Dual Diagnosis and Challenging Behavior Flashcards
Child with DD may face which types of problems
mental and physical that’s personal to their disability symptoms
Developmental Disorders can alter what in other disorders?
symptomatic presentation which makes accurate diagnosis more difficult
When comorbidites and dual diagnoses are not recognized, children can fail in which settings doing what?
education, social, unmanagability at home
showing aggression and self injury
What happens to long term effects if disability is identified and managed early
They are minimized
Why do kids self injury
sensory seeking, attention seeking, feeling hurt/sick
There is a high prevalence of what health problems and what in what type of disorder?
Mental Health Problems, Behavior Disorders, ID
Within __ and ___ Health & ___ Disorders dual diagnosis, there is greater difficulty in what
ID, Mental, Behavioral, Greater difficulites in assessment, evalution, and treatment interventions
Why is it hard to assess IDD difficulties
Tools rely on communication and concept understanding
Treatment/interventions (talk therapy (communication, too abstract))
mental health and behavior disorder undermine the person’s ___
quality of life
Difficulty in evaluation and treatment leads to
greater frustration and stress in caretakers
Despite the difficulties, mental health and what kind of disorder should be what?
behavior, diagnosed and receive specific treatment
What is hard about mental disorder vs psychiatric disorder vs challenging behaviors
There can be unofficial comorbid diagnosis
What’s included in prevalence rates
Some rates include ADHD and ASD as comorbidities for ID/DD
Challenging behavior definition
Any repeated pattern of behavior that interferes with learning or engagement in pro social interactions with peers and adults
Behaviors that are not responsive to the use of developmentally appropriate guidance procedures (typical treatment doesn’t work)
Impacts daily functioning
Examples of challenging behavior
Prolonged tantrums, physical and verbal aggression, disruptive vocal and motor behavior, screaming, sterotypy, property destruction, self-injury, noncompliance, withdrawal
Why growth hormones is a problem to family of PWS
Make the kid stronger a problem if they’re aggressive
The definition for behavior disorders includes
Product of mental health disorder and physical conditions
behavior phenotype
non adaptive behaviors
Examples of behavioral problems
Self injury, manipulation, destructive behavior, aggressiveness, shouting, oppositional attitude, sterotypy, cries, explicit sexual
What is stereotypy
Repetitive behaviors that don’t impact child in the moment
The challenges of stereotypy
Impedes child’s ability to do other things
Physical safety risk
Can be distracting to others
Some genetic syndromes are characterized by what
well established behavioral patterns that are inherit to these conditions eg/ hyperphagia in PWS
These types of inappropriate behaviors are often easier to treat
learned
The types of anxiety disorders
Generalized anxiety disorder, panic disorder, social anxiety disorder, OCD, PTSD, Skin picking disorder
Generalized anxiety disorder
excessive anxiety and worry about family, health, finances, school, or work
Panic disorder
panic attacks that recur; usually beginning during puberty
social anxiety disorder
intense fear of acting in a way or showing anxiety symptoms that will be negatively evaluated
OCD
recurrent thoughts, images, or impulses that are intrusive, inappropriate, and anxiety causing repetitive behaviors or mental acts done to neutralize and obsession or as part of following rigid rules
How much more likley is a IDD kid to develop mental health disorder
4-5x greater than TD rate
1 in ____ children/adolescent within ID/DD receive specialized mental health services
10
Dual diagnosis influences this more than that
parents well being more than severity of ID/DD
Reasons why kids with DD are higher risk for psyhciatric disorders
higher rates for certain psychiatric disorder in specific syndromes
impairment in acquisition of age dependent coping skills
multiple hospitals stays for treatment of associated medical problems
Physical differences readily seen by peers
Family history of psychiatric disorders
Changes in school, classmates, living situations, and family
Early signs and symptoms that there are mental health disorder in people with ID/DD
Changes in routines, likes and dislikes, sleep and feeding patters, unmotivated important weight changes, isolation, apathy, unmotivates cries; smiles; or laughs, Talking to him or herself, Externalized aggression, Self-injury, Unexplained sadness, Inappropiate affect, Intriguing and/or worrying behaviors
Developmental trajectories of verbal and physical aggression and tantrums in Down Syndrome, PWS, Williams, Fragile X
REOD THIS ONE
variablitiy in age range
Down:
PWS: starts less likley and increases with age
Williams: most likley at start and less likely as goes on
FXS:
tantrums: williams decreases with and age down and FXS. PWS is more consistent
What does this mean for individuals with ID/DD
complex disorder with moving parts
challenges and concerns can change with age and by environment
Every child is unique: present with individual strengths and areas of need, important for providers to know some of the associated difficulties or concerns so that they can keep an eye out for them, understanding all of the associated components of ASD allows a child to have access to the best treatment plan possible that is tailored for him or her
The Biopsychosocial model for mental health categories and examples of each
many things go into it no one factor:
Social - peers, family circumstances, school, drug effects, family relationship, trauma
psychological - self esteem, coping skills, social skills, family relationship, trauma, temperament, IQ
biological - physical health, disability, genetic vulnerabilities, drug effects, temperament, iq
In challenging behavior, what are important things in the child’s life to consider?
protective environment, vulnerability, adversity, resilience
Challenging behavior
doesn’t act the same way across individuals – extending to manifestations and how intervention should be approached
Two lines of intervention that are really taking off in last 5 - 10 years with those with IDD
clinical drug trials – having fda approved specific drug trials
telehealth services – for rural environments and getting expert knowledge where there is none especially for rare disorders
What are some treatement options
Medication, CBT, Speech Therapy, Occupational Therapy, Physical Therapy, Tutoring and school services
Physical aggression in Down, PWS, FXS, Williams
Goes down, PWS is higher than the rest though
Tantrums in Down, Williams, FXS, PWS
All go down but Williams starts the highest, PWS, stays at a constant high
Mean verbal aggression in Down, Williams, FXS, PWS
Down and FXS are level then increase, Down starts high then decreases, PWS starts low then smooths out high
Prenatal exposure to alcholo leads to higher rates of which behavioral disorders
conduct disorder
What are the common co-occruring disorders with ID/DD
4-5x rates of psychiatric disorders
What are the common co-occruring disorders with Neurodevelopmental disorders
Behavioral/psychiatric disorders: ADHD, MDD, Anxiety disorders, mood disorders, Self-injury
What are the common co-occruring disorders with down syndrome
Behavior disorders (ADHD, aggression, autism)
What are the common co-occruring disorders with PWS
OCD, Bipolar, Mood disorders, Social phobias, MDD
What are the common co-occruring disorders with Fetal Alcohol syndrome
Suicide, depression, bipolar
What are the common co-occruring disorders with Williams syndrome
ADHD, phobias, GAD
