Childhood Disorders and Concerns

Question 1

Neurodevelopmental Disorders

Answer 1

Characterized by abnormalities in brain development affecting emotion, learning ability, self-control, and memory that unfold as a person grows; Along with of the early onset of symptoms, these disorders have traditionally been acknowledged when development of the nervous system is disturbed leading to a structurally compromised brain; There are a numerous causes contributing to the development of the neurodevelopmental disorders ranging from childhood deprivation, genetic and metabolic diseases, immune disorders, infectious diseases, nutrition, physical trauma, and toxic and environmental factors

Question 2

Intellectual Disability (Intellectual Developmental Disorder)

Answer 2

individual’s significantly impaired cognitive functioning and deficits in adaptive behaviors, for example, self-help, communication, or interpersonal skills. The DSM-5 definition of intellectual disability now includes both intellectual functions and the individual’s functional skills within the environment; use clinical and standardized testing. Mostly comorbid with ADHD, depressive and bipolar, anxiety, autism, stereotypical movement disorder

Question 3

Global Development Delay

Answer 3

for those under 5; when clinicals severity level cannot reliably assessed during early childhood. Fail to meet expected developmental milestones in several areas of intellectual functioning and cannot go through systemic assessment due to age. Usually required reassessment.

Question 4

Unspecified Intellectual Disability

Answer 4

individuals over the age of 5 when IDD is unable to be diagnosed due to sensory or physical impairments as in blindness, prelingual deafness, locomotor disability or presence of sever problem.

Question 5

Language Disorder

Answer 5

key features are difficulties in learning and using language that involve the processing of linguistic information due to deficits in comprehension or production; Not attributed to hearing or sensory impairment; motor dysfunction or any other medical or neurological condition. Diagnosed by history, clinical observation. Comorbid with other neurodevelopmental disorders in terms of specific learning disorder; ADHD and Autism

Question 6

Speech sound disorder

Answer 6

describes problems with pronunciation and articulation to the extent that they interfere with being understood or prevent verbal communication

Question 7

Childhood onset fluency disorder (stuttering)

Answer 7

Childhood onset fluency disorder (stuttering)

Question 8

Social (pragmatic) communication disorder

Answer 8

refers to difficulties in social use of verbal (and nonverbal) communication which affects social participation, relationships, academic achievement or job performance (or any combination) in 4 major areas (knowing what to say; how to say it; when to say it; and/or understanding what is not explicitly stated)

Question 9

Unspecified communication disorder

Answer 9

reserved for those who have symptoms of a communication disorder but who do not meet all criteria and whose symptoms cause distress or impairment

Question 10

Specific Learning Disorder

Answer 10

Describes difficulties learning and using academic skills and affects a child’s ability to acquire and apply reading, writing, and/or math skills; Specific areas of impairment are designated through specifiers; for example, impairment in reading, written expression, and/or mathematics- the particular areas of impairment are then designated in the diagnosis; Severity is also specified ranging from mild, to moderate, to severe (Idyslexia or dycalculia)

Question 11

Developmental coordination disorder

Answer 11

Motor Disorder. also known as dyspraxia or by the pejorative term, clumsy child syndrome characterizing the essential feature of impaired skills requiring motor coordination; hard to ride a bike, use scissors (not diagnosed before age 5)

Question 12

Stereotypic movement disorder

Answer 12

Motor Disorder. involves repetitive, nonfunctional motor behaviors (for example hand waving or head banging) that markedly interferes with normal activities or can result in bodily injury; Emerge before age 3. Not a tic

Question 13

Tic disorders

Answer 13

distinguished by the presence of motor and/or vocal tics and organized around the categories of: (a) Tourette’s disorder (also known as Gilles de la Tourette syndrome), (b) persistent (chronic) motor or vocal tic disorder, (c) provisional tic disorder, and (d) other specified and unspecified tic disorders – can range in presentation from simple to complex motor tics

Question 14

Autism Spectrum Disorder

Answer 14

A neurodevelopmental disorder where severity differs from person to person - ASD now encompasses the previous DSM-IV-TR diagnoses of autism, Asperger’s syndrome, childhood disintegrative disorder, and pervasive developmental disorders not otherwise specified (PDD-NOS); characterized by social deficits and communication difficulties, stereotyped or repetitive behaviors and interests, and in some instances, cognitive delays; Deficits in developing maintaining relationships.

Question 15

ASD Criteria

Answer 15

A. Persistent deficits in social communication and social interaction across multipole contexts. Based on all of the criteria (p. 50). Severity is based on social communication and restricted, repetitive patters of behavior.
B. Restricted patterns of behavior, interests or activities, as manifested by at least 2 of the following criteria (p.50)
C. Symptoms must be present in early childhood, but symptoms man not be obvious until demands meet limited capacity.
D. Symptoms cause clinically significant impairment in social, occupational and other areas of current functioning.
E. These disturbances are not better explained by IDD or global development delay.
Frequently co-occur with IDD.

Question 16

ASD Specify with:

Answer 16

with or without accomp intellectual impairment
with or without accomp. language impairment
associated with a known medical or genetic condition or environmental factor
associated with another neurodevelopmental, mental or behavioral disorder
with catatonia

Question 17

AD/HD

Answer 17

Key behaviors that distinguish ADHD are inattention or a lack of focus, executive functioning difficulties, impulsivity, and hyperactivity beyond what is to be expected of a person’s normal developmental age; These behaviors are demonstrated to the degree that is inappropriate for the child’s age

Question 18

Key Differential for ADHD

Answer 18

1. Key diagnostic criteria for ADHD are inattention and/or hyperactivity-impulsivity that is present before the age of 12 years and get in the way with the person’s functioning or development
2. Symptoms must be present for at least six months
3. A psychotic disorder or another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, personality disorder or substance intoxication and withdrawal) does not better explain the symptom picture.

Question 19

ADHD and Specific Symptoms of Hyperactivity and Impulsivity

Answer 19

A child must show six or more of the following nine symptoms of hyperactivity and impulsivity (older adolescents or adults must demonstrate at least five symptoms):
Excessive motor activity seen in fidgeting, tapping or squirming
Often leaves his or her seat when staying seated is expected
Often runs around and, for adults, seem restless
Often unable to play quietly or engage in leisure activities
Unable to sit still for an extended period of time and often seems “on the go” or acting as if driven by a motor
Often talks excessively
Often blurts out an answer before the question is completed or completes other people’s sentences
Often has difficulty waiting his or her turn, and
Excessively interrupts others

Question 20

ADHD Specifiers

Answer 20

1. Combined presentation - applies when symptoms of inattention and hyperactivity-impulsivity are evident for the past 6 months
2. Predominately inattentive presentation specifier - used when symptoms of inattention are met but signs of hyperactivity-impulsivity have been absent for the past 6 months
3. Predominately hyperactive/impulsive presentation - reserved for when symptoms of hyperactivity-impulsivity without inattention are shown for the past 6 months
4. The diagnosis can be further refined by remission - specifically in partial remission
5. Severity

Question 21

Disruptive, Impulse-Control, and Conduct Disorders

Answer 21

1. are distinguished by problems in emotional and behavioral self-control and tend to have first onset in childhood or adolescence
2. unique in that the individual’s problems are shown in behaviors that violate the rights of others (for example, aggression or destruction of property) and/or bring the person into conflict with societal norms or authority figures
   Onset usually childhood and early onset

Question 22

Guidelines for Disruptive, Impulse and Conduct Disorders

Answer 22

Ask: are behaviors adaptive and functional or do they cause conflict? Do they cause distress?

1. Assess lifestyle behaviors, expected standards or behavior, and everyday activities relevant for cultural adaptation and survival
2. Comprehend meanings, labels, and interpretations commonly used to describe a child’s behavior or emotional problems
3. Evaluate the cultural context of what, on the face of it, appears as illness behaviors to determine whether they essentially support DSM diagnostic criteria
4. Determine whether DSM diagnostic criteria are valid for the specific population to be assessed
5. Consider the child’s and the parents’ (and significant others in the child’s life) threshold of stress and how they cope with the child’s behavioral problems
6. Recognize how the client perceives the practitioner’s social position
7. Be self-aware and pay full attention (avoid stereotypes) to the client’s cultural background

Question 23

Oppositional Defiant Disorder (ODD)

Answer 23

Characterized as an ongoing pattern of disobedient, hostile and defiant behavior toward authority figures which goes beyond the bounds of normal childhood behavior

Question 24

ODD Criteria

Answer 24

Must show at least 4 symptoms from any of 3 categories;

1. Angry/irritable mood - frequent loss of temper, touchy or easily annoyed, or often angry and resentful
2. Argumentative /defiant behavior - arguing with adults or other authority figures, being noncompliant, annoying others, or blaming others for mistakes or misbehavior
3. Vindictiveness - spiteful or malicious at least twice within the past 6 months

Behaviors must cause some level of impairment in key areas of functioning such as interpersonal relationships or in school
These behaviors can be seen on most days for at least 6 months for children under 5 years of age

For those who are 5 years of age and older, the behavior should occur at least once a week for at least 6 months

A psychotic, substance use, depressive, or bipolar disorder does not better explain the symptom picture

Severity – mild, moderate to severe

Question 25

Intermittent Explosive Disorder (IED)

Answer 25

Essential feature of IED is distinct episodes of failure to resist aggressive impulses that are evident in verbal aggression (such as temper tantrums, tirades, arguments) or physical aggression (fighting with others) and:

Seen in explosive outbursts wherein the person is unable to control his (or less often her) aggressive impulses
Happens about twice a week for at least 3 months
Person may be involved in more serious assaultive acts that may cause injury or destroy property (over the past year)
Are out of proportion to any provocation or precipitating stressor
Not premeditated
Causes distress
Seen in individuals as young as 6 years of age
And not better explained by another mental disorder

Question 26

Conduct Disorder (CD)

Answer 26

Essential feature of CD is a consistent pattern of violating the rights of others or major age-appropriate societal norms or rules are violated – tend to be seen before age 15 (Note: if 18 years or older, criteria not met for antisocial disorder)

Specify whether onset is before or after age 10

Question 27

Criteria for Conduct Disorder (CD)

Answer 27

Requires the presence of any 3 of the following 15 symptoms (from 4 major categories) for at least 12 months - one symptom present over the past 6 months:
Aggression to people and animals – 7 symptoms
Destruction of property – 3 symptoms
Deceitfulness or theft – 3 symptoms
Serious violation of rules – 3 symptoms

Causing social, occupational, or occupational impairment
Specifiers – onset, severity, and “with prosocial emotions”

Question 28

Pyromania

Answer 28

Essential feature is the deliberate and purposeful setting of a fire on more than one occasion and experiences of :

Tension or emotional arousal before setting the fire

Fascination, interest, curiosity about or attraction to fire and its situational contexts

A sense of relief experienced when setting fires, witnessing its effects, or participating in its aftermath

No motivation for setting a fire

And not better explained by conduct disorder, a manic episode or antisocial personality disorder

Question 29

Kleptomania

Answer 29

Central feature distinguishing kleptomania - a rare disorder - is the individual’s inability to resist stealing something that has no personal use nor any monetary value and:

Experiences a sense of tension just before the theft

Feels a sense of relief or gratification at the time of the theft

Not done to express anger or vengeance or part of a delusion