Lecture 20: Common developmental/Behavioral Issues

Question 1

By what age should we expect a child to have an adult sleep pattern?

Answer 1

Age 3

Question 2

Sleep disorders are characterized under the age of…

Answer 2

12

Question 3

Usually by () weeks, a baby should be able to sleep through the night.

Answer 3

12 weeks

Question 4

Children older than 6 months sometimes wake up during the night because they want to feed. To encourage them to sleep through the night, you should…

Answer 4

Consume a full meal at night so they don’t sleep hungry

Question 5

Contrary to instinct, it is recommended to () when a baby makes noise at night due to hunger.

Answer 5

Leave the baby alone and see if it goes back to sleep without parental intervention.

Question 6

Trained night awakenings are when you wake a child up between 4-8 months of age but ()

Answer 6

They dont require a feeding.

Question 7

Why does object permanence affect sleep at 8 months?

Answer 7

Kids remember things exist even if they are out of sight.

Developmental night awakenings

Question 8

Sleep-onset associations are when a child develops () behavior to go to sleep

Answer 8

Learned behavior, aka they fall asleep only in certain situations

Question 9

Limit setting disorder is when a parent () bedtime routines.

Answer 9

Prolongs/extends

No more one more!

Question 10

Unusual behaviors/experiences that occur during sleep or transition between sleeping and awakneing are known as…

Answer 10

Parasomnias

Question 11

Night terrors are different from nightmares because…

Answer 11

You don’t remember night terrors

Question 12

Night terrors tend to occur during the () 3rd of the night

Answer 12

1st third of the night

Question 13

A parent asks when their kids night terrors will stop. You reassure them that 95% resolve on their own by age…

Answer 13

8

Question 14

Nightmares MC occur between the ages of () - ()

Answer 14

3-6 years

Question 15

Separation anxiety can develop if there is poor trust building during the () year of life

Answer 15

1st year of life

Question 16

An infant with high levels of mistrust tends to be (more/less) clingy to their caregiver

Answer 16

More clingy

Question 17

Stranger anxiety tends to appear around () months, but can last beyond () months

Answer 17

Begins around 6-8 months, but can last past 24 months.

Question 18

You should consider professional help if your child remains aggressive and destructive by (grade)

Answer 18

Kindergarten

Question 19

Aggression in a young child can eventually lead to… (3) serious disorders

Answer 19

• Conduct disorder
• Oppositional defiant disorder
• Substance abuse

Question 20

Temper tantrums are MC between the ages of () to () years

Answer 20

1-4 years

Question 21

Tantrums are considered a reflection of…

Answer 21

Immaturity

Question 22

List of how to deal with temper tantrums at WCC

Answer 22

Question 23

The general rule of thumb for time outs is () minute per year of age

Answer 23

1 minute per year of age.

Question 24

T/F: You should give in to your child’s tantrum

Answer 24

Never!!!!!

Question 25

Cyanotic breath holding spells are usually due to ()/(), whereas pallid breath holding spells are due to ()/()

Answer 25

* Cyanotic: anger/frustration * Pallid: Minor injury/fear

Question 26

Pallid spells start with () cries, whereas cyanotic spells start with () cries | Loud vs quiet

Answer 26

* Pallid: brief/silent * Cyanotic: Short loud cry

Question 27

Breath-holding spells are associated with () anemia

Answer 27

Iron-deficiency

Question 28

Generally, breath-holding spells are treated via

Answer 28

Parental education | Meds not recommended

Question 29

Children generally become aware of their need to go potty by months ()-()

Answer 29

12-18 months

Question 30

By 18-24 months, children can briefly control their () muscles | Urinary related

Answer 30

Sphincter muscles

Question 31

By 24-36 months, children can start () parent's bathroom behaviors

Answer 31

Mimicking same sex parent's bathroom behavior

Question 32

Sticker charts work really well for potty training in what age range?

Answer 32

3 years or older

Question 33

One way to potty train a child is to () them every hour

Answer 33

Put them on the toilet every hour

Question 34

The best way to potty train a child is...

Answer 34

Whatever way works

Question 35

Thumb sucking is a universal action in infants, but typically goes away by the age of...

Answer 35

4/preschool

Question 36

The physical issue we are worried about with kids that continually thumb suck is...

Answer 36

Dental malocclusion | Teeth misalignment

Question 37

The most effective way to manage thumb sucking is a combination of () treatment and ()

Answer 37

Aversive taste treatment and reward system

Question 38

Nail biting is an extension of...

Answer 38

Thumb sucking

Question 39

T/F: Children seeking attention usually have a legit reason

Answer 39

True

Question 40

Exploration begins around age () months, and peaks around () years. It will also restart in adolescence

Answer 40

2 months, peaking at 4 years | Pretty much humping

Question 41

Generally, infants/children have a similar physiologic orgasmic response to adults, but the exception is...

Answer 41

Ejaculation

Question 42

A parent sees their 2 year old child kinda banging their head and rocking out. They are concerned that this may cause brain injury. You tell the parent...

Answer 42

Assure them it does not cause brain injury.

Question 43

Encopresis is....

Answer 43

Leakage of stool into clothing (usually involuntary)

Question 44

The MCC of encopresis is...

Answer 44

Constipation

Question 45

Retentive encopresis is characterized by () leakage of fecal material due to impaction, eventually leading to an () sphincter.

Answer 45

Involuntary leakage, eventually leading to an incompetent sphincter.

Question 46

Physical exam of retentive encopresis usually reveals a () on abdominal exam and a () rectum on rectal exam

Answer 46

* Abdominal mass * Dilated rectum

Question 47

Tx of acute retentive encopresis is via

Answer 47

Enema + miralax

Question 48

Tx of chronic retentive encopresis is via...

Answer 48

* Miralax/lactulose QD for like 6 months * Laxatives if megacolon * Increased fiber | Once impaction is cleared.

Question 49

Acute retentive encopresis should be seen in () after impaction is cleared.

Answer 49

1 week

Question 50

Nonretentive encopresis is...

Answer 50

Passage of **normal BMs** into underwear rather than toilet | They dont want to use the toilet so they poop voluntarily.

Question 51

Management for nonretentive encopresis is...

Answer 51

Reward training

Question 52

Pervasive development disorders are characterized by () reciprocal social interactions, () language development, and () behavior repetoire

Answer 52

* Impaired reciprocal social interactions * Aberrant language development * Restricted behavioral repertoire

Question 53

PDD usually occur prior to the age of...

Answer 53

4

Question 54

Autism spectrum disorder is characterized by 3 symptom categories, which are: 1. qualitative () in social interaction 2. impairment in () 3. Restricted, repetitive, and stereotyped ()

Answer 54

* Qualitative imapirment in social interaction * Impairment in communication * Restricted, repetitive, and stereotyped behavior

Question 55

What developmental screening tool helps screen for ASD?

Answer 55

MCHAT

Question 56

DSM-V diagnosis of ASD uses 3 categories related to social interaction in multiple settings, which are:

Answer 56

* Social-emotional reciprocity * Nonverbal communication for social interaction * Relationship development/maintenance | Must impair function, present early, and no other explanation.

Question 57

ASD behaviors include: (4)

Answer 57

* Stereotyped behaviors * Ritualistic/unchanging patterns * Highly restricted/focused/nicheinterests * Increased/Decreased response to sensory stimuli

Question 58

In ASD, the social communication/interaction is graded on a severity of level 1-3. Level 1 requires () support, where as level 3 requires ()

Answer 58

* Level 1 requires no support * Level 3 requires substantial support

Question 59

In ASD, the repetitive/restricted behavior is graded on a severity of level 1-3. Level 1 requires () support, where as level 3 requires ()

Answer 59

* Level 1 requires support, significant effect on function. * Level 3 require substantial support and extreme effects.

Question 60

The TOC to manage ASD is...

Answer 60

Educational and behavioral interventions

Question 61

In the US, Asperger syndrome falls under

Answer 61

Autism spectrum disorder

Question 62

The hallmark sign of asperger syndrome/ASD is...

Answer 62

Atypical social development

Question 63

Per the DSM-5, Asperger syndrome corresponds to level () of ASD.

Answer 63

Level 1 of ASD without intellectual impairment