childhood + neurodevelopmental disorders Flashcards
intro
20% kids suffer from major MI that causes sig impairment -> home, school, peers, com
disrupt normal pattern of childhood dev -> affect life trajectory
barriers to assessing, dx, tm of youngins -> stigma (self, peers, parent), difficult to dx bc lack of lang
lack of services (screening, lack of coordination among, consistent - pediatrician, school, lack of providers) and premature termination of tm -> high cost, parents dont agree
effects of childhood mental illness
long term mental disorder in adulthoods -> esp if untreated, increase in seriousness, decrease in self esteem
thwarted development -> in brain
diminished productivity
conflict w/n fam and community
child welfare involvement
juvenile justice involvement
special edu resources needed
phys health impairments -> poor self care
rf
bio: genetic predis, neurobio, prenatal and post natal
psych = temperament -> attitude/mood/behavior used to cope with env, adjusted with good parenting
env = abuse, trauma, low SES, parenting (poor role modeling), neglect
resiliency
adapt to change/adversity, inner strength, healthy coping strategies, function amid strong emotions, reach out for help/support, form nurturing relationships with older adults when parent unavailable
protective factor against MI
peer relationships, + attitude
increase resiliency
building blocks for self esteem; support and social connnectedness
+ self image, family cohesion, + relationships with at least 1 parent, + early fam experiences, support, academic, achievement, + peer relationships, temperament
temperament
can be adjusted with good parenting
nc with kids and fam
thorough assess, identify early (parent edu), fam needs, promote rights in tm, avoid seclusion and restraint
restraints need continuous monitoring by trained specialists, need to notify, not punishment
interview assessment
based on dev level, est tm alliance (listen, genuine), assess interactions btw child and parent (holding, pulling away)
child = internal s/s
parent = external s/s (behavior)
interview is same format as adults except…
watch non verbal, don’t judge
simple concrete phrases, concrete thinkers, corroborate infor with adult (detailed view of what’s happening), direct Qs, no open ended Q, may use play media, may not have accurate timeline
interview: preschool
difficult putting feelings into words, think concretely
use play
interview: school aged
longer explanations, use constructs
est rapport through competitive games
try to meet with parents and child separately, then meet all together with dr
interview: adolescents
cant share info with parent if >16
egocentric, increased self consciousness, fear of being shamed
let them know what info will be shared with parents, direct, candid
try to meet with parents and child separately, then meet all together with dr
assessment includes
fam functioning, parent-child relationship
current problem: nature, severity, L, better/worse, behaviors at home, response to discipline (and type), empathy, violence, risk; triggers/events
hx: previous tm, fam hx, dev and social, abuse
mental status (some of this is just by observation), PA
cognitive
ability to learn and problem solve
social and emotional
ability to interact with others, help self, self control
speech and lang
ability to understand and use lang
fine motor
ability to use small muscles, hands and fingers
gross motor
ability to use large muscles
developmental assessment
intellectual, gross and fine motor function
cognition, thinking and perception, social interaction and play
basic principles of childrens behaviors
all behavior has meaning
address the need behind the behavior
children want to behave and please those they care about
children with MH issues often dont clearly communicate needs
basic communication guidelines
treat with respect to preserve dignity
seek solutions, not blame
avoid “no”, “dont”, use “lets do it this way”
instill hope for success by helping child
learn to comm needs clearly, manage feelings, learn they are competent and worthwhile
never give up, catch them being good
interventions for children and adolescents
tokens, reward positive behavior (close in young, older can be delayed)
behavioral, bibliotherapy (stories for insight), expressive arts, journal, music, fam, pharm, disruptive behavior management, play therapy
play therapy
younger, “language” of children, rooted in psychodynamic therapy
goal is not to be fun
vehicle for change, expression of feelings (outlet), trust, relationship building
creative and dynamic process, cant standardize
therapist is role of trusted participant, not aberrant perp, should not play violent role, child can play perp
