Week 11 - Childhood Disorders Flashcards
What are the neurodevelopmental disorders>
intellectual disability, Autism spectrum disorder, specific learning disorder, ADHD
What are the impulse, conduct disorders?
Oppositional Defiant Disorder, Conduct disroder
What are mood disorders?
Disruptive Mood Dysregulation Disorder (DMDD)
What is neurodevelopment disorder with many areas of function delay?
pervasive developmental disorder
What is the IQ mean?
100
What is the standard deviation of IQ?
15
What is the DSM for intellectual disability?
A. deficits in function confirmed with clinical, individualized, standardized test (IQ
What are the types of intellectual disabilities?
mild, moderate, sever, profound
What is the prevalence of ID?
1% pop
Who is ID more common in?
boys
What are some comorbid disorders with ID?
autism. anxiety, depression, dementia, psychotic
What are some preg risk factors for ID?
teratogens, anoxia, premature
What are some childhood illnesses that are risk factors for ID?
encephalitis, meningitis, lead poisioning, head injuries, abuse
What are some risk factors for ID?
chromosome abnorm, metabolic disorders, preg prob, childhood illness, cultural-familial intellectual disabilty
What is the treatment for ID?
living arrangment, special education, self-care training, psychotherapy
Is ID pervasive?
yes
What are the two areas of deficit in ASD?
social communication and interaction
What are some associated problems with ASD?
ID, self-injurious, savant skills
What is the prevalence of ASD?
1 in 88
Who is ASD more common in?
boys
What are co morbid disorders with ASD?
ID, anxiety, depression, medical problems
What is a quick screening for autism?
M-CHAT
Who does M-CHAT screen?
toddlers 16-30 mo
What is the downside to M-CHAT?
high false positive
Is autism genetically linked?
yes strong heritability
What are the risk factors for autism?
prenatal issues, social brain issues (prefrontal cortex, limbic, amygdala, cerebellum, too many synapses, deficits in social cognition
How does an autistic brain differ than typical?
more pathways and weaker connections
What is the treatment for autism?
intensive behavior therapy - ABA, parent training
Sign language or communication tools
Academic tutoring/instructions
Special education services
What medtions can you use in autism?ica
anticonvulsants, atypical antipsychotics, psychostimulants
What are the three types of ADHD?
inattentive, hyperactive/impulse, combined
What are symptoms of IA ADHD?
fails attention to detail/careless mistakes difficulty sustaining attention doesn't listen when spoken to does not go through instructions loses things Avoids or dislikes sustained effort tasks Easily distracted Forgetful
What are the symptoms of HI ADHD?
fidgets, leaves seat, runs or climbs, difficulty playing quietly, on the go, talks excessively, blurts out answers, difficulty waiting turn, interrupts
How many symptoms and for how long do you need for ADHD?
> /=6 for 6 mo
Who only needs 5 sx in ADHD dx?
> 17 yo
What is the DSM criteria for ADHD?
A. 6 mo of 6 or more symptoms (interferes w/ fxn)
B. before age 12
C. 2 settings
D. evidence it interferes
E. does not occur during other mental illnesses
What type of mental health disorder is ADHD?
chronic
Who gets ADHD the most?
boys
What is the severity of intellectual disorder based on?
adaptive functioning
What is the DSM=5 for ASD?
A. defitits in social communication and interaction
B. restricted repetative patter of interest, activities
C. early development
D significant impairment
E not explained by ID or GDD
What are the specifiers for ASD?
w or w/o intellectual impairment
w or w/o language impair
associated condition (genetic, medical, environmental)
associated with neurodevelopment, mental or behavioral disorder
w/ catonia
What are the nonverbal issues for autism specturm disorder?
pointing, waving, gestures, EYE CONTACT
What is special about girls with ASD?
usually worse
What is joint attention and who doesn’t have this?
follows gaze of adult, AUTISM
What are the comorbid disorders with ADHD?
oppositional defiant disorder, academic problems
What is a way to assess for ADHD, ODD, and CD?
conners rating scales revised
What is the scale that can rate ADHD and academic problems?
vanderbilt scales
What is the scale that determines impact of sx on functioning?
Impairment Rating Scale (IRS)
What are risk factors for ADHD?
genetic
maldevelopment of frontal striatal cerebellar circuits in brain
What are the prenatal risk factors for ADHD?
Prenatal exposure to alcohol Prenatal exposure to tobacco smoke Prematurity Total increased pregnancy complications Maternal stress during pregnancy
What are the risk factors for postnatal risk factors?
Hypoxia
Tumors, infections
Lead poisoning (0-3 years old)
Low birth weight
What are the evidence based treatment for ADHD?
behavioral therapy - parent management
Medications - psychostimulants
combo meds
What is the DSM=5 of learning disorder?
A. difficulties learning and using academic skills, at least one of the following SZ, persisting for 6 mo, despite provision of interventions to target difficulties
B. academic skills are below what is expected for age and intereferes with academic or daily living (confirmed by standard achievement meaures and comprehensive lcinical assessment)
C. learning problem begins during school age
D. not better accounted for by intellectual disability, uncorrected vision or auditory problems, or language issues
How does ADHD present in preschool?
High motor activity: always on the go, climbing on things, getting into things Decreased or restless sleep High curiosity Vigorous, often destructive play High attention needs More intense temper tantrums Require closer, more frequent monitoring Disobedience
How does ADHD present in elementary/middle school?
Academic difficulties; difficult homework time
School complaints of disruptive behavior (e.g., blurting out, leaving seat, missing directions)
Help with chores and responsibilities
Low frustration tolerance
Social difficulties; conflict and rejection
May have low self-esteem
How does ADHD present in adolescence?
Approximately 70-80% still display sx; 40-70% ADHD persists
More restless and fidgety, rather than hyperactivity
Continued academic difficulties
Difficulty with authority figures
At risk for earlier sexual behavior and cigarette smoking
Higher rates of risky driving, substance abuse, and risky sexual behaviors
How does ADHD present in adulthood?
Syndrome persists in 50%+
Prevalence in adults is 4%
More subtle presentation
Difficulties initiating and organizing daily tasks
Inconsistent performance and trouble with deadlines
Restlessness, trouble relaxing
Socially inappropriate
What are the specifier for SLD?
reading, written, mathematics
mild moderate or severe
What are the comorbities with SLD?
ADHD, substance use
What is the assessment for SLD?
refer to school for testing, write letter
What are the risk factors for learning disorder?
heritable, chromosomal abnormalities, exposure to teratogens
What is the DSM 5 for ODD?
A. angry/irritable, argumentative, vendictiveness for at least 6 mo, 4 or more symptoms (towards someone that is not a sibiling)
B. disturbance causes individual or others distress, negat impact fxn
C. Not during psychotic, substancem depresive or bipolar
CRITERIA NOT MET FOR DMDD
What are the angry/irritablity symptoms?
loses temper, easily annoyed, angry and resentful
What are the argumentative definant behaviors?
argues with authority
noncompliant
deliberately annoys others
blames others for own mistakes
What are vindictiveness?
spiteful or vindictive at least 2 times in past 6 mo
What are the specifiers for ODD?
mild moderate severe
What is the DSM-5 for conduct?
A. pattern of rights of others or society norms is violated with 3 of the 15 symptoms in the past yEAR with at least 1 criterion present in past 6 mo
B.Disturbance cause impairment in social, academic, or job
C. if 18+ , does not meet criteria for antisocial personality disorder
What are the conduct disorder symptoms?
Bullies/intimidates Initiate physical fights Used weapon for harm Physically cruel to people Physically cruel to animals Steals while confronting a victim Forced sexual activity Deliberate fire setting (intention to cause harm) Deliberate destruction of property Broken into house, car, etc Lies/cons to obtain goods/favors or avoid obligations Steals without confronting victim Stays out all night (
What are teh specifiers for CD?
Childhood onset, adolescent onset, unspecified onset
With limited prosocial emotions (lack of remorse/guilt, callous- lack of empathy, unconcerned about performance, shallow/deficient affect
Mild, moderate, severe
Which one is more common ODD or CD?
ODD
Who is ODD and CD more common in?
boys
What are comorbid disorderswith ODD and CD?
Comorbid with each other ADHD Substance Use Disorders Antisocial Personality Disorder (after age 18) Anxiety Depression Learning Problems
What are risk factors for ODD and CD?
Modest heritability – below 50%
Genetic risk for difficult temperaments and hyperactivity/impulsivity that predisposes them for conduct problems
Emotional reactivity
Excessive emotional reactivity (low frustration tolerance)
Impulsivity and aggression
Coercive parent-child interactions (reinforces defiant behavior )
Low parental monitoring
Peer rejection
Low SES and high crime neighborhoods
What is the treatment for ODD and CD?
behavior therapy
anger coping and coping power
multisystem therapy - family based approach
Can you have ODD with DMDD?
NO
What is the DSM5 for DMDD?
A. Severe recurrent temper outbursts manifested verbally and/or behaviorally that are grossly out of proportion in intensity or duration to the situation or provocation
B. Temper outbursts are inconsistent with developmental level
C. Temper outbursts occur, on average, 3 or more times per week
D. Mood between outbursts is persistently irritable or angry, nearly every day, and observed by others
E. Sx A-D present for 12 months or more. Has not had a period lasting 3 or more consecutive months without all of the Sx in A-D
F. Criteria A and D are present in 2 out of 3 settings (home, school, peers) and are severe in 1 of the settings
G. Do not make diagnosis before 6 years old or after 18 years old
H. Age of onset of symptoms is before 10 years old (by history or observation)
I. Never a distinct period (lasting more than 1 day) during which the full sx criteria for a manic or hypomanic episode have been met
J. Behaviors do not occur exclusively during an episode of major depressive disorder, and not better explained by a mental health disorder
Note. Cannot diagnose with ODD, intermittent explosive disorder, or bipolar disorder
Note. Can co-occur with ADHD, MDD, CD, substance use
K. Sx are not due to substances, or medical/neurological
