Week 9 - Neurodevelopmental disorders, indigenous culture and mental health

Question 1

Cognition definition

Answer 1

The mental action or process of acquiring knowledge and understanding through thought, experience and the sense

Question 2

70% of mental health problems have their onset…

Answer 2

During childhood or adolescence

Question 3

Young people aged 15 to 24 are more likely to experience…

Answer 3

Mental illness and/ or substance use disorders than any other age group

Question 4

Risk factors of childgood mental illness

Answer 4

▪ biological factors
▪ unhealthy child development
▪ abusive parents
▪ substance abusing parents
▪ family trauma
▪ negative peer relationships
▪ cultural factors
▪ learning disabilities/ academic failure
▪ illness and disability
▪ children in care of family services
▪ children with parents with mental illness
▪ children with multiple risk factors increase likelihood of mental health problems
▪ any of the social determinants of health influence - ie. lack of community resources, etc.

Question 5

Assessment of children and adolescents

Answer 5

▪ consider the stage of growth and development
▪ assess in the context of family culture and family circumstances
▪ gather information from multiple sources
▪ include the child/ adolescent’s perspective, sense of identity, self esteem
▪ mental status exam - make adaptable to child’s age (using age-appropriate language - examples)

Question 6

Intellectual Disability (Defined) (Intellectual Developmental Disorder)

Answer 6

Onset during the developmental period with deficits in conceptual, social and practical domains
A. Deficits in intellectual functions, i.e., reasoning, problem solving, IQ score 65-75
B. Deficits in adaptive functioning, ie., social participation, independent living
C. Onset of deficits during the developmental period

Question 7

Autism Spectrum Disorder epidemiology

Answer 7

approaching 1% of the population

Question 8

Autism Spectrum Disorder rates

Answer 8

3-5x’s higher in males than in females

Question 9

Autism Spectrum Disorder onset

Answer 9

12 to 24 months

Question 10

Autism Spectrum Disorder cause

Answer 10

▪ Remains unknown
▪ Structure/ function of the CNS?
▪ Genetic link
▪ Environmental
▪ Is not related to vaccines or parenting styles

Question 11

Autism Spectrum Disorder cause

Answer 11

Remains Unknown?
▪ Structure/Function of the CNS?
▪ Genetic Link
▪ Environmental
▪ Is not related to vaccines or parenting styles

Question 12

Autism Spectrum Disorder diagnosis

Answer 12

▪ Observation/ screening tools
▪ Neurological, cognitive and language testing

Question 13

Autism Spectrum Disorder is characterized by:

Answer 13

Persistent deficits in social communication and social interaction across multiple contexts including:
A. Restricted, repetitive patterns of behaviour, interests, or activities
B. Symptoms are present in the early developmental period (typically recognized 12-24 months of age)
C. Symptoms cause significant impairment in social, occupational or other areas of functioning
▪ Within the diagnosis, individual characteristics are noted through the use of specifiers

Question 14

Autism Spectrum Disorder other specifiers include:

Answer 14

With or without accompanying intellectual, language impairment

Question 15

Autism Spectrum Disorder Impairment in Communication

Answer 15

▪ Delayed language development
▪ Echolalia may be present
▪ Extreme concrete interpretation of language
▪ Pronoun reversals

Question 16

Autism Spectrum Disorder Interventions

Answer 16

▪ Early Intervention - Special education
▪ Structured environment
▪ Development of language skills
▪ Play therapy for cognitive, social, and emotional skills - including self-control
▪ Applied Behavioural Analysis (ABA)
▪ To learn to “tuck” special interests away
▪ Virtual reality/ computer games
▪ Medications to manage hyperactivity and stereotypical behaviour:
- Antipsychotics/ antidepressants/ anti-anxiety
- Meds for seizures

Question 17

Attention Deficit Hyperactivity Disorder combination of symptoms

Answer 17

Inattention
Hyperactivity-impulsivity

Question 18

Three types of ADHD

Answer 18

ADHD, Predominately Inattentive ADHD, Predominately Hyperactive-Impulsive ADHD, Combined Type

Question 19

ADHD, Predominately Inattentive

Answer 19

▪ Unable to get focused on or stay focused on task/activity.
▪ Individual does not display significant hyperactive/impulsive behaviors

Question 20

ADHD, Predominately Hyperactive-Impulsive

Answer 20

▪ Person is very active – often acts without thinking
▪ Individual does not display significant inattention problems

Question 21

ADHD, Combined Type

Answer 21

Individual is inattentive, hyperactive, and impulsive

Question 22

Attention Deficit Hyperactivity Disorder demographic

Answer 22

▪ Affects 3 to 5% of all children - 4.4% of adults
▪ Symptoms decrease over time in many children
▪ Impulsivity may persist into adulthood
▪ Sometimes ADHD is 1st diagnosed in adulthood
▪ Male to female ration 2:1 - females present more with inattentive features

Question 23

Attention Deficit Hyperactivity Disorder cause

Answer 23

No clear cause

Temperamental
Environmental
Neurological/ genetic theories

Question 24

Attention Deficit Hyperactivity Disorder diagnosis

Answer 24

▪ Diagnosis – DSM criteria – no standardized test
▪ Behaviors are the rule – not the exception
▪ Symptoms occur in at least 2 settings with consistent pattern (i.e., school and home)
▪ Can resemble a mood disorder
▪ May have co-occurring disorders, i.e., depression, anxiety, conduct disorder
▪ Emotional aspects and effects on mental health

Question 25

ADHD, Predominately Inattentive Type Potential Outcome

Answer 25

Risk of worse academic outcome

Question 26

ADHD, Combined Type Potential Outcome

Answer 26

Risk of worse academic outcome

Question 27

ADHD, Predominately Hyperactive-Impulsive Potential Outcome

Answer 27

Potential for good academic outcome – but more difficulty with interpersonal injuries or interpersonal relationships

Question 28

ADHD Treatment

Answer 28

Early identification and timely specialized assessments and interventions including:
▪ Specific skill instruction
▪ Accommodations
▪ Compensatory strategies
▪ Self-advocacy skills – helping the child build their self-esteem

Goal: To provide structure and predictability through help with routines, organization, minimize distraction

Question 29

ADHD medications

Answer 29

Stimulants - (Methylphenidate/ Ritalin)
▪ Stimulants found to improve core symptoms
▪ Rapid onset; approx 90 min
▪ Short acting - duration of 4 hours
▪ Side effects: nervousness, irritability, difficulty falling asleep or staying asleep, dizziness, nausea.
Antidepressants - (Nortriptyline, Bupropion, Fluoxetine)

Question 30

Symptoms of ADHD in adults

Answer 30

▪ Inattention and Memory
▪ Hyperactivity
▪ Impulsiveness
▪ Emotional Turmoil
▪ Irritability/Easily Angered

Question 31

Positive characteristics of persons with ADD/ADHD

Answer 31

▪ Creativity
▪ Enthusiasm
▪ Spontaneity
▪ High Energy

Question 32

The Adverse Childhood Experiences (ACES) Study

Answer 32

Studies of the last three decades on ACES and traumatic stress have emphasized their impact and the importance of preventing and addressing trauma across all service systems utilizing universal systemic approaches.