance use, prostitution.

35
Q

CD- most frequently diagnosed d/o among

A

most frequently diagnosed d/o among child/adolescent inpatient psych units
similar to ODD, but more dangerous
main difference is clear lack of empathy or remorse (precursor to Antisocial Personality D/O)

36
Q

CD - interventions (also ODD) - and what type of groups are good?

A

protect others from client’s aggression (intervene prophylactically!)
teach/role-model social skills, anger mgmt
tx comorbid disorders (e.g. referrals for learning disabilities)
assist client to take responsibility for his/her behavior – peer confrontation groups are helpful
birth control, STD screen/tx, drug tests prn

37
Q

Intermittent Explosive Disorder (IED)

A

don’t need to know much about this
impulsive, emotional outbursts and aggressive/violent behavior, but different from CD because these kids feel remorseful afterward

38
Q

Separation Anxiety Disorder

A

inappropriate and excessive anxiety about being away from home or primary attachment figure (often leads to school phobia)

39
Q

Reactive Attachment Disorder of Infancy and Early Childhood - 2 types (react to abuse)

A

result of gross pathologic care, repeated caregiver changes, abuse, neglect, incest.
two types: inhibited (they can’t get close to anyone) and disinhibited (they love everyone)

40
Q

Tourette’s Disorder (a motor disorder

A

strong genetic component; males 2X > females
motor and vocal tics (e.g. blinking, coprolalia (curse words) (<10%), squatting) vocal tic - throat clearing, grunting
low self-esteem often develops 2/2 ridicule from other kids

41
Q

interventions for all

A

Family Therapy
Group Therapy
Milieu Therapy
Behavioral Therapy
Cognitive Behavioral Therapy
Quiet Room
Time Out
Play Therapy - kids less than 12 yrs old
Mutual Storytelling
Therapeutic Games
Bibliotherapy
Therapeutic Drawing
Psychopharmacology

42
Q

Enuresis - what age is not normal?

A

repeated voiding of urine into the bed or clothes -not normal past age of 4.

43
Q

Encopresis (pres)

A

repeated passing of feces into inappropriate places (e.g. bed or the corner of the room)

44
Q

elimination disorders - causes

A

Constipation is a major cause of both enuresis and encopresis. Assess and treat for this first!

45
Q

what nanda for CD (CDs are defensive)

A

defensive coping

46
Q

separation anxiety disorder - treatment

A

use desensitization, CBT
strong genetic component (e.g. parents with panic d/o)

47
Q

autism - speech

A

stereotyped and repetitive use of language
inflexible adherence to routine
stereotyped or repetitive motor mannerisms (e.g.spinning) picky eaters, might wear sunglasses. spinners are hyporespontsive to vestibular.

48
Q

autism - flexibility

A

intolerance for environmental changes (e.g. bed moved)
impairment in forming peer relationships - can’t go from parallel play (w/ other kids) to imaginary interactive play. usually around age 2 or 3.
sensory integration issues

49
Q

elimination disorders - treatment (elimination bell)

A

Behavioral therapy (e.g. bell and pad technique) can be helpful for enuresis
Assess for stressors, esp with encopresis. Therapy can be helpful.

50
Q

ASD

A

autism spectrum disorder

51
Q

ADHD - age of onset

A

7 yrs old

52
Q

copralalia

A

tourette’s - curse words

XIO (372 decks)

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