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Behavioral Health > Pediatric Psychology > Flashcards

Pediatric Psychology Flashcards

(66 cards)

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1
Q

Potential Roles of Primary Care Clinicians

A 
Prevention
Early identification/screening
Early intervention/engagement
Referral/collaborative care
Monitoring progress in care
Care coordination
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2
Q

Barriers of Mental Health Care in Primary Care Settings

A 
Ambivalence/variability
Discomfort
Time constraints
Poor payment
Variable access to MH specialty resources
Administrative barriers to MH services
Limited information exchange with MH specialists
Stigma
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3
Q

Assisting a Parent Caring for a Child with a Disability

A 
Seek the assistance of other parent
Know that you are not alone
Rely o positive resources in your life
Take it one day at a time
Seek information
Do not be intimidated
Maintain a positive outlook
Find programs for your child
Take care of yourself
Keep daily routines as normal as possible
KEEP YOUR SENSE OF HUMOR
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4
Q

What is important in the assessment of a psychiatric condition in a pediatric patient?

A

Developmental milestones

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5
Q

Approach to the Adolescent Mental Health Patient

A

No judgements or assumptions
Rules of confidentiality: outline the rules, not absolute, ask them to explain confidentiality, alone time with the patient
HEADSSS assessment

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6
Q

Define HEADSSS

A 
H: home
E: education
A: activities
D: drugs
S: sex
S: suicide/depression
S: safety
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7
Q

Define Intellectual Disability

A

Neurodevelopment disorder with multiple etiologies that encompass a broad spectrum of functioning, disability, and strengths

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8
Q

Define Global Developmental Delay

A

Children under 5 who fail to meet expected developmental milestones and have significant impairments in several areas of functioning

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9
Q

Two Components of Intellectual Disability

A

Adaptive behavior

Intellectual functioning

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10
Q

Define Adaptive Behavior

A

Collection of conceptual, social, and practical skills that all people learn in order to function in their daily lives

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11
Q

Define Intellectual Functioning

A

Reasoning, learning, and problem solving

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12
Q

Clinical Features of a Patient with an Intellectual Disability

A

Parent concerns
Younger sibling overtakes an older sibling
Fails to meet expected developmental milestones
Immature behavior
Difficulty learning
Severely affected

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13
Q

Causes of Intellectual Disability

A

Genetic
Embryonic development
Congenital infections
Congenital hypothyroidism
Teratogens: alcohol, lead & valproate
Environmental deprivation (Abuse/neglect)
Hereditary abnormalities

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14
Q

Screening Tools for Intellectual Disability

A

Ages and Stages Questionnaires (ASQ): 4-60 months
Bayley Infant Neurodevelopment Screener (BINS): 4-25 months
Brigance Screens-II: 4-90 months
Infant-Toddler Checklist for Language and Communications: 6-24 months
Parent’s Evaluation of Developmental Status (PEDS)

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15
Q

DSM V for Intellectual Disability Criteria

A

IQ = 70
Deficits or impairments in adaptive function in at least 2 of the following: communication, self-care, home living, social/interpersonal skills, use of community resources, self-direction, functional academic skills, work, leisure, health, safety
Onset before age 18 years old

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16
Q

Treatment of Intellectual Disability

A

Early intervention program
Multidisciplinary team support
Family support & counseling

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17
Q

Typical Learning Disabilities

A

Dyslexia
Dyscalculia
Dysgraphia

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18
Q

Epidemiology of Dyslexia

A

Boys > Girls
Run in families
Often in patients with ADHD

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19
Q

Signs/Symptoms of Dyslexia

A

Delayed language production
Speech articulation difficulties
Difficulties remember letters, numbers, & colors
Reversals or visual confusions (b/d, m/w, h/n)

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20
Q

Common Problems with Individuals with Dyslexia

A

Processing & understanding what they hear
Difficulty comprehending rapid instructions
Following more than one command at a time
Remembering the sequence of things
Reversals of letters (b/d)
Reversal of words (saw/was)
May read from right to left
May fail to see/hear similarities & differences in letters & words
May not recognize spacing between words
May be unable to sound out pronunciation of an unfamiliar word

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21
Q

Dyslexia Screening & Diagnosis

A 
Medical exam
Cognitive exam
Sensory processing
Educational
Psychological factors
Vision
Hearing
Neurologic
Psychologic assessment
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22
Q

Treatment of Dyslexia

A

Remedial education
Testing can reveal areas to work on
Use several senses to learn
No way to correct underlying brain malfunction

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23
Q

Dyslexia Prognosis

A

Tutoring each week
Progress may be slow
Milder forms: read well enough to succeed in school
Severe forms: may never be able to read well

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24
Q

Define Dyscalculia

A

Difficulty performing math calculations

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25
Signs/Symptoms of Dyscalculia
Difficulty understanding number lines, carrying/borrowing numbers, word problems, & counting change or money
26
Strategies for Dyscalculia
Allow use of fingers & scratch paper Use diagrams & draw math concepts Provide peer assistance Suggest use of graph paper
27
Define Dysgraphia
Learning disability resulting from the difficulty in expressing thoughts in writing
28
Dysgraphia Difficulties
Handwriting Grammar & syntax Formulating, expressing, & organizing ideas in writing Ability to use sound-letter relationships effectively
29
Who can diagnose dysgraphia?
Psychologist who specializes in learning disabilities
30
Treatment of Dysgraphia
Accommodations Modifications: essays shorter or put in question form Remediations: writing practice
31
Define Enuresis
Repeated voiding of urine during the day or night into bed or clothing
32
Define Encopresis
Repeated passage of feces into inappropriate places
33
Define Primary Enuresis
Never have had a dry night
34
Define Secondary Enuresis
Child is completely potty trained and then has a patch where the child wets the bed
35
Common Causes of Enuresis
Failure to arouse Increase production of urine while asleep Overactive bladder
36
Enuresis & Psychiatry/Psychology
Stressors: family crises, new school, new sibling | Become withdrawn & anxious
37
Etiology of Daytime Incontinence
Overactive bladder | Constipation
38
Diagnosing Enuresis
H&P Voiding diary UA with PVR Abdominal X-ray
39
What is included in a voiding diary?
Timing of daytime voids Volume of voided urine Lower urinary tract symptoms
40
Treatment of Enuresis
Stop fluids before bed Scheduled night waking Alarms: underwear or bedding Medications
41
Medication Options for Enuresis
Desmopressin acetate (DDAVP) Oxybutynin Imipramine
42
Two Types of Encopresis
Primary | Secondary
43
Define Primary Encopresis
Has always soiled their pants
44
Define Secondary Encopresis
Completely potty trained & then returns to soiling themselves
45
Physical Cycle of Encopresis
Stool retention Intestinal walls & nerves stretch Retained stool becomes harder Liquid stool passes around retained feces
46
Clinical Presentation of Encopresis
Repeated soiling of underwear | Child denies visible & olfactory signs of soiling
47
Psychological Effects of Encopresis
Struggle within the family Conflict in other areas of child's life Homework with suffer Chores may be ignored
48
Diagnostics of Encopresis
Abdominal X-ray
49
Management of Encopresis
Educate child on bowel function Behavior or reward systems Psychological counseling
50
Treatment Goals for Encopresis
Establish regular bowel habits Reduce stool retention Restore normal physiological control over bowel function Diffuse conflicts and reduce concerns
51
Initial Treatment Phase of Encopresis
Enemas | Strong laxatives
52
Maintenance Phase of Treatment of Encopresis
Schedules toilet times Daily laxative Proper diet: lots of fiber
53
Define Autism
Neurodevelopment disorder that affects the functioning of the brain- primarily communication & social interaction
54
Classic Autistic Disorder
``` Limited emotional connection Very into their own world Constant routines Deeply effected by noises, bright lights, & smells Generally low functioning ```
55
Key Diagnostic Features of Autism
Severe deficits in social responsiveness & interpersonal relationships Abnormal speech & language development Repetitive, rigid, or stereotypes interests or behaviors Onset before age 3 Difficulty feeding Focus on one thing at a time
56
Key Features in Infancy for Autism
Delayed/absent social smile Failure to anticipate interaction with parents Lack of attention to parent's face
57
Key Features in Toddlers for Autism
Deficiencies in imitative play Lack of interest in interactions with others Language development delay
58
Communication Symptoms of Autism Spectrum Disorder
Avoid eye contact Act as if deaf Develop language, then abruptly stop talking Fail to use spoken language, without compensating by gesture
59
Exploration of Environment Symptoms of Autism Spectrum Disorder
Remain fixated on a single item or activity Repetitive actions like rocking or hand-flapping Sniff or lick toys or put unusual objects in mouth or need toys to chew on Show no sensitivity to burns or bruises, & engage in self-mutilation Intensely preoccupied with a single subject, activity, or gesture Show distress over change Insist on routine or rituals with no purpose Lack fear
60
Social Relationships of Autism Spectrum Disorder
Act as if unaware of the coming & going of others Are inaccessible Fail to seek comfort Fail to develop relationships with peers Have problems seeing things from another person's perspective May physically attack & injure others without provocation
61
Complications of Autism
30% develop seizure disorder Higher cognitive individuals may become depressed as they become aware of their deficits Some adults live in 24 hour care centers
62
Specifications fo Autism Spectrum Disorder
With/without accompanying intellectual impairment With/without accompanying language impairment Associated with a known medical or genetic condition Associated with another neurodevelopment, mental, or behavioral disorder With catatonia
63
Rankings of Autism Spectrum Disorder
1: requiring support 2: requiring substantial support 3: requiring very substantial support
64
Treatment for Autism Spectrum Disorders
Require specialized therapy, special schooling Special techniques & psychotherapeutic approaches Sometimes antipsychotic drugs & antidepressants
65
Specialized Therapeutic & Teaching Approaches for Autism Spectrum Disorders
Applied behavior analysis (ABA) Picture exchange communication system (PECS) Early start Denver model (ESDM) More than words Treatment & educations of autistic & communication related handicapped children (TEACCH) Child's talk
66
Screening Tools for Autism Spectrum Disorder
Checklist for Autism in Toddlers (M-CHAT) Screening Tool for Autism in Toddlers & young children (STAT) Child look & point when they want you to see something? Child look when you point to something? Child use imagination to play?

Behavioral Health (25 decks)

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