L11: Child Psychiatric Disorders Flashcards
Def of Autism Spectrum Disorder
Qualitative deficits in reciprocal social interaction,
communication skills and restricted patterns of behavior.
Diagnostic Criteria of Autism Spectrum Disorder
levels of severity of Autism Spectrum Disorder
Level 1
- Has social interaction and speech.
Level 2
- Has minimal speech and interaction.
Level 3
- Has no speech or social interaction.
Epidemiology of Autism Spectrum Disorder
- Autism spectrum disorder is generally a lifelong disorder with a guarded prognosis.
- Two-thirds remain severely handicapped and dependent.
- Improved prognosis if IQ > 70 and communication skills are seen by ages 5 to 7 years.
- The prognosis is variable, but the two most important predictors of adult outcome are level of intellectual functioning and language impairment.
Onset of Autism Spectrum Disorder
before age of 3 years.
Etiology of Autism Spectrum Disorder
DDx of Autism Spectrum Disorder
- Schizophrenia with childhood onset
- Children with intellectual disorder with behavioral symptoms
- Children with acquired aphasia with convulsion
- Children with Congenital deafness or severe hearing impairment
- Children with Psychosocial deprivation
How is Schizophrenia with childhood onset: Diffrentiated from Autism Spectrum Disorder?
- It is is rare in children under the age of 5.
- Accompanied by hallucinations or delusions.
- With a lower incidence of seizures and mental retardation and a more even IQ.
How is Children with intellectual disorder with behavioral symptoms Diffrentiated from Autism Spectrum Disorder?
- Children usually relate to adults and other children in accordance with their mental age.
- They use the language they do have to communicate with others.
How is Children with acquired aphasia with convulsion Diffrentiated from Autism Spectrum Disorder?
- Child is normal for several years before losing both receptive and expressive language.
- A profound language comprehension disorder then follows, characterized by deviant speech pattern and speech impairment.
How is Children with Congenital deafness or severe hearing impairment Diffrentiated from Autism Spectrum Disorder?
- Infants have a history of relatively normal babbling that tapers off gradually and may stop from 6 months to 1 year of age.
- Children respond only to loud sounds.
- Children usually relate to their parents, seek their affection, and enjoy being held as infants.
How is Children with Psychosocial deprivation Diffrentiated from Autism Spectrum Disorder?
- Children improve rapidly when placed in a favorable psychosocial environment.
Consider ……. as the diagnosis if there is a rapid deterioration of social and/or language skills during the first 2 years of life.
ASD
- 15% of ASD cases are associated with a known genetic mutation.
- Fragile X syndrome is the most common known single gene cause of ASD.
…
ASD has high comorbidity with intellectual disability & Association with epilepsy.
…
Course & Prognosis of ASD
- Autism spectrum disorder is generally a lifelong disorder with a guarded prognosis.
- Two-thirds remain severely handicapped and dependent.
- Improved prognosis if IQ > 70 and communication skills are seen by ages 5 to 7 years.
- The prognosis is variable, but the two most important predictors of adult outcome are level of intellectual functioning and language impairment.
The prognosis of ASD is variable, but the two most important predictors of adult outcome are ……..
level of intellectual functioning and language impairment.
Managment of ASD
There is no cure for autism, but various treatments are used to help manage associated symptoms & to improve basic social, communicative and cognitive skills:
- Remediation
- Psychotherapy
- Pharmacotherapy
Remedition in ASD
- Structured classroom training in combination with behavioral methods is the most effective treatment method.
- Language and academic remediation are often required.
Psychotherapy in ASD
Parents are often need support and counseling.
Pharmacotherapy in ASD
Def of ADHD
persistent and marked pattern of inattention and/or hyperactive and impulsive behavior.
Types of ADHD
- Hyperactive impulsive type
- Inattentive type
- Combined type
Diagnostic Critereria of ADHD
Duration of ADHD
Symptoms lasts for at least 6 months & must be:
- present before the age of 12 years
- present in at least two settings (e.g: at home and school)
- interfere with the appropriate social, and academic functioning.
Typical signs of ADHD
- talking excessively
- fidgeting, frequent interruptions
- impatience, difficulty organizing and finishing tasks
- distractibility, and forgetfulness
what is Fidgeting?
*Fidgeting is making small movements with your body, usually your hands and feet. It’s associated with not paying attention
Epidemeology of ADHD
- Occurs in 3% to 7% of grade-schoolers.
- Male:Female ratio is 3:1 to 5:1. (0 > 9)
- Symptoms often present by 3 years.
Etiology of ADHD
DDx of ADHD
Bipolar disorder and childhood-onset schizophrenia:
- There is more waxing and waning of symptoms in bipolar disorder and hallucinations or delusions in childhood schizophrenia.
Learning disorders:
- Inability to do math or read is not because of inattention.
Anxiety disorder:
- May be manifested by overactivity and easy distractibility.
Managment of ADHD
Characters of Disruptive Behaviour Disorders
- Includes two persistent constellations of disruptive symptoms.
- Categorized as: A. Oppositional defiant disorder B. Conduct disorder.
- Result in impaired social or academic function in a child.
Diagnostic Criteria of Opposotional Defiant Disorder (ODD)
a. A pattern of defiant, angry, and negative behavior enduring for at least 6 months.
b. The child is manifested by:
* frequently loses his or her temper
* resentful and easily annoyed
* actively defies requests and rules in the presence of familiar adults and peers
Etiology of Opposotional Defiant Disorder (ODD)
- Possible result of unresolved conflicts.
- May be a reinforced, learned behavior.
TTT of Opposotional Defiant Disorder (ODD)
A child may have oppositional defiant disorder if he/she has no difficulty getting along with peers but will not comply with rules from parents or teachers.
….
Diagnostic Criteria of Conduct Disorder
…….. are the corner stone in treatment of disruptive behavior disorder.
Parents
- What distinguishes Conduct disorder from ODD is …….
- Unlike conduct disorder, ODD does not involve………
- aggression (e.g. stealing, bullying and cruel behaviors toward others).
- physical aggression or violating the basic rights of others.
Etiology of Conduct Disorder
- Multifactorial.
- Maladaptive aggressive behaviors are associated with family instability, physical and sexual victimization, socioeconomic factors, and negligent conditions.
- Often coexists with: ADHD, learning disorders, or communication disorders.
- A subset may have low plasma levels of dopamine and B-hydroxylase.
TTT of Conduct Disorder
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