Behavior/Mental Health

Question 1

Infants who are fussy and irritable, living with mother who appears tired, what should you offer?

Answer 1

Supportive services to both child and mother
Early intervention and mental health services

Question 1

Infants who are fussy and irritable, living with mother who appears tired, what should you offer?

Answer 1

Supportive services to both child and mother
Early intervention and mental health services

Question 2

What does the Home Visiting Program do?

Answer 2

Who: serve at-risk expectant parents and families with children up through kindergarten entry

Goal: Improve family health and relationships, economic self-sufficiency, child development, and school readiness

Things they provide: case management, educational programs, family support services

Question 3

What does the Women, Infants, and Children (WIC) service do?

Answer 3

Provide food, nutrition education, growth monitoring

Question 4

What does the Early Head Start program do?

Answer 4

Who: Children <3 yo, pregnant women with low income

Services: prenatal/adult education. Early intervention (state run)

Question 5

National helpline for info on resources in their community

Answer 5

211

Question 6

What neurohormonal changes are seen with aggressive behavior?

Answer 6

Decreased serotonin, oxytocin, Y-aminobutyric acid (GABA), and increased dopamine and vasopressin

Question 7

Diagnosis of bipolar disorder

Answer 7

at least 1 week of euphoria, out-of-control irritability with severe impairment (mania)

Question 8

What do you recommend for defiant, argumentative, aggressive child (i.e. antisocial disorder)?

Answer 8

Parent management training

Question 9

Is masturbation/self exploration common? At what ages?

Answer 9

normal until 5 yo, then decreases

Question 10

What are concerning sexual behaviors in children

Answer 10

Rubbing body against others
Trying to insert tongue in mouth while kissing
Touching peer/adult genitals
Crude mimicking of movements associated with sexual acts
Sexual behaviors that are disruptive to others
Inserting objects into genitals
Asking peer/adult to engage in specific sexual act
Explicitly imitating intercourse
Touching animal genitals
Sexual behaviors that are frequently disruptive to others
Behaviors are persistent/resistant to parental distraction

Question 11

What sexual behaviors in children would warrant reporting to child protective services

Answer 11

Any sexual behavior between kids >4y apart
Variety of sexual behaviors displayed on daily basis
Sexual behavior that results in emotional distress or physical pain
Sexual behavior associated with physically aggressive behavior
Coercion
Child becomes angry if distracted

Question 12

Head-banging management

Answer 12

Screen for developmental disability if > 5 yo
Can be normal from 9-18 mo and resolves by 4 yo

Question 13

When is applied behavioral analysis therapy used?

Answer 13

Children with already confirmed autism disorder

Question 14

When is applied behavioral analysis therapy used?

Answer 14

Children with already confirmed autism disorder

Question 15

According to PREP, what can be used for colicy infants?

Answer 15

probiotics (not FDA approved)

Question 16

Prior diagnosis of ADHD is associated with what other diagnosis?

Answer 16

depression

Question 17

Diagnosis of depression in adolescents

Answer 17

> 2 weeks of depressed or irritable mood +/- anhedonia, usually changes in weight

Also other SIG E CAPS sx

Question 18

Evidence based psychotherapies for adolescents (2)

Answer 18

interpersonal psychotherapy - relationships
CBT - reframing negative thoughts and changes behaviors

Question 19

In a child who had experienced violence and poverty, what type of parenting would promote resilience?

Answer 19

Authoritative:
clear expectations and rules, engaged by loving and responsive parents

Question 20

Treatment for OCD: first step and then second

Answer 20

1st: CBT
Second: SSRIs if CBT doesnt work

Question 21

OCD is associated with (3)

Answer 21

tic disorders
anxiety
ADHD

Question 22

ADHD medications associated with HTN

Answer 22

methylphenidate
atomoxetine
Amphetamine

Question 23

alpha-agonist options for ADHD

Answer 23

clonidine
guanfacine

Question 24

Night awakenings for infants, management

Answer 24

If dependent on specific stimulus to sleep, use EXTINCTION (teaches self-soothe)
- limit contact at night to 1-2 minutes

FADING: moves bedtime to desired bedtime slowly over several weeks

Sleep cycles for infants are 60-90 minutes long

Question 25

When are night feedings no longer necessary

Answer 25

6 mo

Question 26

Sleep duration by age including naps

Answer 26

4-12 mo: 12-16 hours (+ 3-4 naps)
1-2 yo: 11-14 hrs
3-5 yo: 10-13 hrs
6-12 yo: 9-12
13-18 yo: 8-10

Question 27

What screening tool can you use for sleep problems

Answer 27

BEARS
Bedtime problems
Excessive daytime sleepiness
Awakenings during the night
Regularity and duration of sleep
Snoring

Question 28

What is a risk factor for social anxiety disorder

Answer 28

behavioral inhibition (withdraw from unfamiliar or new situations)

Question 29

Evidence based treatment for anxiety disorders

Answer 29

CBT
SSRIs (though only approved for depression and OCD)

Question 30

Neurotransmitters associated with anxiety

Answer 30

GABA
serotonin
norepinephrine

Question 31

Can children with anxiety disorders qualify for Section 504 plan?

Answer 31

yes!

Question 32

Child changing rules of games, cheating, and stealing, what’s the most common age?

Answer 32

6 yo
Understands rules but cannot control impulses, doesn’t know right from wrong/social conscience

Question 33

Breath holding spell diagnosis and management

Answer 33

Age: 6 mo to 4 yo
Cause: unclear ?dysfunction of autonomic nervous system, delayed maturation in myelination of brainstem
Family history of BHS 50%

Usually provoked by injury or crying (UNLIKE SEIZURE), lasts <1 min

Cyanotic (may develop generalized motor seizure) vs. pallid (can be sleepy afterwards, bradycardic)

Management: give iron 5-6 mg/kg/day (usually iron depleted)

Question 34

How do you diagnose psychogenic nonepileptic seizure disorder?

Answer 34

vEEG