Behavioural and developmental issues and disorders in children

Question 1

_______ refers to the personality characteristics
you are born with—what is innate rather than
learned

Answer 1

Temperament

Question 2

two-thirds of children can be classified into one of three categories of temparament
1
2
3

Answer 2

easy, 15%
difficult 15%
slow to warm up 70%

Question 3

A child with a difficult temperament

will be __________

Answer 3

emotionally labile and have difficulty coping

with new experiences

Question 4

A child with a _____ will have some difficulty coping with
new experiences, but will eventually manage after
repeated exposures

Answer 4

slow-to-settle

temperament

Question 5

A child with an easy temperament will _____

Answer 5

cope easily with new experiences and will have a

calm nature.

Question 6

______ is the view you have of the world based on

your own experiences; it is the ‘soup in your head

Answer 6

Schema

Question 7

The three main ways in which
attachment can go wrong are:
1
2
3

Answer 7

Carer not responding
Carer responding inconsistently
Carer responding inappropriately

Question 8

Implications if Carer not responding

Answer 8

People who are
raised in this way can even develop what is called
‘learnt unresponsiveness’ and be emotionally
barren.

Question 9

Implications if Carer responding inconsistently

Answer 9

this can lead to

uncertainty and anxiety in the child

Question 10

Implications if carer responding inappropriately—such as

with aggression or anger

Answer 10

It creates a terrible and unsolvable paradox for children,
where the person on whom they are completely
reliant to teach them how to relate to the world is
also a threat.

Question 11

The most effective forms of discipline are actually

____ and _______

Answer 11

praise and encouragement—of wanted behaviours

Question 12

Consequences work only with children _____years of
age, and should be used solely in response to a small
fraction of a child’s behaviour, regardless of the child’s
temperament.

Answer 12

> 3

Question 13

There are three types of consequences that work

(in decreasing order of usefulness):

Answer 13

Natural consequences:
Related consequences:
Losing a privilege:

Question 14

________where there is a natural
flow from the misdemeanour to the consequence.
For example, if a child refuses to have dinner, he
or she goes to bed hungry

Answer 14

Natural consequences:

Question 15

_________ where there is some link
between the unwanted behaviour and the
result. This is also sometimes called a ‘logical
consequence’. For example, if a child makes
a mess, he or she must clean it up

Answer 15

Related consequences:

Question 16

__________ This can be a very powerful
technique as it focuses the child’s attention
but is more punitive than natural and related
consequences

Answer 16

Losing a privilege:

Question 17

_______ are useful from 2–3 years of
age, and can take the heat out of a situation, for both
the parent and child.

It should be consistent, enforced promptly and calmly, even with empathy, and short—a good rule of thumb is a minute per year of age

Answer 17

Time-outs

Question 18

Responses that don’t work when disciplining

children include:

Answer 18

screaming, constantly explaining,
repeatedly warning, threatening, pleading, arguing,
bribing and giving in, as well as smacking.

Question 19

__________ are when we lose control of our feelings and

behaviour.

Answer 19

Tantrums

Question 20

Tantrums

They are more common in toddlers (particularly
between________) because
they have not learned any or many other emotional
responses to challenging situations, such as ignoring,
negotiating, reconsidering or reframing a situation

Answer 20

18 months and 3 years of age

Question 21

_________ from predictable tantrum
triggers, ‘scaffolding’ (giving necessary support) to
handle the event (e.g. a 5-minute warning), distraction
or active listening in the build-up to a tantrum can be
useful strategies to employ

Answer 21

Diverting a child

Question 22

T or F

Skill-building toddlers in how to handle emotionally
challenging situations (i.e. expanding their repertoire
beyond tantrums) is best done either before or after
(‘What else could you have done?’).

Answer 22

T

Question 23

________ is common (around 5% of children do
so at some stage), and occurs between 6 months and
6 years (peak at age 2). While frightening to watch,
such attacks are harmless, and no treatment or action
is required.

Answer 23

Breath-holding

Question 24

There are two types of breath holding spells:

• ______ (more common)—these happen in
response to being upset or angry. The child cries
loudly then holds his or her breath at the end of
expiration
•_______—these happen in response to pain or
a fright

Answer 24

blue spells

pale spells

Question 25

In Mx of breath holding T or F They can last from 10–60 seconds, and can cause the child to faint or, rarely, fit. They cause no harm, and parents should be reassured. Approaches to discipline should not change because of them

Answer 25

T

Question 26

Head banging They are more frequent in children with _____and ______where these behaviours may be more pervasive through the day.

Answer 26

developmental disability and autism,

Question 27

What are the features of head-banging

Answer 27

• Usually starts after 8–9 months, and is rare after 2 years of age • Usually prior to going to sleep • Child usually not distressed and rarely selfinjurious

Question 28

_______ usually begins at age 2–4 years, as | children start to use more words and longer sentences

Answer 28

Stuttering

Question 29

Up to 12% of children will stutter by the age ______

Answer 29

of 4.

Question 30

Forms of stuttering

Answer 30

Stutters can be repetitions (of a sound, word or phrase), prolongations of a sound (e.g. ‘aaaand’), a block (where no sounds comes out) or combinations of these.

Question 31

The most common program used in Australia to treat stuttering is the ________, which is often successful and can even sometimes stop the stutter

Answer 31

Lidcombe Program

Question 32

There are two common types of habit cough: 1 A ________ (heard from the waiting room) in teenage girls. There is no dyspnoea or sputum production. 2 A_________commonly seen in boys aged 7–10. This is related to a transient tic disorder.

Answer 32

honking-type cough throat-clearing cough

Question 33

_________is a neurodevelopmental disorder characterised by deficits in intellectual and adaptive functioning that present before 18 years of age

Answer 33

Intellectual disability (ID

Question 34

The term ____________ is usually used to describe children <5 years of age who fail to meet expected developmental milestones in several areas of development.

Answer 34

‘global developmental delay’ (GDD)

Question 35

MCC of developmental delay

Answer 35

trisomy 21 | fragile X syndrome

Question 36

_______is a physical disability that affects movement and posture, and is the most common physical disability in childhood (2 in 1000 live births).

Answer 36

Cerebral palsy (CP)

Question 37

CP is associated with what factors?

Answer 37

associated with numerous antenatal and perinatal factors, including antenatal infections (e.g. rubella, CMV), birth defects, preterm birth, IUGR, multiple pregnancy, perinatal hypoxia and postnatal head trauma or cerebral infection

Question 38

5 Key elements of CP ``` 1 2 3 4 5 ```

Answer 38

1 It is an umbrella term for a group of disorders. 2 It is permanent, but not unchanging. 3 It involves a disorder of movement and/or posture and of motor function. 4 It is due to a non-progressive interference, lesion or abnormality. 5 The interference, lesion or abnormality originates in the immature brain.

Question 39

``` CP is classified according to: 1 2 3 4 ```

Answer 39

1. severity 2. topographic location 3. motor function 4. muscle tone

Question 40

Tests to be done in CP

Answer 40

visual and hearing tests, pathology tests (e.g. karyotyping, genetic testing, urine metabolic screening) or imaging such as a cerebral MRI.

Question 41

Changes in the DSM criteria for autism ________superseded autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS) and Asperger disorder,

Answer 41

Autism spectrum disorder (ASD)

Question 42

Changes in the DSM criteria for autism: This resulted in a change in the way autism was diagnosed, with three domains (social deficits, communication deficits and repetitive behaviour) reducing to __________

Answer 42

two (social–communication deficits | and repetitive behaviour).

Question 43

Severity criteria of autism

Answer 43

``` level 3 (very substantial support), level 2 (substantial support) and level 1 (some support) ```

Question 44

IN autism, In about __________f cases there may be actual regression, with the child beginning to say words but stopping, commonly between the ages of 15 and 24 months.

Answer 44

25–30% o

Question 45

A typically developing child should smile in response to a familiar caregiver’s smile or ‘baby talk’ by _____ months. At ______, an infant will follow a parent’s gaze, that is, look in the same direction as the parent is looking. Children should be able to follow their parent’s point by ____ months and start pointing themselves by ____ They then begin to point to share (‘look at this’) by _______

Answer 45

2–4 8 months 10–12 12–14 months. 16 months

Question 46

Younger children with ASD often appear to have little desire to ________. They may have problems imitating actions (such as clapping).

Answer 46

connect with others

Question 47

Communication deficits in autism include deficits | in both _________

Answer 47

non-verbal and verbal communication, and | expressive and receptive language

Question 48

____ and ______ language, including echolalia (‘parroting’ of learned phrases or scripts) is common

Answer 48

Stereotyped and repetitive

Question 49

Children with ASD tend not to play imaginatively (e.g. pushing the car along and saying ‘brrm’) and instead will engage in :

Answer 49

unusual repetitive play, such | as lining up toys, or spinning the wheels of a car

Question 50

Patients with ASD: They frequently show little interest in social play (e.g. peek-a-boo or pattycake) and their play is often ____________ rather than people-focused

Answer 50

object-focused (e.g. computer games)

Question 51

Red flags for autism

Answer 51

• Lack of babbling or pointing by 12 months • No sharing of interest in objects or activities with another person • No single words by 16 months, or no two-word (non-echoed) phrases by 24 months • Any loss of language or social skills at any age

Question 52

______ (from the Greek, meaning ‘disorder of practising’) is a disorder of the planning, organising and carrying out of motor tasks. It can affect articulation and speech, perception and thought, though it is not associated with decreased intelligence

Answer 52

Dyspraxia

Question 53

other term for Dyspraxia

Answer 53

Another term that | is used is developmental coordination disorder (DCD

Question 54

A delay in _____ and _______ can become a barrier to socialisation (e.g. not being able to play or perform in team sports) or academic achievement (e.g. writing) and can have flow-on effects on self-esteem and mood

Answer 54

fine and gross motor skills

Question 55

A _____________ is characterised by persistent difficulties in reading, writing, arithmetic and mathematical reasoning skills during school years.

Answer 55

specific learning disorder (SLD)

Question 56

______ (from the Greek, meaning ‘disorder of words’) is an SLD of reading and spelling, while still having otherwise normal learning abilities. The condition was originally called ‘word blindness’.

Answer 56

Dyslexia

Question 57

_________ is a disorder affecting attention, hyperactivity and impulse control

Answer 57

Attention deficit hyperactivity disorder (ADHD)

Question 58

ADHD It is very common, affecting ____ of Australian children

Answer 58

3–5%

Question 59

2 types of ADHD

Answer 59

There are 3 types: predominantly hyperactive/impulsive; predominantly inattentive; and mixed, with the latter being the most common

Question 60

______ are the single most effective treatment for ADHD, and became the standard treatment in the 1980s

Answer 60

Stimulants

Question 61

Meds for ADHD

Answer 61

• methylphenidate (Ritalin, short acting, effect duration 3–4 hours) • slow-release methylphenidate (Ritalin LA 6–8 hours, Concerta 10 hours) • dexamphetamine • atomoxetine (Strattera)

Question 62

Side effects of meds for ADHD

Answer 62

``` • Common side effects: — decreased appetite — poor weight gain • Uncommon side effects: — headache/dizziness — stomach aches — insomnia — irritable, withdrawn or highly emotional ```

Question 63

• Sometimes suggested for ADHD, but research is unclear about existence of and/or extent of benefit • Contains high amounts of omega-3 fatty acids • May help improve symptoms in some children

Answer 63

Fish oil

Question 64

____________ is defined as an ongoing pattern of anger-guided disobedience and hostile and defiant behaviour towards authority figures that goes beyond the bounds of normal childhood behavior

Answer 64

Oppositional defiant disorder (ODD)

Question 65

3 types of ODD

Answer 65

1. angry/irritable mood, 2. argumentative/defiant behaviour 3. vindictiveness

Question 66

ODD is common (with an incidence estimated at 5–10%) 21 and often undiagnosed, and has a large incidence of co-diagnosis with ______

Answer 66

ADHD,

Question 67

ODD The onset is usually gradual, becoming evident before the age of _________

Answer 67

8

Question 68

ODD is caused by a combination of ____ and______

Answer 68

difficult temperament traits and environmental factors

Question 69

ODD cab progress to what conditions

Answer 69

* Disruptive mood dysregulation disorder (DMDD | * Conduct disorder

Question 70

characterised by severe and recurrent temper outbursts greatly out of proportion in intensity or duration to the situation >3/week for >12 months

Answer 70

Disruptive mood dysregulation disorder (DMDD)

Question 71

where there is behaviour that violates the rights of others or societal norms, such as aggression directed towards people, animals or property, often with a callous manner and lack of empathy

Answer 71

Conduct disorder

Question 72

_______ are sudden, rapid, recurrent involuntary vocalisations or movements usually appearing in bouts that wax and wane in intensity, frequency and type

Answer 72

Tics

Question 73

Tic disorders are classified into 1 2 3

Answer 73

* Tourette syndrome * persistent motor or vocal tic disorder * provisional tic disorder

Question 74

``` • _________ —motor and vocal tics for >1 year •__________—motor or vocal tics for >1 year • ________—motor and/or vocal tics for <1 year ```

Answer 74

Tourette syndrome persistent motor or vocal tic disorder provisional tic disorder

Question 75

Tic disorder • average of _______ from onset to diagnosis

Answer 75

5 years

Question 76

Difference of complex tic vs compulsions of OCD

Answer 76

they are not cognitive, | preplanned or anxiety reducing

Question 77

Examples of complex tics ``` — _______ (making obscene gestures) — _____ (copying others) — wounding oneself — echolalia (repeating others) —______ (repeating oneself) — _______ (uttering obscenities) ```

Answer 77

copropraxia echopraxia palilalia coprolalia