Early Onset Disorders Part 1 Flashcards
(62 cards)
1
Q
Intellectual-Mental Retardation
Symptoms
Population
A
-
Symptoms
- Significant sub-average on general intellectual functioning
- Concurrent deficits in adaptive behavior
- Onset <18 YO
- 3% of school-age children
- Boys > girls
2
Q
Intellectual-Mental Retardation
Causes
Treatment
A
-
Causes
- Lack of stimulation
- Inadequate nutrition
- Exposure to toxins (lead)
- Chromosomal or metabolic abnormality (25%)
- Down Syndrome, Fragile X
- Phenylketonuria
- Pregnancy trauma
- Drugs, radiation, toxemia, alcohol
- Infection (German measles)
- Infections (encephalitis)
-
Treatment
- Parental support/guidance
- Special programs
3
Q
Developmental: Pervasive Development Disorders
Symptoms
Types (2)
A
- Distortions in timing, rate, sequence of many basic psychological functions involved in the development of social skills & language
- Types
- Autism
- Asperger’s Disorder
4
Q
Autism
Characteristics
Causes
A
-
Characteristics
- Impaired non-verbal behaviors (eye contact, gestures)
- Failure to develop age appropriate peer relations
- Lack of social reciprocity
- Delay or lack of spoken language
- Lack of make-believe play
- Restricted stereotyped patterns of behavior
- Causes: genetics, infections
5
Q
Asperger’s Disorder
Characteristics
Treatment
A
-
Characteristics
- Impaired social interaction
- Restricted, stereotyped patterns of behavior
-
Treatment
- Parental support
- Special programs
6
Q
Specific Developmental Disorders (Learning Disorders)
Symptoms
Population
Treatment
A
- Symptoms
- Delay in rate of learning a specific function so that children behave as though they are passing through an earlier normal developmental stage substantially below expected for chronologic age
- May be one or more in areas of arithmetic, expressive writing, reading, articulation, expressive language, receptive language, coordination
- 10% of children
- Boys > girls
- Treatment: remedial work
7
Q
Unclassified Speech Disfluencies
Symptoms
Cause
Treatment
A
- Symptoms
- Stuttering (sound & syllable repetition)
- 3-4 YO
- Cause: developmental
- Treatment
- Ignore
- 1% persists & require speech therapy
8
Q
Behavioral: Oppositional Defiant Disorder
Symptoms
A
Pattern of negativistic, hostile & defiant behavior
(at least 6 mo)
- Signs
- Often loses temper
- Often argues w/ adults
- Defied or refuses to comply
- Deliberately annoys
- Blames others
- Resentful, spiteful & vindictive
- Signs
9
Q
**Behavioral: Oppositional Defiant Disorder **
Population
Cause
Treatment
A
- Children & adolescents
- Boys > girls
- Cause
- Environmental (parents over-assert control)
- Treatment
- Parent training program
- Psychotherapy
- Social skills training
- Cognitive behavior therapy
10
Q
What are the symptoms of Attention Deficit Disorder?
A
- Fidgety or restless
- Unable to sit for a long time
- Always on the go
- Easily distracted
- Can’t concentrate well on work
- Impulsively acting before thinking
- Forgetting what was said or not listening
- Difficulty finishing work on time
- Often losing personal things
- Difficulty waiting in lines or jumping ahead of others
11
Q
Attention Deficit Disorder
Population
Causes
A
- 5% of children
- Many times children w/ ADD have other learning problems
- Often starts in kindergarten or 1st grade & continues for years
- Causes
- Children are born w/ ADD & can’t control symptoms easily
- Often runs in families (hereditary)
- Not caused by allergies or too much sugar
12
Q
How is Attention Deficit Disorder treated?
What happens if ADD is untreated?
A
-
Medications
- Ritalin (methylphenidate), Metadate, Concerta, Dexedrine (dextroamphetamine), Adderall, Cylert (pernoline), Pamelor (nortriptyline), Norpramin (desipramine), Catapres (clonidine), Strattera
-
Psychotherapies
- Behavioral therapy
- Parent management training
- Family therapy
-
Educational
- Special education classes
-
Untreated
- Can lead to difficulty w/ learning, classroom behavior, making friends, following rules at home
- Many children don’t outgrow ADD when they get older & benefit from long-term medication
13
Q
What are the symptoms of Conduct Disorder?
A
- Frequent lying, stealing, truancy
- Running away from home
- Frequent fighting/bullying
- Property destruction
- Fire-setting
- Being mean to animals or people
- Breaking & entering into someone’s house or car
14
Q
What is the population of Conduct Disorder?
A
- Older children & teenagers
- Boys > girls
- Most children w/ CD have other problems
- ADD
- Depression
- Alcohol abuse
- Family problems
15
Q
What are the causes of Conduct Disorder?
What are teenagers at risk of?
A
- Causes
- Exact cause unknown
-
Many factors may contribute to behavioral problems
- Drugs
- Family problems
- Low self-esteem
- Physical abuse
- Impulsivity
-
Teenagers at risk…..
- Dropping out of school
- Being seriously injured in flights
- Getting hooked on street drugs
- Trouble w/ the police
16
Q
What is the treatment for Conduct Disorder?
What happens if untreated?
A
Without treatment, many children/teenagers continue to have similar problems as adults (may become imprisoned)
-
Medication
- Meds for depression
- Lithium for aggressive & impulsive behavior
-
Psychotherapy
- Behavioral therapy
- Group therapy
- Family therapy
-
Special programs
- Probation programs
- Residential programs
17
Q
What are the symptoms of Generalized Anxiety Disorder (GAD)?
A
- constant worrying
- unable to relax
- aches & pains (headaches, stomachaches)
- self-consciousness
- nightmares about the same things that cause worry
18
Q
What are the symptoms of Separation Anxiety Disorder (SAD)?
A
- unable to leave parents b/c of worries that something bad may happen to them
- fear of going to sleep
- reluctant to go to school
- fear of being kidnapped
19
Q
GAD & SAD
Population
Causes
A
- Children & teenagers
- SAD = younger children (7-10 YO)
- GAD = teenagers (12-15 YO)
- Causes
- Exact cause unknown
- Tendency to develop severe anxiety runs in some families (hereditary)
- Stress can play a role (death, parent’s illness, another medical problem, learning problems)
20
Q
How are GAD & SAD treated?
A
-
Medications
- Tofranil (imipramine)
- Xanax (alpraxolam)
- BuSpar (Buspirone)
- Paxil (paroxetine)
- Zoloft (sertraline)
-
Psychotherapy
- Behavioral therapy
- Cognitive behavioral therapy
- Family therapy
21
Q
What are the symptoms of Obsessive Compulsive Disorder (OCD)?
A
- Obsessions – thoughts or images (memories/pictures) that keep coming into one’s mind even though the person wants the thoughts to stop
- Compulsions – actions & behaviors that one feels need to be done over & over again; one can’t stop doing them
- _Worries & anxiety occur if one tries to stop the obsessions or compulsions _
22
Q
Obsessive Compulsive Disorder
Population
Causes
A
- Children & teenagers (1%)
- Causes
- Exact cause unknown
- Some parts in the brain don’t seem to work well in OCT (basal ganglia) post strep infection
23
Q
How is OCD treated?
A
-
Medication
- Anafranil (clomipramine)
- Prozac (fluoxetine)
- Zoloft (sertraline)
- Luvox (fluvoxamine)
-
Psychotherapy
- Behavioral therapy
- Cognitive behavioral therapy
24
Q
What are the symptoms of Panic Disorder?
A
Periods of extreme anxiety or fear that begin suddenly (min to hrs)
- Shortness of breath
- Feeling dizzy or faint
- Racing heartbeat
- Feeling shaky
- Stomach upset
- Sweating
- Thinking one may lose control
- Big fear of getting another period of anxiety
25
What is the typical **population** of Panic Disorder?
* Rare in young children
* More frequent in **teenagers**
* Tendency to have PD runs in families (hereditary)
26
What **causes** Panic Disorder?
* In a very frightening situation, the symptoms of panic attack (extreme anxiety or fear) would be normal or expected
* In people w/ PD, the part of the brain that controls anxiety **(locus coeruleus) reacts for no apparent reason**, giving the person extreme anxiety even though he/she is not in a frightening situation
27
How is Panic Disorder **treated**?
* **Medication**
* Tofranil (imipramine)
* Xanax (alprazolam)
* Paxil (paroretine)
* **Psychotherapy**
* Cognitive behavioral therapy
28
What are the **symptoms** of Post-Traumatic Stress Disorder (PTSD)?
* **Nightmares or flashbacks** (re-experiencing the trauma in one’s mind, along w/ a sudden feeling of fear that the trauma is happening again)
* Avoid situations that bring the trauma back into memory
* Difficulty remembering the trauma
* Losing interest in things
* **Hopelessness** (the future doesn’t look good)
* Constant fear about not being safe
* **Severe anxiety & depression **
29
People w/ PTSD have had a very bad experience (physically or sexually abused, natural disasters, seriously injured), which leads to **intense & continuing feelings** of \_\_\_\_\_& \_\_\_\_\_\_\_\_.
**PTSD** may also be seen in ______ who have witnessed a serious accident or saw someone get badly injured
Anyone, of any age, who has lived through a traumatic event might show \_\_\_\_\_\_\_\_\_\_\_\_\_\_.
threat, helplessness
children
PTSD symptoms
30
What are the **causes** of PTSD?
* **Trauma** that caused PTSD is so intensely frightening that the **fears & memories** are present for a long time
* It is almost as if some parts of the brain, such as the parts involved in remembering things, become over-charged & stay too active
* It is not clear why some people who experience trauma get PTSD & why others don’t
31
**Post-Traumatic Stress Disorder **
How long do symptoms last?
What happens if untreated?
Treatment?
* **Range of symptom length**
* Weeks – months
* Years
* **Untreated PTSH can lead to…**
* Depression
* Substance abuse
* Aggressive behavior
* Personality changes
* **Treatment**
* Treatments used for depression or anxiety may be useful
32
What are the **symptoms** of Depressive Disorders?
* **Depressed (feeling sad)**
* Losing interest in things
* **Sleep problems** (difficulty staying or falling asleep, or sleeping too much)
* Changes in appetite or weight
* Difficulty concentrating
* Feeling slowed down
* Feeling worthless (like you’re a bad person)
* Feeling that life is not worth living
* **Hopelessness **
33
What is the **population** of Depressive Disorders?
* People of all ages can have depression
* Teenagers \> children
* 5% of teenagers in teenage yrs
34
What are the **causes** of depressive disorders?
* Some types inherited
* Certain people under a lot of stress can develop depression
* **Stress can include…**
* Losing someone important
* School problems
* Frequent arguments w/ family
* Having been abused
* Medical problems
* At other times, the part of the brain that keeps the mood happy (brain chemicals – serotonin & NE) doesn’t function well
35
When **not treated**, depression in children & teenagers might last for \_\_\_\_\_\_\_\_\_.
A person who has had **one episode of depression** might _______ \_\_\_\_\_\_\_ at a later time
**Teenagers** who have serious depressions may be at risk of developing ______ \_\_\_\_\_\_\_\_\_\_\_\_in the future (substance abuse or suicide attempts)
months to years
develop another
other psychiatric problems
36
How are **Depressive Disorders** treated?
* **Tricyclic anti-depressant medications**
* Norpramin (desipramine)
* Pamelor (nortriptyline)
* **SSRIs**
* Prozac (fluoxetine)
* Celexa (citalopram)
* Zoloft (sertraline)
* Luvox (fluvoxamine)
* Paxil (paroxetine)
* **MAOIs**
* Nardil (Phenelzine)
* Parnate (tranylcypromine)
* **Psychotherapy**
* Cognitive therapy
* Interpersonal therapy
* Family therapy
37
What are the **symptoms** of Bipolar Disorder?
*Depressive symptoms at some times & manic at other times*
* Depressive symptoms (see previous card)
* **Manic symptoms**
* Abnormally “high” mood (euphoria, feeling too good)
* Extreme irritability
* Impulsive behavior
* Abnormally high self-esteem
* Racing thoughts & talking more than usual
* Decreased need for sleep
* High energy level
* Inability to concentrate well
38
**Bipolar Disorder**
Population
Cause
* Relatively uncommon in young children
* **More common in older teenagers**
* Tendency to develop mania runs in some families
* Overall, much less frequent than depression
* **BP believed to be due to a chemical imbalance**
* The part of the brain that keeps the mood stable isn’t working well
* Most people w/ BP go through cycles of depression, mania & normal mood
* Many times, it’s a lifelong problem, but can respond well to medication
39
What are some things that **Bipolar Disorder** can progress to?
* **Depression**
* Substance abuse
* Suicide attempts
* Anxiety
* **Mania**
* Violence
* Making bad decisions
* Exhaustion
40
How is **Bipolar Disorder** treated?
* **Medications**
* Eskalith CR (lithium)
* Tegretol (carbamazepine)
* Anti-psychotic medication
* Trilafon (perphenazine)
* Depakene or Depakote (valproate)
* Klonopin (clonazepam)
* Lamictal (Iamotrogine)
* Zyprexa (olanzapine)
* **Psychotherapy**
* Supportive therapy
* Cognitive treatment for depression
* Family therapy
41
What are the **symptoms** of Psychosis?
* **Hallucinations**
* Hearing or seeing things that are not there
* “mind is playing tricks on you”
* **Delusions**
* Beliefs that are impossible or unrealistic
* Other people don’t believe
* Convinced that these beliefs are really true
* Difficulty organizing thoughts & actions
* Other people may have a hard time understanding what you are saying/doing
42
**Schizophrenia** always has ________ as a symptom.
psychosis
43
**Psychosis**
Population
Causes
* Children & adolescents can have psychosis
* **Not a disorder, but a symptoms that can happen in many disorders**
* Some disorders, like depression or bipolar, can happen w/ or w/o psychosis
* Intoxication w/ stress drugs can produce a _temporary psychosis_
* **Causes**
* Some brain parts may be too active in psychosis
* Dopamine (NT) may be overproduced
44
How long does **P****sychosis** last?
* **Very brief (hrs or days) or very long (yrs)**
* Can happen only once or come back many times
* Some people require hospitalization
45
How is Psychosis **treated**?
* **Medication**
* Trilafon (perphenazine)
* Haldol (haloperidol)
* Mellaril (Thioridazine)
* Thorazine (chlorpromazine)
* Risperdol (resperidone)
* **Psychotherapy**
* Supportive therapy
* Family therapy
46
What are the **symptoms** of Elimination Disorders?
* Elimination of urine or feces in inappropriate places (clothing) whether involuntary of intentional
* **Encopresis** – passage of feces (constipation + overflow incontinence or w/o constipation)
* **Enuresis** – passive of urine (nocturnal only or diurnal only)
47
**Elimination Disorders**
Population
Causes
* Both genders can have an elimination disorder
* Boys \> girls
* _Encopresis_: age 4
* _Enuresis_: \>5 YO
* **Causes**
* Not due to laxatives or diuretics
* Neurological disease (seizure, spina bifida)
* Medical condition (infection, diabetes)
48
_What may happen_ to children as a result of an elimination disorder?
Parental frustration w/ subsequent child abuse, humiliation, teasing
49
How are **Elimination Disorders** treated?
* **Physical exam**
* Encopresis (laxatives, stool softener, restraining)
* Enuresis (retraining, pad & bell, behavior therapy)
* **Medication**
* Impreamine
* DDAVP
50
**Reactive Attachment Disorder**
Symptoms
Population
* **Symptoms**
* Inhibited, withdrawn
* Hypervigilant or excessive & inappropriate sociability w/ strangers
* Limited eye contact
* Children up to _age 5_
51
What are some **causes** of Reactive Attachment Disorder?
* Maltreatment
* Deprivation
* Repeated changes in primary caregivers
* Impaired parenting (retardation, depression, substance abuse)
52
**Reactive Attachment Disorder **
What may happen
Treatment
* **What may happen to children**
* May spontaneously remit
* May have malnutrition, infection or death
* Long term behavior changes
* Short stature, low IQ
* **Treatment**
* Medical care
* Nutrition
* Foster
* Work w/ parents
53
What are the **symptoms** of Anorexia?
* losing a lot of weight through diet/exercise
* thinking one is fat despite weight loss
* afraid of gaining weight
* may stop having monthly period
54
What are the **symptoms** of Bulimia?
* brief periods during which an enormous amount of food is eating (binging)
* feeling like one cannot control eating
* trying not to gain weight by exercising, dieting, pills, vomiting
* lot of worries about weight
55
**Eating Disorders**
Timeline
Causes
* Mostly girls, usually start having problems during **teenage years **
* Few weeks/months → long time & more serious
* Death can result from _starvation_ in anorexia
* Many people w/ bulimia suffer from _depression_
* **Causes**
* Different factors may play a role
* Brain parts (hypothalamus) involved in controlling appetite & hunger may not work well
* Other factors: stress, belief that it’s important to be thin
56
How are Eating Disorders **treated**?
* **Medication**
* Anorexia + depression: anti-depressants
* Bulimia: Tofranil (imipramine), Prozac (fluoxetine)
* **Psychotherapy**
* Cognitive behavioral therapy
* Family therapy
57
What are the **symptoms** of Tourett's Disorder?
* Quick **body movements** (tics) that one can’t control
* Making **sounds** (like grunts) or saying **words** (sometimes swear words) w/o thinking & w/o being able to control it
58
**Tourett's Disorder**
Population
Causes
* Most children are **boys** (but can happen in girls)
* Starts at 7-10 YO
* Many times children have **other problems**
* ADHD or OCD
* Causes
* Exact cause unknown
* Some parts of the brain (basal ganglia) that control movements are not functioning well
59
Tics may come & go, but are usually a ______ problem
People w/ tics may be ___________ b/c they are embarrassed about their symptoms & avoid social contacts.
lifelong
socially disabled
60
How is Tourett's Disorder **treated**?
* **Medications**
* Haldol (haloperidol)
* Orap (pimozide)
* Inversine (mecamylamine HCl)
* **Psychotherapy**
* Support therapy
* Family therapy
61
What are the symptoms of **Tic Disorder**?
What can result from this?
* Single or multiple motor or vocal tics
* Sudden, rapid, recurrent, non-rhythmic, stereotyped motor movements or vocalizations
* _What may happen_: teasing, humiliation
62
**Tic Disorder**
Causes
Treatment
* **Causes**
* Unknown
* Not due to Huntington’s chorea, Wilson’s disease, post-viral encephalitis or medication (stimulants)
* **Treatment**
* Psychotherapy
* Behavior modification
* Medication
