Development/Neuropsych/ADHD Flashcards
What is the difference between attachment and bonding?
Attachment is made from the emotional needs of the infant from its mother.
Bonding refers to the moms feelings for her baby.
Who is best known for their work on imprinting?
Konrad Lorenz
Name Piaget’s stage to the following characteristics:
- Children respond to stimuli in environment and learn, object permanence, understand symbols
- egocentrism, thought that events that occur together cause one another (transductive reasoning), animistic thinking, decentration (another point of view can be taken into consideration), sense that punishment for bad deeds is unavoidable (immanent justice, MORALITY OF CONSTRAINTS),
- operational thought, inductive reasoning, put things in order due to commonalities, develop concept of conservation of mass and reversibility, rules of bhx seen as mutual acceptance (MORALITY OF ACCEPTANCE)
- can think abstractly, reason deductively, able to develop hypothesis, think rules are necessary for cooperation and fairness (MORALITY OF COOPERATION)
- sensorimotor stage (birth - 2 years)
- pre-operational stage (2-7yrs)
- concrete operations stage (7-adolescence)
- formal operations stage (adolescence
During Piaget’s sensorimotor stage, at what age does object permanence–> development of separation anxiety and stranger anxiety?
8-12months
During Piaget’s preoperational stage, at what ages do they have symbolic function and switch to decentration?
symbolic function (2-4 years)
- egocentric
decentration (4-7 years)
Kholberg’s theory of morality: Name levels
Level 1: focus on self (to age 10)
– Stage 1: obey rules to avoid punishment
– Stage 2: deal-making and mutual favors “look out for number one”
Level 2: focus on others (10-18y/o)
– Stage 3: good intentions and social approval “good girl/nice boy”
– Stage 4: fixed rules of law & order for society’s functioning
*Level 3: focus on principles (18+)
– Stage 5: focus on individual rights that can differ from laws “social contract”
– Stage 6: individual principles of conscience
Level 1: pre-conventional morality (to age 10)
Level 2: conventional morality (10-18y/o)
Level 3: post-conventional morality (18+)
Name Freud’s phases of psychosexual development:
1. Birth -1year: mouth most sensitive body regions, self-stimulating activities, key experience: weaning
- 1-3 years: controlling and clinging bhxs, anal mucosa “erotogenized”, key experience: toilet training
- 3-6 years: focus on genitals, hostility towards same sex parent (children develop a desire for their opposite-sex parents, and the anxiety from this causes them to model after their same-sex parent), sexual and aggressive urges, exhibitionist and possessive
- 6 years-puberty: resolution of oedipal-complex, development of superego (internalized sense of right/wrong from their parents), no urges
- Puberty- death: maturing sexuality, achieving independence, ego now developed
Oral phase (birth – 1 year)
Anal phase (1–3 years)
Phallic – Oedipal phase (3–6 years)
Latency (6 years – puberty)
Genital (puberty – death)
Below are Eriksonian’s stages of development what is the virtue of each stage:
- Birth -1.5year: trust vs. mistrust
- 1.5-3 years: autonomy vs. shame and doubt
- 3-5 years: initiative vs guilt
- 5 years-puberty: industry vs. inferiority
- puberty to ~18years: identity role vs. confusion
- 18-40years: intimacy vs. isolation
- 40-65years: generativity vs. stagnation
- 65 years+: integrity vs. despair
- hope
- will
- purpose
- competence
- Fidelity (alignment to ones developing identity and moral code)
- Love
- care
- wisdom
Name Mahler’s breakdown of psychosexual/childhood development:
Stage 1: Normal autistic stage
Stage 2: Symbiotic stage (until ~5 months): oneness b/w mother and child
Stage 3: Separation Individuation Stage
- 5-9 months: beginning awareness of separate identity of self, mother and world
- 9-16 months: crawling/walking, exploring
- 16-24 months: child becomes more tentative in exploring, wants mother in sight
- 24+ months: completion of stage, child accepts separation; internalization (development of mother representation), when done well they give comfort, when inadequate develop anxiety/low self-esteem
5-9 months: Differentiation/Hatching
9-16 months: Practicing
16-24 months: Rapproachment
24+ months: Object constancy
Between what ages do kids understand death’s finality and show fascination with the body and what happens during injury?
6-12 y/o
What does Conner’s Continuous performance test assess for?
attention, used for ADHD at times
What test is used to assess for self-sufficiency in those with ID, ASD, ADHD and neurocognitive disrders?
VIneland Adaptive Behavior scale
What are the 5 stages of grief?
1) Denial
2) Anger
3) Bargaining
4) Depression
5) Acceptance
What is the most common heritable cause of intellectual disability?
Fragile X syndrome
What is the most common genetic cause of intellectual disability?
Trisomy 21 (Down’s syndrome)
What is the most common environmental and preventable cause of intellectual disability?
Fetal alcohol syndrome
What syndrome is an X-linked dominant (lethal in males) syndrome characterized by agenesis of the corpus callosum, developmental delay, and infantile spasms?
Aicardi syndrome
At what age should kids be able to do the following:
copy a circle
draw a cross
draw a square
draw a triange
draw a diamond
stick figures at 5y/o
3: circle
4: cross
4.5: square
5: triangle
6: diamond
T/F: Leiter International Performance Scale is a nonverbal, language free test used as a measure of intelligence in individuals who have difficulty in responding to traditional tests. It can be used to assess individuals of a wide variety of ages, between 3-75 years. As the test is nonverbal, neither the examiner nor the individual being assessed are required to speak,
True
Which theorist states you must go through one stage successfully to get to the next one AKA epigenetic priniciple?
Erikson
Mental ‘trial and error’ starts at what age?
2y/o
1y/o can walk, 2y/o can run/climb, 3y/o can stand on a foot, 4y/o hop on one foot, 5y/o skip
At what age can you drink from straw and find hidden objects?
2y/o
At what age can a child start to distinguish fantasy from reality?
5y/o
At what ages do the 4 stages of play progress?
1) Solitary play–>onlooker
2) Parallel play
3) Associative play
4) Cooperative play
Stages 2-4 are broadly known as peer play
1) Solitary play–>onlooker: 0-2.5y/o
2) Parallel play: 2.5-3 y/o
3) Associative play: 3-4 y/o
4) Cooperative play: 4-6+ y/o
For schemas which is assimilation vs. accommodation.
A) information from the environment is fit into existing schemas
B) an existing schema is changed in light of new information (kind of like having to change concept)
A) assimilation
B) accommodation
Which syndrome occurs between 3-7y/o and presents as a sudden or gradual development of loss of speech (aphasia) AND an abnormal EEG.
Landau-Kleffner syndrome (LKS) aka infantine acquired aphasia or aphasia with convulsive d/o
–affects Brocas & Wernicke’s
Vygotsky believed in 3 forms of language: Name them
- 2y/o: speech used for social interaction and to communicate their needs to caregivers (express thoughts of hunger, pleasure or pain
- 3-7y/o: speech directed to self to guide and aid young children in process of thinking and acting on different tasks
- 8+ y/o: hidden or covert speech, connected with thoughts
- social/external speech
- private/egocentric speech
- inner speech
What is the name of the test for attention that can be used for ADHD?
Conner’s Continuous performance test
Wechler memory scale, auditory verbal learning test, california verbal learning test and hopkins verbal learning test are what forms of neuropsych testing?
Tests of memory
test of verbal comprehension (understanding) and requires no reading or oral response? 175 cards with 4 pictures on each
Peabody Picture Vocabulary test
Beery test of Visual motor integration assesses visual-motor skills. Kids copy geometric figures in ascending order of difficulty in what population of patients?
Autism
Which neuropsych test examines personality characteristics and emotional functioning of patients along with assessing for underlying thought disorders?
Rorschach Inkblot test
Which symptoms match with Wernicke’s vs. Brocas? identify location of lesion.
A) fluent speech, impaired auditory comprehension, impaired repetition, naming
- associated with R homononymous hemianopsis but NO sensory or motor loss
B) broken stuttering, staccato speech with intact comprehension, with impaired repetition
- associated with depression AND R hemiparesis and sensory loss
A) Wernicke’s: superior temporal gyrus
B) Broca’s: L posterior inferior frontal gyrus
Which aphasias present like Broca’s and Wernicke’s but repetition remains intact?
Transcortical motor aphasia (Broca’s)
Transcortical sensory aphasia (Wernicke’s)
Pt develops sudden ignoring of L side of body (unilateral neglect). What part of brain is damaged?
R parietal
Which part of the brain is most directly involved in the reward system and in addiction?
Nucleus accumbens
Match the neuroimaging with the clinical presentation:
A) overactivity in orbitofrontal cortex
B) enlarged Lateral ventricles
C) larger brain volume, or abnormally fast growth
D) smaller brain volume (3-5%)Children with reading disorders and hypo activity in premotor and prefrontal areas
E) difference in size asymmetry in the planum temporale (part of Wernickes language area)
F) dysfunction in striatum or basal ganglia or dopaminergic transmission issue
A) OCD
B) Schizophrenia
C) Autism
D) ADHD
E) Reading disorder (in normal brain asymmetry is expected w/a larger planum temporale in dominant hemisphere)
F) Tourette’s disorder
Stroop color and word test is a test for what?
Test of executive function
The Lidcombe program is the best treatment for what issue in children 5 and under?
stuttering
What in order of most to least common are the comorbid conditions associated with Tourettes disorder?
1st: ADHD
2nd: OCD
3rd: MDD
What neuroimaging modality is ideal for studying children with neurodevelopmental disorder?
PET scan
What murmur is associated with Fragile X-syndrome?
Mitral valve prolapse (systolic murmur)
Which assessment test would you use for to detect articulation of words vs. syntax of language/grammar issues?
Goldman-Fristoe Test of Articulation 2 (GFTA- 2)
Rice-Wexler Test of Early Grammatical Impairment
Goldman-Fristoe Test of Articulation 2 (GFTA- 2): used for detection and grading of problems with articulation of words, mispronunciation
Rice-Wexler Test of Early Grammatical Impairment: assess the syntax of the language and the grammatical morphology
Phonemic awareness training is used for children suffering from what disorder?
dyslexia
What is the first-line pharmacotherapy agent used in treatment of Tourette’s?
Clonidine
ADHD has been associated with _____ (pos/neg) emotionality, ____ (inc/dec) novel seeking behavior, ____ (inc/dec) behavioral inhibition, and _____ (inc/dec) effortful control.
ADHD has been associated with negative emotionality, increased novel seeking behavior, decreased behavioral inhibition, and decreased effortful control.
T/F
There is a specific reading disability/dyslexia locus on chromosome 6 that correlates with performance on a reading test.
True
What is this disorder?
It is defined as one or more symptoms affecting voluntary motor or sensory function. The symptoms cause impairment in daily functioning and are not better explained by another medical or mental disorder. The symptoms are not intentional and there is no compatibility between symptom and recognized neurological or mental conditions. Often, these patients will present with a lack of concern regarding their own symptoms
Functional neurological symptoms disorder (aka conversion disorder)
What is the MOA of methylphenidate?
NE and DA reuptake inhibitor
agonist at 5HT1A receptor
agonist at alpha-2 receptors
What is the MOA of amphetamine?
-NE and DA reuptake inhibitor
AND
- leads to the direct release of both norepinephrine and dopamine
-inhibits MOA
Which anticonvulsant is associated with the development of ID and ASD with in-utero exposure?
Valproic acid
What is the most common cause of childhood disability?
cerebal palsy
- may see persistent primitive reflexes
What is the most common comorbid disorder seen with ADHD?
ODD (45-65%)
Whis symptoms of ADHD is first to remit? last to remit?
hyperactivity is first to remit
distractibility is last to remit
Reduced metabolism in prefrontal cortex and smaller total cerebral volumes is seen on neuroimaging with which disorder?
ADHD
What do you see on EEG in patients with ADHD (related to theta and beta waves)?
increased theta (slow wave) activity in prefrontal area
increased theta:beta wave ratios
The Conners Continuous Performance test, Test of Variable Attention (TOVA) and Qb Test are all what type of tests for ADHD?
computerized ADHD testing
What disorder is the MTA study looking at?
ADHD
What neurons are located in the somatosensory cortex and responsible for:
becoming activated when performing actions and when observing others performing actions. They are considered crucial in learning through observation and imitation.
Mirror neurons
What is the estimated heritability of ADHD?
70%
What 3 instances would Atomoxetine be first line for ADHD treatment?
- Substance use d/o
- Anxiety d/o
- Tics
How long does it take for Atomoxetine (Strattera) to see result?
4-6 weeks
What is MOA of Atomoxetine (Strattera)?
NE reuptake inhibitor
What is the FDA black box warning for Atomoxetine (Strattera)?
Suicide
Does Atomoxetine have any effects on liver?
yes, can cause liver damage
A multi-factored evaluation can be requested by a parent or school personnel when what condition is expected?
Developmental delay
Speech refers to the actual spoken words including pronunciation, rhythm, and volume while language refers to the words that we use, and communication refers to the sharing of information whether it be speaking (speech), writing, or other.
What type of assessment evaluates the child’s learning ability without linguistic and cultural bias. Also ,it is the most reliable and adaptable tool that helps differentiate a language different from a disorder by the commonly utilized test-teach-retest method.
Dynamic assessment
Match the 4 aspects of language:
Phonology, syntax, pragmatics, semantics
- Producing correct sounds
- Meanings of utterances (morpheme=smallest unit of meaning)
- Correct order of words in sentences
- Correct use of language in differing contexts
- Phonology
- Semantics
- Syntax
- Pragmatics
Match the attachment theories in Strange situation
A) distressed during separation, soothed when caregiver returns. avoid stranger when alone but friendly when mother present.
B) displays little apparent distress during separation and does not seek caregiver at reunion. mother and stranger equally able to comfort child
C) Extreme distress during separation, both seeks out and resists caregiver at reunion, cannot be soothed. fearful of stranger.
D) Displays of contradictory behavior, often simultaneously. Displays odd postures, freezing, fear grimaces. No clear strategy with respect to caregiver.
A) Secure attachment
B) Avoidant attachment
C) Resistant/ambivalent attachment
D) Disorganized attachment
What 2 hormones are involved in attachment?
- oxytocin
- vasopressin
FSH and LH
* Females
– _____: stimulates follicular growth
– _____: surge leads to ovulation
* Males
– _____: spermatogenesis
– _____: stimulates Leydig cells in testes to produce testosterone
FSH and LH
* Females
– FSH: stimulates follicular growth
– LH: surge leads to ovulation
* Males
– FSH: spermatogenesis
– LH: stimulates Leydig cells in testes to produce testosterone
T/F: Girls tend to have growth spurt (12y/o) before menarche, and boys tend to have growth spurt (14y/o) after spermarche.
True
Social rituals facilitate __________ for rites of passage.
transitions
The _____ reflex is the only primitive reflex that may persist in healthy children up to 2 years but can disappear by 12 months.
Babinski
According to Piaget, children younger than a year may continue searching for an object in a familiar location even when it is visible at a different location. This task involves the child suppressing a previously reinforced plan and having a new retrieval plan. What is the name of this task that is a part of the sensorimotor stage?
A not B task
T/F: By age 12 months, a child’s weight should triple and height should increase by 50%.
True
The Chess and Thomas Temperament System, one of the better-known systems, includes 9 _______ characteristics: activity, regularity, initial reaction, adaptability, intensity of response, mood, distractibility, persistence and attention span, and sensitivity.
temperament
_______, is associated with deletions of genetic material located on the long arm of chromosome 7 (7q11.23). Children have typical elfin-like facies with post-natal growth failure and hypercalcemia. The most common cardiac defect in these patients is supravalvular aortic stenosis.
Williams syndrome