Common Pediatric Behavioral Disorders Flashcards
What are the three most common disruptive behavioral disorders?
- Oppositional defiant disorder (ODD)
- Conduct disorder (CD)
- Attention deficit hyperactivity disorder (ADHD)
- Boys are more likely to suffer from behavioral disorders
What is the definition of Oppositional Defiant Disorder (ODD)?
Persistent pattern of negative, hostile an defiant behavior towards adults
* does impair social, family,and academic functioning * Does not typically cause significant harm to others
What is the treatment for Oppositional Defiant Disorder (ODD)?
- Managed with behavior therapy
- ODD is viewed as a precursor to conduct disorder
What is the definition of conduct disorder (CD)?
Persistent, repetitive, pattern of behavior that infringes on rights of others
* Violates major age-appropriate societal norms * Starts by age 15
What is the diagnostic criteria for Conduct Disorder? (CD)
- Aggression toward people or animals
- Destruction of property
- Deceitfulness or theft
- A serious rule violation
- Disturbance causes clinically significant impairment
What happens if Conduct Disorder is not treated?
It can develop into antisocial personality disorder
What is the treatment for Conduct Disorder? (CD)
- stabilize the environment
- counseling
- mood stabilizers
- Risperidone
What is the prognosis for Conduct Disorder?
The prognosis is poor, 40% will develop anti-social personality disorder
What is the definition of Attention Deficit/Hyperactivity Disorder? (ADHD)
- CORE symptoms of inattention, hyperactivity, and impulsivity
- Persistent and pervasive
- etiology is
- Genetic, neural, and environmental
What are some of the coexisting conditions of ADHD?
-Oppositional defiant disorder, conduct disorder, anxiety, depression, learning disabilities, language disorders, tic disorders
What is the diagnostic criteria for ADHD?
- present in more than one setting
- persist for at least six months
- present before the age of 12
- impaired function in academic, social
- Conner’s Rating scales or Vanderbilt Assessment Scale
What are symptoms of hyperactivity (ADHD)?
- fidgety or restless
- running or climbing excessively
- “driven by a motor”
- Talking excessively
What are the symptoms of impulsivity? (ADHD)
- blurting out answers
- frequency interruptions
What is the treatment for ADHD?
- Behavioral management/ modification
- Stimulant medication are the first line agents for treatment of ADHD
What are Sympathomimetics?
- Stimulants
- Schedule II drugs (controlled substances)
What are the different types of methylphenidate (stimulant)
Concerta
Ritalin
Dexmethylphenidate
What are the different types of Amphelamine? (Stimulants)
Adderall
Lisdexamfetamine
Dyanavel XR
What are the common side effects of stimulants?
Appetite suppression
Sleep disturbances
Headaches
Tics
What is a non-stimulant used for families who abuse substances?
Selective norepinephrine inhibitor (Strattera)
What medication can be added when ADHD patients are lacking symptom control?
Risperidone (Risperidol)
What are neurodevelopmental disorders?
-group of disorders in where the development of the central nervous system is disturbed
What are the two most common neurodevelopmental disorders?
ADHD
Autism spectrum disorder
What are the two categories of deficits in people with Autism?
- Social communication and social interaction
2. Restricted repetitive behaviors, interest, and activities
What is Asperger Disorder?
-Impaired social interaction, restricted behavior and interest with normal language and cognitive skills
What can improve the prognosis of Autism Spectrum Disorder (ASD)
-Higher IQ and better language skills
What are signs of Autism in infants and young children?
Infants
*Delayed or absent social smiling
Young child
*Spend hours in solitary play and socially withdrawn
*** language development is most important indicator of future development
When should Autism screening be done?
AAP (American Academy of Pediatrics)
*Recommends 18-24 months of age
M-CHAT (Modified Checklist for Autism in Toddlers0
*16-30 months
What is the diagnostic criteria of Autism Spectrum Disorder?
- Persistent deficits qualitative impairment in social interactions
- Qualitative impairment in communication skills
- Repetitive and stereotyped patterns of behaviors
What is the treatment of Autism?
-Start early intervention with speech and language pathologist
What is is infantile colic?
- the baby is constantly crying
- more than 3 hours a day
- at least 3 days a week
- For more than 3 weeks
What is the etiology and epidemiology of temper tantrums?
Etiology
*normal human developmental stage
Epidemiology
*Common 18 months to 4 years
What is Enuresis?
-Urinary incontinence
What is the management for Enuresis?
- Desmopressin acetate (DDAVP)
- Behavioral strategies
What is encopresis?
-Passage of stools into inappropriate places
What is the management of Encopresis?
-enemas, stool softeners, laxatives
How does the DSM-V classify eating disorders?
Psychiatric illnesses
What is Anorexia Nervosa?
The intense fear of gaining weight despite being underweight
* Patient has an unrealistic body image and feels too fat, despite appearing excessively thin * Low albumin levels
What are the clinical features associated with Anorexia Nervosa?
- wearing oversized layered clothing
- Lanugo (fine hair on the face and trunk)
- Emaciated and cachexic (muscle wasting)
What is the diagnostic criteria of Anorexia Nervosa?
- Refusal to maintain weight
- Intense fear of gaining weight
- Disturbance in the way in which one’s body weight or shape is perceived
- Denial of low body weight
What is a complication of Anorexia Nervosa?
Refeeding syndrome
*Fatal shifts in fluids and electrolytes in malnourished patient receiving artificial refeeding
What is bulimia Nervosa?
- purging behaviors
- patient is normal weight or overweight
What is the diagnostic criteria of Bulimia Nervosa?
Recurrent episodes of binge eating at least once a week for 3 months
* Lack of control * Compensatory behavior to prevent weight gain (purging)
What are physical exam or lab findings of bulimia Nervosa?
- Teeth pitting or enamel erosion
- Petechial hemorrhages
- Russell’s sign: abraded knuckles
- Hypokalemia and hypermangensium
What is the treatment for Bulimia Nervosa?
- Cognitive behavior counseling
- Prozac
What is Binge Eating Disorder (BED)
- eating an amount of food that is definitely larger than most people would eat
- Occurs least once a week for three months
- Lack of control
Are there compensatory behaviors associated with binge eating disorder?
No
*psychotherapy is the preferred treatment
What are panic attacks?
- abrupt surge of intense fear
* sense of impending doom
What is agoraphobia?
- the fear of situations where escape is difficult or would draw unwanted attention to the person
- Avoids situations
- last 6 months or more
What is PTSD?
Post traumatic stress disorder
* re-experiencing a traumatic event in which actual or threatened death or serious injury was possible * Accompanied by avoidance of stimuli
What is Separation anxiety disorder? (SAD)
- Developmentally inappropriate wish to maintain close proximity with caregivers
- Somatic symptoms associated
- Irrational concerns
What is Separation anxiety disorder a risk factor for?
-Risk factor for developing a panic disorder, agoraphobia, and depression
what is the criteria for major depressive disorder (MDD)?
Minimum of 2 weeks of core symptoms
* Either depressed mood OR/AND * Loss f interest or pleasure in all activities (Anhedonia)
what is Parasominas?
- Sleep disorders
* defined as disruptive sleep disorder that occurs during arousals from REM or NREM
What are night terrors?
- Sleep terrors
* children wake up suddenly at night and act very upset
What is confusional arousals?
-The child behaves in a confused way because they are in between sleeping and waking up
What are communication disorders?
-An impairment in the ability to receive, send, process, and comprehensive concept or verbal, nonverbal and graphic symbol systems
What are the two major types of communication disorders?
Speech disorder
*Impairment in articulation of speech sounds, fluency, and/or voice
Language disorder:
*impaired Comphehension and/or use of spoken, written, and/or other symbol systems
What are the different types of speech disorders?
Articulation disorder *ability to produce speech sounds Fluency disorder *Stuttering Voice disorder *abnormal production of vocal quality, pitch, loudness, resonance Resonance disorder *Hyper/hyponasality
