Development and adolescence

Question 1

• Central focus of adolescence is the emergence of a _________________
  
  • Autonomy and ___________
  • _________ and recreational goals
  • __________ and vocational goals
  • ________ integrity
  • _____ self-concept
  • _____ value system
  • _______ independence

Answer 1

• Central focus of adolescence is the emergence of a coherent sense of self
  
  • Autonomy and independence
  • Peer relationships and recreational goals
  • Eduacational and vocational goals
  • Body image integrity
  • Sexual self-concept
  • Moral value system
  • Financial independence

Question 2

Early adolescence (10-14) - ______ focus

Middle (15-17) - ______ focus

Late (18+) _____/_____, intimate relationships

Answer 2

Early adolescence (10-14) - biological focus

Middle (15-17) - peer focus

Late (18+) educational/vocational, intimate relationships

Question 3

Name 3 situations when can confidentiality be broken?

Answer 3

• At risk of harming or killing themselves
• At risk of being harmed, or being harmed
• Harming someone else, or at risk of harming someone else
• Court subpoena
• Child protection

Question 4

• What are some static, and dynamic risk factors when assessing risk?

Answer 4

• Static
  
  • Past and family history
  • Existing diagnoses
  • Developmental deficits
• Dynamic
  
  • Current stressors
  • Recent changes to self or supports/environment

Question 5

Discuss some strategies to increase safety for a patient who self harms

Answer 5

• Restrict access to sharps
• Restrict access to medications
• Regular checking in on young person every 30 mins

Question 6

1. ADHD is a developmental problem with deficits in…?
2. Discuss the two main facets of managing ADHD

Answer 6

1. Inattention, impulsivity, hyperactivity
2. Pharma and non-pharma
   
   • Pharma - stimulants
     
     • Dexamphetamine
     • Methylphenidate
   • Non-pharma - Pyschosocial/behavioural strategy
     
     • Positive parenting, boosting self esteem
     • Optimise learning environment
     • Focused counselling for child and family with psychologist

Question 7

1. What are 4 critical clinical features of ODD?
2. How is it best managed?

Answer 7

1. Frequent temper tantrums, argue with adults, refuse to obey rules, low self esteem
2. Child and family interventions - most importantly refer to a psychologist
   
   • Child
     
     • Cognitive behavioural therapy
     • Social skills
       
       • Often have poor learning, and poor verbal abilities which are the root cause of their low self esteem
       • Help them make and keep friends, play cooperatively
       • Help them accept ‘no’
   • Family
     
     • Teach parents to teach children how to manage their emotion
       
       • Anger/anxiety management for parents
     • Encourage child-parent relationship
       
       • Positive environment with positive reinforcement of good behaviour
     • Provide social support
     • Individual and relationship counselling for parents
       *

Question 8

If intervening between a parent refusing treatment for child, and treatment for the child. What 3 things do you have to consider?

Answer 8

1. How will not intervening harm the child?
2. Is the attempt likely to bring about treatment for the child?
3. Is the attempt itself likely to cause harm to the child

Question 9

What is a mature minor?

What assumptions can be made regarding age?

Answer 9

1. A mature minor is a young person (under 18) who has cognitive and psychological capacity (ie competence) to make decisions for themselves.
2. < 14 assume not, > 16 assume is (unless evidence to contrary). In between you should assess

Question 10

Newborn milestones

Answer 10

• Responds to human voice - can distinguish mother
• Smell - can distinguish mothers milk
• Basic reflexes - Suck, moro

Question 11

6 months milestones

Answer 11

Gross motor

• Leads with head to sit
• Unsupported sitting
• Weight bearing

Fine motor

• Holds feet, feet to mouth
• Holds bottle

Social

• Smiles at mirror
• Response to stranger
• Vocalises

Question 12

9 month milestones

Answer 12

Gross motor

• Cruising

Fine motor

• Pincer grip
• Cross midline with hands

Social

• Concetrates on toys and games
• Two syllable vocalizations

Question 13

12 months milestones

Answer 13

Gross motor

• Walk with support
• Stable sitting

Fine motor

• Clasp hands, pointing

Social

• Understands words with meaning - i.e. where is the …
• Kiss on request

Question 14

18-24 months milestones

Answer 14

Gross motor

• Running, stairs, kick ball

Fine motor

• Building blocks, self feeding
• Can copy vertical line

Social

• Pointing to pictures and body parts
• Imitative and parallel two word phrases

Question 15

3 years milestones

Answer 15

Gross motor

• Stairs one at a time
• Rides tricycle
• Stands one foot

Fine motor

• Helps with dressing
• Copy circle
• Draw person

Social

• Knows gender
• Can count
• Follow 2-step commands

Question 16

4-5 years milestone

Answer 16

Gross motor

• Skipping/jumping

Fine motor

• Copy a square/triangle
• Can draw a person with some basic features
• Tie laces

Social communication

• Questioning things
• Tells stories
• Knows left from right, AM from PM