child and adolescent

Question 1

Piaget: sensorimotor stage

Answer 1

birth-2

child learns he is separate from environment and aspects of environment exist when out of reach of senses

Question 2

Piaget: preoperational stage

Answer 2

talking age-7
child uses symbols to represent objects, personifies objects, can think about things not present, difficulty conceptualizing time
takes in info and changes it to fit his ideas

Question 3

Piaget: concrete stage

Answer 3

first grade-early adolescence
develops ability to think abstractly and make rational judgments about concrete or observable phenomena without physical manipulation (needed previously)

Question 4

Piaget: formal operations

Answer 4

adolescence

no longer requires concrete objects to make rational judgments, capable of hypothetical and deductive reasoning

Question 5

attachment theory

Answer 5

describes dynamics of long-term relationship between humans in families and life-long friendships
*infant needs to develop relationship w at least one primary caregiver for social and emotional development to occur normally, pattern for further relationships

Question 6

transitional object

Answer 6

something that takes place of mother-child bond, like doll, teddy bear, or blanket

Question 7

social isolation and development

Answer 7

nursing strengthens mother-child bond d/t intimate body contact, not just feeding
isolation = blank staring, stereotyped repetitive behavior, self-mutilation in baby rhesus monkeys

Question 8

temper tantrum

Answer 8

undesirable behavior or emotional outbursts in response to unmet needs or desires, or inability to control emotions d/t difficulty expressing need or desire
begins at 12-18 mos, worse between 2-3y, infrequent after 4y

Question 9

intellectual disability IQ scores

Answer 9

borderline intellectual functioning: 70-80

mild: 50-70
moderate: 35-50
severe: 25-40
profound: below 25

Question 10

communication disorders

Answer 10

expressive language disorder and mixed receptive-expressive language disorder (DSM5 calls these “language disorder”)
phonological disorder (speech sound disorder)
stuttering (childhood-onset fluency disorder)
social/pragmatic communication disorder (persistent difficulties in social uses of verbal and non-verbal communication; *cannot be diagnosed if sx of autism)

Question 11

dyslexia and dyscalculia

Answer 11

specific types of reading and mathematics deficits

Question 12

specific learning disorder

Answer 12

reading disorder
mathematics disorder
disorder of written expression
learning disorder NOS

Question 13

Rett’s disorder

Answer 13

pervasive developmental disorder: genetic, developmental
F»»M
normal for 6 mos, then motor skills stagnate and regress, head circumference normal at birth then slows b/t 5-48 mos

Question 14

childhood disintegrative disorder

Answer 14

pervasive developmental disorder; children develop normally until 3-4y, over few months lose language, motor, social, other learned skills

Question 15

pervasive developmental disorders

Answer 15

Rett’s disorder
childhood disintegrative disorder
autism
Asperger’s disorder

Question 16

autism dx

Answer 16

1- impairment in social interaction (nonverbal comm, failure to dev peer relationships, lack of seeking shared enjoyment, lack of social or emotional reciprocity)
2- communication impairments (spoken language delay/lack, initiating or sustaining conversation, repetitive or idiosyncratic language, lack of make-believe play)
3- restricted interest patterns (preoccupation w patterns of interest w abnormal intensity or focus, inflexible rituals, repetitive motor mannerisms, persistent preoccupation w parts of objects)

Question 17

prevalence of autism

Answer 17

1-2 / 1000 worldwide, CDC reports 9/1000 in USA

*inc dx since 80s, ? change in diagnostic practice or true increase in prevalence

Question 18

causes of autism

Answer 18

strong genetic basis, unclear genetics and mechanisms (rare mutations or rare combos of common mutations?)
controversies about environmental causes (heavy metal, pesticide, childhood vaccines)
*vaccine theory implausible and lacks evidence

Question 19

Asperger’s disorder

Answer 19

ASD
difficulties in social interaction, restricted and repetitive behaviors and interests
*relative preservation of linguistic and cognitive development vs other ASDs
physical clumsiness and atypical language use reported frequently but not required for dx
*likely genetic but cause unknown

Question 20

autism spectrum disorders in the DSM5

Answer 20

encompasses autistic disorder, Asperger’s disorder, childhood disintegrative disorder, pervasive developmental disorder NOS

Question 21

social communication disorder

Answer 21

in DSM5, deficits in social communication and social interaction
but no restricted repetitive behaviors, interests, and activities = not ASD

Question 22

ADD/ADHD

Answer 22

inattention, hyperactivity, impulsivity
*difficult to define because ~ normal levels for kids
sx must be observed in 2+ settings for 6+ months, to a greater degree than other kids of same age
some sx must be before age 12

Question 23

subtypes of ADHD

Answer 23

1- predominantly hyperactive-impulsive
2- predominantly inattentive
3- combined hyperactive-impulsive and inattentive

Question 24

screening and severity assessment for ADHD

Answer 24

Connor’s scale

child behavior checklist

Question 25

prevalence of ADHD

Answer 25

3-5% children globally, 2-16% school-aged children | 30-50% diagnosed in childhood have sx in adulthood

Question 26

ADHD tx

Answer 26

stimulants: methylphenidate, amphetamine salts, bupropion (off label) alpha-agonists: clonidine, guanfacine atomoxatine

Question 27

adult ADD criteria

Answer 27

only 5 (instead of 6 for kids) symptoms required for inattention and hyperactivity/ impulsivity

Question 28

disruptive, impulse-control, and conduct disorders

Answer 28

oppositional defiant disorder, conduct disorder (*closely a/w antisocial personality d/o), disruptive behavior disorder intermittent explosive disorder, pyromania, kleptomania all have problems in emotional and behavioral self-control

Question 29

oppositional defiant disorder

Answer 29

excessive persistent anger, frequent temper tantrums or angry outbursts, disregard for authority; may annoy others on purpose, blame others for their mistakes, are easily annoyed; more rigid and defiant than siblings; may be resentful and revengeful

Question 30

tx of ODD

Answer 30

key factor in development and maintenance is reinforcement of unwanted behavior, so behavioral therapy focuses on teaching parents to not reward these negative behaviors

Question 31

conduct disorder dx

Answer 31

repetitive behavior wherein rights of others or social norms are violated sx: verbal/ physical aggression, cruel behavior toward people/pets, destructive behavior, lying, truancy, vandalism, stealing

Question 32

conduct disorder social implications

Answer 32

may inflict serious physical or psychological harm on others greatly increased risk incarceration, injury, depression, substance abuse, death by homicide or suicide after 18y, may become antisocial personality disorder

Question 33

separation anxiety disorder

Answer 33

excessive anxiety related to separation from home or people to whom pt is strongly attached significant and recurrent amount of worry upon or in anticipation of separation often comes to attention when child refuses to go to school

Question 34

reactive attachment disorder

Answer 34

disturbed and developmentally inappropriate ways of relating socially ex: persistent failure to initiate or respond to social interactions (inhibited), or indiscriminate sociability w relative strangers (disinhibited)

Question 35

reactive attachment disorder tx

Answer 35

concentrate on increasing responsiveness and sensitivity of caregiver or placing child with different caregiver *being evaluated

Question 36

tx of childhood behavioral issues

Answer 36

CBT using aspects of classical and operant conditioning | parenting strategies

Question 37

MDD in children

Answer 37

same criteria as MDD in adults (SIGECAPS) may be irritable vs depressed young children may have somatic complaints, lose interest in school, and show academic decline *dx may be dismissed as normal moodiness

Question 38

tx of childhood MDD

Answer 38

for pts 18-24 yo, there is a higher risk of suicidal ideations and behavior if treated with SSRIs

Question 39

bipolar d/o in kids vs adults

Answer 39

kids may have both depressive and manic symptoms daily mania may present w psychotic sx and mixed manic-depressive episodes may also have anger, dysphoria, irritability, belligerence

Question 40

tx of childhood bipolar d/o

Answer 40

drugs- mood stabilizers, atypical antipsychotics, or combo | lithium for kids 12+

Question 41

childhood-onset schizophrenia

Answer 41

usually after 5yo following normal development | *rare, difficult to distinguish from other dev d/o like autism

Question 42

teen psychosis

Answer 42

hallucinations are common, so making dx is difficult | brief auditory hallucinations common in stressed kids w mood d/o or dissociative d/o

Question 43

tic disorders

Answer 43

Tourette's, chronic motor tic d/o, chronic vocal tic d/o, transient tic d/o

Question 44

encopresis

Answer 44

involuntary fecal soiling in toilet-trained people often d/t painful constipation M>F triggers: beginning school w shared bathrooms, negative parental rxn to feces

Question 45

enuresis

Answer 45

inability to contro urination in individuals old enough to be expected to exercise such control

Question 46

selective mutism

Answer 46

children > adults fully capable of understanding and speaking but fail to speak in certain situations can be confused with "shyness" or autism

Question 47

tx for selective mutism

Answer 47

"stimulus fading" - gradually introduce people into situation when child talking normally w someone they are comfortable with; a form of CBT

Question 48

PTSD in kids

Answer 48

more likely to feel at fault for trauma vs adults sexually abused children may have problems with fear, worry, sadness, anger, feeling alone, judged, low self-worth, being untrusting

Question 49

PTSD in teens

Answer 49

more likely than younger kids and adults to show impulsive and aggressive behavior common: aggression, out-of-place sexual behavior, self-harm, drug or alcohol abuse

Question 50

tx for PTSD

Answer 50

``` play therapy (young kids) PFA (psychological first aid) - comfort and support, affirmation that reactions are normal CBT - learn self-assertion or changing distortions around trauma ```

Question 51

duty to report

Answer 51

mandatory reporters: health care providers and facilities, mental health providers, teachers, school personnel, social workers, daycare providers, law enforcement