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Mental Health > Children and Adolescent Mental Health > Flashcards

Children and Adolescent Mental Health Flashcards

1
Q

What is autism characterised by?

A

Impairment in social interaction
Impairment in communication
Restrictive stereotyped behaviours and interests

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2
Q

What are the main risk factors for autism?

A 
Male - 4x more likely
Prenatal:
- Mother >40
- Genetic - chromosome 7
- Sodium valproate use by mother
- Viral infections - rubella

Ante-natal:

  • Difficult birth - hypoxia
  • Low birth weight
  • Premature

Postnatal:

  • Exposure to toxins - lead, mercury
  • Pesticide exposure
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3
Q

What behaviours may be seen in a child with autism?

A

Rocking and twisting
Upset at routine change
Prefer same foods, toys etc.
Obsessively pursued interests

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4
Q

What communication abnormalities may be seen in a child with autism?

A

Delayed speech

Echolalia - repeat words

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5
Q

What social aspects may be observed in a child with autism?

A

Unaware of social rules
No emotional expression
Lack of eye contact
Few gestures - waving/nodding

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6
Q

What conditions are associated with autism?

A 
Epilepsy - 20% chance of developing it
Visual impairment
Hearing impairment
Infections
Pica - eating inedible objects
Constipation
Sleep disorders
ADHD, depression, bipolar, anxiety
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7
Q

How common is autism? What is the typical age of onset?

A

1.1% of the population

Before 3yo

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8
Q

How is autism diagnosed?

A

Ask parents what things they play with, who they play with, food habits, abnormal movements, development concerns

Do full developmental assessment

Hearing tests

Screening tools - M-CHAT (Modified Checklist for Autism in Toddlers)

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9
Q

How is autism managed?

A

Bio:

  • Treat co-existing disorders
  • Antipsychotics if challenging behaviours that isnt othewise solved
  • Melatonin - sleep

Psycho:

  • Psychoeducation for family
  • CBT if child is able and motivated

Social:

  • Modify home - light and sound
  • Social communication intervention - play based strategies
  • Self-help groups
  • Special schooling
  • Support in life skills
  • Support for carers and family
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10
Q

What is asperger’s syndrome?

A

Abnormalities in social interaction
Restricted stereotyped behaviours
BUT
No impairment to language - may still struggle with tone of voice, sarcasm and facial expressions

Average or above average cognition and IQ

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11
Q

What is ADHD characterised by?

A

Inattention, Hyperactivity and Impulsivity
+
Early onset, persistent, present in >1 situation
+
More frequent and severe than comparable individuals

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12
Q

How common is ADHD?

A

2.4% prevalence

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13
Q

What can cause ADHD?

A

Genetic - DRD4/5 gene
Neurochemical - dopaminergic pathway changes
Neurodevelopmental - pre-frontal cortex abnormalities
Social - Drug/alcohol in parents, social deprivation

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14
Q

How is ADHD diagnosed?

A

Assessment by CAMHS to observe child, talk to parents and teachers and looking at school reports

DIVA test is used to judge symptoms

To be diagnosed, symptoms must interfere with performance

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15
Q

What inattentive signs are typical of ADHD?

A 
Distracted so doesnt finish tasks
Avoid tasks that req. concentration for a long time
Doesnt listen
Lose and forget belongings
Trouble organising tasks
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16
Q

What hyperactivity/impulsive signs are typical of ADHD?

A 
Fidget and restless
Doesn't engage in quiet activities
Temper tantrums and aggression
Doesnt wait their turn
Talk lots, interrupt others, blurt out answers at school
17
Q

How does ADHD present?

A

Can be a mixture of inattentive and hyperactivity signs

May be predominantly one of the other too

18
Q

How is ADHD managed pre-school?

A

Train parents to reinforce good behaviours and manage disruptive behaviours

19
Q

How is ADHD managed at a school age?

A

Psychoeducation, CBT and behaviour modification
Drug treatment:
- Methylphenidate (Ritalin)
- Atomoxetine if Ritalin fails

20
Q

What are the general management principals for ADHD?

A

Stress importance of balanced diet and exercise
Educate and support parents
Consider family therapy
Address underlying learning difficulties

21
Q

How are learning disabilities defined?

A

State of arrested or incomplete development of the mind leading to impairment of skills that are learnt over the developmental period and that contribute to overall intelligence

22
Q

How can learning disabilities be categorised?

A

Mild - IQ 50-70
Moderate - IQ 35-49
Severe - IQ 20-34
Profound - IQ <20

23
Q

How would an individual with a mild learning disability appear?

A

Adequate language and social skills but academic difficulties, can live independently but may need support

24
Q

How would a moderate learning disability appear?

A

Can communicate with limited language

May need supervision with self-care

25
Q

How would a severe learning disability appear?

A

Marked motor impairment
Very simple communication
May be associated physical disorders

26
Q

How would profound learning disabilities appear?

A

Severe motor impairment and communication difficulties
Struggle with self-care
Most have physical disorders and require residential care

27
Q

What physical disorders are associated with learning disabilties?

A

Epilepsy
Hearing and visual impairment
Motor disability
Incontinence

28
Q

How common are learning disabilities?

A

2% prevalence

29
Q

What can cause learning disabilities?

A 
Brain haemorrhage
Hypoxia
Meningitis/Infection
Pre-eclampsia
Genetic - Down's, fragile X, Prader-Willi
Cerebral Palsy
Autism
Tuberous Sclerosis
Alcohol/caffeine
Neglect
Nutritional deficiency/galactossaemia
30
Q

What is important to consider when managing patients with learning disabilites?

A

40% have co-existing mental health problem

Genetic issues - children/parents

More life stressors - inc. way viewed by society

Poor access to services

31
Q

How are patients with learning disabilities managed?

A 
CBT
Psychodynamic therapy
Family therapy
Special schooling
Anti-psychotics may be needed if challenging behaviour
32
Q

What is a conduct disorder?

A

Severe pattern of antisocial behaviour:

  • Aggression towards people and animals
  • Property destruction
  • Stealing
  • Rule violation - skipping school, running away
33
Q

What may place a child at increased risk of conduct disorder?

A

Male
Abuse
Poor socio-economic status
Parental psychiatric disorders

34
Q

What are emotional disorders?

A

Mental disorder in which a persons personality is taken over by their emotional thinking

Purely psychological (no biological cause)

35
Q

What can cause emotional disorders?

A

Abuse
Exposure to pre-natal drugs
Poverty

36
Q

What may children with emotional disorders have?

A

Conduct disorder
Affective disorders - depression and bipolar common
Personality disorders
Anxiety disorders - most common emotional disorder
ADHD
Oppositional defiant disorder - lose temper and argue a lot

Mental Health (12 decks)

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