disorders of childhood and adolescence
Terms
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- what is the difference between "disorders ususally first diagnosed in infancy, childhood, and adolescence" and "diagnoses that may be applied to children and adolescents." ?
- most disorders already discussed in this course may be applied to children and adolescents. "Disorders first diagnosed in infancy, childhood, and adolescence" refers to disorders to disorders that must present in the earlier years in order to be diagnosed
- Clinical features of ADHD
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1. impulsive
2. overactive behavior that interferes with the ability to accomplish tasks - 3 types of ADHD
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1. inattentive
2. hyperactive/impulsive
3. combined - 3 causal theories of ADHD
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1. genetic/biological - smaller frontal lobe
2. learning - enforced by attention
3. psychoanalytic - parental personality - 2 most common treatments for ADHD
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1. Medications - stimulants
2. Cognitive-behavioral - positive reinforcement
*medications appear to be more effective however not much research in long term side effects* - Oppositional Defiant Disorder
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found in earlier childhoood.
recurrent pattern of negative, defiant, disobedient and hostile behavior toward authority figures - Conduct Disorder
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Found later.
-persistent repetitve violation of rules and disregard for the rights of others.
-patterns of lying
-req. diagnosis by age 15 for Antisocial pathological disorder to be diagnosed later in life - causal factors of disruptive behavior disorders
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1. biological - frontal lobe probs
2. personal pathology - genetic predisposition
3. family patterns - learned/genetic
4. peer relationships - associate with similar kids - attriution bias and how it relates to the development of disruptive behavior disorders
- child interprets ambiguous act as hostile -> aggression towards others -> retaliation by others -> further angry aggression to others
- 2 most common treatments for disruptive behavior disorders
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1. cohesive family model - teaching parenting skills
2. behavioral techniques - reduce neg behaviors, works best in younger children - causal factors associated with anxiety disorders in children
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1. sensitivity to aversive stimuli - frightened
2. early illness - long time in hospital
3. modeling effect - learned from parents
4. detached parents
5. cultural issues - emphasis on compliance
6. exposure to violence - two most common treatments for anxiety disorders among children
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1. antidepressants
2. behavioral therapy - enuresis
- bedwetting that is not organically caused in children at least 5yo
- encopresis
- children at least 4yo not learned appropriate toileting for bowel movements
- tic
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persistent, intermittent muscle twitches/spasms limited to a localized muscle goup
ususally face or shoulder - Touretts Syndrome
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tic involving multiple motor and vocal patterns
ex. facial tics with grunting and shouting - pervasive developmental disorder
- severely disabiling conditions that are the result of structural differences in the brain
- clinical features of Asperger's syndrome
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severe and sustained impairment in social interaction:
1. egocentric
2. lack of interaction
3. emotionally inappropriate
4. limited interest, preoccupation
5. repetitve routine/rituals
6. large vocabulary
7. impaired comprehension
8. motoric clumsiness - how is Asperger's different from Autism
- Autism differs greatly in that autism presents a lack of vocabulary
- What are the main clinical features of Autism
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1. social deficit - no need for interactions
2. absence of speech - not used to communicated
3. self-stimulation - repetitve movements
4. impaired intellectual ability
5. preoccupatoin with maintaining sameness - Main treatments for autism
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1. applied behavior analysis
2. school-based special education
3. medication - not proven effective
4. special living arrangements - Does treatment for autism tend to work? why?
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long term results have been unfavorable
learning behavior in one situation does not help them in others - Dyslexia
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problems in word recognition and reading comprehension - 1. deficient in spelling
2. omission of words
3. slow and painful reading
4. distortion of words - learning disorder
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restricted to cases in wich there is a clear impairment not due to mental retardation
ex. ADHD - biological causal factors for learning disorders
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1. CNS impairments
2. one side of brain develops at a different rate than the other
3. deficiency of physiological activation in brain center with rapid visual processing
4. genetic predisposition - Mild retardation
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IQ 50-70:
1. educable social adj. of adolescent
2. req. some measure of supervision
3. can adjust socially, master simple academic and occupational skills; self-supporting citizen - Moderate retardation
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IQ 35-50:
1. "trainable"
2. achieve intellectual levels of 4-7yo children
3. achieve partial independence in family or other sheltered environments - Severe retardation
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IQ 20-35
1. dependent
2. motor and speech development severely retarded
3. limited levels of personal hygiene and self help skills always dependent on others for care
4. can perorm simple occupational tasks under supervision - Prfound retardation
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IQ below 25:
1.life support retarded
2. severely deficient in adaptive behavior and unable to master any but simplest tasks
3. rudimentary if any speech
4. physical deformities
5. must remain in custodial care entire life
6. poor health and low resistance to disease - 5 organic causes of mental retardation
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1. genetic-chromosomal
2. infections/toxic agents
3. trauma (hypoxia)
4. ionizing radiation
5. malnutrition - Down Syndrome
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irreversible limitations on survivability, intellectual achievement and competence in managing life skills
extra genetic material - trisomy of chrom.21 (47 rather than 46) - Phenylketonuria
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baby appears normal at birth but lacks a liver enzyme needed to break down phenylalanine.
only significant when large quantities of phenylalanine are ingested
both parents must carry recessive gene - microcephaly
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small headdedness - impaired development consequent failure to attain normal sized cranium
- result of infect. in mother - hydrocephaly
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- abnormal accumulation of cerebrospinal fluid w/in cranium - enlargement of skull
at birth or following development of tumor, subdural hematoma, meningitis..... - treatment for mental retardation
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1. short term facilities for eval. and training
2. small private hospitals specializing in rehabilitative techniques
3. group homes or halfway houses
4. nursing homes
5. enriched foster-home environments