Lecture - Childhood disorders 1 & 2

Question 1

Intellectual disability:

1. What does this term describe?
2. With these limitations, the child is slower than a typical child in what areas?

Answer 1

1. When a person has certain limitations in MENTAL FUNCTIONING and in skills such as COMMUNICATING taking care of himself/herself
2. Learning and developing are slower

Question 2

Intellectual Disability:

1. What is the DSM-5 criteria for it?
2. What are some symptoms with ID?

Answer 2

1. You need an IQ equal or less than 70 and have deficit adaptive functioning. Other that that, it’s ONSET during developmental period and across multiple settings. If the kid is under 5 can’t do the cognitive testing then give them global developmental delay so they can be supported until they’re assessed.
2. You have deficit in intellectual functioning and in adaptive functioning.
   - With intellectual - means you can’t reason, problem solve, plan, learn, judge etc.
   - With deficit adaptive functioning, it means you aren’t as independent as you should be in daily life. You have problems in communication and social and independence.

Question 3

What’re the differences between mild, moderate, severe and profound ID in terms of:

• IQ
• symptoms sorta?
• how do they fare when they grow up?

Answer 3

Mild:

• IQ 50-55 to 70
• Usually same as normal kids until school starts and then you see slow learning
• As adults, they can work and live as long as they have help when needed

Moderate:

• IQ 35-40 to 70
• Can progress minimally in academic skills (like reading) and by adolescence, have good self-care so can perform simple tasks
• As adults, most can work at unskilled or semiskilled jobs with supervision

Severe ID:

• IQ 20-25 to 35-40
• May learn to talk and develop basic self-care skills
• As adults, can perform simple tasks with supervision
• Usually live in group homes or with fam

Profound ID:

• IQ below 20-25
• Require constant care and have limited ability to talk
• Often have neurological conditions that accounts for disability

Question 4

Intellectual Disability:

1. What is the origin?
2. What co-morbidity can you have with it?

Answer 4

1. Genetic (e.g. Down syndrome, Turner syndrome)
   - Acquired brain injury like with prenatal toxins (alcohol etc) or postnatal brain injury (e.g. illness during pregnancy)
2. ADHD, autism, anxiety, depression and bipolar

Question 5

Specific Learning Disorder:

What is it?

Answer 5

It involves difficulties in learning using academic skills and usually seen in formal schooling. It causes significant interference with academic performance or activity of daily living.

When an individual has a low sorta intellectual functining but have deficit in something that’s 2 standard deviations below what’s expected with intelectual functioning - so in a specific area so if in reading then you’ll struggle with social studies

See this around 8 when they’re getting to know what they’re doing

Question 6

Autism Spectrum disorder:

1. What does it affect? (3). Kids with ASD interpret the world and what’s happening around them as what?
2. What does ‘spectrum’ refer to?

Answer 6

1. Affects
   -communication
   -social skills
   -behaviour
   They interpret it differently than kids around them
2. Refers to the wide range of differences kids can have. Symptoms can vary according to personal, age etc

Question 7

Autism Spectrum Disorder

1. What are the two criteria for ASD as said in DSM-5?
2. When is the onset?
3. Causes significant i____
4. What two other impairments can you have (they’re specifiers)

Answer 7

1. You have deficit in SOCIAL, COMMUNICATION AND INTERACTION
   - so problems with non-verbal communication (too much eye contact or not enough) or like, relationships or when communicating to them, they’re like giving you a lecture.

You also have two or more restricted, REPETITIVE behaviours:

• stereotyped motor behaviours, use of objects etc (like watching a coin spin)
• are inflexible (can’t stand change)
• restricted interests like vacuum cleaner parts
• hyper/hypo -reactivity to stimuli (like hate socks or love socks)

2. In early development
3. Impairment
4. Intellectual and language impairment

Question 8

Autism Spectrum Disorder:

1. Describe their intellectual ability
2. What’s like the difference between someone who has ID and is autistic vs not
3. What about their sensitivity?
4. What other things are associated features (3)?

Answer 8

1. It ranges from having ID to being a genius. Some also have special talents/above average skills in a specific area
2. Someone with ID and no autism has an ‘even’ intellectual profile (aka have difficulties over all the areas. Someone with autism and ID: lower verbal scores
3. They can be oversensitive or undersensitive
   - oversensitive to e.g. loud noises, bright lights, crowds
   - seem to not get cold
4. They have motor clumsiness, self-injurious behaviours and information processing difficulties

Question 9

Autism Spectrum Disorder:

1. What are some co-morbidities?
2. What is the etiology?
3. What is the prognosis?
4. What are things that better outcomes are associated with?

Answer 9

1. ID, Language disorder, ADHD, other mental disorders. Also medical conditions like motor/sensory impairments
2. Not sure but not vaccinations
3. 1-2% obtain personal independence and independent employment but they can have problems with law bc have trouble understanding
4. Intellectual level being high, early detection and treatment, development of communicative language by 5

Question 10

ADHD (attention-deficit/hyperactivity disorder)

1. Developmentally inappropriate levels of three things - what are they? They interfere with child’s behavioural, academic and social functioning or development
2. ADHD symptoms must occur…….
3. What age must the kid be before the symptoms occur?

Answer 10

1. Inattention, impulsivity and hyperactivity
2. In multiple settings so we know it’s not like they’re bad at home but all goods at school
3. 12 Years Old

Question 11

ADHD

1. What are the symptoms in DSM for ADHD?
2. There is a persistent pattern of Inattention ____/_____ Hyperactivity/Impulsivity
3. What are the three subtypes?

Answer 11

1. Inattention: careless, doesn’t listen, forgetful, avoids tasks that require sustained effort, easily distractible

Hyperactivity: fidgets, talks excessively, can’t work quietly, runs or climbs excessively

Impulsivity: blurts out answers, can’t wait for turn, intrudes or interrupts others

2. AND/OR
3. Combined presentation, predominantly inattentive presentation or predominantly hyperactive/impulsive presentation

Question 12

ADHD:

1. Is it heritable?
2. When is it difficult to diagnose?
3. Common co-morbid withhhhh?

Answer 12

1. Yes
2. Difficult to diagnose in early years (4-6)
3. Autism, ID and ODD

Question 13

Oppositional Defiant Disorder:

1. What do kids with ODD display?
2. Child’s behaviour often disrupts the child’s what?

Answer 13

1. Extreme resistance to authority, conflict with parents, and other authority figures, outbursts of temper and spitefulness with peers
2. Normal daily activities, including actives within the family at school

Question 14

Oppositional Defiant Disorder:

1. What is the DSM-5 criteria?
2. What’s the course of ODD?
3. What’re risk factors for ODD?

Answer 14

1. Need to have at least 4 of the following for more than 6 months:
   - Angry/irritable mood: loses temper, easily annoyed, restful
   - Argumentative/defiant behaviour: argues, defies, deliberately annoys, often blames others for his mistakes

And this is between other people- not siblings

And it must cause distress in immediate social context or impact negatively on social, emotional, occupational or other areas functioning

2. Symptoms appear during preschool, and there is greater risk of CD, anxiety, depressive disorders. It is co-morbic with ADHD, SLD and ID. Children with ODD might become adults with problems with impulse control, substance abuse and exhibit antisocial behaviour
3. History of abuse or neglect, parent who has mood disorder or substance abuse, exposure to violence, lack of supervision, instability in fam, financial problems etc or parents who have ODD, CD, ADHD etc

Question 15

ODD Differential Diagnosis:

Go read this and explain it back (slide 65)

Answer 15

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Question 16

Conduct Disorder:

1. What is it? Repetitive and persistent…..
2. What does the disturbance in behaviour cause?
3. Diagnosis them with CD if individual is 18+ and doesn’t?

Answer 16

1. Repetitive and persistent pattern of behaviour in
   which the basic rights of others or major ageappropriate
   societal norms or rules are violated
2. The disturbance in behaviour causes clinically significant impairment in social, academic, or
   occupational functioning
3. If individual is 18 years or older does not meet criteria for antisocial personality disorder

Question 17

Conduct Disorder:

1. What is the DSM-5 criteria?
2. Go read the differential diagnoses

Answer 17

1. Repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by:

TRAP-
Theft, Rule breaking, Aggression (to people and animals), and Property Destruction

Question 18

Conduct Disorder:

1. What is the course of it?
2. What are the risk factors?

Answer 18

1. First symptoms usually appear bw middle childhood and middle adolescence (ODD is a precursor). If had early onset, then worse prognosis. But after onset, course is variable so like usually behaviours becomes more serious but like, it can remit by adulthood.
2. Risk factors include previous diagnosis of ODD, children who are adopted, parental separation or substance abuse/abandonment, or like fams that have increased rates of mood disorders, learning disorders, anti-social personality disorders