Exam 5 Flashcards
What are the diagnostic criteria for enuresis?
- twice a week for 3 months or be accompanied by significant distress or impairment
- at least 5 years old
- can’t be due to a medical condition or diuretic
Compare and contrast the two types of enuresis
Diurnal:
- daytime
- wetting occurs during waking hours
- usually during early afternoon on school days
- more common in girls
- uncommon after age 9
- related to social anxiety or preoccupation with school event
Nocturnal:
- nighttime or during sleep
- typically occurs during first third of the night
- more common than diurnal
- affects ~7% of all 8 year olds
- affects boys more than girls
What are some common characteristics of enuresis?
- 13-33% of 5 year olds
- boys>girls
- prevalence declines with maturity
- higher prevalence among less educated, lower SES, & institutionalized children.
- Primary: if child never attained continence (80%)
- Secondary: if est. continence was lost (less common)
What are the causes and treatment for enuresis?
Causes:
- nocturnal is linked to deficiency in ADH
- primary may be associate with immature signaling mechanisms
Treatment:
- behavioral training methods (alarm & reinforcement)
- synthetic diuretic (high relapse rate and less effective than alarm)
What are the diagnostic criteria for encopresis?
- once per month for at least 3 months
- at least 4 years old
- can be primary or secondary
- can’t be due to a medical condition
What are the characteristics, causes, and treatment of encopresis?
Characteristics:
- occurs in 1.5%-3% of children
- 5-6 times more common in boys
- declines rapidly with age
- 20% of children with encopresis show psychological probs.
Causes:
- may be related to untreated constipation
- 50% of cases are associated with abnormal “defecation dynamics”
Treatment:
- fiber, enemas, laxatives, or lubricants to relieve constipation
- behavioral methods to reestablish healthy elimination
Why is sleep important?
- primary activity of brain during early development
- essential for brain development and regulation
- produces “uncoupling” of neurobehavioral systems, allowing for retuning of CNS components
What are some maturational changes that occur with regard to sleep?
Sleep patterns, needs, and problems change over course of maturation
- infants & toddlers: night-waking problems
- preschoolers: falling asleep problems
- young school age: going to bed problems
- adults & adolescents: difficulty going to sleep or staying asleep or not getting enough sleep.
What are some common complaints parents have about their children’s sleep patterns?
- bedtime resistance
- difficulty settling at bedtime
- night waking
- difficulty waking up
- fatigue
What are some problems comorbid with sleep problems?
- adhd
- anxiety
- depression
- conduct disorder
- bipolar disorder
- autism
Compare and contrast sleep deficits with ADHD.
not enough sleep can lead to
- less executive functioning
- impulsivity
- distractibility
- crankiness
- emotional lability
*not enough sleep messes with the pre-frontal cortext which is the part that has to do with ADHD so not enough sleep can look like ADHD
What is the difference between a dyssomnia and a parasomnia?
dyssomnia is difficulty going to sleep or maintaining sleep and parasomnia is events that intrude on ongoing sleep
What are some types of dyssomnias?
Insomnia Hypersomnia Narcolepsy Breathing-related sleep disorder Circadian rhythm sleep-wake disorder
Name the symptoms, prevalence rate, and treatment for insomnia.
Symptoms:
- difficulty initiating or maintaining sleep or sleep that is not restorative
- in infants, repetitive night waking and inability to fall asleep
Prevalence:
-25 to 50% of 1 to 3 year olds
Treatment: behavioral (sleep hygiene)
Name the symptoms, prevalence rate, and treatment for hypersomnia.
Symptoms:
-complaints of excessive sleepiness that is displayed as either prolonged sleep episodes or daytime sleep episodes
Prevalence:
-common in young children
Treatment:
-behavioral
