L11: Child Psychiatric Disorders Flashcards

1
Q

Def of Autism Spectrum Disorder

A

Qualitative deficits in reciprocal social interaction,
communication skills and restricted patterns of behavior.

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2
Q

Diagnostic Criteria of Autism Spectrum Disorder

A
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3
Q

levels of severity of Autism Spectrum Disorder

A

Level 1
- Has social interaction and speech.

Level 2
- Has minimal speech and interaction.

Level 3
- Has no speech or social interaction.

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4
Q

Epidemiology of Autism Spectrum Disorder

A
  • Autism spectrum disorder is generally a lifelong disorder with a guarded prognosis.
  • Two-thirds remain severely handicapped and dependent.
  • Improved prognosis if IQ > 70 and communication skills are seen by ages 5 to 7 years.
  • The prognosis is variable, but the two most important predictors of adult outcome are level of intellectual functioning and language impairment.
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5
Q

Onset of Autism Spectrum Disorder

A

before age of 3 years.

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6
Q

Etiology of Autism Spectrum Disorder

A
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7
Q

DDx of Autism Spectrum Disorder

A
  • Schizophrenia with childhood onset
  • Children with intellectual disorder with behavioral symptoms
  • Children with acquired aphasia with convulsion
  • Children with Congenital deafness or severe hearing impairment
  • Children with Psychosocial deprivation
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8
Q

How is Schizophrenia with childhood onset: Diffrentiated from Autism Spectrum Disorder?

A
  • It is is rare in children under the age of 5.
  • Accompanied by hallucinations or delusions.
  • With a lower incidence of seizures and mental retardation and a more even IQ.
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9
Q

How is Children with intellectual disorder with behavioral symptoms Diffrentiated from Autism Spectrum Disorder?

A
  • Children usually relate to adults and other children in accordance with their mental age.
  • They use the language they do have to communicate with others.
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10
Q

How is Children with acquired aphasia with convulsion Diffrentiated from Autism Spectrum Disorder?

A
  • Child is normal for several years before losing both receptive and expressive language.
  • A profound language comprehension disorder then follows, characterized by deviant speech pattern and speech impairment.
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11
Q

How is Children with Congenital deafness or severe hearing impairment Diffrentiated from Autism Spectrum Disorder?

A
  • Infants have a history of relatively normal babbling that tapers off gradually and may stop from 6 months to 1 year of age.
  • Children respond only to loud sounds.
  • Children usually relate to their parents, seek their affection, and enjoy being held as infants.
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12
Q

How is Children with Psychosocial deprivation Diffrentiated from Autism Spectrum Disorder?

A
  • Children improve rapidly when placed in a favorable psychosocial environment.
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13
Q

Consider ……. as the diagnosis if there is a rapid deterioration of social and/or language skills during the first 2 years of life.

A

ASD

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14
Q
  • 15% of ASD cases are associated with a known genetic mutation.
  • Fragile X syndrome is the most common known single gene cause of ASD.
A

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15
Q

ASD has high comorbidity with intellectual disability & Association with epilepsy.

A

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16
Q

Course & Prognosis of ASD

A
  • Autism spectrum disorder is generally a lifelong disorder with a guarded prognosis.
  • Two-thirds remain severely handicapped and dependent.
  • Improved prognosis if IQ > 70 and communication skills are seen by ages 5 to 7 years.
  • The prognosis is variable, but the two most important predictors of adult outcome are level of intellectual functioning and language impairment.
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17
Q

The prognosis of ASD is variable, but the two most important predictors of adult outcome are ……..

A

level of intellectual functioning and language impairment.

18
Q

Managment of ASD

A

There is no cure for autism, but various treatments are used to help manage associated symptoms & to improve basic social, communicative and cognitive skills:

  • Remediation
  • Psychotherapy
  • Pharmacotherapy
19
Q

Remedition in ASD

A
  • Structured classroom training in combination with behavioral methods is the most effective treatment method.
  • Language and academic remediation are often required.
20
Q

Psychotherapy in ASD

A

Parents are often need support and counseling.

21
Q

Pharmacotherapy in ASD

A
22
Q

Def of ADHD

A

persistent and marked pattern of inattention and/or hyperactive and impulsive behavior.

23
Q

Types of ADHD

A
  1. Hyperactive impulsive type
  2. Inattentive type
  3. Combined type
24
Q

Diagnostic Critereria of ADHD

A
25
Q

Duration of ADHD

A

Symptoms lasts for at least 6 months & must be:

  1. present before the age of 12 years
  2. present in at least two settings (e.g: at home and school)
  3. interfere with the appropriate social, and academic functioning.
26
Q

Typical signs of ADHD

A
  • talking excessively
  • fidgeting, frequent interruptions
  • impatience, difficulty organizing and finishing tasks
  • distractibility, and forgetfulness
27
Q

what is Fidgeting?

A

*Fidgeting is making small movements with your body, usually your hands and feet. It’s associated with not paying attention

28
Q

Epidemeology of ADHD

A
  • Occurs in 3% to 7% of grade-schoolers.
  • Male:Female ratio is 3:1 to 5:1. (0 > 9)
  • Symptoms often present by 3 years.
29
Q

Etiology of ADHD

A
30
Q

DDx of ADHD

A

Bipolar disorder and childhood-onset schizophrenia:
- There is more waxing and waning of symptoms in bipolar disorder and hallucinations or delusions in childhood schizophrenia.

Learning disorders:
- Inability to do math or read is not because of inattention.

Anxiety disorder:
- May be manifested by overactivity and easy distractibility.

31
Q

Managment of ADHD

A
32
Q

Characters of Disruptive Behaviour Disorders

A
  • Includes two persistent constellations of disruptive symptoms.
  • Categorized as: A. Oppositional defiant disorder B. Conduct disorder.
  • Result in impaired social or academic function in a child.
33
Q

Diagnostic Criteria of Opposotional Defiant Disorder (ODD)

A

a. A pattern of defiant, angry, and negative behavior enduring for at least 6 months.

b. The child is manifested by:
* frequently loses his or her temper
* resentful and easily annoyed
* actively defies requests and rules in the presence of familiar adults and peers

34
Q

Etiology of Opposotional Defiant Disorder (ODD)

A
  • Possible result of unresolved conflicts.
  • May be a reinforced, learned behavior.
35
Q

TTT of Opposotional Defiant Disorder (ODD)

A
36
Q

A child may have oppositional defiant disorder if he/she has no difficulty getting along with peers but will not comply with rules from parents or teachers.

A

….

37
Q

Diagnostic Criteria of Conduct Disorder

A
37
Q

…….. are the corner stone in treatment of disruptive behavior disorder.

A

Parents

38
Q
  • What distinguishes Conduct disorder from ODD is …….
  • Unlike conduct disorder, ODD does not involve………
A
  • aggression (e.g. stealing, bullying and cruel behaviors toward others).
  • physical aggression or violating the basic rights of others.
39
Q

Etiology of Conduct Disorder

A
  • Multifactorial.
  • Maladaptive aggressive behaviors are associated with family instability, physical and sexual victimization, socioeconomic factors, and negligent conditions.
  • Often coexists with: ADHD, learning disorders, or communication disorders.
  • A subset may have low plasma levels of dopamine and B-hydroxylase.
40
Q

TTT of Conduct Disorder

A
41
Q

..

A