Childhood Psychopathology

Question 1

Intellectual Disability

Answer 1

• Widespread delays in development (if under 3yo > global developmental delay)
• Social behaviors NML for developmental age
• IQ < 70
• adaptive daily living skills <70
• onset prior to age 18
• male to female = 1.5:1

Question 2

Mild ID

Answer 2

IQ 50-55 to approx. 70

• MC
• typically attain reading and math skills up to 5th grade by 18yo
• usually work and live semi-independently

Question 3

Moderate ID

Answer 3

IQ 35-40 to 50-55

• attain speech in early childhood
• 2nd grade level
• need moderate supervision for personal care
• work in sheltered or supported employment programs
• live in community or supervised settings

Question 4

Severe ID

Answer 4

IQ 20-25 to 35-40

• little or no speech in early childhood
• some familiarity with alphabet, numbers, sight reading of “survival words”
• perform simple tasks in closely supervised settings
• liver in group homes or with family

Question 5

Profound ID

Answer 5

IQ below 20-25

• no speech, no academic skills, almost no self-care
• may be trained to have some rudimentary communication
• most have a neurological condition that accounts for it
• motor and sensory impairments common

Question 6

General rules of ID

Answer 6

• As severity increases, incidence decreases
• As severity increases, age of dx decreases
• As severity increases, comorbidity increases
• As severity increases, mortality increases

Question 7

Specific learning disorder

Answer 7

• With impairment in reading, math, writing
• 6m or more
• assessment or historical evidence <17yo
• may not be apparent until adulthood

Question 8

Developmental coordination disorder

Answer 8

• Clumsy, inaccurate, poor handwriting
• interferes with daily living
• onset in developmental period
• not better accounted for by ID, vision impairment, cerebral palsy

Question 9

Stereotypic movement disorder

Answer 9

Repetitive, seemingly purposeless motor behavior

• interferes with daily life
• onset in developmental period
• not better accounted for by ID, vision impairment, cerebral palsy

Question 10

Tic disorders

Answer 10

<18yo, at least 1 y duration

• Tourette’s = motor and vocal
• Persistent motor or vocal tic disorder

Question 11

Language disorder

Answer 11

• causes functional limitations
• onset in early development
• not attributable to something higher
• comprehension and/or production difficulties

Question 12

Speech sound disorder

Answer 12

• causes functional limitations
• onset in early development
• not attributable to something higher
• kids in speech therapy for “r’s” and “l’s”

Question 13

Child-onset fluency disorder

Answer 13

• causes functional limitations
• onset in early development
• not attributable to something higher
• stuttering

Question 14

social (pragmatic) language disorder

Answer 14

• causes functional limitations
• onset in early development
• not attributable to something higher
• social greetings, contextuality, rules, turn-taking, inferences, and interpretation

Question 15

ASD

Answer 15

• Social problems (reciprocity, non-verbal, relationships)
• Repetitive behavior (stereotyped movement, insistence on sameness/inflexibility, highly restricted interests, hypo/hyper reactivity to sensory)
• Male to female 4:1
• overlap w/ intellectual disability

Question 16

Therapies for ASD

Answer 16

• Lovaas therapy or discrete trial training (DTT) > 30-40 hours/week, one-on-one, intense
• TEAACH - preschool program
• vitamins/supplements
• speech therapy

Question 17

ADHD

Answer 17

• A: persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development as characterized by 1 and/or 2
  1. inattention 6+ for at least 6 months
• Fails to give close attention to details, careless mistakes
• Difficulty sustaining attention in tasks or play
• Does not seem to listen when spoken to
• Does not follow through on instructions and fails to finish chores, school work
• Difficulty organizing tasks
• Avoids, dislikes or reluctant to engage in tasks that require sustained mental effort
• Often loses things
• Easily distracted by extraneous stimuli
• Forgetful in daily activities
  2. Hyperactivity 6+ for at least 6m
• Fidgets, squirms
• Leaves seat when not supposed to
• Runs about or climbs excessively
• Difficulty playing quietly
• Acts as if “on the go” or “driven by a motor”
• Talks excessively
• Blurts out answers before questions have been completed
• Difficulty awaiting turn
• Interrupts, intrudes

B: sx present prior to 12yo
C: sx present in 2+ settings
D: sx interfere w/ social, academic, or occupational fxn
E: not schizophrenia, psychotic disorder, or better accounted for by another disorder

Question 18

ADHD types

Answer 18

Primarily Inattentive Type
Primarily Hyperactive-Impulsive Type
Combined Type

Question 19

Oppositional Defiant Disorder

Answer 19

A. A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness, for at least 6 months and is characterized by:

1. losing temper
2. arguing
3. defying, refusing
4. deliberately annoying
5. blaming others for own misbehavior
6. touchy, easily annoyed
7. angry resentful, spiteful, vindictive

B. With someone other than a sibling!
C. Causes distress at home, school, or work
D. Not from psychotic, substance, or mood disorder

Question 20

Conduct Disoder

Answer 20

A.  Repetitive persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated.
1.  aggressive conduct that causes or threatens harm
against people or animals
2.  property loss or damage
deliberate fire-setting, vandalism
3.  deceitfulness or theft
breaking and entering, lies, steals
4.  serious rule violations
breaks curfew, runs away, truant

Question 21

Elimination Disorder

Answer 21

-Enuresis
Wetting bed or clothing after 5 years of age
Nocturnal, diurnal, both

-Encopresis
Soiling clothes, or on floor after 4 years of age
With/without constipation and overflow incontinence

Question 22

Separation Anxiety

Answer 22

A. Developmentally inappropriate and excessive fear of separation from attachment figure

• Excessive distress upon separation
• Worry about losing attachment figure
• Excessive worry about untoward event (getting lost, being kidnapped) that would cause separation from attachment figure
• Refusal to go to school, etc.
• Nightmares involving separation
• Physical complaints upon separation or in anticipation of separation

At least 4 weeks, causes impairment in functioning, not better explained by….autism, delusions, agoraphobia, GAD, etc.

Question 23

Selective Mutism

Answer 23

• Won’t speak in specific social situations (e.g., school) despite speaking in other situations
• Interferes with educational or occupational functioning
• At least 1 month
• Not due to lack of knowledge/comfort with the language of that specific setting
• Not better explained by…Comm. Dis, autism, psychosis