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Neuropsychological Assessment > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

Transactional Model for Child/Adolescent Disorders (3 components)

A

CNS development/maturation, Bidirectional feedback mechanisms, and Academic/behavioral/psychological manifestations

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2
Q

CNS Development/maturation

A

Biogenetic factors (chromosomal abnormalities, temperament) and environmental factors (pre/postnatal toxins, birth complications)

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3
Q

Bidirectional feedback mechanisms

A

Intellectual, cognitive, and perceptual capacity, subcortical structures (RAS, thalamus) and Cortical Structures (frontal, temporal, parietal, occipital, association regions)

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4
Q

Academic, behavioral, and psychological manifestations

A

Home environment (parents, SES), social environment (peers) and school/classroom (expectations, teaching, reinforcement)

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5
Q

Folate supplementation

A

Recommended during pregnancy to prevent neural tube defects

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6
Q

Risk factors associated with premature birth

A
  • periventricular leukomalacia (PVL)
  • hypoxic ischemic encephalopathy (HIE)
  • Intraventricular hemorrhage (IVH)
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7
Q

Key window of brain development

A

ages 0-6

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8
Q

Tourette’s syndrome

A
  • Tic disorder marked by multiple motor and vocal tics
  • Tics increase with stress
  • Symptoms present before age 18
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9
Q

Dopamine hypothesis of Tourette’s

A

Deficiency in dopamine in the prefrontal lobes corresponding with sensitivity of dopamine receptors in the striatal and nucleus accumbens region, results in disinhibition of subcortical regions

lack of DA in frontal lobes + sensitive DA receptors in striatal and nucleus accumbens = disinhibition of subcortical regions

excess dopamine in the striatum is thought to excite the thalamo-cortical circuits, producing tics. When external stressors activate the hypothalamic-pituitary-adrenal (HPA) axis, more dopamine is produced, furthering the excitation of tic-producing pathways

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10
Q

Coprolalia

A

Involuntary/repetitive use of obscene language
(rare symptom of Tourette’s)

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11
Q

Echolalia

A

Repetition of words just spoken by another person (symptom of Tourette’s)

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12
Q

Tourette’s is commonly comorbid with

A

OCD

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13
Q

Autism (brain areas)

A

Abnormalities in the cerebellum, brain stem, limbic system, and temporal lobes

Enlargement of lateral ventricles

Delayed maturation of frontal lobes

Reduced activity in the amygdala during processing of facial emotions

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14
Q

Children with autism would be expected to be below expected performance on

A

Executive control and frontal lobe function tasks, perseverative errors

  • Tower of Hanoi
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15
Q

Asperger’s

A

Marked by impaired social interactions, normal development of age-appropriate self-help/adaptive bx, restricted/repetitive/stereotyped patterns of bx/interests/activities

Flat/dull affect, monotonous speech, little reciprocity, lack of interest in others

Appears before age 4

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16
Q

ADHD

A

3-5% school age children

Disturbance of stimulus boundedness, disturbances in attention span, self-reg, activity level, and impulse control

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17
Q

Conduct disorder

A

3-7% in general pop, 3x more likely in males

Marked by aggressive bx without taking into consideration the feelings of others, physical/verbal aggression, stealing, lying

Negative bias on testing with the tendency to interpret ambiguous stimuli as hostile/negative

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18
Q

Sociopathic “Macdonald” Triad

A

1) Arson/obsession with fire starting
2) Animal cruelty
3) Enuresis

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19
Q

Language disorders

A

Symptoms include stuttering/stammering, not understanding words, inability to express themselves, difficulty speaking words/making sentences, delayed speech

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20
Q

Auditory Processing Disorder

A

Appears to have combination of many symptoms including:
- Difficulty understanding speech
- Difficulty following multi-step directions presented verbally
- Difficulty attending to long lectures
- Difficulty remembering/summarizing info presented verbally
- Difficulty reading, spelling, writing
- Trouble following abstract thought/ideas
- Delayed/misunderstanding jokes, sarcasm, etc.

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21
Q

Learning Disorder in Reading

A
  • Difficulty acquiring rapid, context-free word reading skills
  • Associated with symmetrical planum temporale
  • Reduced insular and frontal lobe volumes
  • Cortical malformations in the frontal/temporal areas
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22
Q

Learning disorder in math

A

Subtypes include anarithemetria, acalculia, and spatial dyscalculia

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23
Q

Anarithemetria

A

Difficulty performing math operations

24
Q

Acalculia

A

Deficits knowledge of math concepts

25
Q

Spatial dyscalculia

A

difficulty organizing and manipulating numbers spatially

26
Q

Written Language Expression

A

May be a function of bilateral hemispheric substrates
Dysfunction in complementary roles in processing:
- Right hemisphere (anterior, central, posterior)
- Left hemisphere (temporal-parietal, anterior)

27
Q

Nonverbal LD

A

Intact left hemisphere with right hemisphere dysfunction resulting in complex social/emotional and academic difficulties

Tactile/visual interception deficits, impaired complex psychomotor skills, inattention to tactile/visual info, verbal skill deficits (prosody, semantics, content)

Most commonly associated with math LD

28
Q

Developmental delay

A

Failure to meet expected developmental milestones in 1+ of following:
= physical, social, emotional, intellectual, speech/language, adaptive development

Child performs below 25-35% of age norms

Progress occurs at slower than expected rate

29
Q

Possible causes of developmental delay

A
  • Chromosomal abnormalities
  • Genetic/congenital disorders
  • Severe sensory impairments (hearing/vision)
  • Inborn errors of metabolism
  • Disorders relating to disturbance of the development of the nervous system
  • Congenital infections
  • Exposure to toxins (e.g., FAS)
30
Q

Gershwind-Galaburda theory

A

Proposes that embryonic surges of testosterone delay the development of the left hemisphere in males

31
Q

Down’s Syndrome

A

Common chromosomal disorder, most common is trisomy 21

mild to severe cognitive impairment, small head, flat nose, folds in corners of eyes, protruding tongue, heart/ear/eye defects

Sleep apnea common
Prone to spinal injuries

32
Q

Phenylketonia (PKU)

A

abnormal recessive disorder affecting phenylalanine to tyrosine metabolism causing bx/antisocial problems (may look like ADHD)

33
Q

Lesch-Nyhan Syndrome

A

Progressive metabolic disorder caused by abnomality of an enzyme (HGPRT) on the X chromosome, severe cognitive impairment and often accompanied by choreoathetoid movements (twitching/writing)

34
Q

Fragile X

A

X chromosome compressed/broken, more common in males

females have higher rates of normal IQ, marked by long face, prominent ears/jaw/forehead

35
Q

Klinefelter Syndrome

A

extra X chromosome on #47, marked by infertility, male breast development, underdeveloped masculine build, social/cognitive/academic difficulties, long legs, tall stature, small testes/penis, bx problems, peer relation difficulties

36
Q

Noonan Syndrome

A

Short stature, webbed neck, ptosis (upper eyelid droop), hypertelorism (increased distance between the eyes), high arched palate, low set ears

Generally lower IQ but relatively preserved verbal skills

37
Q

X-linked andenoleukodystrophy

A

Marked by visual-perception deficits

38
Q

Neurofibromatosis/Von Recklinghausen’s

A

inherited, spots of skin pigmentation, benign tumors on/under skin, tumors in the iris, focal lesions (basal ganglia, subcortical white matter, brain stem, cerebellum), learning problems, anxiety due to appearance, seizures

39
Q

Tuberous Sclerosis

A

Heart/lungs/bones/kidney problems, facial lesions, white spots on the skin

Results from abnormal proliferation of brain cells and glia during embryonic development, cognitive impairment, seizures, hemiplegia

40
Q

Sturge-Webber Syndrome

A

Seizures, cognitive impairment, bx difficulties, infantile hemiplegia

41
Q

Partial Seizures

A

Structural lesions, no LOC, can develop to generalized tonic-clonic (grand mal)

42
Q

Simple partial seizures

A

Grey matter origin/motor strip with electrical discharge, no LOC

43
Q

Complex partial seizures

A

LOC/loss of impairment

44
Q

Absence Seizure

A

Petit mal, abrupt LOC, return to normal activity, most consistent with a neuropsychological deficit in visual memory

45
Q

Tonic-clonic seizure

A

Grand mal, most common in children, LOC followed by a fall and crying

46
Q

Febrile Seizures

A

Convulsion in a child that may be caused by a spike in body temperature (fever)

Can be simple or complex

47
Q

Cerebral Palsy

A

a group of disorders that affect a person’s ability to move and maintain balance and posture

Injuries causing CP can occur pre/post natally (infancy to early childhood)

“floppy baby” with gradual increase in restricted movement

6 subtypes: spastic hemiplegia, spastic quadriplegia, spastic diplegia, extrapyramideal CP, atonic CP, ataxic CP

48
Q

Fetal Alcohol Syndrome

A

Result from birth parent consuming EtOH during pregnancy

Side effects
- low body weight
- non-typical facial features
- vision and hearing problems
- cognitive difficulties
- executive fx challenges

49
Q

Pediatric tumors brain locations

A

70% are posterior fossa (a small space in the skull, found near the brainstem and cerebellum)
30% supratentorial (the upper part of the brain)

50
Q

Resection of a cerebellar tumor may be marked by

A

Mutism, ataxia, and emotional lability

51
Q

Leukemia

A

Radiation may lead to cognitive impairment - can manifest as non-verbal LD

Can impact social relationships because of range of emotions and stress

52
Q

Turner Syndrome (TS)

A

Affects females, results from one of the X chromosomes being missing/partially missing

Short height, failure of ovaries and heart to develop

Weakness in processing speed, motor skills, math

53
Q

Landau-Kleffner Syndrome

A

Rare, age-related epileptic encephalopathy manifesting in children ages 3-8 despite previously normal development

Regression in language, epilepsy, and social-cognitive deficits

Acquired aphasia and paroxysms (sudden spasm)

INITIAL SYMPTOM: auditory agnosia

54
Q

Flynn Effect

A

the substantial and long-sustained increase in both fluid and crystallized intelligence test scores over time (i.e., why someone would score lower on the WAIS-IV than the WAIS-III)

55
Q

Most important factor to consider when interpreting discrepancies between test scores in children

A

Base rates

56
Q

Should you allow others to sit on on a child assessment?

A

NO

Neuropsychological Assessment (9 decks)

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