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OTA 140 - Pediatrics > Childhood Mental Health > Flashcards

Childhood Mental Health Flashcards

1
Q

Mental Health disorders affect:

A
  • Regulation/control of behaviors
  • Interaction/collaboration with others
  • Forming/maintaining friendships
  • Relating to/taking directions from adults
  • Attending to tasks
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2
Q

Incidence of Mental Health Disorders in Children

A

1 in 5 children has a mental health disorder

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3
Q

Settings for Mental Health Intervention

A
  • Psychiatric units in acute care hospitals
  • Independent psychiatric hospitals
  • Day tx centers
  • Community mental health centers
  • Public schools
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4
Q

Multidimensional Factors of Mental Health

A
  • BIOLOGICAL: biochemical imbalances, genetics, etc.
  • SOCIOCULTURAL: culture, race, economic status, etc.
  • SOCIAL: human context (family, ppers, community, etc.)
  • PSYCHOLOGICAL: cognition, personality, self-concept, etc.

**An INTEGRATIVE MODEL that considers all four of these is used to understand each child’s disorder.

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5
Q

Neurodevelopmental Disorders

A 
Interfere with successful engagement in personal, social, academic or occupational functioning.
Includes:
• ADHD
• Motor disorders
• Tic disorders
• Specific learning disorders (SLDs)
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6
Q

ADHD

A

2 presentations:
- Inattentive
- Hyperactivity-impulsivity
• Symptoms must be present before 7 yr and last at least 6 mo
• Must interfere with child’s performance
• ID’d by multidisciplinary health care team
• Interventions: sensory integration, behavior mgmt. programs, classroom/home modifications, meds
• Possible FOR: applied behavioral

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7
Q

Motor Disorders

A

Deficits in acquisition and execution of coordinated movements.
• Clumsiness
• Slow to perform daily occupations
• Movements stereotypic and purposeless
• Interferes with social, academic and adaptive functioning

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8
Q

Tic Disorders

A

(ie: Tourette Syndrome)
• Genetic disorder, onset at 6-7 yo
• Repetitive, involuntary motor and vocal tics
• Related comorbidities: ADHD, behavior problems, learning disabilities, OCD
• Interventions: meds, behavioral mgmt. programs, anxiety/anger mgmt. programs
• Include social participation goals to prevent onset of bullying!

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9
Q

Specific Learning Disorder (SLD)

A
  • 5-15% of school-aged children
  • Perform below average; severe discrepancy betw ability and achievement
  • Mild, moderate, and severe
  • Dyslexia: reading disability
  • Dysgraphia: writing disability
  • Dyscalculia: math disability
  • Interventions: based on symptoms; may include sensory integration, coaching techniques, cognitive-behavioral therapy, or compensatory strategies
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10
Q

Disruptive, Impulse-Control, and Conduct Disorders

A
  • Socially disruptive behaviors
  • Violate rights of others (aggression; property destruction)
  • Problems with emotions (anger, irritation) and behaviors (aggression, defiance)
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11
Q

Childhood-Onset Conduct Disorder

A
  • Long-standing behaviors that violate rights of others and rules of society.
  • Physical aggression toward others (incl animals)
  • Mugging, shoplifting, burglary
  • Destruction of property
  • Breaking rules
  • Impaired school performance
  • Skipping school/suspensions
  • At risk for poor outcomes (dropping out, unemployment)
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12
Q

Oppositional Defiant Disorder

A
  • Negative, hostile, defiant behaviors, uncharacteristic of other children
  • Outbursts of temper
  • Hostility toward authority
  • Poor academics
  • Few friendships
  • Ignoring others’ feelings
  • May be indication of underlying major depression
  • Interventions: behavior programs that establish limits; strategies to develop self-regulatory behaviors; strategies for constructive expression of emotions
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13
Q

Intermittent Explosive Personality Disorder

A
  • Recurrent aggressive behavior outbursts
  • Magnitude out of proportion to provocation
  • Not premeditated
  • Impulsive and/or anger based
  • Deficits in social, academic, adaptive functioning
  • May result in criminal charges if against property/person
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14
Q

Anxiety Disorders

A
  • Prevalence: 13 in 100; more common in females
  • Normal adaptive response to stress (palpitations, pain, restlessness, etc.) maladaptive if interferes with functioning
  • Extreme: raised heart rate, vomiting
  • Difficulty making decisions, learning, concentrating, perceiving situations
  • Poor school attendance, low self-esteem, adjustment difficulties, poor social skills
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15
Q

Generalized Anxiety Disorder (GAD)

A

Excessive anxiety and worrying without a trigger.
• About future, school performance, family health
• Cannot control fears, resulting in:
- Irritability
- Negative self-image
- Inability to relax
- Difficulty concentrating
- Disrupted sleep
• Difficulties with performance in all areas of occupation

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16
Q

Separation Anxiety Disorder

A

Extreme anxiety when anticipating separation from home/caregiver.
• Refusal to go to school or overnights
• Nightmares of separation
• Somatic/physical symptoms (headaches, dizziness, palpitations, stomachaches, nausea)
• Delayed social development
• Poor academic performance

17
Q

Social Anxiety (Social Phobia) Disorder

A

Specific, persistent and recurring fear of social situations.
• Panic attacks
• Avoidance of phobia is disabling
• Interventions: cognitive-behavioral therapy, meds, relaxation strategies, play/creative activities

18
Q

OCD

A

Characterized by intrusive, disruptive thoughts that cause anxiety.
• Compulsive, ritualistic, repetitive patterns of behavior to reduce anxiety
• Rearranging, hand washing, excessive checking
• Obsessive thoughts that are irrational concerns or fears
• Disgust with germs, fear that harm will come to family member, etc.

19
Q

Other Compulsive Disorders

A
  • Body Dysmorphic Disorder: preoc with perceived physical flaws/deficits
  • Hoarding Disorder: difficulty getting rid of items (indecisiveness/avoidance)
  • Trichotillomania: hair pulling
  • Excoriation: skin picking
20
Q

Trauma and Stress-Related Disorders

A
  • Reactive Attachment Disorder: pattern of delayed attachment behaviors (child minimally turns to caregiver for comfort, etc.)
  • Disinhibited Social Engagement Disorder: pattern of behavior when child is overly familiar with strangers
21
Q

Acute and Post-Traumatic Stress Disorder (ASD/PTSD)

A

Both develop in response to a traumatic event.
• ASD is immediate stress response to trauma that lasts 1 mo
• PTSD symptoms last longer than 1 mo
• Recurring nightmares
• Repeated memories of event
• Difficulty sleeping
• Changes in eating habits
• Complaints of physical symptoms
• Difficulties with all areas of occupation

Comorbid Disorders: panic attacks, substance abuse.

22
Q

Disruptive Mood Dysregulation Disorder

A
  • Child betw 7-18 yo who is angry/irritable all the time.
  • Verbal or behavioral outbursts at least 3 times/week across environments
  • Aggressive, destructive acts against property, self, or others
23
Q

Major Depressive Disorder

A

Most common mood disorders are major depression, minor depression, and brief recurrent depression.
• No single cause; biological, social, sociocultural, and psychological factors can increase likelihood (physical/emo/sex abuse, neglect, lack of affection)
• many functional difficulties (poor concentration, not completing tasks, learning difficulties, aggressiveness)
• Shows: irritability, pessimism, somatic complaints, social withdrawal, changes in weight, low self-esteem/body image, agitation, poor school attendance
• Comorbidities: phobias, substance abuse, sexual promiscuity
• Consider multidimensional model
• Risk of suicide
• Interventions: meds, supervision in safe environment

24
Q

Bipolar Disorder

A
  • Genetic predisposition
  • 2 extremes of mood: Depression and Mania
  • Extreme moods go in cycles
  • Poor school performance
  • Few social relationships
  • Disorganization
  • Difficulty regulating behavior
25
Q

Schizophrenia

A
  • Serious, chronic condition
  • Positive symptoms of an acute episode: delusions, hallucinations, disorganized speech, disorganized motor behavior
  • Negative symptoms: lethargy, blunted affect
  • Prodromal stage: before first acute psychotic episode; withdrawal from activities and social contacts; may self-medicate
  • Interventions: meds, facilitate development of age-approp skills
26
Q

Rumination Disorder

A

Regurgitates food repetitively. May re-chew, swallow, or spit out the food.

27
Q

Enuresis

A

Repeated elimination of urine involuntarily or intentionally in inappropriate places (at least 2 occurrences per week for 3 mo)

28
Q

Encopresis

A

Repeated elimination of feces in inappropriate places (at least once a month for 3 mo)

29
Q

Sleep-Wake Disorders

A

Individual has poor quality, timing, and amount of sleep.
• Insomnia: difficulty going/staying asleep
• Breathing-related disorders:
- Obstructive Sleep Apnea Hypopnea Disorder (repeated episodes of obstruction of pharyngeal airway)
- Sleep-related Hypoventilation (episodes of shallow breathing)
- Parasomnias (experiential or physiological events that occur while sleeping—sleepwalking, sleep terrors, nightmares)

30
Q

Substance-Related Disorders

A
  • Misuse of drugs, toxins, meds
  • Abuse: pattern of use causes adverse consequences
  • Dependence/Addiction: pattern of continued use despite serious cognitive, behavioral, physiological symptoms
  • At least 3 of following: tolerance, unpleasant withdrawal, using increasing amt, desires to stop but fails, excessive time spent, neglect of/decline in occupational performance, continued use
31
Q

Inhalant-Related Disorder

A
  • Common among children/adolescents
  • Huffing/sniffing (gas, glue)
  • Can cause psychotic experiences
  • Can cause serious medical/life-threatening conditions
  • Neglect of self-care
  • Decreased attendance and performance in school
32
Q

Data Gathering/Evaluation of Mental Health

A

• OTR determines assessment to be used, and interprets data
• Observation one of most important tools
• Review of records, interviews, structured assessments
• Structured Evaluations:
- Piers-Harris Scale
- Child Occupational Self-Assessment
- Volitional Questionnaire

33
Q

Intervention Planning for Mental Health

A
  • Guided by FOR
  • Considers strengths and weaknesses
  • Establishes long-term and short-term goals
  • Determines interventions
  • Includes frequency/duration
34
Q

Intervention Implementation for Mental Health

A
  • Use of techniques/strategies based on selected FOR
  • Typically in groups
  • May be on individual basis
  • Types of groups: imaginative play, life skills, social skills, task skills
35
Q

Intentional Relationship Model (IRM)

A

Method of therapeutic use of self for mental health disorders.
• Advocating, collaborating, empathizing, encouraging, instructing, problem-solving

OTA 140 - Pediatrics (18 decks)

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