What are the diagnostic criteria for ADHD?
Before age 12 and in two or more settings:
1. Six (or more) of the following persisting for at least 6 months (inattention):
- Often fails to give close attention to detail
- Often has difficulty sustaining attention in tasks or play
- Often does not seem to listen when spoken to directly
- Often does not follow through on instructions
- Often has diffiulty organizing tasks and activities
- Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
- Often loses things necessary for tasks or activities
- Often easily distracted by extraneous stimuli
- Often forgetful in daily activites
2. Six (or more) of following persisting for at least 6 months (hyperactivity-impulsivity)
- Often fidgets
- Often leaves seat in classroom
- Often runs or climbs excessively in inappropriate times
- Often has difficulty playing or engaging in leisure activities quietly
- Often "on the go" or "driven by a motor"
- Often talks excessively
- Often blurts out answers before questions have been completed
- Often has difficulty awaiting turn
- Often interrupts or intrudes on others
What shows a poor prognosis for ADHD?
- Early onset aggression
- Co-morbid conduct disorder
- Worsening of symptoms in adolescence
-- substance abuse
-- mood disorders
-- higher incidence of suicidality
What is the treatment for ADHD?
What are the diagnostic criteria for Conduct Disorder?
12 months or more of at least 3 behavior Disturbances:
Aggression to People and animals
Destruction of property
Deceitfulness or theft
Serious violations of rules
Behavior disturbances cause clinically significant impairment in social, academic, or occupational functioning
If the individual is 18yrs or older, cirteria are not met for Antisocial Personality Disorder
What is consider to diagnose Conduct Disorder as Mild, Moderate, or Severe?
Mild: few if any conduct problems in excess of those required to make the diagnosis and only cause minor harm to others
Moderate: number of conduct problems and effect on others intermediate
Severe: Many conduct problems in excess of those required to make the diagnosis or conduct problems cause considerable harm to others
What suggests a poor prognosis for Conduct disorder?
- Early onset
- Conduct symptoms:
--> greater freq
--> comorbid ADHD
What is the treatment for conduct disorder?
- School interventions
--> Boot camp and group therapy not affective
What are the diagnostic criteria for Oppositional Defiant Disorder (ODD)?
1. A pattern of negativistic, hostile, and defiant behavior lasting at leaset 6 months, during which four (or more) of following are present:
- Often loses temper
- Often argues with adults
- Often actively defies or refuses to comply with adults rules
- Often deliberately annoys people
- Often blames others for his or her mistakes or misbehavior
- Touchy or easily annoyed by others
- Angry and resentful
- Spiteful or vindictive
2. Behavior causes impairment in school, social, or occupational functioning
3. Behaviors do not occur exclusively during psychotic or mood disorder
What are the diagnostic criteria for Tourette's Disorder?
1. Both multiple motor and one or more vocal tics have been present
2. Tics occur many times a day (usually in bouts) nearly every day or intermittently throughout a period of more than 1 year, during this period, there was never a tic-free period of more than 3 consecutive months
3. Onset before 18yrs old
4. Disturbance not due to direct phsyiological effects of a substance or a general medical conditions
What are the diagnostic criteria for Chronic Motor or Vocal Tic disorder?
1. Single or multiple motor or vocal tics, but not both, have been present
2. Tics occur many times a day nearly every day or intermittently throughout a period of more than 1 yr, no tic-free period of more than 3 consecutive months
3. Onset before 18yrs
4. Not due to direct physiological effects of a substance or general medical condition
5. Criteria have never been met for Tourette's
What are the diagnostic criteria for Transient Tic Disorder?
1. Single or multiple motor and/or vocal tics
2. Tics occur many times a day nearly every day or for at leaset 4 weeks but not longer than 12 consecutive months
3. Onset before 18yrs
4. Disturbance is not due to substances or general medical conditions
5. Criteria have never met Tourette's or Chronic Motor or Vocal Tic Disorder
What are the diagnostic criteria for Encopresis?
1. Repeated passage of feces into inappropriate places (i.e. clothing or floor) whether involuntary or intentional
2. At least one such event a month for at least 3 months
3. Chronological age is at least 4 yrs
4. Behavior not due to substanc or general medical disorder
What are the diagnostic criteria for Feeding Disorder of Infancy or Early Childhood?
1. Feeding disturbabnce as manifested by persistent failure to eat adequately with significant failure to gain weight or significant loss of weight over at least 1 month
2. Disturbance not due to associated gastrointesetinal or other general medical condition
3. Disturbance not better accounted for by another mental disorder (i.e. Rumination Disorder) or by lack of food
4. onset before 6yrs
What are the diagnostic criteria for Enuresis?
1. Repeated voiding of urine into bed or clothes (whether involuntary or intentional)
2. Clinically significant as manifested by either a frequency of twice a week for at least 3 consecutive months or presence of clinically significant distress or impairment in social, academic, or other important areas of functioning
3. At least 5 yrs old
4. Not due to substance or general medical condition
What are the specific types of Enuresis?
Nocturnal and Diurnal
What are the diagnostic criteria for Separation Anxiety Disorder?
1. Developmentally inappropriate and excessive anxiety concerning separation from home or from attachment figures
2. Common and familial disorder
3. School absenteeism common (school refusal)
4. Used to be ONLY child; now any age can develop
5. Probable risk factor for future anxiety disorders
6. Treatment includes psychopharmacology individual and parental counseling
What is the diagnostic criteria for selective mutism? Treatment?
- Failure to speak in specific social situations
- Psychodynamic factors
- Temperamental factors (heritable shyness)
- Treatment options include psychopharmacology, behavioral therapy, parent counseling
What is the most common cause of intellectual disability?
Most common: ideopathic
Most common genetic: trisomy 21
Most common inherited: Fragile X
Wht are the diagnostic criteria for Global Developmental Delay?
Reserved when an intellectual disability scale cannot be reliably determined
- Also applies when the patient cannot unergo systematic assessments
- Child must be under the age of 5
What are the types of Communication Disorders??
Cognitively intact, but have communication problems:
- Language Disorder: Limited vocab, tense errors, word recall, or difficulty producing complex sentences
- Mixed receptive-expressive language disorder: Difficulty understanding words, sentences, or specific types of words (i.e. spacial terms)
- Speech Sound Disorder: Does not use developmentally expected speech sounds (lisp)
- Childhood-onset Fluency Disorder (stuttering)
- Social (pragmatic) Communication Disorder: Social connection lost; problems with taking turns; over formal
What are the diagnostic criteria for Autism Spectrum Disorders?
- Age at diagnosis 19mo to 3yrs
- Qualitative impairment in social intrxn (eye contact, peer relationships, etc)
- Qualitative impairment in communication (language delay, lack of imaginative play, etc)
- Restricted repetitive and stereotyped patterns of behavoir, interests, and activities (inflexible adherence to routines, repetitive motor mannerisms, etc)
What are the diagnostic criteria for Rett's?
Only occurs in Girls (X-linked)
- Normal development through first 5 months
- Normal head circumference at birth
- Deceleration of head growth between 5-48months
- Loss of social engagement
- Loss of previous purposeful hand movements
- Severely impaired expressive and receptive language
What are the diagnostic criteria for Childhood Disintegrative Disorder?
Normal development first 2 yrs
--> loss of previously acquired skills:
expressive or receptive language
social skills or adaptive behavior
bowel or bladder control