Symposium 2 - Child and Adolescent Psychiatry Flashcards

Question

How may Separation Anxiety Disorder (SAD) present in young people?

Answer 1

Between the ages of 18 months and three years, it's very common for children to feel some anxiety when a parent leaves the room or their line of sight. Older children also experience SAD. It may take them longer than most YP to calm down. Psychically and psychologically they can experience, - e.g., extreme homesickness and feelings of misery over not being near loved ones. *Have to starts low with management given and not judge parents decisions (we will never understand how hard)

Answer 2

Treatment options for YP with anxiety are similar to those for adults albeit modified for developmental age and stage. - Psychological therapies (CBT) can help YP with anxiety unlearn avoidance behaviours. It also helps them learn more helpful patterns of thinking. - Antidepressant medication is considered if symptoms are severe, or if there is no significant improvement with psychological therapy alone.

Answer 3

Obsessive-Compulsive Disorder is characterised by the presence of persistent obsessions or compulsions, or most commonly both. Obsessions are repetitive and persistent thoughts, images, or impulses/urges that are intrusive, unwanted, and are commonly associated with anxiety. The individual attempts to ignore or suppress obsessions or to neutralize them by performing compulsions. Compulsions are repetitive behaviours including repetitive mental acts that the individual feels driven to perform in response to an obsession, according to rigid rules, or to achieve a sense of ‘completeness’. An obsession is a thought, image or urge that keeps coming into your mind even though you may not want it to. Examples include thinking you: - Are unclean or might spread disease - Might get hurt or hurt someone else - Might have an illness - Are convinced something bad will happen to someone. - Having an obsession often leads to feelings of anxiety or discomfort and you might then get the urge to 'put it right'. This is where compulsions come in.

Answer 4

In order for obsessive-compulsive disorder to be diagnosed, obsessions and compulsions must be time consuming (e.g. taking more than an hour per day) or result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning. If functioning is maintained, it is only through significant additional effort. Developmentally normative preoccupations (e.g., worrying about interacting with strangers in young children) and rituals (e.g., skipping over cracks in a sidewalk) should not be attributed to a presumptive diagnosis of Obsessive-Compulsive Disorder and are differentiated from obsessions and compulsions characteristic of Obsessive-Compulsive Disorder because they are transient, age-appropriate, not time-consuming (e.g., taking more than hour per day), and do not result in significant distress or impairment.

Answer 5

Individuals with Obsessive-Compulsive Disorder vary in the degree of insight they have about the accuracy of the beliefs that underlie their obsessive-compulsive symptoms. Although many can acknowledge that their thoughts or behaviours are untrue or excessive, some cannot, and the beliefs of a small minority of individuals with Obsessive-Compulsive Disorder may at times appear to be delusional in the degree of conviction or fixity with which these beliefs are held (e.g., an individual is convinced that she will become seriously ill if she does not maintain her washing rituals). Insight may vary substantially even over short periods of time, for example depending on the level of current anxiety or distress, and should be assessed with respect to a time period that is sufficient to allow for such fluctuation (e.g., a few days or a week).

Answer 6

Onset before age 10 is more common among males (approximately 25%), whereas adolescent onset is more likely among females. Younger age of onset is associated with greater genetic loading and poorer outcomes due to interference of symptoms with achieving developmental milestones (e.g., forming peer relationships, acquiring academic skills). Although childhood-onset Obsessive-Compulsive Disorder typically follows a chronic course, particularly if left untreated, symptoms tend to wax and wane and many (approximately 40%) experience full remission by early adulthood.

Answer 7

OCD is a disorder where a YP experiences obsessions and/or compulsions that affect their everyday life. Some YP use the phrase OCD to describe being very tidy or having a very specific routine. However, just being tidy or precise does not mean that you have OCD. In YP with OCD, these habits are unpleasant and upsetting and can have a huge and negative affect on their lives. *Significant functional impairment, can have other disorders pre-dating it

Answer 8

Compulsions are things you feel you need to do to control your 'obsessions', even though you may not want to. It can be hard to stop yourself from doing these compulsions. Often, a compulsion means doing something again and again. This is also known as a 'ritual'. Doing the compulsion will probably make you feel as though you can stop or reduce your anxiety about what you fear may happen.

Answer 9

Genes – OCD is a complex disorder. Studies have shown that there are different genetic risk factors involved in whether someone develops OCD. People who have a relative with OCD are more likely to develop OCD than people who don’t. Stress – Stressful life events like someone dying or getting sick, can bring on OCD. This is the case in about one or two in every three people who develop OCD. Life changes – Big events in someone’s life can be a catalyst for developing OCD. E.g. puberty, moving house or changing school. Brain changes – If you have the symptoms of OCD for more than a short time, researchers think that there may be changes in how a chemical called serotonin works in your brain. We don't know if these changes cause OCD, or are caused by OCD. Personality – If you are a neat, meticulous, methodical person with high standards you may be more likely to develop OCD. These qualities are normally helpful, but can slip into OCD if they become too extreme. Ways of thinking – Nearly all of us have odd or distressing thoughts or pictures in our minds at times. For example, thinking about stepping out in front of a car when you’re on a busy street, even if you don’t actually want to. Most of us quickly dismiss these ideas and get on with our lives. But, if you have particularly high standards of morality and responsibility, you may feel that it's terrible to even have these thoughts. So, you are more likely to watch out for them coming back, which makes it more likely that they will.

Answer 10

Some examples of compulsions include: - Washing - Checking - Touching - Ordering, arranging or lining things up - Counting - Thinking certain thoughts If you have compulsions you might find yourself trying to avoid any situation that could set off obsessive thoughts.

Answer 11

One of the most helpful psychological treatments for OCD is cognitive behavioural therapy (CBT). This is a treatment that helps you to change the way you think and behave. Exposure and response prevention (ERP) is a type of CBT that aims to stop compulsive behaviours and anxieties from strengthening each other. Selective Serotonin Reuptake Inhibitors (SSRIs) is a type of antidepressant that can be effective in treating OCD. *For exams, psychological therapy and medication

Answer 12

Need to give hope!

Answer 13

A child's experiences at early life forms the foundation for all future learning, behaviour, health. Neuron circuits grow and the more they are used grow stronger based upon experiences and less fade away through pruning. Neurons form strong connections for motor skills, behaviour, memory, visual and language.

Answer 14

Developmental psychopathology is an approach or field of study designed to better understand the complexities of human development. Looks at; - How are individuals similar to and different from each other in the healthy and maladaptive paths they take as they grow older? - accounts for why individuals experience differences in psychological functioning over time? - What characteristics within (genes, personality) and outside (family relationships, neighbourhoods) the individual are responsible for similarities and differences in psychological development over time? - What consequences do people's histories of experiences, coping, and adjustment have on their subsequent mental health? - Understanding why sone children develop disorders or maladaptation whereas other children develop normally necessitates considering a whole host of factors that undermine or foster healthy adjustment.

Answer 15

Child development can be affected by both their immediate family and peers, but also by wider socio-economic and cultural factors.

Answer 16

A strong emotional bond to primary care giver in life is critical to development. Strong bond and feel attached gives us chance to explore world and feel secured knowing we can return. People secure can trust and do better in life. 3 types of insecure; - anxious avoidance - anxious ambivalent - anxious disorganised

Answer 17

Joe stays with his uncle who thinks a good education means being strict and if he gets to loud his uncle gets angry which scares Joe. This teaches Joe to avoid fear he has to hide his feelings. As an adult he has issues entering relationships as he still does this and his image of himself is negative - Anxious Avoidance Attachment

Answer 18

Ann aged 3 struggles to cope with new inattention, to her mother acts unpredictably and is anxious about their relationship, becoming clingy, raising emotional state and screaming. When her mum responds to what Ann predicts she becomes ambivalent and doesn't show her true feelings. Later in life others think Ann is unpredictable or moody. Her self image is less positive

Answer 19

Reacts disorganised to stress Amy who is 1 year old gets sent to a nursery where the staff are often overworked and very stressed. Some are outright abusive and Amy becomes anxious from the people she receives care from, a conflict which totally disorganises her ideas about love and safety. As she is experiencing fear with no resolution she tries to avoid all social situations. As an adult she thinks of herself as unworthy to love and negative image of herself - her attachment is Anxious Disorganised

Answer 20

Attachment is formed in the very first years of our lives when we cannot communicate anxiety. We experience levels of stress, producing adrenaline and cortisol, our BP goes up and we experience stress called Toxic Stress, which impairs a child's development of their brain and weakens their immune system. Can change switches on genes affecting health many years later.

Answer 21

Do this by watching child play with mother and when she leaves and come sback see how reatcs. Securely attached hugs mother and calms down then plays, insecurely attached can start crying or refuse to continue playing.

Answer 22

Can workout likelihood of dropping out of university at age of 3 with 77% accuracy. 91% of those who had broken relationship to mother had diseases.

Answer 23

The way parents interact with children is a key factor that affects children's development. However, the impact of parenting practices on children is affected by other characteristics in the larger ecological context, including child or parent characteristics (temperament, personality), the quality of family relationships, and parameters in the community (neighbourhood, schools, peer relations) and culture.

Answer 24

The effects of various parenting practices on children vary across different ethnic groups. Although strict parental discipline styles increase children's risk for psychological difficulties (anxiety, depression, submissiveness, poor self-confidence) among white families, the sane discipline styles according to some studies appears to pose little or no risk for children in Asian or African U.S. families. The same parenting practices take on different meanings in families with different cultural backgrounds. For example, strict control may be interpreted as a sign of involved, caring, and effective parenting within certain ethnic and cultural groups. Child development therefore is best understood as embedded in a variety of social and ecological contexts, including community, cultural, and ethnicity.

Answer 25

Both normal and abnormal development are regarded as a cumulative result of multiple influences originating in the child, family, and larger community or cultural setting.

Answer 26

Can change type of adult becoming, increase number stressful events increases health conditions. Can include physical, emotional and neglect. Like domestic violence, parents splitting, parent with mental illness, or someone in house in prison. More ACE's I have now more risk as adult. 4+ ACES makes more likely to develop heart disease, type 2 diabetes, be in prison, committed violence, smoking, drinking and drugs. Things like bullying, loosing a parent, not having a home and being poor can also impact. 4 or more aces 3 times more likely to live in a deprived area. Having an adult makes effect of ACE's less. 260,000 living in poverty in Scotland. 7/10 families have an adult working.

Answer 27

Risk factors increase the likelihood of experiencing psychological difficulties. Family risk factors include: - Child maltreatment - Parental rejection - Inconsistent or harsh discipline practices - Parental conflict - Parental mental illness - Substance use

Answer 28

Exposure to even the most harmful risk factors does not doom all or even most children to a life of psychological problems. Children exposed to the same risk factor may have a range of healthy and maladaptive psychological outcomes. Although parental depression is one of the most robust risk factors, children of depressed parents exhibit a wide range of adaptive and maladaptive outcomes (depression, anxiety, aggression, academic problems).

Answer 29

Exposure to parental mental illness does not affect children in a psychological vacuum Parental psychopathology (depression, alcoholism) often co-occurs with other risk factors: - Familial (marital discord, poor extended family relations). - Sociocultural (poverty, community isolation) - Biological (transmission of risk through genes, substances, birth complications, temperament).

Answer 30

Epigenetics; - Exposure to environmental risk factors at sensitive periods of development may result in DNA methylation. - These epigenetic changes may lead to greater vulnerability to stress and increased risk of specific psychiatric conditions. - It is possible these changes may also be heritable.

Answer 31

Four Types of Unresponsive Care; - Occasional Inattention - Chronic Under-Stimulation - Severe Neglect in a Family Context - Severe Neglect in an Institutional Setting Occasional Inattention - No harm, sometimes benefit Chronic Under-Stimulation - On regular basis children have less interaction with adult, will show 'catch up' on serve and return Severe Neglect in a Family Context - Prolonged periods of inattention, lack of responsiveness, not being fed enough, not being bathed enough. Severe Neglect in an Institutional Setting - Children living in warehouse type situations like orphanages. Really alters child's brain architecture with new person every shift etc.

Answer 32

When child doesn’t get input from those around them. Serve and Return is when the parent notices the child doing this and responds. When baby isnt responded to the stress system responds in baby and reacts. Key synapses fail to form.

Answer 33

The search for mediators answers the question of "how" and "why" risk conditions lead to maladaptive outcomes. Mediators are the processes or mechanisms that explain or account for why family characteristics increase children's risk for psychopathology. In parental depression for example, a primary goal of a developmental psychopathologist would be to identify the mechanisms by which parental depression leads to child behaviour problems.

Answer 34

Moderators in models of risk answers questions of "who" is at greatest risk and "when" is the risk greatest. The assunption is that the likelihood that a risk factor leads to disorder varies across different individuals and conditions. Answering the question of who is at greatest risk involves searching for attributes of the person (gender, temperament, personality) that might amplify or increase the likelihood that they will experience a disorder when exposed to risk.

Answer 35

Moderating mechanisms - Parental discord is especially likely to increase psychological problems for children who have difficult, rather than easy, temperaments. - Attributes outside the person (family, school, community, peers) may also intensify the effects of the risk factor.

Answer 36

Trauma leads to exaggerated fight or flight responses Low Road (Fast Pathways) involves low parts such as amygdala; - Data Analyst (Thalamus - gathers data from external and internal world from all 5 senses external world, proprioception from internal worlds - HR, BP, Joint position). Sends all this info in 2 directions by the slow pathways (high road) and fast pathway (low road). Send via low road (as fast as possible to emergency alarm) - Emergency Alarm (Amygdala - emotional brain) - if detects real or perceived threats fires off danger. If alarm doesn’t work you wont live very long as seen in evolution. - Security Guard (sympathetic nervous system) - does he take cover or shoot?

Answer 37

Trauma leads to exaggerated fight or flight responses High Road (Slow Pathways) involves part close to cerebral; cortex hence high; - Data Analyst (Thalamus - gathers data from external and internal world from all 5 senses external world, proprioception from internal worlds - HR, BP, Joint position). Sends all this info in 2 directions by the slow pathways (high road) - Mission Control (Medial prefrontal Cortex - just Infront of eyes). Gathers all data and makes informed decision (taps into parts of cerebral cortex). Can think if need to take action or if it’s a perceived threat (a few microseconds slower). - Amygdala/Emergency Alarm also send info to Mission control (Medial prefrontal Cortex) which is slower than the immediate response to the security guard.

Answer 38

What happens in brain when people are traumatised leading to exaggerated fight or flight responses; Low Road (Fast Pathways) involves low parts such as amygdala; - Data Analyst (Thalamus - gathers data from external and internal world from all 5 senses external world, proprioception from internal worlds - HR, BP, Joint position). Sends all this info in 2 directions by the slow pathways (high road) and fast pathway (low road). Send via low road (as fast as possible to emergency alarm) - Emergency Alarm (Amygdala - emotional brain) - if detects real or perceived threats fires off danger. If alarm doesn’t work you wont live very long as seen in evolution. - Security Guard (sympathetic nervous system) - does he take cover or shoot? High Road (Slow Pathways) involves part close to cerebral; cortex hence high; - Data Analyst (Thalamus - gathers data from external and internal world from all 5 senses external world, proprioception from internal worlds - HR, BP, Joint position). Sends all this info in 2 directions by the slow pathways (high road) - Mission Control (Medial prefrontal Cortex - just Infront of eyes). Gathers all data and makes informed decision (taps into parts of cerebral cortex). Can think if need to take action or if it’s a perceived threat (a few microseconds slower). - Amygdala/Emergency Alarm also send info to Mission control (Medial prefrontal Cortex) which is slower than the immediate response to the security guard. So in a trauma brain, the data analyst (thalamus) is continuously sending inaccurate data to the overworking security alarm (amygdala) which is firing off again and again telling the security guard over and over to take cover or shoot - giving sympathetic arousal with anger, irritability, fear, startle, withdrawal and retreat over and over again.

Answer 39

Mindfulness, grounding, self compassion works on medial prefrontal Cortex of brain (Mission Control)

Answer 40

*Highly interactive process between individual characteristics of a person and the environment that person has developed in. balancing difficult thing in child's life with positive things in family and community. Like a scale weighing out good and bad things and our genes predispose the fulcrum position influencing the tipping point of the scales (can be more sensitive to maltreatment). Influences how much events influence you positively or negatively. Experiences move the fulcrum and genes response differently to different experiences and turns up and down circuits in brain. Adults are key in building relationship for resilience in a child.

Answer 41

Even when multiple risk factors are present many children at risk develop along normal, adaptive trajectories. Developmental psychopathologists use the term resilience to refer to children who develop convetently and adapt successfully to life's challenges under adverse conditions. Resilience, by definition, cannot occur without some appreciable risk. Thus, a primary challenge is to distinguish between two general groups of children: - (a) the relatively "normal" children, who experience minimal or no adverse conditions, and - (b) the resilient children, who developed relatively normally in the face of considerable risk. - It cannot be assumed that children of depressed parents who experience healthy development are resilient. - Some of these children may, in fact, experience contexts of development characterized by caregiver warmth, consistent discipline, safe and supportive neighbourhoods, and high quality schools. - The competence of some of these children may result from the absence of risk rather than the presence of resilience.

Answer 42

Once people who meet the criteria for exhibiting resilience are identified, the next step is to search for the protective factors that account for their healthy outcomes. Protective factors dilute or counteract the negative effects of risk factors. Like risk factors, protective factors can be characteristics of the individual (personality) or the larger ecological setting (family, school, peers). For example, child intelligence appears to offset the negative effects of inter-parental conflict on children. Likewise, various family characteristics and relationships (parental warmth, good sibling relations) appear to act as buffers that help shield children from the risk posed by parental conflict.

Answer 43

Disorders often follow the course of several stages, including: - Onset - Maintenance (continuation of symptoms) - Remission (tenporary alleviation of symptoms) - Recurrence (redevelopment of symptoms) - Termination Each of these stages of maladaptation may be associated with different sets of factors, causes, and consequences.

Answer 44

Family conflict may play a causal role in the onset of children's conduct problems, but peers and teachers may maintain or further intensify the problems even in the face of marked reductions in family conflict.

Answer 45

Normal and abnormal development are regarded as a cumulative result of multiple influences originating in the child, family, and larger community or cultural setting.

Answer 46

Developmental psychopathologists try to understanding why some children develop disorders or maladaptation whereas other children develop normally.

Answer 47

Mental health problems can be lifelong and usually start in childhood.

Answer 48

Interaction between genes and the environment is mediated through multi-factorial developmental processes.

Answer 49

Brain is programmed to alter behavioural patterns in accord with changing environmental conditions.

Answer 50

Interventions seek to alter developmental trajectory.

Answer 51

Remodelling in the brain occurs where 2 things occur; - Pruning in brain, connections and synapses are being formed and the connections are growing but the brain prunes itself cutting back some connections to specialise the brain to find their passion and not just retain everything generally like a child. Hence use or loose principles. - Myelin formation - healthy sheath that allows connected neurons to communicate in a much more effective way up to 100x faster and is 30 times shorter resting period (3,000 times more effectively).

Answer 52

Can use the focus of your attention to be aware of people which reinforces parts of the brains you want to hold on to. Neuroplasticity is this and how your brain responds to experiences.

Answer 53

The ultimate goal of brain remodelling is to make an integrated brain by pruning and linkage giving a more integrated brain which is the pathway to wellbeing. Mindsight exercises helps increase integration and give insight, empathy and integration. When integration is present we have more kindness and compassion giving deep connections, honouring vulnerability, wanting to help people.

Answer 54

5% children M 3:1 F - May be due to how presents differently in girls (more attentive)

Answer 55

Persistent pattern of inattention symptoms or a combination of hyperactivity and impulsivity symptoms Symptoms have onset before age 12* years and are: - Outside the limits expected for age and level of intellectual development - Persistent (26 months) and severe enough to have a negative effect on academic, occupational, or social functioning - Evident across multiple situations or settings (eg, horT%*, school, work, with friends or relatives), but may vary with the structure and demands Of the setting Symptoms are not: - Due to the effects of a substance (eg, cocaine) or medication (eg, bronchodilators, thyroid replacement medication) on the CNS, including Withdrawal effects - Due to a disease of the nervous system - Better accounted for by another mental disorder (eg, anxiety or fear-related disorder, neurocognitive disorder such as delirium) ICD has 11 symptoms and DSM-5 has 9 of each (many rating scales come from DSM-5). Issue is DSM-5 has cut off of 6/9 required for diagnosis

Answer 56

Inattentive Symptoms; - Difficulty sustaining attention to tasks that do not provide a high level of stimulation or reward or require sustained mental effort - Lacking attention to detail - Making careless mistakes in school or work assignments - Not completing tasks - Easily distracted by extraneous stimuli or thoughts not related to the task at hand - Often does not seem to listen when spoken to directly - Frequently appears to be daydreaming or to have mind elsewhere - Loses things - Is forgetful in daily activities - Has difficulty remembering to complete upcoming daily tasks or activities - Difficulty planning, managing, and organizing schoolwork, tasks, and other activities

Answer 57

Hyperactive/lmpulsive Symptoms; - Excessive motor activity - Leaves seat when expected to sit still - Often runs about - Has difficulty sitting still without fidgeting (younger children) - Feelings of physical restlessness, a sense of discomfort with being quiet or sitting still (adolescents and adults) - Difficulty engaging in activities quietly - Talks too much - Blurts out answers in school, comments at work - Difficulty waiting turn in conversation, games, or activities - Interrupts or intrudes on others conversations or games - A tendency to act in response to immediate stimuli without deliberation or consideration of risks and consequences (eg, engaging in behaviours with potential for physical injury; impulsive decisions; reckless driving)

Answer 58

History; - Developmental, Sleep, School, Family and Social - From child and parents Examination; - Assessment tools: Vanderbilt's Conners Q to P&T - Reports from teachers and other involved adults - Consider the impact of difficulties on the child and family - Consider formulation

Answer 59

- Smoking and alcohol increases ADHD risk - Sodium Valproate can increase neurological problems

Answer 60

Heart murmurs and cardiovascular disease

Answer 61

In formulation, ontological (diagnostic hierarchy), causal (biopsychosocial model) and meaning (verstehen) perspectives combine to give an overall picture of an individual case and a basis for treatment and care 4P factor model; - Predisposing (Vulnerabilities that can lead to problem) - Precipitating (Increase risk of problem) - Perpetuating (Keep problem going) - Protective - Biological - Psychological - Social *Formulation helps to think about perpetuating factors. While a lot could be down to circumstances and parents doesn't mean cant be neurological developmental issue, need to be thorough to differentiate.

Answer 62

- ADHD focussed Group Parenting Programme (PINC) - School adjustments - Assess comorbidities, autism, tics - Medications need to monitor height weight pulse BP, FH of sudden death or any fatigue/ SOB/ Syncope on exercise NICE guideline 87 SIGN 145 due update

Answer 63

1st line - Methylphenidate (Stimulant (short acting about 4 hours - can get longer ones) SE - on sleep and appetite). 2nd Line - Lisdexamfetamine (Stimulant) 3rd line - Atomoxetine/ Guanfacine (Non-stimulant - taken daily (useful in anxiety and tics as stimulants can cause). Cardiac risks need to rule out).

Answer 64

1-2% children M 4:1 F

Answer 65

- Persistent deficits in initiating and sustaining social communication and reciprocal social interactions that are outside the expected range of typical functioning given the individual's age and level of intellectual development. Specific manifestations of these deficits vary according to chronological age, verbal and intellectual ability, and disorder severity. - Persistent restricted, repetitive, and inflexible patterns of behaviour, interests, or activities that are clearly atypical or excessive for the individual's age and sociocultural context. - The onset of the disorder occurs during the developmental period, typically in early childhood, but characteristic symptoms may not become fully manifest until later, when social demands exceed limited capacities. - The symptoms result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

Answer 66

History - Ask questions and get score (need trained) Examination - Vanderbilt (ADHD) and SRS2 (Autism - Social responsiveness) Questionnaires - School report +/ - observations - ADOS 2 (Autism - main) - Speech and Language assessment * - Ask about eye contact, peers, speech, how in groups, empathy, do they share, speech delay - Repetitive movements, moving, etc - Skipped and hummed around playground, sensitive to noise, textural issues with food. - Normal birth.

Answer 67

High risk of seizures in autism and increase in GI (constipation)

Answer 68

ADOS-2; - Standardized, play-based, observational assessment - Elicit particular types of behaviors, communication, and social interactions - Presence of behaviors related to ASD rated by a formally trained clinician - Algorithm indicates likelihood of ASD - Purpose = DIAGNOSTIC TOOL - Goal = Answer the question: "Does this child have ASD, yes or no?" - 5 Modules based on developmental and language level, and chronological age

Answer 69

Neurofibromatosis (conditions with mutations for RAS, related to cell division and growth) - Cafe au lait Neurodevelopmental delays, cardiac problems

Answer 70

- Parent-mediated Intervention Programme CYGNET - Environmental Adjustment and Behavioural Interventions - Consider co-morbidities sleep disturbance, ADHD, anxiety, depression, intellectual disability - Investigations Microarray and Fragile X,? (Associated with autism) Refer to Genetics - Support for Communication SALT - Occupational Therapy - Medication: Melatonin for sleep. (Management of irritability and aggression Aripriprazole and Risperidone)

Answer 71

Fragile X (distinctive long face, prominent ears

Answer 72

P-10 syndrome - large circumference of heard (linked to cancers, thyroid colon)

Answer 73

Ashley Mark Hills or hyperpigmented macules found in tuberous sclerosis (dominant condition) - Associated with non cancerous growths, seizures and neurodevelopmental disorders

Answer 74

ASQ - Ages and stages Questionaries SE - social and emotional development - History - Examination - Further Assessment to aid formulation

Answer 75

Many features described in neglected/emotionally abused children with those found in children suffering from autistic spectrum disorder or attention deficit hyperactivity disorder. *Systematic review on emotional abuse and neglect and found kids been through this trauma present with features of autism and ADHD that helps with this assessment and can relate to psychopathological developmental lecture

Answer 76

- Often visual thinkers and learners - Memory for facts and figures - Specialised areas of interest and knowledge - Logical Problem Solvers - Creative and out-of-the-box thinkers - Observant

Answer 77

- Use clear concise language - Play/move - Allow time for processing - Dealing with one situation may not be applied to other situations - Prepare people for change (Transitions) - Written answers, statements or pictures may be more effective than speaking - Explain what is to be expected of them and the environment - If you do have to repeat yourself then be sure to use the same words used originally - Do not rely on implied meanings (suggested but not directly expressed) - Remember that unstructured times can be the most difficult

Symposium 2 - Child and Adolescent Psychiatry Flashcards

(101 cards)