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psych disorders in children Flashcards

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
Q

pharmacologic treatements of ADHD

A

CNS stimulants are first line (methylphenidate, dextroamphetamine, and amphetamine salts; atomoxetine is nonstim that works too; alpha 2 ags

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26
Q

alpha 2 ags for ADHD

A

can be used if stimulants cannot be tolerated due to side effects; clonidine, guanfacine

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27
Q

nonpharm treatments for ADHD

A

psychotherapy; parent education; educational interventions

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28
Q

pervasive developmental disorders

A

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

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29
Q

examples of pervasive developmental disorders

A

autistic disorder, asperger disorder, Rett disorder, childhood disintegrative disorder; PDD NOS

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30
Q

definition of Autistic disorder

A

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

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31
Q

category 1 problems in autistic disorder

A

problems with social interaction

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32
Q

category 2 problems in autistic disorder

A

impairments in communication

33
Q

category 3 problems in autisitc disorder

A

repetitive and stereotyped behavior and activities

34
Q

seventy percent of individuals with autism meet criteria for MR

A

right

35
Q

autistic disorder is assoc with

A

fragile X, tuberous sclerosis, and seizures

36
Q

predictors of adult outcome in kids with autism

A

level of intellectual functioning and communicataive competence

37
Q

Asperger disorder

A

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
Q

Rett disorder

A

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
Q

Rett disorder kids will then develop

A

stereotyped hand movements (hand wringing, hand washing), impaired language, and psychomotos retardation and problems with gait or trunk movements

40
Q

features of Rett disorder

A

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
Q

gene in Rett syndrome

A

MECP2 gene mutation on X chrom

42
Q

tretment for Rett syndrome

A

supportive

43
Q

childhood disintegrative disorder

A

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
Q

childhood disintegrative disoder onset

A

onset after age 2, usually between ages 3 and 4, must be before age 10

45
Q

childhood disintegrative disorder other features

A

more common in boys; etiology unknown; high rates of EEG abnormality and seizure disorder; assoc with various general med conditions

46
Q

treatment for childhood disintegrative disorder

A

supportive, with a focus on helping kids relearn basic skills

47
Q

tourette disorder

A

tics disorder characterized by multiple daily motor and some vocal tics with onset before age 18

48
Q

examples of vocal tics in tourette disorder

A

coprolalia (repetitive speaking of obscene words); echolalia (exact repitition of words)

49
Q

diagnosis of tourette’s syndrome

A

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
Q

tics in tourettes

A

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
Q

both motor and vocal tics must be present to dx Tourettes

A

right

52
Q

tourette symptoms peak in severity at what age

A

between 8 and 12, decreasing with puberty

53
Q

prognosis of tourettes

A

many exerience marked reduction of sx by their late teens, with one third to one half becoming virtually asymp in adulthoo

54
Q

tourettes has high comorbidity with OCD and ADHD

A

right

55
Q

neurochemical factors that may contribute to tourettes

A

impaired red of dopamine in the caudate nuc (and possibly impaired reg of endogenous opiates and the noradrenergic system)

56
Q

tourettes psych factors

A

symptom exacerbations follow stressful life events, fatigue, extremes of temp, and external simuli

57
Q

nonpharm treatment for tourettes

A

supportive and behavioral therapy

58
Q

pharm treatment of tourettes

A

atypical neuroleptics (risperidone), alpha 2 ags (clonidine, guanfacine), typical neuroleptics (haloperidol, pimozide) for severe cases

59
Q

OCD patients with comorbid tics have good response to

A

SSRI augmentation of antipsychotics

60
Q

when is continence (both urinary and bowel) usually achieved by?

A

age 4

61
Q

enuresis

A

urinary incontinence after age 5 (at least twice a week for at least 3 consec mos or with marked impairment)

62
Q

encopresis

A

fecal incont greater than age 4 (at least once a month for at least 3 mos);

63
Q

treatment for bowel and/or bladder incontinence

A

high spontaneous remission rate; psychotherapy; behavior modification, DDAVP, TCAs, bowel catharsis and stool softeners

64
Q

selective mutism

A

refusal to speak in certain situations for at least 1 mo

65
Q

onset of selective mutism

A

around age 2-5; not noticed until time of entry into school

66
Q

treatment for selective mutism

A

psychotherapy, management of anxiety

67
Q

separation anxiety disorder

A

excessive fear for greater than 4 weeks of leaving one’s parents or other major attachment figures

68
Q

treatment for separation anxiety

A

therapy and low dose antidepressants

69
Q

at what age are kids most at risk for sexual abuse?

A

between ages 7 and 13

70
Q

a diagnosis of MR cannot be made with just a low IQ

A

deficits in adaptive skills must also be present

71
Q

FMR-1 gene defect

A

fragile X syndrome, the most common inherited form of MR

72
Q

difference between conduct disorder and oppositional defiant disorder

A

ODD does not involve physical aggression or violation of basic rights of others

73
Q

kids who have no difficulties getting along with peers but will not comply with expectations from parents or teachers

A

think oppositional defiant disorder

74
Q

cruelty to animals

A

think conduct disorder

75
Q

how is asperger disorder different from autism

A

kids with asperger disorder have normal language acquisition and cognitive development

76
Q

difference between Rett disorder and childhood disintegrative disorder

A

in childhood disintegrative disorder, head growth does not slow, and the unusual hand movements are not present

77
Q

tic disorders are ne of the few psych disorder in which a dx can be given without sx causing signif distress

A

right

78
Q

when is separation anxiety age approp

A

from 7 mos to 6 years

79
Q

when does stranger anxiety peak

A

8-12 mos of age

Psych (23 decks)

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