Lecture 20: Common developmental/Behavioral Issues Flashcards
By what age should we expect a child to have an adult sleep pattern?
Age 3
Sleep disorders are characterized under the age of…
12
Usually by () weeks, a baby should be able to sleep through the night.
12 weeks
Children older than 6 months sometimes wake up during the night because they want to feed. To encourage them to sleep through the night, you should…
Consume a full meal at night so they don’t sleep hungry
Contrary to instinct, it is recommended to () when a baby makes noise at night due to hunger.
Leave the baby alone and see if it goes back to sleep without parental intervention.
Trained night awakenings are when you wake a child up between 4-8 months of age but ()
They dont require a feeding.
Why does object permanence affect sleep at 8 months?
Kids remember things exist even if they are out of sight.
Developmental night awakenings
Sleep-onset associations are when a child develops () behavior to go to sleep
Learned behavior, aka they fall asleep only in certain situations
Limit setting disorder is when a parent () bedtime routines.
Prolongs/extends
No more one more!
Unusual behaviors/experiences that occur during sleep or transition between sleeping and awakneing are known as…
Parasomnias
Night terrors are different from nightmares because…
You don’t remember night terrors
Night terrors tend to occur during the () 3rd of the night
1st third of the night
A parent asks when their kids night terrors will stop. You reassure them that 95% resolve on their own by age…
8
Nightmares MC occur between the ages of () - ()
3-6 years
Separation anxiety can develop if there is poor trust building during the () year of life
1st year of life
An infant with high levels of mistrust tends to be (more/less) clingy to their caregiver
More clingy
Stranger anxiety tends to appear around () months, but can last beyond () months
Begins around 6-8 months, but can last past 24 months.
You should consider professional help if your child remains aggressive and destructive by (grade)
Kindergarten
Aggression in a young child can eventually lead to… (3) serious disorders
- Conduct disorder
- Oppositional defiant disorder
- Substance abuse
Temper tantrums are MC between the ages of () to () years
1-4 years
Tantrums are considered a reflection of…
Immaturity
List of how to deal with temper tantrums at WCC
The general rule of thumb for time outs is () minute per year of age
1 minute per year of age.
T/F: You should give in to your child’s tantrum
Never!!!!!
Cyanotic breath holding spells are usually due to ()/(), whereas pallid breath holding spells are due to ()/()
- Cyanotic: anger/frustration
- Pallid: Minor injury/fear
Pallid spells start with () cries, whereas cyanotic spells start with () cries
Loud vs quiet
- Pallid: brief/silent
- Cyanotic: Short loud cry
Breath-holding spells are associated with () anemia
Iron-deficiency
Generally, breath-holding spells are treated via
Parental education
Meds not recommended
Children generally become aware of their need to go potty by months ()-()
12-18 months
By 18-24 months, children can briefly control their () muscles
Urinary related
Sphincter muscles
By 24-36 months, children can start () parent’s bathroom behaviors
Mimicking same sex parent’s bathroom behavior
Sticker charts work really well for potty training in what age range?
3 years or older
One way to potty train a child is to () them every hour
Put them on the toilet every hour
The best way to potty train a child is…
Whatever way works
Thumb sucking is a universal action in infants, but typically goes away by the age of…
4/preschool
The physical issue we are worried about with kids that continually thumb suck is…
Dental malocclusion
Teeth misalignment
The most effective way to manage thumb sucking is a combination of () treatment and ()
Aversive taste treatment and reward system
Nail biting is an extension of…
Thumb sucking
T/F: Children seeking attention usually have a legit reason
True
Exploration begins around age () months, and peaks around () years. It will also restart in adolescence
2 months, peaking at 4 years
Pretty much humping
Generally, infants/children have a similar physiologic orgasmic response to adults, but the exception is…
Ejaculation
A parent sees their 2 year old child kinda banging their head and rocking out. They are concerned that this may cause brain injury. You tell the parent…
Assure them it does not cause brain injury.
Encopresis is….
Leakage of stool into clothing (usually involuntary)
The MCC of encopresis is…
Constipation
Retentive encopresis is characterized by () leakage of fecal material due to impaction, eventually leading to an () sphincter.
Involuntary leakage, eventually leading to an incompetent sphincter.
Physical exam of retentive encopresis usually reveals a () on abdominal exam and a () rectum on rectal exam
- Abdominal mass
- Dilated rectum
Tx of acute retentive encopresis is via
Enema + miralax
Tx of chronic retentive encopresis is via…
- Miralax/lactulose QD for like 6 months
- Laxatives if megacolon
- Increased fiber
Once impaction is cleared.
Acute retentive encopresis should be seen in () after impaction is cleared.
1 week
Nonretentive encopresis is…
Passage of normal BMs into underwear rather than toilet
They dont want to use the toilet so they poop voluntarily.
Management for nonretentive encopresis is…
Reward training
Pervasive development disorders are characterized by () reciprocal social interactions, () language development, and () behavior repetoire
- Impaired reciprocal social interactions
- Aberrant language development
- Restricted behavioral repertoire
PDD usually occur prior to the age of…
4
Autism spectrum disorder is characterized by 3 symptom categories, which are:
- qualitative () in social interaction
- impairment in ()
- Restricted, repetitive, and stereotyped ()
- Qualitative imapirment in social interaction
- Impairment in communication
- Restricted, repetitive, and stereotyped behavior
What developmental screening tool helps screen for ASD?
MCHAT
DSM-V diagnosis of ASD uses 3 categories related to social interaction in multiple settings, which are:
- Social-emotional reciprocity
- Nonverbal communication for social interaction
- Relationship development/maintenance
Must impair function, present early, and no other explanation.
ASD behaviors include: (4)
- Stereotyped behaviors
- Ritualistic/unchanging patterns
- Highly restricted/focused/nicheinterests
- Increased/Decreased response to sensory stimuli
In ASD, the social communication/interaction is graded on a severity of level 1-3. Level 1 requires () support, where as level 3 requires ()
- Level 1 requires no support
- Level 3 requires substantial support
In ASD, the repetitive/restricted behavior is graded on a severity of level 1-3. Level 1 requires () support, where as level 3 requires ()
- Level 1 requires support, significant effect on function.
- Level 3 require substantial support and extreme effects.
The TOC to manage ASD is…
Educational and behavioral interventions
In the US, Asperger syndrome falls under
Autism spectrum disorder
The hallmark sign of asperger syndrome/ASD is…
Atypical social development
Per the DSM-5, Asperger syndrome corresponds to level () of ASD.
Level 1 of ASD without intellectual impairment