Common Developmental and Behavioral Issues - Exam 3 Flashcards
sleep disorders are common in up to ___% of healthy kids younger than 5 and up to ___% of kiddos with special needs
Up to 25% of healthy kids younger than 5
Up to 80% of children with special needs
When are day/night patterns developed? When is the adult pattern of sleep established?
usually by 4 months
usually by 3 years old
What are the 2 stages of sleep? How long do infants need to sleep?
REM and NREM
Infants sleep 16-20 hours per day, then transition to 9-12 hour blocks with a nap in between
What is the common sleep disorder for children under 12?
Difficulty initiating or maintaining sleep that is viewed as a problem by child or caregiver
______ is linked to inadequate sleep
obesity
How should an infant sleep?
Infant fed in parents’ arms then placed in crib to sleep
and Put to bed when moderately tired to reduce resistance and help develop self-soothing techniques
When can an infant start to sleep through the night 6+ hours?
Around 12 weeks infant can and should sleep through night 6+ hours
What is the tx for night awakenings for trained night feeding?
night time awakenings around 5-6 mos and appearing genuinely hungry are probably ready for solids
OR
need to increase volume of formula/breast milk throughout the day
At around ____ don’t go into room at first sound of rustling or fussiness. Allow to return to sleep without parental intervention
4 months old
What are some causes of trained night awakening when the goal is NOT feeding? What age range?
Begins when child gets ill, travels, or any change in routine
May persist b/c child gets secondary reward of parents attention
4-8 months
What is the parental education for night awakenings?
need to practice patience!!
re-establish bedtime routines
bedding with parent scent and into bed while awake
daytime naps should NOT be longer than 2 hours
“scheduled visiting”
touch, but DO NOT pick up or cuddle
When is a common time for kiddo to experience developmental night awakenings? What is the pt education?
6 mo well-child
try night light
give a couple minutes to let child self-soothe
go into room and reassure child that they are okay and can lay down beside bed/crib in the child’s eyesight and go to sleep there
What is the parent education for bedtime fears?
Check for monsters with flashlight
Don’t let watch movies/play video games that are scary (at any time)
Nightlights
Parental reassurance
_______ are unusual behaviors or experiences that occur during sleep or the transition between sleep and wake
Parasomnias
Do children remember parasomnias? Are they fully awake? When will it resolve?
Child is NOT fully awake and may or may not remember the event the next morning
generally resolves spontaneously
_____ are when the child may sit up, scream, and appear terrified. Are they awake? Will they remember it? Are they responsive to their environment?
night terrors
partial awakened from sleep
does NOT remember anything
Usually unresponsive to parental comforting
When are night terrors more likely to occur? What is the pattern?
first 1/3rd of the night
Occur in bouts for weeks at a time, then disappear, then reappears
What is the tx for night terrors? What age?
Parental reassurance of benign nature
Resolve 95% of the time by age 8
Empty bladder before bedtime, keep room dark and quiet
Can wake child up 15 min before expected episode for a week and may take 30-60 minute afternoon nap
When can kiddos start to dream clearly? What time of night? What age range are nightmares the most common?
around 14 months
last 1/3 of night
Most common between 3 and 6 years
In nightmares the dream content is ______ and can be _______
recalled
can be comforted and responds to parental reassurance
What are nightmares associated with? What is the tx for very severe nightmares?
Can be associated with stress, PTSD, anxiety, and sleep deprivation
If very severe, can give trazodone or Benadryl with the idea of deep sleep to sleep through
When does trust develop? What is the result if the infant mistrusts more than trusts?
Trust develops in the first year to the extent that the infant learns that the caregiver is a predictable and reliable provider of essential physical/emotional needs
ends to be more clinging and demanding as a result of insecurity of caregiver’s availability
What is the tx for separation anxiety?
reassurance that you will be back
When does stranger anxiety typically start? Is it normal?
around 6-8 months and can last up to 24 months
YES, natural phase of development