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RC Prep - Dev Peds > Behaviors & Mental Health > Flashcards

Behaviors & Mental Health Flashcards

(59 cards)

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1
Q

4 components of anxiety management in a teen with school avoidance

A

1) Psychoeducation
2) School plan - gradual return to school
3) Medication
4) Psychotherapy (CBT)

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2
Q

2 non-pharmacological interventions for behavior disorders

A

Parent education and training programs (Triple P Parenting)

Family therapy

Multimodel interdiscimplinary care (coordinated with school, therapist, home, medical)

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3
Q

3 drugs NOT to use in treatment of violent behaviors

A

carbamazepine
Lithium
haloperidol

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4
Q

ABC stand for in challenging behaviors

A

A - antecedent
B - behavior
C - consequence

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5
Q

Child with aggressive outbursts, angry in between outbursts, what is the diagnosis?

A

Disruptive mood dysregulation disorder –DSM-V TR

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6
Q

Name 2 school strategies for aggressive behavior at school for child with NDDs

A

Identify and minimize triggers
Avoid inadvertent reinforcement
positive reinforcement alternatives

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7
Q

4 symptoms of separation anxiety?

A
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8
Q

4 antecedents of behavior?

A

SEAT
Sensory - feels good
Escape - undesired situation or demand
Attention - gain attention
Tangible - seek a desired object

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9
Q

5 treatable causes of problem behavior

A

Sleep disturbance
Pain
Constipation
GERD
Dental abscess
Headache
Fracture

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10
Q

6 symptoms of panic disorder

A
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11
Q

Obsession vs normal thought
adaptive response vs compulsion

A
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12
Q

Diagnostic criteria for OCD

A
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13
Q

Difference between MDD in children from adults

A

Irritable mood in kids/adol instead of depressed
Failure to make expected weight gain (instead of change in weight/appetite)

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14
Q

Criteria for MDD?

A

Plus:
B- causing significant impairment
C - episode is not attributed to physiological effects of substance or other condition
D- not better explained by schizoaffective disorder
E- no history of mania or hypomania

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15
Q

What is the first line treatment for MDD if mild vs mod to severe ?

A

mild-mod: Psychotherapy
Mod-sev: Rx + therapy

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16
Q

2 medications to treat depression in kids and 4 side effects of this class of medication

A

Fluoxetine
Sertraline or citalopram (second line)

SSRI S/E:
- Sleep disturbances
- GI upset
- restlessness
- Headache
- Appetite changes
- Mania or hypomania
- increase suicidal thought
- seratonin syndrome
- QT prolongation

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17
Q

5 comorbidities for children with bipolar or DMDD

A

Anxiety
ADHD
Substance use disorder
Personality disorders (borderline, antisocial, schizotypal)
Conduct disorder
MDD

DMDD CANNOT co-exist with ODD, IED or bipolar

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18
Q

3 risk factors for PICA in ASD+IDD

3 strategies to treat

A

nutritional deficiency (iron) - due to restricted diet

Sensory seeking/oral exploring

lack of inhibition / lack of supervision

  • alternative sensory (chew toy)
  • increase supervision
  • treatment of iron deficiency
  • distraction
  • limit access
  • OT
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19
Q

4 syndromes associated with high levels of self injury behaviors

A

Fragile X
Prader Wili
Angelman syndrome
Lesch Nyhan
Cornelia de Lange syndrome

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20
Q

3 causes of self-injurous behavior in ASD?

A

social attention
lack of communication
Escape from demands
sensory/pain/discomfort

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21
Q

Non-pharm tx of self-injury

A

minimize reinforcement
routine/visual schedule
improve communication
treat underyling cause (pain)

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22
Q

Normal sexual beahviors in children 2-6 (list 4)

A
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23
Q

name 3 psychological diagnosis in children with history of abuse or sexual behaviors

A

PTSD, Depression, Anxiety

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24
Q

3 treatments for gender dysphoria (medical)

Study These Flashcards
A

luperon (GnRH agonist)
Hormonal replacement (testosterone, estrogen)
Surgery

25
Differential dx for ODD
Anxiety Depression DMDD ADHD IDD SLD Sleep disturbances Conduct disorder Bipolar disorder ASD IED Language disorder
26
Define GAD vs social phobia
27
5 negative consequences of conduct disorder
- school suspension or expulsion, - problems in work adjustment, - legal difficulties, -sexually transmitted diseases, -unplanned pregnancy, - physical injury from accidents or fights.
28
3 risk factors for aggressive behaviors in a child (long term)
maltreatment/abuse witness violence or parental violence parental use of physical discipline media exposure poor parental mental health or substance use low SES Neglect young maternal age disability (ADHD, ASD, IDD)
29
3 evidence based options for treatment of behavior concerns?
Parental education. &training psychotherapy medication
30
quetionaires for depression? name 3
PHQ-9 BASC 3 Columbia Depression rating scale
31
treatment approach for self injurous beahviors
ABC - A -remove triggers - B - reward/reinforce good beahviors - C - extinction of negative reinforcing strategies
32
Dx criteria for Pica
33
2 standardized tests for language in school aged child
CELF-5 (clinical evaluation of language fundamentals) OWLS-II (oral and written language scales) PPVT-4 (Peabody picture vocabulary test) preschool - Bayley 4 or CELF-P2, or PPVT-4
34
14yo girl with ASD and anxiety. Based on the 2016 ATN toolkit, name 4 things to discuss with parents regarding anxiety management.
Assessment: multi-method approach check for anxiety symptoms that may be related to the core symptoms of ASD assess for and treat possible medical and psychiatric conditions that are contributing to symptoms assess for psychosocial stressors, adequate behaviour and educational supports Treatment: psychoeducation and care-coordination is always first-line - delineate goals of treatment CBT can treat and modify anxiety - parents can be involved medications can help - SE of meds referral to mental health practitioner may be necessary if severe or interventions are not working - safety and elopement plan
35
4 most important effects of marijuana to counsel teenager with autism and anxiety who is using:
Intoxication - doubles risk of MVC Associated with cannabis disorders (Cannabis Use Disorder and Cannabis Withdrawal Disorder) Associated with depression, and possibly anxiety Associated with psychosis and schizophrenia Increased risk of poor academic performance Sleep impacts
36
AAP sleep guidelines recommended sleep duration for 3-year-old
Infants 4 months to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 1 to 2 years of age should sleep 11 to 14 hours per 24 hours Children 3 to 5 years of age should sleep 10 to 13 hours per 24 hours Children 6 to 12 years of age should sleep 9 to 12 hours per 24 hours Teenagers 13 to 18 years of age should sleep 8 to 10 hours
37
2 differentials for childhood apraxia? vs fluency difficulties?
Dysarthria (weak oral muscles) Articulation Disorder (specific speech sounds) Stuttering Dysfluency = Speech Sound Disorders (rather than language disorders)
38
Child drops the last consonant of words. What is the name of this speech disorder
Speech sound disorder
39
4 components of SLP assessment?
Expressive language Receptive language Phonological awareness Social pragmatics
40
SLP assessments for language impairment in FASD?
PPVT-4 - receptive language Test of narrative language (EVT) - expressive language CELF-5 - social/pragmatics
41
Developmental dysfluency vs stuttering (childhood onset fluency disorder)
42
3-year-old with developmental delay. Mild hypotonia on exam. Genetics normal. Keeps waking up at night and is very upset and cannot be consoled. Parents have tried sleep hygiene with no help. What is the next step in your evaluation? ddx?
Sleep diary EEG Polysomnography iron studies DDx parasomnias seizures OSA /sleep disordered breathing sleep association restless leg
43
4 strategies to support language development in a child with ESL/multiple language exposures and expressive delay?
Speak the language the family is most comfortable with Do not mix languages other same as expressive language delay (langauge rich, repeat, face to face, etc.)
44
4 strategies to support a child with developmental dysfluency
45
3 areas to support child with language disorder?
School Home SLP therapy
46
4 challenges in school (risk for later) in a child with dysarthria in preschool? (normal EL/RL)
Social challenges Academic difficulties (difficulty expressing their knowledge and participating in discussion) Emotional and behavioral issues (low self-esteem) Continued speech difficulties
47
Criteria of restless leg syndrome?
urge to move legs at rest relieved by movement worse at night/evening 3x/week or more for >3 months distressing not attributed to other medical/behavioral dx or effects of drug/medication
48
Ix for restless leg other than iron studies?
Iron studies, ferritin kidney function (elevated BUN or creatinine) Glucose (peripheral neuropathy in DM can mimic) tsh (hypothyroid) Vitamin D level Magnesium levels
49
Treatment for restless leg other than iron
melatonin clonidine gabapentin benzodiazepines nonbenzo hypnotics - zoplicone (adolescents not children)
50
2 groups of children at risk for low literacy?
Immigrants Indigenous Canadians Family history Low SES/social determinants of health risks
51
late talkers are at risk for what 4 diagnosis?
ASD ADHD IDD SLD
52
4 classical findings on history that pre-date a child diagnosed with childhood apraxia of speech?
- feeding difficulties - limited early vocalization/babbling - gross motor coordination issues - irregular or inconsistent speech production patterns
53
A 8 year old boy you just diagnosed with ADHD complains of early morning headaches and non-refreshing sleep. His only medication is Strattera 25 mg daily. He sleeps in his own room and goes to bed after reading at 9pm. He wakes twice to go the washroom. He needs to be woken by his parents at 8am. He has no evidence of tonsillar hypertrophy. His ENT and respiratory exam are normal. His blood pressure is 80/50 and his BMI is 25.
Polysomnography
54
Polysomnography results AHI = 10 what are the next steps? what is a normal result?
AHI <1, 1-5 is mild weight loss ENT referral Nasal steroids then consider CPAP
55
Child with ADHD and poor sleep onset, most likely dx?
Restless leg syndrome (also review behaviors/sleep routine)
56
What are the three most important factors affecting child and youth resilience during parental separation or divorce?
Effective parenting parent-child relationships Controlling conflict
57
Counseling for parents on separation by age group of child - infant - preschool - school-age - teens
Infants – attachment issues; insecure and disorganized attachment styles Preschoolers – blame themselves, separation anxiety, fear of abandonment, externalizing; School-age – strong moral duty, tend to take side; Teens – parents not as important as peer group but important support, limit setting
58
3 components of family resilience
Belief system Organizational patterns (routines that promote connection, social & economic resources) Communication processes (clear, open, and consistent communication - listen to each other and solve problems together)
59
4 skills a child should have to enter school in speech and language
100% intelligible Understand multipart instructions Retelling an experience in a sequence Defining words by use

RC Prep - Dev Peds (12 decks)

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