Development Flashcards
Diagnostic criteria for ADHD
A. A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development as characterized by (1) or (2):
1. Inattention (6/9) - Fails to give close attention to details or makes careless mistakes - Often has difficulty sustaining attention in tasks or play activities - Does not seem to listen when spoken to directly - Does not follow through on instructions and fails to finish schoolwork, chores or duties - Often has difficulty organizing tasks and activities - Often avoids, dislikes or is reluctant to engage in tasks that require sustained mental effort - Often loses things necessary for tasks or activities - Often easily distracted by extraneous stimuli - Is often forgetful in daily activities 2. Hyperactivity and impulsivity (6/9) - Often fidgets with or taps hands/feet, or squirms in seat - Leaves seat in situations when remaining seated in required - Runs about or climbs in situations where it is inappropriate - Unable to play or engage in leisure activities quietly - Acts as if "driven by a motor" - Talks excessively - Blurts out an answer before a question has been completed - Often interrupts or intrudes on others
B. Several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years
C. Several inattentive or hyperactive-impulsive symptoms are present in two or more settings
D. There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning
E. The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder
Clinical features of Psychosocial Deprivation Syndrome?
- Mimics hypopituitarism
- Mechanism not fully understood
- Low levels of IGF-1 and inadequate levels of GH
- May see normal or premature puberty
- Often have perverted or voracious appetites, enuresis, encopresis, insomnia, hyperphagia and normal BMI
- Will catch up and grow normally once in a more supportive household
DSM V Criteria for Autism Spectrum Disorder
A. Persistent deficits in social communication and social interaction across multiple contexts
1. Deficits in social-emotional reciprocity 2. Deficits in nonverbal communication behaviours used for social interaction 3. Deficits in developing, maintaining and understanding relationships
B. Restricted, repetitive patterns of behaviour, interests or activities as manifested by at least two of the following:
1. Stereotyped or repetitive motor movements, use of objects, or speech 2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behaviour 3. Highly restricted, fixated interests that are abnormal in intensity or focus 4. Hyper- or Hyporeactivity to sensory input or unusual interest in sensory aspects of the environment
C. Symptoms must be present in the early developmental period
D. Symptoms cause clinically significant impairment in social, occupational or other important areas of current functioning
E. These disturbances are not better explained by ID or GDD, though ID may be comorbid
DSM-V Criteria for Conduct Disorder
A. Manifested by the presence of any 3 or more of the following criteria in the past 12 months, with at least one criterion present in the past 6 months
“DART” (and you throw 3 darts)
○ Aggression to people and animals
1. Often bullies, threatens or intimidates others 2. Often initiates physical fights 3. Has used a weapon that can cause serious physical harm to others 4. Has been physically cruel to people 5. Has been physically cruel to animals 6. Has stolen while confronting a victim 7. Has forced someone into sexual activity
○ Destruction of property
1. Has deliberately engaged in fire setting with the intention of causing harm 2. Has deliberately destroyed others' property
○ Deceitfulness or theft
1. Has broken into someone's house, building or car 2. Often lies to obtain goods or favours or to avoid obligations 3. Has stolen items of non-trivial value without confronting a victim
○ Serious violation of rules
1. Often stays out at night before age 13 2. Has run away from home overnight x2 3. Is often truant from school before age 13
B. Causes clinically significant impairment in social, academic or occupational functioning
C. If the individual is 18 years or older, criteria is not met for antisocial personality disorder
Criteria for Developmental Coordination Disorder
A. The acquisition and execution of coordinated motor skills is substantially below that expected given the individual’s chronological age and opportunity for skill learning and use
- Clumsiness (dropping or bumping into objects) - Slowness - Inaccuracy of performance of motor skills (catching an object, using scissors or cutlery, handwriting, riding a bike, sports participation)
B. The motor skills deficit in criterion A significantly and persistently interferes with activities of daily living and affects academic/school productivity, pre-vocational and vocational activities, leisure and play
C. Onset of symptoms is in the early developmental period
D. The motor skills deficits are not better explained by intellectual disability or visual impairment and are not attributable to a neurologic condition affecting movement (e.g. Cerebral palsy, muscular dystrophy, degenerative disorder)
DSM-V Criteria for Oppositional Defiant Disorder
A pattern lasting at least 6 mo of angry, irritable mood, argumentative/defiant behavior, or vindictiveness exhibited during interaction with at least 1 individual who is not a sibling.
- For preschool children, the behavior must occur on most days - In school-age children, the behavior must occur at least once a week. - The severity of the disorder is considered to be mild if symptoms are confined to only 1 setting (e.g., at home, at school, at work, with peers), moderate if symptoms are present in at least 2 settings, and severe if symptoms are present in 3 or more settings.
- A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 mo as evidenced by at least 4 symptoms from any of the following categories, and exhibited during interaction with at least 1 individual who is not a siblingAngry/Irritable Mood
1. Often loses temper 2. Is often touchy or easily annoyed 3. Is often angry and resentful
Argumentative/Defiant Behavior1. Often argues with authority figures or, for children and adolescents, with adults 2. Often actively defies or refuses to comply with requests from authority figures or with rules 3. Often deliberately annoys others. 4. Often blames others for his or her mistakes or misbehavior
Vindictiveness
1. Has been spiteful or vindictive at least twice within the past 6 mo. - The disturbance in behavior is associated with distress in the individual or others in his or her immediate social context (e.g., family, peer group, work colleagues), or it impacts negatively on social, educational, occupational, or other important areas of functioning
- The behaviors do not occur exclusively during the course of a psychotic, substance use, depressive, or bipolar disorder. Also, the criteria are not met for disruptive mood dysregulation disorder.
Criteria for selective mutism
Children talk almost exclusively at home, although they are reticent in other settings, such as school, daycare, or even relatives’ homes
The mutism must be present for ≥1 mo.
DSM-V Criteria for Tourette Syndrome
A. Both multiple motor and one or more vocal tics have been present at some time during the illness, although not necessarily concurrently
B. The tics may wax and wane in frequency but have persisted for more than 1 year since first tic onset
C. Onset is before age 18
D. The disturbance is not attributable to the physiological effects of a substance or another medical condition
DSM-V Criteria for Persistent/Chronic Motor or Vocal Tic Disorder
A. Single or multiple motor or vocal tics have been present during the illness but not both motor and vocal
B. The tics may wax and wane in frequency but have persisted for >1 year
C. Onset is before age 18 years
D. The disturbance is not attributable to the physiological effects of a substance or another medical condition
E. Criteria is not met for Tourette’s Disorder
DSM-V Criteria for Provisional Tic Disorder
A. Single or multiple motor or vocal tics
B. The tics have been present for <1 year
C. Onset is before age 18 years
D. The disturbance is not attributable to the physiological effects of a substance or another medical condition
E. Criteria is not met for Tourette’s Disorder or persistent/chronic motor or vocal tic disorder
DSM-V Criteria for Social Pragmatic Communication Disorder
A. Persistent difficulties in the social use of verbal/nonverbal communication
1. Deficits in using communication for social purposes such as getting and sharing information, in a manner that is appropriate for the social context 2. Impairment of the ability to change communication to match context or the needs of the listener 3. Difficulties following rules for conversation and storytelling, such as taking turns in conversation, rephrasing when misunderstood, and knowing how to use verbal and nonverbal signals regulate interaction 4. Difficulties understanding what is not explicitly stated (e.g. making inferences) and nonliteral or ambiguous meanings of language (e.g. idioms, humour, metaphors, multiple meanings that depend on the context for interpretation)
B. The deficits result in functional limitations in effective communication, social participation, social relationships, academic achievement, or occupational performance, individually or in combination
C. The onset of the symptoms is in the early developmental period
D. The symptoms are not attributable to another medical or neurological condition or to low abilities in the domains of word structure and grammar, and are not better explained by ASD, IN, GDD or another mental disorder
What are the thresholds for progression through carseats?
- Rear-facing car seats
- use until 10 kg (22 lbs) and are at least 1 year of age and able to walk
- Try and use as long as possible (MofT)
- Forward facing car seats
- 10-22 kg and up to 122 cm
- Booster seats
- at least 18 kg and have exceeded the weight and height limits of their forward-facing car seat
- Seat belts
- > 36 kg and are at least 8 years of age
- must be taller than 145 cm
What is the Rome IV criteria for infantile colic?
- <5 months of age when the symptoms start and stop
- Recurrent and prolonged periods of infant crying, fussing or irritability that occurs without obvious cause and cannot be prevented or resolved by caregivers
- No evidence of infant failure to thrive, fever or illness
- Crying/fussing for >3 hours per day or >3 days a week
- Total daily crying is confirmed to be >3 hours when measured by at least one prospectively kept 24 hour dairy
Should soy formulas be suggested for children with infantile colic?
No, soy is a common allergen
In what cases should dietary changes should be made in a child with suspected colic?
- If severe colic & concern of cow’s milk protein allergy → try therapeutic trial of a hypoallergenic diet (limited x 2 weeks)
- If breastfed & concern of CMPA → eliminate cow’s milk from maternal diet
- Ensure sufficient calcium and vitamin D intake
- If no benefit x 2 weeks, lift the dietary restrictions
What treatments are available for conduct disorder? (medical and non-medicinal)
○ Behavioural treatment: residential treatment and therapeutic foster care is seen in more severe cases, parental training, functional family therapy, social skills training, problem-solving skills training, cognitive behaviour skills training
○ No specific medication
§ Medications may be used to treat comorbid conditions and manage aggression i.e. stimulants for ADHD, SSRI for anxiety and depression, Atypical antipsychotics/First-generation antipsychotics/Anticonvulsants/Li for aggression
What is diencephalic syndrome?
Presence of a tumour in the diencephalon
- Profound emaciation including a uniform loss of body fat (adipose tissue) despite normal or near normal caloric intake, length (linear growth) may be normal
- Neurological testing is normal (may see nystagmus)
- Some children are overactive and restlessness (hyperkinesia), happy and outgoing
- Pallor
- Vomiting (emesis)
- Headaches
- Vision loss
- Hydrocephalus
- Low blood sugar (hypoglycemia)
- Excessive sweating
- Hypertension
When should children with developmental dysfluency be sent to SLP
- Parents or child are concerned
- Presence of secondary behaviours (e.g. eye blinking, jaw jerks, head or other involuntary movements are noted)
- Repetitions are parts of words or single sounds (e.g. li-li-li-like; a-a-a-apple)
- Speech appears blocked
- Persists for more than 8 weeks
