Child and Adolescent Disorders

Question 1

What type of disorder is autism?

Answer 1

Spectrum disorder

Question 2

What does ASD (autism spectrum disorder)’s severity range from?

Answer 2

Mild to severe (minimal supervision to constant supervision)

Question 3

When is ASD manifested?

Answer 3

Early childhood (primarily from 18-36 months of age)

Question 4

What are children with High-functioning Autism known as?

Answer 4

Either intellectually gifted or “savant”

Question 5

What categories do children with high-functioning autism normally excel in?

Answer 5

Music, art, memory, math, or perceptual skills such as puzzle building

Question 6

Is there scientific evidence that supports that there is a link between the MMR and thimerosal containing vaccines?

Answer 6

No

Question 7

What has been proved to decrease the risk of ASD?

Answer 7

Prenatal vitamins containing folic acid, before, at conception and through pregnancy

Question 8

What has been proven to double the risk of the baby developing ASD by seven years of age?

Answer 8

Antidepressant use during the second or third trimester

Question 9

What are a few social differences of children suffering with ASD?

Answer 9

• Doesn’t maintain eye contract or makes very little eye contact
• Doesn’t respond to a parents smile or other facial expressions
• Doesn’t look at objects a parent is looking at or pointing to
• Doesn’t point to objects to get a parent to look at them
• Doesn’t bring objects of interest to show a parent
• Often doesn’t have appropriate facial expressions
• Unable to perceive what others might be thinking or feeling by looking at their facial expressions
• Doesn’t show concern (empathy) for others
• Unable to make friends or uninterested in making friends

Question 10

What are a few communication impairments of children suffering with ASD?

Answer 10

• Common sign
• Range form absent to delayed speech
• May lose language or other social milestones (regression)
• Should have hearing and speech evaluated if delay or regression is noted
• Repeats exactly what others say without understanding the meaning (like a parrot)
• Doesn’t respond to name being called but does respond to other sounds (like a car horn)
• May mix up pronouns (he went to the market, instead of I)
• Often doesn’t seem to want to communicate
• Doesn’t use toys or other objects to represent people or real life in pretend play
• May use gestures instead of words (may also grunt or hum)
• May have a good rote memory

Question 11

Define rote memory.

Answer 11

Memorization of information based on repetition

Question 12

What are a few behavioral differences of children suffering with ASD?

Answer 12

• Rocks, spins, sways, twirls fingers, walks on toes for a long time, or flaps hands, stimming
• Likes routines, order, and rituals and have difficulty with change
• Obsession with a few or unusual activities, doing them repeatedly during the day
• Not imitating the actions of others
• Plays with parts of toys instead of the whole toy (wheels)
• Doesn’t appear to feel pain
• May be very sensitive to smells, sounds, lights, textures, and touch
• Unusual use of vision or gaze (looks at objects from unusual angles
• May have intense temper tantrums or show aggression

Question 13

Define stimming.

Answer 13

self-stimulating behaviors usually involving repetitive movements or sounds

Question 14

What are a few other conditions children with ASD might have?

Answer 14

• Intellectual disabilities
• Learning disabilities
• ADHD
• Motor coordination problems
• Sleep disorders
• Significant GI symptoms (constipation)
• Seizure disorders

Question 15

Why might children with ASD be gluten free or sugar free?

Answer 15

To help with GI issues

Question 16

At what ages will children have standardized screening at well visits for ASD?

Answer 16

• 9 months-developmental screening
• 18 months-developmental + autism (M-CHAT)
• 24 months to 30 months-developmental + autism screening (M-CHAT)

Question 17

What is considered to be the gold standard for diagnosing ASD?

Answer 17

Autism diagnostic observation schedule (ADOS)

Question 18

What school programs can be used for children with ASD?

Answer 18

• Birth to three year- early childhood intervention
• Three to five years-preschool program for children with disabilities
-individualized education program (IEP)
• Five to 21 years-special education (IEP)

Question 19

When should you refer to ECI and what services do they offer?

Answer 19

As soon as diagnosis of autism is suspected. Services include language, behavioral and social skills

Question 20

What calming activities are beneficial for ASD?

Answer 20

• Walk breaks
• Jobs that involve lifting
• Jumping on a trampoline
• Stress ball
• Feeling Velcro
• Gum/lollipop
• Brushing hair
• Weighted blanket

Question 21

Define hippotherapy.

Answer 21

Use of the movements of the horse as a strategy by physical therapists, occupational therapists, and speech pathologists

Question 22

Define Applied Behavior Analysis Therapy (ABA)

Answer 22

Method to teach, reinforce, and maintain new skills and desirable behaviors (such as communication and social interactions, reading, and academics, and motor skills, hygiene and grooming) Parents have to agree to be trained as well
-method to extinguish problematic maladaptive behaviors (self-injury and aggression)

Question 23

What must ABA offer to be useful?

Answer 23

• Provide a minimum of 25 hours per week
• Individualized
• Highly structured
• Systemically planned developmentally appropriate
• Costs approximately $70,000 per year
• Medicaid is looking at covering it

Question 24

Define maladaptive behaviors.

Answer 24

Those that stop you from adapting to a new or difficult circumstance

Question 25

What are a few symptoms of inattention?

Answer 25

* Often fails to give close attention to details or makes careless mistakes * Often has difficulty sustaining attention in tasks or play * Often does not seem to listen when spoken to * Often does not follow through on instructions and fails to finish schoolwork, chores, or duties * Often has difficulty organizing tasks/activities * Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as homework) * Often loses things necessary for tasks/activities (homework, pencils, books, etc.) * Often is easily distracted * Often forgetful in daily activities

Question 26

What are a few symptoms of hyperactivity-impulsivity?

Answer 26

* Often fidgets with hands or feet or squirms in seat * Often leaves seat in classroom * Often runs around or climbs excessively in situations in which it is inappropriate * Often has difficulty playing quietly * Often “on the go” or acts as if “driven by a motor” * Often talks excessively * Often blurts out answers before questions have been completed * Often has difficulty awaiting turn * Often interrupts others

Question 27

What is evaluated in a diagnostic evaluation?

Answer 27

* Medical history (including developmental history) * Pregnancy and birth history * Physical exam (including vision and hearing * Neurological evaluation * Psychological testing * Behavioral checklist and adaptive scales

Question 28

How can ADHD be therapeutically managed?

Answer 28

* Family education and counseling * Medication * Proper classroom placement * Environment manipulation * Behavioral therapy or psychotherapy-child

Question 29

What does behavioral therapy focus on?

Answer 29

Prevention of undesirable behavior

Question 30

How are psychostimulants useful for ADHD?

Answer 30

Cause an increase in dopamine and norepinephrine levels that lead to stimulation of the inhibitory system of the CNS (drugs are available in short and long-acting form

Question 31

Which medication is administered in the evening and why?

Answer 31

Methylphenidate HCl (Jornay PM)-delayed release and extended release capsule

Question 32

What nonstimulant medications are used?

Answer 32

Atomoxetine (Strattera) *monitor for suicidal thinking* | -selective adergeneric agonists

Question 33

Define Oppositional defiant Disorder (ODD)

Answer 33

Recurrent pattern of: • Negativity • Disobedience/defiance/hostility/stubbornness • Argumentativeness • Explosive angry outbursts • Low frustration tolerance/unwillingness to compromise • Blaming others for disagreements or accidents • Coming easily annoyed/annoy others • Seeks revenge

Question 34

What do people with ODD see their behavior as?

Answer 34

They do not see themselves as defiant, they see their behavior as a response to unreasonable demands and/or circumstances

Question 35

What is ODD frequently associated with?

Answer 35

* Anxiety disorder * Mood disorders * ADHD * Learning disabilities

Question 36

What are the treatment options for ODD?

Answer 36

• Parent training programs • Individual and/or family psychotherapy to improve communication (emphasis on anger management) -identify situations that trigger negative thoughts and feelings -discuss strategies to control negative situations and cope effectively with conflict Cognitive behavioral therapy -social skills training

Question 37

When left untreated, what will 80% of ODD progress to?

Answer 37

Conduct disorder

Question 38

What represents conduct disorder?

Answer 38

* Aggressive behavior * Fights * Bullies * Intimidates * Assaults others (physically or sexually * Poo relationships with peers/adults * Violates other’s rights and society’s rules

Question 39

What physical characteristics does conduct disorder have?

Answer 39

* More common in males * Onset prior to 18 years of age * Onset before age 10 are more likely to develop antisocial behavior * Genetic * Psychosocial (stress or conflict in the family)

Question 40

What are a few contributing factors for conduct disorder?

Answer 40

* Parental rejection and neglect * Difficult infant temperament * Inconsistent or harsh discipline * Physical/sexual abuse * Lack of supervision * Large family size * Delinquent friends * Parent with mental illness

Question 41

What are the treatment options for conduction disorder?

Answer 41

* Prevention is best plan * Early intervention is key * Parenting education * Special skill training * Family and/or individual therapy * Antipsychotics * Mood stabalizers

Question 42

Oppositional defiant

Answer 42

```  Disobedience  Argumentativeness  Explosive angry outbursts  Low frustration tolerance  Tend to blame others for quarrels/accidents  Easily annoyed  Seeks revenge ```

Question 43

Conduct Disorder

Answer 43

```  Aggression to people and animals  Bullying, physical fights  Vandalism, destruction of property  Lying  Shoplifting  Truancy from school  Firesetting ```