Child And Adolescent Disorders Flashcards

(84 cards)

1
Q

Autism spectrum disorders

A

Spectrum disorder
Severe autism - high functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Severe autism

A

May have trouble getting themselves dressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

High functioning autism

A

A high end fully verbal group
“Savants” excel in particular areas music, art memory math or perceptual skills such as puzzle building

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ASD manifest at which ages

A

Early child hood / toddler years primarily 18-36 mo
Parent may start seeing things they notice is different

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why is autism increasing now

A

Increased awareness and better screening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Clinical manifestations of ASD demonstrate in

A

Social interaction
Communication
Behavior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Social differences in ASD

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Communication impairments common sign in ASD?

A

Range from absent to delayed speech
May lose language or other social milestones (regression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If someone comes in with delayed speech what is done next

A

Hearing and speech is avaluated if a delay or regression in noted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Echolalia

A

Repeats exactly what others say without understanding the meaning (parroting or echoing) immediate or delayed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Stereotypic behavior or stimming

A

Rocks ,spins away , twirls fingers, walks on toes for a long time or flaps hands

The behaviors often involve repetitive movements or sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What may someone with ASD be sensitive to?

A

Smells, sounds, lights, textures and touch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

T o F
someone with ASD hardly has tantrums

A

False
They may have intense temper tantrums or show aggression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When is standardized screening done at?

A

At well visits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What gets screened at 9 mo

A

Developmental screening
Are they where they should be at 9 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is screened at 18 mo

A

Developmental and autism screening MCHAT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Screening for 24- 30 mo

A

Developmental and autism again MCHAT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MCHAT

A

Modified check list for autism in toddlers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Gold standard for diagnosing ASD

A

Autism diagnostic observation schedule (ADOS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Purpose of behavior modification programs

A

We are trying to modify behaviors so we are trying to give positive rewards for positive behaviors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Applied behavior analysis (ABA)

A

Teach reinforces and maintains new skills and desirable behaviors
In
Communication
Social interactions
Reading& academics
Motor skills
Hygiene and grooming

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What problematic behaviors can ABA help extinguish?

A

Self injury like banging head on wall
and aggression toward others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What kind of problems do we run into with ABA

A

Intensive therapy and it requires a minimum of 25 hours a wk for it to work so time wise is hard on parents who have to work
Also expensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

If someone w autism is diagnosed and we refer them to local state dept of mental health and developmental disabilities - why is this?

A

Because they have access to social workers and resources that will be helpful for them
They can be able to access programs that they qualify for

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
early childhood intervention (ECI)
Birth to 3 years We refer to this program as soon as autism is SUSPECTED If caught during this time frame for autism the child can have home visits, PT, OT , speech therapy
26
Individualized education programs (IEP)
Pre school program (3-5 yrs) autism What do they need to be successful in school?
27
Special education
5-21 yrs Into regular school IEP Here is what they need to be successful
28
Hippotherapy
Therapeutic horseback riding
29
Hippotherapy
Complimentary therapies /alternative medicine Therapeutic horseback riding Strategy used by PT, OT and speech pathologist
30
Diet/supplements for ASD ?
Gluten free* Casein-free diets (protein present in dairy) * Vitamin and omega 3 supplementation High fat and low carb diet (keto)
31
Anti-psychotic meds for ASD and what is it used for
Resperidone (risperdal) Apripazole (abilifly) Aggressive behavior Deliberate self injury Temper tantrums
32
What is used in sleep issues for ASD?
Melatonin along with a weighted blanket
33
As far as nursing care, how can we decrease stimulation for someone with ASD?
Private room , avoid extraneous auditory and visual distractions
34
Nursing care for an autistic child
Decrease stimulation Minimal holding touch and eye contact Organize care so we are not in there all the time
35
ADHD
Inattention Impulsiveness Hyperactivity
36
How long does some one experiencing ADHD symptoms have to be experiencing them before diagnosed
6 months Have to be careful when diagnosing because it can be developmental instead of ADHD
37
At how many settings and what settings are symptoms of ADHD that must be present to get a confirmed diagnosis
In 2 or more settings At school (academic) At home Social setting
38
3 sub types of ADHD
*Combined type (most common) *Predominantly inattentive * Predominantly hyperactive impulsive type
39
Diagnostic - Maladaptive with ADHD
Is it causing some kind of problem in ther life (Stops them form adapting to new or difficult situations ) and inconsistent w their developmental age
40
Two diagnostic test for adhd
Psychological testing Behavioral check list
41
Psychological testing
ADHD Projective testing and IQ & achievement levels
42
Behavioral checklist
For ADHD Parents and teachers can fill out Do you see this behavior and how often?
43
Multimodal treatment
For adhd Pharmacotherapy Behavioral intervention ADHD coaching
44
ADHD coaching
Teaches the individuals to manage their inattention, hyperactivity and impulsivity by by developing self awareness and strategies
45
What is medication determined by for adhd
Age Usually wait till 5 years and older to give medications
46
Psychostimulants
For adhd Start small dose initially Gradually increase till we get the desired response
47
Jornay PM
ADHD psychostimulant Type of Ritalin extend and release First and only medication dosed at night
48
Methylphenidate hydrochloride
ADHD Ritalin Most commonly used
49
Dextroamphetamine sulfate
Dexedrine ADHD Not commonly used
50
Lisdexamfetmine (Vyvanse)
ADHD Psycho stimulant If Ritalin is not working this is the next line drug
51
Dextroamphetamine -amphetamine (adder-all)
Psychostimulant ADHD
52
Side effects of stimulant meds (adhd)
Loss of apetite (weight loss) Abdominal pain (n&v) Suppression of growth Sleeplessness Headaches Crying and irritability Cardiovascular stimulation (hypertension)
53
Atomoxetine ( strattera)
Non stimulant medication Suicidal thoughts is side effect Teach parents change in mood or signs of depression
54
Adjunct therapy Selective adrenergic agonist ADHD
Clonidine (catapres) extend and release
55
Meds for adjunct therapy Tricyclic antidepressants ADHD
Notriptyline( pamelor) Imipramine( tofranil) Desipramine( norpramin) Side effect- increase in the incidence of dental caries
56
Adjunct therapy meds for adhd
Selective adrenergic agonist Tricyclic antidepressant
57
Environment changes that can help with adhd
Organizational charts * Families and teacher- same goal High structured environment Parents, school, pediatrician working together Decrease distractions* Show parents how to monitor positive behavior
58
What is important to teach about caffeine and stimulants ?
Caffeine decreases the efficacy of stimulant medications
59
What would we teach parents who’s child is having issues with weight loss due to side effect of stimulant adhd
Nutritious snacks in evening when effects of med is decreasing Serve frequent small meals and healthy on the go snacks(cheese sticks fruits)
60
If child on a stimulant is having trouble sleeping what can we do to help?
Change the dosing
61
What are children with adhd AT RISK FOR
Increased risk for accidents and unintentional injuries due to impulsivity And decrease judgement of dangerous activities
62
When is stimulant methylphenidate , dextroamphetamine medication used for ODD
Only used if they have ADHD too. Will not use alone for ODD.
63
When are antidepressant (fluoxetine, setraline)meds used in ODD?
When behavior management is only achieving lemonade, results and hostile and aggressive behaviors are on going
64
If ODD is untreated what can progress to
Conduct disorder . And if that isn’t handled it can turn to anti social or personality disorder
65
Hallmark signs of conduct disorder
Aggressive behavior
66
In conduct disorder what do they lack regarding aggressive actions to people or property
Remorse
67
What is the best treatment for conduct disorder
Prevention - catch at ODD
68
What medications are used for conduct disorder
Antipsychotics and mood stabilizers
69
Gender dysophoria diagnostic criteria in children
A noticeable in congruence between ones experienced / expressed gender and signed gender At least 6 mo duration Manifested by at least 6 of criterion
70
Diagnostics criteria for gender dysphoria
Is it causing distress in their life?
71
Biological sex
Assigned gender
72
Gender expression
What they identify as Identity
73
Hormonal suppressors
Puberty blockers Fully reversible Give child more time to make. Dont know long term effects
74
Regular cross sex Hormone therapy
Longer they are on this the less reversible they are As they develop secondary charecteristics can’t reverse
75
Meds for childhood depression
Tricyclic antidepressants Selective serotonin reuptake inhibitors (SSRI)
76
SSRIs for depression
Fluxetine (Prozac) Escitalopram (lexapro) Sertaline (Zoloft)
77
With antidepressants how long does it take for them to work
2-4 weeks
78
Adverse effect of antidepressant
Increased suicidal thinking in pediatric pt (black box warning) teach parents to report change in behavior
79
Suicide risk assessment
Presence of suicide ideation Specific plans for self injury History of actual self harm or threats or gestures
80
Suicide
The deliberate act of self injury with the intent that ine injury results in death
81
Suicide ideation
Involves a preoccupation with thoughts about committing sucicide (may be a precursor to suicide) Just thinking about
82
Suicide attempt
Attempted to accuse injury or death
83
With previous suicide attempts its important to know
They are at high risk for doing it again so monitor closely
84
Meds for conduct disorder
Antipsychotics, mood stabilizer