Class 1

Question 1

5 Areas of child development

Answer 1

■Cognitive
■Language
■Gross motor
■Fine motor
■Socio-emotional
■Sphincters control

Question 2

Piaget’s 4 stages of cognitive development

Answer 2

■0-2 yo: Sensorimotor
–Trial and error, object permanence
■2-6 yo: Preoperational
–Symbolic thinking, use of language, egocentric thinking, animistic, increase in imagination and experience
■7-11 yo: Concrete operational
–Development of logic, objective and rational interpretation, law of conservation, numbers, ideas, classification
■>12 Formal operational
–Abstract thinking, hypothetical ideas, ethical, political, moral and social
■2 key concepts: balance between assimilation (acquisition of new symbols) and accommodation (categorization of symbols)

Question 3

Erickson’s Psychosocial Theory

Answer 3

Trust vs. Mistrust: From birth to 12 months of age
Autonomy vs. Shame/Doubt: As toddlers (ages 1–3 years)
Initiative vs. Guilt (3-6 y)
Industry vs. Inferiority (6-12 y)
Identity vs. Role Confusion (12-18)
Intimacy vs. Isolation (20-40)
Generativity vs. Stagnation (40s to mid 60s)
Integrity vs. Despair (mid 60s to end of life)

Question 4

Intellectual disabilities criteria

Answer 4

Requires 3/3:
A.Deficits in intellectual functions (reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience)
B.Deficits in adaptive functioning (failure to meet developmental and sociocultural standards for personal independence and social responsibility)
C.Onset during the developmental period
SPECIFIERS :
–Mild, Moderate, Severe, Profound

Question 5

Epidemiology ID

Answer 5

■ Heterogeneous population
■ 1-3% of the population would have an ID
■ M > F
■ Arbitrary IQ boundary below 70 (average 100)

Question 6

ID MILD age

Answer 6

9-12 yo

Question 7

ID MODERATE age

Answer 7

6-9

Question 8

ID SEVERE

Answer 8

3-6 yo

Question 9

ID PROFOUND

Answer 9

<3 yo

Question 10

Biopsychosocial etiology ID

Answer 10

■Prenatal (35%), perinatal (10%), postnatal (20%), unknown (30-50%)
■Genetics:
–Trisomy 21 is the first cause of ID of genetic origin
–Fragile X, Prader-Willi, Cri-du-chat, phenylketonuria, Rett, Neurofibromatosis, Tuberous sclerosis, Lesh-Nyan Sy
■Acquired/developmental factors:
–Prenatal period: Rubeola, syphilis, toxoplasmosis, herpes simplex, HIV, CMV, FASD
–Perinatal period: Cerebral hypoxia, complications of childbirth (e.g. Placenta previa)
–Childhood: Infection (meningitis, encephalitis), head trauma, asphyxia, long exposure to lead

Question 11

Cognitive testing ID

Answer 11

IQ <70 or 2 SD

Question 12

Adaptive functioning scales ID

Answer 12

Vineland adaptive behavioral scales II

Conceptual, Social, Practical domains

Question 13

Id comorbidities

Answer 13

ADHD, depressive and bipolar disorders;anxiety disorders;ASD;stereotypic movement disorder(with or without self-injurious behavior);impulse-control disorders; andmajor neurocognitive disorder.
ID are more likely to show psychosis, autism, and behaviordisorders and are less apt to be diagnosed with substance abuse and affective disorders.

Question 14

Language disorder

Answer 14

–Difficulties in acquisition and use of language across modalities (spoken, written, sign)
–Domains: Semantics (vocabulary), Morphology (discourse), Syntax (sentence structure)
–Expressive ability and receptive ability must be assessed separately
–Language disorder,particularly expressive deficits, may be found to co-occur withspeech sound disorder.

Question 15

Speech sound disorder

Answer 15

–Difficulty in “articulation of the phonemes” (Verbal dyspraxia)
–Requires both the phonological knowledge and the ability to coordinate the movements of the articulatorswith breathing and vocalizing for speech.
–Mostly intelligible speech by age 3 years
–Most speech sounds should be produced clearly by age 7 years
–“Late eight” (l,r,s,z,th,ch,dzh,andzh)
–Lisping (i.e., misarticulating sibilants) is particularly common and may be associated with an abnormal tongue-thrust swallowing pattern.
–Responds generally well to treatment
–However, when comorbid with a language disorder has a poorer prognosis and may be associated with specific learning disorders.

Question 16

Stuttering (Childhood-Onset Fluency Disorder)

Answer 16

A.Disturbances in the normal fluency and time patterning of speech that are inappropriate for the individual’s age and language skills, persist over time 1/8:
Sound and syllable repetitions –Sound prolongations of consonants as well as vowels –Broken words –Audible or silent blocking –Circumlocutions–Words produced with an excess of physical tension –Monosyllabic whole-word repetitions
B.The disturbance causes anxiety about speaking or limitations
C.Onset of symptoms is in the early developmental period.
D.The disturbance is not attributable to a speech-motor or sensory deficit, dysfluency associated with neurological insult, or another medical condition and is not better explained by another mental disorder.
Presentation: Mostly occurs at 6 yo (2-7 yo), 65%–85% of children recover from the dysfluency, severity of fluency disorder at age 8 years predicting recovery or persistence

Question 17

ASD

Answer 17

A.Persistent deficits in social communication and social interaction across multiple contexts 3/3
1.Deficits in social-emotional reciprocity
2.Deficits in nonverbal communicative behaviors
3.Deficits in developing, maintaining, and understanding relationships
B.Restricted, repetitive patterns of behavior, interests, or activities 2/4:
1.Stereotyped or repetitive motor movements
2.Rigidity (insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior)
3.Highly restricted, fixated interests
4.Hyper-or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment
C.Present in the early developmental period
D.Clinically significant impairment in social, occupational, or other important areas of current functioning.
E.Not better explained by ID or global developmental delay.
SPECIFIERS
–With or without accompanying intellectual impairment
–With or without accompanying language impairment
–Associated with a known medical or genetic condition or environmental factor
–Associated with another neurodevelopmental, mental, or behavioral
–With catatonia

Question 18

ASD severity levels

Answer 18

Level 1“Requiring support”
■Without supports in place, deficits in social communication cause noticeable impairments
■Interference with functioning in one or more contexts
Level 2“Requiring substantial support”
■Social impairments are apparent even with supports in place
■Obvious to the casual observer and interference with functioning in a variety of contexts
Level 3“Requiring very substantial support”
■Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning, very limited initiation of social interactions, and minimal response to social overtures from others.
■Extreme difficulty coping with change, interferes with all spheres

Question 19

ADHD criteria

Answer 19

A.Persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, with 1. or 2.
B.Several Sx prior to 12 yo
C.Several Sx are present in 2 or more setting
D.Sx interfere with/reduce the quality of, social, academic, or occupational functioning
E.Sx do not occur exclusively during the course of scz or other psychotic disorder and are not better explained by another mental disorder.Not due to defiance or lack of comprehension.
■SPECIFIERS:
–Combined presentation
–Predominantly inattentive presentation
–Predominantly hyperactive/impulsive presentation
–In partial remission
–Severity (Mild, Moderate, Severe)
1.Inattention: 6/9 for at least 6m; inconsistent with developmental level and direct negatively impacts
a.Inattention to details or makes careless mistakes
b.Difficulty sustaining attention in tasks or activities
c.Doesn’t seem to listen when spoken to directly
d.Fail to go through on instructions and fails to finish tasks
e.Difficulty organizingtasks and activities
f.Avoids, dislikes tasks that require sustained mental effort
g.Losesthings
h.Easily distractedby extraneous stimuli/thoughts
i.Forgetfulin daily activities
2.Hyperactivity and impulsivity: 6/9 for at least 6m; inconsistent with developmental level and direct negatively impacts
a.Fidgetsor taps hands or feet or squirms in seat
b.Leaves seatin inappropriate situations
c.Runsor climbs in inappropriate/restless
d.Unable to play or engage in leisure activities quietly
e.“On the go,” acting as if “driven by a motor”
f.Talksexcessively
g.Answer before the end of the question
h.Difficulty waiting his or her turn
i.Interruptsor intrudes on others

Question 20

SUD etiology

Answer 20

-genetic
–Parental substance use or abuse
–Poor parent–child relationships
–Low perceived parental support
–Poor communication
–Poor parent supervision and management of the adolescent’s behavior
–Conflict between parents and adolescents
–Insufficient parental monitoring
–Inconsistent or otherwise ineffective discipline
–Child abuse/neglect

Question 21

Abandonment

Answer 21

Refers to a situation in which a child’s parents are deceased or fail to provide for the child’s care, maintenance or educationand those responsibilities are not assumed by another person in accordance with the child’s needs

Question 22

Neglect

Answer 22

–(1)a situation in which the child’s parents or the person having custody of the child do not meet the child’s basic needs
–(i)failing to meet the child’s basic physical needs with respect to food, clothing, hygiene or lodging, taking into account their resources
–(ii)failing to give the child the care required for the child’s physical or mental health, or not allowing the child to receive such care
–(iii)failing to provide the child with the appropriate supervision or support, or failing to take the necessary steps to provide the child with schooling
–(2)a situation in which there is a serious risk that a child’s parents or the person having custody of the child are not providing for the child’s basic needs in the manner referred to in subparagraph 1

Question 23

Psychological ill-treatment”

Answer 23

refers to a situation in which a child is seriously or repeatedly subjected to behavior on the part of the child’s parents or another person that could cause harm to the child, and the child’s parents fail to take the necessary steps to put an end to the situation. Such behavior includes in particular indifference, denigration, emotional rejection, isolation, threats, exploitation, particularly if the child is forced to do work disproportionate to the child’s capacity and exposure to conjugal or domestic violence

Question 24

“Sexual abuse”

Answer 24

–(1)a situation in which the child is subjected to gestures of a sexual nature by the child’s parents or another person, with or without physical contact, and the child’s parents fail to take the necessary steps to put an endto the situation
–(2)a situation in which the child runs a serious risk of being subjected to gestures of a sexual nature by the child’s parents or another person, with or without physical contact, and the child’s parents fail to take the necessary steps to put an end to the situation

Question 25

Physical abuse”

Answer 25

–(1)a situation in which the child is the victim of bodily injury or is subjected to unreasonable methods of upbringing by her/his parents or another person, and the child’s parents fail to take the necessary steps to put an end to the situation
–(2)a situation in which the child runs a serious risk of becoming the victim of bodily injury or being subjected to unreasonable methods of upbringing by her/his parents or another person, and the child’s parents fail to take the necessary steps to put an end to the situation

Question 26

“Serious behavioral disturbance”

Answer 26

refers to a situation in which a child behaves in such a way as to repeatedly or seriously undermine the child’s or others’ physical or psychological integrity, and the child’s parents fail to take the necessary steps to put an end to the situation or, if the child is 14 or over, the child objects to such steps

Question 27

Other situations?

■Section 38.1:The security or development of a child may be considered to be in danger where

Answer 27

(a)She/he leaves her/his own home, a foster family, a facility maintained by an institution operating a rehabilitation centre or a hospital centre without authorization while her/his situation is not under the responsibility of the director of youth protection;
–(b)She/he is of school age and does not attend school, or is frequently absent without reason;
–(c)Her/his parents do not carry out their obligations to provide her/him with care, maintenance and education or do not exercise stable supervision over her/him, whiles he/he has been entrusted to the care of an institution or foster family for one year.