L11: Child Psychiatric Disorders

Question 1

Def of Autism Spectrum Disorder

Answer 1

Qualitative deficits in reciprocal social interaction,
communication skills and restricted patterns of behavior.

Question 2

Diagnostic Criteria of Autism Spectrum Disorder

Answer 2

Question 3

levels of severity of Autism Spectrum Disorder

Answer 3

Level 1
- Has social interaction and speech.

Level 2
- Has minimal speech and interaction.

Level 3
- Has no speech or social interaction.

Question 4

Epidemiology of Autism Spectrum Disorder

Answer 4

• Autism spectrum disorder is generally a lifelong disorder with a guarded prognosis.
• Two-thirds remain severely handicapped and dependent.
• Improved prognosis if IQ > 70 and communication skills are seen by ages 5 to 7 years.
• The prognosis is variable, but the two most important predictors of adult outcome are level of intellectual functioning and language impairment.

Question 5

Onset of Autism Spectrum Disorder

Answer 5

before age of 3 years.

Question 6

Etiology of Autism Spectrum Disorder

Answer 6

Question 7

DDx of Autism Spectrum Disorder

Answer 7

• Schizophrenia with childhood onset
• Children with intellectual disorder with behavioral symptoms
• Children with acquired aphasia with convulsion
• Children with Congenital deafness or severe hearing impairment
• Children with Psychosocial deprivation

Question 8

How is Schizophrenia with childhood onset: Diffrentiated from Autism Spectrum Disorder?

Answer 8

• It is is rare in children under the age of 5.
• Accompanied by hallucinations or delusions.
• With a lower incidence of seizures and mental retardation and a more even IQ.

Question 9

How is Children with intellectual disorder with behavioral symptoms Diffrentiated from Autism Spectrum Disorder?

Answer 9

• Children usually relate to adults and other children in accordance with their mental age.
• They use the language they do have to communicate with others.

Question 10

How is Children with acquired aphasia with convulsion Diffrentiated from Autism Spectrum Disorder?

Answer 10

• Child is normal for several years before losing both receptive and expressive language.
• A profound language comprehension disorder then follows, characterized by deviant speech pattern and speech impairment.

Question 11

How is Children with Congenital deafness or severe hearing impairment Diffrentiated from Autism Spectrum Disorder?

Answer 11

• Infants have a history of relatively normal babbling that tapers off gradually and may stop from 6 months to 1 year of age.
• Children respond only to loud sounds.
• Children usually relate to their parents, seek their affection, and enjoy being held as infants.

Question 12

How is Children with Psychosocial deprivation Diffrentiated from Autism Spectrum Disorder?

Answer 12

• Children improve rapidly when placed in a favorable psychosocial environment.

Question 13

Consider ……. as the diagnosis if there is a rapid deterioration of social and/or language skills during the first 2 years of life.

Answer 13

ASD

Question 14

• 15% of ASD cases are associated with a known genetic mutation.
• Fragile X syndrome is the most common known single gene cause of ASD.

Answer 14

…

Question 15

ASD has high comorbidity with intellectual disability & Association with epilepsy.

Answer 15

…

Question 16

Course & Prognosis of ASD

Answer 16

• Autism spectrum disorder is generally a lifelong disorder with a guarded prognosis.
• Two-thirds remain severely handicapped and dependent.
• Improved prognosis if IQ > 70 and communication skills are seen by ages 5 to 7 years.
• The prognosis is variable, but the two most important predictors of adult outcome are level of intellectual functioning and language impairment.

Question 17

The prognosis of ASD is variable, but the two most important predictors of adult outcome are ……..

Answer 17

level of intellectual functioning and language impairment.

Question 18

Managment of ASD

Answer 18

There is no cure for autism, but various treatments are used to help manage associated symptoms & to improve basic social, communicative and cognitive skills:

• Remediation
• Psychotherapy
• Pharmacotherapy

Question 19

Remedition in ASD

Answer 19

• Structured classroom training in combination with behavioral methods is the most effective treatment method.
• Language and academic remediation are often required.

Question 20

Psychotherapy in ASD

Answer 20

Parents are often need support and counseling.

Question 21

Pharmacotherapy in ASD

Answer 21

Question 22

Def of ADHD

Answer 22

persistent and marked pattern of inattention and/or hyperactive and impulsive behavior.

Question 23

Types of ADHD

Answer 23

1. Hyperactive impulsive type
2. Inattentive type
3. Combined type

Question 24

Diagnostic Critereria of ADHD

Answer 24

Question 25

Duration of **ADHD**

Answer 25

Symptoms lasts for at least 6 months & must be: 1. present before the age of 12 years 2. present in at least two settings (e.g: at home and school) 3. interfere with the appropriate social, and academic functioning.

Question 26

Typical signs of **ADHD**

Answer 26

* talking excessively * fidgeting, frequent interruptions * impatience, difficulty organizing and finishing tasks * distractibility, and forgetfulness

Question 27

what is **Fidgeting**?

Answer 27

*Fidgeting is making small movements with your body, usually your hands and feet. It's associated with not paying attention

Question 28

Epidemeology of **ADHD**

Answer 28

- Occurs in 3% to 7% of grade-schoolers. - Male:Female ratio is 3:1 to 5:1. (0 > 9) - Symptoms often present by 3 years.

Question 29

Etiology of **ADHD**

Answer 29

Question 30

DDx of **ADHD**

Answer 30

**Bipolar disorder and childhood-onset schizophrenia:** - There is more waxing and waning of symptoms in bipolar disorder and hallucinations or delusions in childhood schizophrenia. **Learning disorders:** - Inability to do math or read is not because of inattention. **Anxiety disorder:** - May be manifested by overactivity and easy distractibility.

Question 31

Managment of **ADHD**

Answer 31

Question 32

Characters of **Disruptive Behaviour Disorders**

Answer 32

* Includes two persistent constellations of disruptive symptoms. * Categorized as: A. Oppositional defiant disorder B. Conduct disorder. * Result in impaired social or academic function in a child.

Question 33

Diagnostic Criteria of **Opposotional Defiant Disorder (ODD)**

Answer 33

a. A pattern of defiant, angry, and negative behavior enduring for at least 6 months. b. The child is manifested by: * frequently loses his or her temper * resentful and easily annoyed * actively defies requests and rules in the presence of familiar adults and peers

Question 34

Etiology of **Opposotional Defiant Disorder (ODD)**

Answer 34

- Possible result of unresolved conflicts. - May be a reinforced, learned behavior.

Question 35

TTT of **Opposotional Defiant Disorder (ODD)**

Answer 35

Question 36

A child may have oppositional defiant disorder if he/she has no difficulty getting along with peers but will not comply with rules from parents or teachers.

Answer 36

....

Question 37

Diagnostic Criteria of **Conduct Disorder**

Answer 37

Question 37

........ are the corner stone in treatment of disruptive behavior disorder.

Answer 37

Parents

Question 38

- What distinguishes Conduct disorder from ODD is ....... - Unlike conduct disorder, ODD does not involve.........

Answer 38

- aggression (e.g. stealing, bullying and cruel behaviors toward others). - physical aggression or violating the basic rights of others.

Question 39

Etiology of **Conduct Disorder**

Answer 39

- Multifactorial. - Maladaptive aggressive behaviors are associated with family instability, physical and sexual victimization, socioeconomic factors, and negligent conditions. - Often coexists with: ADHD, learning disorders, or communication disorders. - A subset may have low plasma levels of dopamine and B-hydroxylase.

Question 40

TTT of **Conduct Disorder**

Answer 40

Question 41

..

Answer 41