Disorders in Children and Adolescents Flashcards
what is the most common co morbidity in children and adolescents with mental illnesses
- ADHD: attention deficit-hyperactivity disorder
2. Depression
Risk factors for children who have depressed parents
risk of developing
- anxiety disorder
- mood disorder
- conduct disorder
- substance abuse
- learned helplessness (b/c they watch the parent’s inability to cope)
what can a child with conduct disorder develop?
antisocial personality
A child who witnesses trauma or violence has risk of developing..
- depression
- anxiety
- nightmares
- intrusive thoughts
- hyper-vigilance
- aggressive and delinquent behaviour
- drug use
- academic failure
- poor self esteem
what is temperament?
style of habitual behaviour used to adapt to the demands and expectations of the environment
what are characteristics of a resilient child?
- adaptability to changed environment
- Forming nurturing relationships with other adult when parent isnt there
- can distance themselves from emotional chaos
- good social intelligence
- good problem solving
Characteristics of a mentally healthy child or adolescent
- trust others and see the world as safe
- correctly interprets reality
- behaves appropriately to age level
- positive and realistic self concept and develops identity
- adapts and copes to stress and anxiety (appropriate to age)
- learn and master developmental tasks in new situations
- creative and spontaneous expression of self
- develops satisfying relationships
what are the guiding principles of play therapy?
- accept the child and follow their lead
- establish friendly relationship to help them share feelings
- recognize their feels and reflect them back so that they can gain insight into the behaviour
- accept their ability to solve problems
- set limits only to provide security and reality
What impairment is shown in children with Neurodevelopmental Disorders
impairment in:
language speech learning memory motor skills
when does autism spectrum disorder first become evident?
First 3 years of life
what do people with autism struggle with?
- verbal and non verbal communication
- social interactions
- leisure or play activities
what is savant sydrome?
a rare case when an autistic child (left hemisphere impairment) has a strengthened right hemisphere
presenting symptoms of ASD
- impairment in communication
- language delay or absence
- repetition in language
- imaginary play - impairment of social interactions
- limited eye to eye contact or facial responses
- failure to develop friendships or share - markedly restricted, stereotypical patterns of behaviour, interest and activities
- rigid adherence to routine and rituals (only eat certain textures)
- repetitive motor mannerisms (head banging)
- repetitive actives (flicking light switches)
- rigid adherence to routine and rituals (only eat certain textures)
what is Attention Deficit Hyperactivity Disorder (ADHD)?
inappropriate degree of hyperactivity, inattention, and impulsiveness which affect functioning or development
to diagnoses of ADHD must what?
appear in two settings
ie. home and school
symptoms of ADHD
- inattention
- difficalty listening, easily distracted, misses social ques
- hyperactivity
- talks a lot, always on the go, fidgets and climbs
- impulsive
- blurts out answers before question is complete
- interrupts
- difficulty waiting for turn
what are the prominent acadiemic skill issues of Specific Learning Disorder?
3 D’s
Dyslexia (reading)
Dyscalculia (math)
Dysgraphia (writing)
two types of motor disorders?
- stereotypical movement disorder
2. Tourette’s disorder
what is stereotypical Movement disorder?
repetitive and stereotypical motor behaviour
ie. body rocking, head nodding, waving
self injury ones are head banging, self biting and eye poking
how does Tourettes disorder present itself?
multiple motor tics (sudden repetitive motor movements) and one day more vocal tics
what is oppositional defiant disorder?
recurrent pattern of negativistic, disobedient, hostile, defiant behaviour toward authority figures without going far enough to violate rights of others.
what behaviours to children with oppositional defiant disorder show?
- stubborn
- argumental
- limit testing
- unwilling to give in or negotiate
- touchiness
- quick annoyance
- refusal to accept blame
how is ODD rated in severity?
mild (one setting)
moderate (two settings)
severe (three or more settings)
what do children with ODD have a risk of developing?
antisocial behaviours impulse control issues substance use anxiety depression
What is Conduct disorder?
persistent patterns of antisocial behaviour in which children and adolescents have no concern for the rights of others and they disregard social norms and rules
what do children with CD display?
lack of empathy to others callous- unemotional traits no guilt shadow effect bullying threatening intimidating behaviour
what are the four types of conduct disorder?
- aggression towards people and animals
- property destruction
- theft
- serious violation of rules
predisposing factors of Conduct disorder
- ADHD
- oppostitional child behaviours
- parental rejection
- inconsistent parenting and harsh discipline
- early institutional living
- chaotic home life
- larger family size
- absent mother or father
- parental alcohol abuse
- antisocial or drug dependent family member
- association with delinquent peers
- males
what are the 3 components of bullying?
- harm
- repetition
- unequal power
what are the types of childhood anxiety disorders?
- separation anxiety disorder
- specific phobia
- social anxiety disorder
- adjustment disorder
what is a good therapy combo for anxiety in children?
medication (SSRIs) with CBT
Characteristics of separation anxiety disorder
- excessive distress on separation or anticipating it
- worries they will be lost, parents will be harmed or that their home with be damaged
- fear of being home alone
- wont sleep unless parent is near
- wont attend school/other activities without parents
- physical or somatic symptoms
what is generalized anxiety disorder?
excessive worry about routine activities like school, sports or family
what is rumination disroder
repeated regurgitation and re chewing of food without apparent nausea, retching or GI problems
what are some interventions to adolescent mental health?
- family therapy
- group therapy
- behavioural therapy
- cognitive behavioural therapy
- Milieu management
- mind-body therapies
- play therapy
- psychopharmacology
what are some types of play therapy?
- mutual story telling
- therapeutic games
- bibliotherapy
- therapeutic drawing
Guiding principles of play therapy
- accept the child as he or she is and follow the child’s lead
- establish a warm and friendly relationship so they can express feelings
- recognize their feels and reflect them back so they can gain insight to the behaviours
- accept their ability to solve problems
- set limits to provide reality and security
The two therapies for Autism spectrum disorder
- Behavioural analysis
2. intensive behavioural intervention
Nursing interventions for ASD
- behaviour management plans with a reward system and education of parents (capitalize on the individuals and the family’s strengths)
- pharm agents (risperdal, Clominpraimine, desipramine)
- family counselling
- educational programs
- psychostimulant drugs (Ritalin/ methylphenidate
Interventions for oppositional and conduct disorders
correct faulty personality (ego and superego)
- group therapy
- family therapy
for conduct could send to group home or inpatient hospitalization
- cognitive behaviour to change pattern if misconduct
interventions for anxious child or adolescent
- act as parental surrogate to prevent panic levels
- accept regression and give emotional support
- increase self esteem
- help them get through traumatic events without the use of cognitive distortions or unrealistic fears
- teach and practise positive self talk
- teach coping skills
What are future risks for oppositional defiant disorder
Social difficulties
Impairment in school
Conflict with authority
Substance abuse
Symptoms of PTSD in children
- Increased arousal (fearful)
- Increased anxiety
- Hyper vigilance
- Change in sleep patterns
