Mental Health Flashcards
True or False: Maternal-infant bonding is important immediately after birth
True
What is more important to do in the first hour of life?
- Vitamin K
- Erythromycin
- Maternal-infant skin to skin
Skin to skin
What is the definition of colic?
Crying more then 3 hours per day, more than 3 days per week, for more than 3 weeks for no apparent reason
What causes colic?
Multi-factorial
How is colic diagnosed?
Based on history
*PE doesn’t show anything and no labs to confirm diagnosis
When does colic begin?
2 weeks
When does colic peak?
6 weeks
When does colic resolve?
4 months
How many hours a day of crying can be normal in an infant from birth-6 weeks?
Up to 2 hours
*Same for premature
How many hours of crying a day can be normal in an infant from 6-weeks and beyond?
3 hours a day
*Same for premature
Crying in an otherwise healthy infant that usually starts suddenly and occurs around the same time every day (usually evening)?
Colic
Babies who cry hard and long, draw up their legs, tense their bellies, arch their backs… seems like they are in pain?
Colic
What is management for colic?
- Support/reassurance
2. Have another caregiver take over to reduce parental frustration
When would you prescribe medication (gas drops) or change formula to treat colic?
Never (this will rarely be the correct answer)
True or False: Trying to make the environment nice and quiet actually can make colic worse
True
Infants who cry excessively are at increased risk for what?
Child abuse
2 month old who cries continuously… usually for 2 hours around 5AM and 1 hour around 1AM.. what should parents do?
Reassurance
*Add up total hours crying, only 3, this is normal
True or False: Most kids have temper tantrums at some point in their lives?
True (especially common in toddlers)
What is helpful if tantrums are caused by frustration with a task?
Redirection or distracting them before tantrum can occur
What is helpful for toddlers who have temper tantrums?
Consistent daily routine
What should parents do about temper tantrums?
- Ignore them (unless child is in danger of harming themselves)
- Let the child calm down in a safe place
- Avoid physical restraint (increases child’s frustration)
What age group are breath holding spells usually seen in?
6-18 months
Toddler who is angry, frustrated, or in pain. They cry and then become pale/cyanotic…?
Simple breath holding spell
Toddler who is angry, frustrated, or in pain. They cry and cry until they are unconscious…?
Complex breath holding spell
True or False: A breath holding spell can progress to a hypoxic seizure with a post-ictal period
True: This is still a breath holding spell, not a seizure disorder
What is management for a breath holding spell?
- Behavioral modification
2. Reassure parents it’s not harmful (so they don’g give into child’s demands to avoid them)
What is the golden rule of behavior management?
Praise a child’s desirable behaviors and ignore undesirable behaviors
What is it called when a parent or caregiver withdraws all attention from a child who is displaying undesirable behaviors?
Extinction
What is an extinction burst?
When a parent withdraws attention from a child who is displaying undesirable behaviors and the behavior initially worsens. If parent can hold out, behavior will decrease in frequency.
What hematologic problem has an association with breath holding spells?
Iron deficiency anemia
Treatment of what problem (if present) can reduce the frequency of breath holding spells?
Iron deficiency anemia
*However, anemia is not considered to be the actual cause of breath holding spells
What ages is time out best for?
Age 1 and up
How long should time-outs last?
One minute per year of the child’s age
What is time-in?
Positive feedback: Parent makes reassuring contact when child is engaging in appropriate behavior (positive reinforcement)
What is token economy?
When a child receives a token for positive behavior
What age group is token economy effective in?
3-7
What is the preferred strategy for discipline in kids with ADHD?
Token economy
What needs to be done for a neurologically-intact child between 8 months-4 years who is head-banging (especially around bed time)?
Reassurance: This is normal and doesn’t need any intervention
True or False: Head banging always indicates a sensory deficit
False- this can be a normal finding
Toddler with language delay, poor eye contact, and head banging… what is something to consider besides autism?
Neglect… watch for signs like missed appointment, ect.
Child older than 4 with headbanging and other signs/symptoms of developmental delay… is this normal?
No (outside range of normal head-banding behavior)
Up until what age is biting considered a normal behavior as a reaction to frustration?
3
What is management for biting?
- Redirect and say “No Biting” (verbal scolding- simple/neutral)
- Remove positive reinforcement
- Time-out
What is the best initial intervention for thumb sucking in a toddler?
- Redirecting so they use their thumbs for something else
2. Positive reinforcement when they aren’t thumb sucking
At what age would you consider intervention for thumb sucking?
Over 4, under this age it is likely they will outgrow it
True or False: Most thumb sucking is considered to be harmless and no intervention is needed
True
What can prolonged thumb sucking beyond age 4 lead to?
Dental problems (malocclusion)
What do you do with a pre-school or school age child who is masturbating?
Nothing- this is normal to a certain extent
*If child is imitating sexual activity, this is NOT normal
What are three things which may increase sexual self-stimulation behavior in children?
- Vulvovaginitis
- Recurrent UTI
- Use of bubble baths
What is an age-appropriate discomfort over a situation that is realistic within the context?
Fear
What is an anxiety that is excessive based on the potential danger posed (after accounting for age and developmental level)?
Phobia
How long does something need to interfere with daily function for to be considered a phobia?
6 months
What are 2 ways to manage phobias?
- Desensitization: Gradual exposure to feared object or situation
- Cognitive Behavioral Techniques: Child is shown how to re-frame situations triggering the phobia
*Meds not well-studied for this and likely not correct choice
True or False: Teen parents don’t typically stay together long
True
What can contribute to misinterpretation of age-appropriate behavior?
Unrealistic expectations
*This can result in inappropriate punishment
True or False: Involvement of a teen father is beneficial to the child
True (but is dependent on nature of relationship with Mom)
True or False: School phobia occurs more frequently when there is only 1 caretaker
True
What is the best way to deal with school phobia?
Have Mom go to school with child and wean amount of time spent there
True or False: Separation anxiety can be a normal developmental stage in pre-school children
True
What can pure truancy from school be a component of?
ODD
Teenage female who experiences chronic pains, recurrent nightmares, fears of being alone, diminished interest in school, and/or decreased appetite weeks to months after experiencing a sexual assault?
PTSD
What are the 2 core symptoms of ADD?
- Inattentiveness
2. Impulsivity
Besides inattentiveness and impulsivity, what is the third core symptoms of ADHD?
Hyperactivity
What are the requirements regarding symptoms to be diagnosed with ADD/ADHD?
- Present before age 12
- Present in 2+ settings
- Impair functioning
- Present for at least 6 months
- Not explained by another condition
Which presentation of ADHD is more common in boys?
ADHD- predominantly hyperactive
Which presentation of ADHD is more common in girls?
ADHD-inattentive
When is ADHD often diagnosed?
Upon entering school
*Usually retrospective evidence of symptoms during toddler/preschool years (sleep disturbance, behavioral problems)
What % of kids diagnosed with ADHD continue to meet criteria for diagnosis at adolescence and adulthood?
60-80%