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psych disorders in children Flashcards

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1
Q

Kaufman Assessment Battery for Children

A

intelligence test for ages 2-12

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2
Q

Wechsler intelligence scale for children-revised

A

determines IQ for ages 6-16

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3
Q

mental retardation (intellectual disability) definition

A

IQ less than 70; deficits in adaptive skills approp for age; onset must be before age 18

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4
Q

MR is more common in males than females

A

right

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5
Q

mild, moderate, severe, profound MR cutoffs

A

mild is 55-70; moderate is 40-55; severe is 25-40; profound is less than 25

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6
Q

genetic causes of MR

A

Down syndrome, fragile X syndrome; PKU, prader-willi, williams syndrome, angelman syndrome, tuberous sclerosis

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7
Q

prenatal causes of MR

A

Torch infections (toxo, other, rubeella, CMV, herpes)

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8
Q

def of learning disorder

A

achievement in reading, math or writing that is signif lower than expected; cannot be explained by sens deficits, poor teaching, or cultural factors; often due to deficits in cognitive processing

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9
Q

oppositional defiant disorder

A

at least 6 mos of negativistic, hostile, and defiant behavior during which at least 4 of the criteria have been present

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10
Q

criteria for oppositional defiant disorder

A

freq loss of temper; arguments with adults; defying adults rules; deliberately annoying people; easily annoyed; anger and resentment; spitefulness; blaming others for mistakes or misbehaviors

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11
Q

when does oppositional disorder usually present?

A

can begin as early as age 3, but usually around age 8

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12
Q

prognosis of oppositional conduct disorder

A

twenty five percent of kids will grow out of it; in persistent cases, may progress to conduct disorder

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13
Q

treatment for oppositional defiant disorder

A

pychotherapy; parent management skills training

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14
Q

conduct disorder def

A

most serious; basic rights of others or social norms are violated, as evidenced by at least 3 of 15 described behaviors during the past year;

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15
Q

behaviors of conduct disorder grouped into four categories

A

aggresion toward people and animals; destruction of property; decietfulness or theft; serious violations of rules

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16
Q

epi of conduct disorder

A

many times more common in boys

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17
Q

risk factors for conduct disorder

A

punitive parenting; psychosocial adversity; hx of being abused; biological predisposition

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18
Q

prognosis for conduct disorder

A

up to forty percent will go on to develop antisocial personality disorder in adulthood

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19
Q

treatment for conduct disorder

A

consistent rules and consequences; family involvement; meds can be useful adjunct inf aggression is present (antipsychotics, mood stabilizers, SSRIs)

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20
Q

three subcategories of ADHD

A

predominently inattentive type, predominantly hyperactive-impulsive type, and combined type

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21
Q

diagnosis of ADHD

A

at least six sx of either inattentiveness, hyperacitivity, or both that have persisted for at least 6 mos, present at a degree that is maladaptive, onset before age 7

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22
Q

prognosis of ADHD

A

up to 60% will have sx into adulthood (more impulsiveness than hyperactivity)

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23
Q

neurochemical factors that may contribute to ADHD

A

dysregulation of noradrenergic systems

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24
Q

neuropsych factors that can be demonstrated inADHD

A

certain patients with abnormal EEG patterns or PET

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25
pharmacologic treatements of ADHD
CNS stimulants are first line (methylphenidate, dextroamphetamine, and amphetamine salts; atomoxetine is nonstim that works too; alpha 2 ags
26
alpha 2 ags for ADHD
can be used if stimulants cannot be tolerated due to side effects; clonidine, guanfacine
27
nonpharm treatments for ADHD
psychotherapy; parent education; educational interventions
28
pervasive developmental disorders
disorders that involve problems with social skills, language, and behaviors; impairment is noticeable at an early age of life and involves multiple areas of development
29
examples of pervasive developmental disorders
autistic disorder, asperger disorder, Rett disorder, childhood disintegrative disorder; PDD NOS
30
definition of Autistic disorder
at least six sx must be present by age 3, with at least two from category 1 and at least one from categories 2 and 3
31
category 1 problems in autistic disorder
problems with social interaction
32
category 2 problems in autistic disorder
impairments in communication
33
category 3 problems in autisitc disorder
repetitive and stereotyped behavior and activities
34
seventy percent of individuals with autism meet criteria for MR
right
35
autistic disorder is assoc with
fragile X, tuberous sclerosis, and seizures
36
predictors of adult outcome in kids with autism
level of intellectual functioning and communicataive competence
37
Asperger disorder
same impairments seen in autism inovoling social interactin and restricted or stereotyped interests but differs in that no delay in language, cognitive delveopment, self-help skills or curiosity about environment
38
Rett disorder
normal physical and psychomotor development during the first 5 mos after birth followed by decr rate of head growth and loss of learned hand skills
39
Rett disorder kids will then develop
stereotyped hand movements (hand wringing, hand washing), impaired language, and psychomotos retardation and problems with gait or trunk movements
40
features of Rett disorder
onset between 5 and 48 mos; seen in girls; genetic testing; EEF abnormal and seizures are common; patients become nonambulatory due to motor problems and scoliosis
41
gene in Rett syndrome
MECP2 gene mutation on X chrom
42
tretment for Rett syndrome
supportive
43
childhood disintegrative disorder
normal development in the first 2 years but loss of acquired skills before age 10 in at least two areas (lang, social skills, or adaptive behavior, bowel or bladder control, play, motor skills, and in at least two of social, communic, restricted behaviors/interest)
44
childhood disintegrative disoder onset
onset after age 2, usually between ages 3 and 4, must be before age 10
45
childhood disintegrative disorder other features
more common in boys; etiology unknown; high rates of EEG abnormality and seizure disorder; assoc with various general med conditions
46
treatment for childhood disintegrative disorder
supportive, with a focus on helping kids relearn basic skills
47
tourette disorder
tics disorder characterized by multiple daily motor and some vocal tics with onset before age 18
48
examples of vocal tics in tourette disorder
coprolalia (repetitive speaking of obscene words); echolalia (exact repitition of words)
49
diagnosis of tourette's syndrome
multiple motor and one or more vocal tics (not necessarily concurrently) that are not attributable to CNS disease; onset before age 18; tics occur many times a day, almost every day for at least a year
50
tics in tourettes
many times a day, almost every day for at least a year; no tic free period greater than 3 mos; change in anatomic location and character of tics over time;
51
both motor and vocal tics must be present to dx Tourettes
right
52
tourette symptoms peak in severity at what age
between 8 and 12, decreasing with puberty
53
prognosis of tourettes
many exerience marked reduction of sx by their late teens, with one third to one half becoming virtually asymp in adulthoo
54
tourettes has high comorbidity with OCD and ADHD
right
55
neurochemical factors that may contribute to tourettes
impaired red of dopamine in the caudate nuc (and possibly impaired reg of endogenous opiates and the noradrenergic system)
56
tourettes psych factors
symptom exacerbations follow stressful life events, fatigue, extremes of temp, and external simuli
57
nonpharm treatment for tourettes
supportive and behavioral therapy
58
pharm treatment of tourettes
atypical neuroleptics (risperidone), alpha 2 ags (clonidine, guanfacine), typical neuroleptics (haloperidol, pimozide) for severe cases
59
OCD patients with comorbid tics have good response to
SSRI augmentation of antipsychotics
60
when is continence (both urinary and bowel) usually achieved by?
age 4
61
enuresis
urinary incontinence after age 5 (at least twice a week for at least 3 consec mos or with marked impairment)
62
encopresis
fecal incont greater than age 4 (at least once a month for at least 3 mos);
63
treatment for bowel and/or bladder incontinence
high spontaneous remission rate; psychotherapy; behavior modification, DDAVP, TCAs, bowel catharsis and stool softeners
64
selective mutism
refusal to speak in certain situations for at least 1 mo
65
onset of selective mutism
around age 2-5; not noticed until time of entry into school
66
treatment for selective mutism
psychotherapy, management of anxiety
67
separation anxiety disorder
excessive fear for greater than 4 weeks of leaving one's parents or other major attachment figures
68
treatment for separation anxiety
therapy and low dose antidepressants
69
at what age are kids most at risk for sexual abuse?
between ages 7 and 13
70
a diagnosis of MR cannot be made with just a low IQ
deficits in adaptive skills must also be present
71
FMR-1 gene defect
fragile X syndrome, the most common inherited form of MR
72
difference between conduct disorder and oppositional defiant disorder
ODD does not involve physical aggression or violation of basic rights of others
73
kids who have no difficulties getting along with peers but will not comply with expectations from parents or teachers
think oppositional defiant disorder
74
cruelty to animals
think conduct disorder
75
how is asperger disorder different from autism
kids with asperger disorder have normal language acquisition and cognitive development
76
difference between Rett disorder and childhood disintegrative disorder
in childhood disintegrative disorder, head growth does not slow, and the unusual hand movements are not present
77
tic disorders are ne of the few psych disorder in which a dx can be given without sx causing signif distress
right
78
when is separation anxiety age approp
from 7 mos to 6 years
79
when does stranger anxiety peak
8-12 mos of age

Psych (23 decks)

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