Disorders Infancy,childhood Or Adolescence

Question 0

Name the disorder:

• sub average intellectual functioning with iq of 70 or below
• noticeable deficits or impairments on at least two of the following; communication,self care, home living, interpersonal relationships,academic skills, health, self direction, leisure, and safety.

Answer 0

Mental retardation

Question 1

List the disorders usually first diagnosed in infancy,childhood or adolescence.

Answer 1

1) mental retardation
2) learning disorders
3) motor skills disorders
4) communication disorders
5) pervasive developmental disorders
6) attention-deficit and disruptive behavior disorders
7) feeding and eating disorders
8) tic disorders
9) elimination disorders
10) other disorders: separation anxiety selective mutism, attachment disorders and stereotypic movement disorders

Question 2

Instrumentation to assess for mental retardation

Answer 2

Intelligence tests that can be used:

• Stanford Binet intelligence scale
• wechsler intelligence scales
• test of nonverbal intelligence

To asses adaptive behavior:

• Vineland adaptive behavior scales
• scale of independent behavior
• aacap practice parameters

Question 3

Incidence of mental retardation

Answer 3

1% of the population

85% of which falls under mild retardation

Question 4

Name the three sub types of ADHD

Answer 4

Inattentive
Hyperactivity/impulsivity
Combined type

Question 5

Characteristics of inattention

Answer 5

Inability to remain at a task
To establish and maintain a task
To complete a task

Often unable to ignore irrelevant stimuli and become distracted from task
Difficulty developing and maintaining organizational skills and focusing

Question 6

Characteristics of hyperactivity

Answer 6

Fidgetiness
Restlessness
Squirming
Excessive motor activities
Constant movement

Question 7

Characteristics of impulsivity

Answer 7

Impatience
Interrupting
Blurting out answers before instructions or answers are given
Accident proneness

Question 8

Etiology of ADHD

Answer 8

Under responsive regulation of neurotransmitters, particularly dopamine.
The critical features relate to an inability to prioritize and implement four executive functions
- non-verbal working memory
- internalization of self directed speech
- self regulation of mood and arousal
- reconstitution of the component parts of observed behaviors

Question 9

Name the disorder

• impairment in social, academic or occupational functioning
• symptoms at least 6 months and have produced maladaptive behaviors which are inconsistent with development
• present before 7 years of age and in two or more situations

Answer 9

ADHD

Question 10

2/3 of Children diagnosed with ADHD also have one of these concurrent axis 1 disorder

Answer 10

Oppositional defiant disorder (co morbid rate 35%)
Conduct disorder (co morbid rate 50%)
Learning disorder
Pervasive developmental disorder

(15-75% co morbid mood disorder and 25% anxiety disorder)

Question 11

What to pay attention to when interviewing for ADHD (tools, people)

Answer 11

Cognitive instruments (intelligence tests achievement tests,specific achievement batteries)
Behavioral checklists
Rating scales
Interviews with parents and teachers (behavior assessment system for children BASC), Connors rating scales, child behavior checklist ~ asses adaptive behavior)

Developmental history for onset and parental history

Behavioral observations - classroom interactions

Question 12

Incidence of ADHD

Answer 12

Most common childhood mental disorder
Prevalence 3-7 % school age children
10-60% continue to have disorder as adults
50% with disorder develop mood disorders, particularly bi-polar
Has genetic elements - 70% of children with ADHD have parents either diagnosed or who reveal symptoms of ADHD
4.7% adults have ADHD
Occurs in boys more than girls
Also associated with child abuse and neglect

Question 13

Instruments used to assess for ADHD

Answer 13

Intelligence and achievement

• wechsler iq test WPPSI-R, WISC-III, WAIS-R
• WJ-R or WAIT (wechsler individual Achievement test)

Behavioral assessment

• disruptive behavior disorders rating scale
• child behavior checklist (CBCL)
• impairment rating scale
• Connors rating scale revised

Assess attention, impulsivity, distractibility
- continuous performance test (CPT)

Question 14

Diagnosing ADHD

Answer 14

12 of 18 items for combined type
6 of 9 for the other two
Present at least 6 months

Question 15

Treatment of ADHD in general

Answer 15

• ensure diagnosis correct due to high prevalence of co morbidity with conduct disorder, oppositional disruptive disorder, mood disorders and anxiety disorders
• combine medication and psychotherapy counseling (empower clients to take responsibility of their behaviors and lamenting to recognize the relationship between difficulties managing behavior and difficulties with focusing and cognitive,functioning)

For adults

• education about ADHD
• attention management training
• behavioral management training
• social skills training
• stress management training
• anger management training
• problem solving training

Insight and non-directive therapies may not be as,helpful as structured, directive therapies (medical, psychoeducational, behavioral,cognitive restructuring, communication,social skills,and family origin exploration)

Recent research has focused on EEG biofeedback for treatment

Question 16

Treating children with ADHD

Answer 16

• multimodal, multidisciplinary, long term approach
• parent counseling and training
• client education
• individual and group counseling
• social skills training
• medication
• school intervention