This document provides information on mental retardation and developmental disorders. It discusses:
1) The diagnostic criteria for mental retardation including low intellectual functioning (IQ less than or equal to 70) and deficits in at least two domains of adaptive behavior.
2) The ranges of mental retardation from mild to profound and the characteristics of each.
3) Common causes of mental retardation including genetic conditions like Down syndrome and environmental factors like problems during gestation or delivery.
4) Treatments for mental retardation including education, behavioral treatment, and parent training.
Basic approach on short stature in childrenAzad Haleem
This document provides an overview of short stature, including definitions, types, diagnostic principles, causes, and management. It defines short stature as height below the 3rd percentile and discusses types such as familial short stature. Diagnosis involves accurate height measurements, bone age assessment, mid-parental height comparison, and medical investigations. Causes include growth hormone deficiency, Turner syndrome, and small size at birth. Management consists of dietary counseling, growth hormone injections, and limb lengthening procedures depending on the underlying cause.
This document discusses persistent and chronic diarrhea. Persistent diarrhea lasts at least 14 days and excludes chronic conditions, affecting 10% of diarrhea cases. Chronic diarrhea lasts over 14 days and has identifiable causes like infections, malabsorption, or metabolic disorders. A thorough clinical evaluation including stool tests, imaging, and biopsies can identify causative pathogens or conditions. Treatment focuses on rehydration and specialized diets while also addressing the underlying cause.
This document provides guidance on evaluating floppy infants. It discusses the importance of assessing muscle tone and differentiating between central, peripheral, and mixed hypotonia. A thorough history and physical exam can help localize the cause and narrow the differential diagnosis, which includes various central nervous system disorders, peripheral nerve and muscle diseases, and metabolic conditions. The document outlines steps for evaluating tone, important exam findings for different etiologies, and differential diagnoses to consider in floppy infants.
1. The document discusses different types of seizures including focal onset seizures, generalized onset seizures, and seizures of unknown onset. It provides definitions and examples of motor and non-motor seizures.
2. Etiologies of seizures in the neonatal period and beyond are outlined, including infections, metabolic disorders, brain malformations, drugs/poisons, and epilepsy syndromes.
3. Febrile seizures are defined as seizures associated with fever in children between 6-60 months old. Simple febrile seizures are brief and do not recur within 24 hours, while complex febrile seizures are prolonged or recurrent.
Global developmental delay & Intellectual disabilityDrDilip86
This document provides information on evaluating and investigating children with global developmental delay (GDD) or intellectual disability (ID). It defines GDD and ID and outlines the similar investigations pursued for both, including medical history, physical exam, genetic testing like chromosomal microarray and metabolic testing of blood and urine. The diagnostic yield of investigations is highest when focused on identifying potentially treatable inborn errors of metabolism or single-gene disorders. The document recommends chromosome microarray as the first-line genetic test and discusses other genetic tests, metabolic tests, imaging and neurological evaluation that can help identify underlying etiologies.
This document discusses approaches to diagnosing and treating hypertension in children. It defines hypertension and outlines stages of severity. In infants and young children, hypertension is usually secondary to an underlying condition, while adolescents can develop primary or essential hypertension. Evaluation involves measuring blood pressure properly, considering causes of secondary hypertension, assessing for target organ damage like left ventricular hypertrophy, and determining if hypertension is primary or secondary. Treatment involves lifestyle changes, weight management if overweight, and potentially medications to lower blood pressure below guidelines.
This document provides guidance on evaluating and diagnosing childhood arthritis. It distinguishes arthritis from arthralgia based on clinical features. It lists various differential diagnoses for childhood joint pain or swelling including infectious, rheumatological, neoplastic and traumatic etiologies. It describes tender points seen in fibromyalgia. It outlines features that can distinguish inflammatory, mechanical and sinister causes of joint pain. The approach involves assessing onset, number and type of joints involved, associated systemic symptoms and precipitating factors. Key clues from history and physical exam are described. A review of systems guides evaluation of specific organ systems. Common clinical presentations like acute monoarthritis, chronic monoarthritis and polyarthritis are reviewed. Characteristics of juvenile idiopathic arthritis subtypes
Basic approach on short stature in childrenAzad Haleem
This document provides an overview of short stature, including definitions, types, diagnostic principles, causes, and management. It defines short stature as height below the 3rd percentile and discusses types such as familial short stature. Diagnosis involves accurate height measurements, bone age assessment, mid-parental height comparison, and medical investigations. Causes include growth hormone deficiency, Turner syndrome, and small size at birth. Management consists of dietary counseling, growth hormone injections, and limb lengthening procedures depending on the underlying cause.
This document discusses persistent and chronic diarrhea. Persistent diarrhea lasts at least 14 days and excludes chronic conditions, affecting 10% of diarrhea cases. Chronic diarrhea lasts over 14 days and has identifiable causes like infections, malabsorption, or metabolic disorders. A thorough clinical evaluation including stool tests, imaging, and biopsies can identify causative pathogens or conditions. Treatment focuses on rehydration and specialized diets while also addressing the underlying cause.
This document provides guidance on evaluating floppy infants. It discusses the importance of assessing muscle tone and differentiating between central, peripheral, and mixed hypotonia. A thorough history and physical exam can help localize the cause and narrow the differential diagnosis, which includes various central nervous system disorders, peripheral nerve and muscle diseases, and metabolic conditions. The document outlines steps for evaluating tone, important exam findings for different etiologies, and differential diagnoses to consider in floppy infants.
1. The document discusses different types of seizures including focal onset seizures, generalized onset seizures, and seizures of unknown onset. It provides definitions and examples of motor and non-motor seizures.
2. Etiologies of seizures in the neonatal period and beyond are outlined, including infections, metabolic disorders, brain malformations, drugs/poisons, and epilepsy syndromes.
3. Febrile seizures are defined as seizures associated with fever in children between 6-60 months old. Simple febrile seizures are brief and do not recur within 24 hours, while complex febrile seizures are prolonged or recurrent.
Global developmental delay & Intellectual disabilityDrDilip86
This document provides information on evaluating and investigating children with global developmental delay (GDD) or intellectual disability (ID). It defines GDD and ID and outlines the similar investigations pursued for both, including medical history, physical exam, genetic testing like chromosomal microarray and metabolic testing of blood and urine. The diagnostic yield of investigations is highest when focused on identifying potentially treatable inborn errors of metabolism or single-gene disorders. The document recommends chromosome microarray as the first-line genetic test and discusses other genetic tests, metabolic tests, imaging and neurological evaluation that can help identify underlying etiologies.
This document discusses approaches to diagnosing and treating hypertension in children. It defines hypertension and outlines stages of severity. In infants and young children, hypertension is usually secondary to an underlying condition, while adolescents can develop primary or essential hypertension. Evaluation involves measuring blood pressure properly, considering causes of secondary hypertension, assessing for target organ damage like left ventricular hypertrophy, and determining if hypertension is primary or secondary. Treatment involves lifestyle changes, weight management if overweight, and potentially medications to lower blood pressure below guidelines.
This document provides guidance on evaluating and diagnosing childhood arthritis. It distinguishes arthritis from arthralgia based on clinical features. It lists various differential diagnoses for childhood joint pain or swelling including infectious, rheumatological, neoplastic and traumatic etiologies. It describes tender points seen in fibromyalgia. It outlines features that can distinguish inflammatory, mechanical and sinister causes of joint pain. The approach involves assessing onset, number and type of joints involved, associated systemic symptoms and precipitating factors. Key clues from history and physical exam are described. A review of systems guides evaluation of specific organ systems. Common clinical presentations like acute monoarthritis, chronic monoarthritis and polyarthritis are reviewed. Characteristics of juvenile idiopathic arthritis subtypes
Breath-holding spells are a common psychosomatic disorder seen in children between 6 months and 6 years old. There are two main types - cyanotic spells which involve apnea and cyanosis, and pallid spells which cause hypotonia and loss of consciousness. Breath-holding spells are usually benign and result from an immature autonomic nervous system. A family history of spells is present in about 35% of cases. Diagnosis is based on clinical history and examination, with no additional testing needed. Management involves reassurance, placing the child on their side during spells, iron supplementation, and potentially atropine or piracetam for severe cases.
Prevetable cause of mental retardationRakesh Verma
Mental retardation, now called intellectual disability, is defined by subaverage intelligence and impaired adaptive functioning that arises before age 18. It has various causes including genetic conditions, maternal health factors during pregnancy, neonatal medical issues, infections, trauma, toxins, and psychosocial deprivation. Screening tests can detect developmental delays, while definitive tests like the Bayley Scales assess cognitive abilities. Factors like adequate nutrition, stimulation, and prevention or treatment of certain diseases can help reduce the risk of intellectual disability.
The majority of children have a head size that is appropriate for age and gender. But a few have a too-large head at birth or may be of postnatal acceleration. Macrocephaly is used when the head size exceeds the mean by more than two standard devotions of age and gender. In addition, Macrocephaly is seen in association with several cranio-skeletal dysplastic conditions.
A 15-year-old male presents with concerns of short stature and delayed puberty. Differential diagnoses include gonadotrophin deficiency, gonadal failure, and constitutional delay of growth and puberty. Physical exam and bone age assessment support a diagnosis of constitutional delay of growth and puberty, which is a condition of temporary short stature and delayed puberty but normal expected progression and attainment of full adult height. Reassurance and monitoring are the typical management approach.
This presentation was done by Dr. Julius P. Kessy,MD. An intern Doctor at Dodoma Regional Referral Hospital (DRRH) during pediatrics unit clinical meeting and supervised by Dr. Christina K. Galabawa,MD,Mmed2, Pediatrics and Child Health, University of Dodoma (UDOM) in November, 2017.
This document discusses approaches to macrocephaly and microcephaly. Macrocephaly is defined as a head circumference over 2 standard deviations above the mean, while microcephaly is under 3 standard deviations below the mean. Causes of macrocephaly include genetic factors, hydrocephalus, tumors, and metabolic disorders. Hydrocephalus results from abnormal CSF accumulation and can be obstructive or communicating. Microcephaly can be primary/genetic due to syndromes or secondary from infections, drugs, or hypoxia that impact brain development prenatally or in the first two years. Evaluation and treatment depends on the underlying cause.
Microcephaly is a head circumference more than 3 standard deviations below the mean. It can be primary/genetic due to defects in cellular migration, neurulation or prosencephalization. Secondary microcephaly has prenatal causes like infections, drugs or postnatal causes like birth injuries or infections. Primary microcephaly is usually autosomal recessive and presents with distinctive facial features and severe intellectual disability. Secondary microcephaly has a varied presentation depending on the cause. Evaluation involves examining for dysmorphism, neurological problems and investigating for possible causes. Treatment focuses on managing symptoms while prevention centers around screening for infections and nutritional supplementation.
This document provides an overview of evaluating and managing short stature in children. It discusses evaluating a child's growth pattern, examining family history and performing physical exams. Key factors that can cause short stature are discussed, including familial, constitutional growth delay, chronic diseases, psychosocial, chromosomal, genetic syndromes and endocrine disorders. Investigations discussed include growth charts, bone age assessments, blood tests and other tests depending on symptoms. Management depends on the underlying cause, such as counseling for familial short stature, disease management for chronic illnesses, growth hormone therapy for deficiencies.
This document discusses precocious puberty in a 3 year old girl. On examination, she had breast enlargement and pubic hair development consistent with Tanner stages B3 and Ph2. Lab tests found elevated LH and FSH. Ultrasound showed enlarged uterus and ovaries. The document then reviews physiology of puberty, Tanner staging of breast and pubic hair development, defines precocious puberty, and discusses causes and treatment options like GnRH agonists or surgery.
This document discusses pediatric obesity, including its definition using BMI, epidemiology, causes, complications, treatment, and prevention. Regarding definition and BMI, obesity in children is defined as excess body fat that negatively impacts health, and is diagnosed using BMI centiles where overweight is >91st centile and obese is >98th centile. The document then reviews the rising global rates of pediatric obesity and risk of obesity continuing into adulthood. Causes discussed include genetic predisposition and obesogenic environmental factors that promote overeating and sedentary behaviors. Complications can impact nearly every organ system, while treatment involves lifestyle changes and may include multidisciplinary programs depending on severity. Prevention strategies incorporate breastfeeding, appropriate portion sizes,
This document discusses prematurity and its management. It defines prematurity as infants born before 37 weeks gestation. The main causes of prematurity include fetal, placental, uterine and maternal factors. Key aspects of management include antenatal corticosteroids to aid lung development, careful temperature and fluid regulation, early nutrition including breastmilk, and monitoring for respiratory, cardiac and neurological complications which are common in premature infants. The goal of management is to provide supportive care until organs are developed enough for survival outside the womb.
Hypothyroidism in children can be congenital or acquired. Congenital hypothyroidism is present from birth and is usually caused by thyroid dysgenesis or iodine deficiency in high-risk areas. It presents with poor feeding, constipation, large tongue, and delayed development. If not treated early with thyroxine replacement, it can cause intellectual disability. Acquired hypothyroidism develops later in childhood and may be caused by autoimmune thyroiditis, iodine deficiency, or rare genetic disorders. Hypothyroidism is diagnosed through clinical features, low thyroid hormone levels, and high TSH. Treatment involves lifelong thyroxine replacement to prevent complications of delayed growth and intellectual development
Rickets is a disease characterized by softening and weakening of bones in children, caused by a vitamin D deficiency or impaired metabolism of calcium or phosphorus. It most commonly affects children between 6-24 months old and can lead to fractures and bone deformities. While historically more prevalent, rickets decreased in developed countries in the 20th century but remains common in developing nations and populations with dark skin where access to vitamin D-fortified foods is limited. Treatment involves increasing dietary intake of calcium, phosphorus and vitamin D through supplements, exposure to sunlight, or vitamin D-fortified foods and formula. Physical therapy can help reduce bone and muscle pain through stretching and strengthening exercises.
The document discusses diabetic ketoacidosis (DKA), a life-threatening complication that occurs most often in patients with type 1 diabetes. DKA is characterized by hyperglycemia, metabolic acidosis, and ketosis. It results from a lack of insulin and excess counterregulatory hormones that cause fat and protein breakdown. This leads to ketone accumulation and high blood glucose levels. Treatment involves insulin, intravenous fluids, electrolyte replacement, and monitoring for complications like cerebral edema.
constipation in children , pediatric constipation , management of constipation in children , understanding constipation , causes of constipation in children , functional constipation in children , treatment of constipation ,approach to constipation in children ,constipation in infants
This document discusses chronic kidney disease in children. It defines chronic kidney disease as either kidney damage or a glomerular filtration rate below 60 ml/min/1.73m2 for over 3 months. Causes in children include congenital abnormalities, glomerulonephritis, cystic kidney diseases, and inherited disorders. Chronic kidney disease progresses through 5 stages and can cause complications affecting multiple organ systems. Treatment aims to replace kidney function, slow progression, and manage complications through measures like fluid/electrolyte control, nutrition, anemia treatment, bone disease management, and slowing kidney damage progression.
This document defines intellectual disabilities and describes their causes, characteristics, and treatment approaches. Intellectual disabilities originate before age 18 and involve deficits in both intellectual functioning and adaptive behaviors. Common causes include genetic syndromes like Down syndrome, fetal alcohol syndrome, and fragile X syndrome. Symptoms vary depending on severity but may include impaired language, cognition, memory, and behavioral issues. Treatment focuses on developing skills through education, training programs, managing medical issues, and supporting independence.
Marrie, a 24 month old, presented with severe deficits in social engagement including ignoring others and increasing physical distance. She had poor memory, difficulty transitioning between tasks, low self-esteem, and was easily overwhelmed. Doctors noticed delays in language, motor skills, self-care, and sensory processing. Autism is a developmental disorder appearing in the first 3 years, affecting social and communication skills through impaired communication, language, motor skills, and thinking abilities. It has a strong genetic basis and higher prevalence in males.
Breath-holding spells are a common psychosomatic disorder seen in children between 6 months and 6 years old. There are two main types - cyanotic spells which involve apnea and cyanosis, and pallid spells which cause hypotonia and loss of consciousness. Breath-holding spells are usually benign and result from an immature autonomic nervous system. A family history of spells is present in about 35% of cases. Diagnosis is based on clinical history and examination, with no additional testing needed. Management involves reassurance, placing the child on their side during spells, iron supplementation, and potentially atropine or piracetam for severe cases.
Prevetable cause of mental retardationRakesh Verma
Mental retardation, now called intellectual disability, is defined by subaverage intelligence and impaired adaptive functioning that arises before age 18. It has various causes including genetic conditions, maternal health factors during pregnancy, neonatal medical issues, infections, trauma, toxins, and psychosocial deprivation. Screening tests can detect developmental delays, while definitive tests like the Bayley Scales assess cognitive abilities. Factors like adequate nutrition, stimulation, and prevention or treatment of certain diseases can help reduce the risk of intellectual disability.
The majority of children have a head size that is appropriate for age and gender. But a few have a too-large head at birth or may be of postnatal acceleration. Macrocephaly is used when the head size exceeds the mean by more than two standard devotions of age and gender. In addition, Macrocephaly is seen in association with several cranio-skeletal dysplastic conditions.
A 15-year-old male presents with concerns of short stature and delayed puberty. Differential diagnoses include gonadotrophin deficiency, gonadal failure, and constitutional delay of growth and puberty. Physical exam and bone age assessment support a diagnosis of constitutional delay of growth and puberty, which is a condition of temporary short stature and delayed puberty but normal expected progression and attainment of full adult height. Reassurance and monitoring are the typical management approach.
This presentation was done by Dr. Julius P. Kessy,MD. An intern Doctor at Dodoma Regional Referral Hospital (DRRH) during pediatrics unit clinical meeting and supervised by Dr. Christina K. Galabawa,MD,Mmed2, Pediatrics and Child Health, University of Dodoma (UDOM) in November, 2017.
This document discusses approaches to macrocephaly and microcephaly. Macrocephaly is defined as a head circumference over 2 standard deviations above the mean, while microcephaly is under 3 standard deviations below the mean. Causes of macrocephaly include genetic factors, hydrocephalus, tumors, and metabolic disorders. Hydrocephalus results from abnormal CSF accumulation and can be obstructive or communicating. Microcephaly can be primary/genetic due to syndromes or secondary from infections, drugs, or hypoxia that impact brain development prenatally or in the first two years. Evaluation and treatment depends on the underlying cause.
Microcephaly is a head circumference more than 3 standard deviations below the mean. It can be primary/genetic due to defects in cellular migration, neurulation or prosencephalization. Secondary microcephaly has prenatal causes like infections, drugs or postnatal causes like birth injuries or infections. Primary microcephaly is usually autosomal recessive and presents with distinctive facial features and severe intellectual disability. Secondary microcephaly has a varied presentation depending on the cause. Evaluation involves examining for dysmorphism, neurological problems and investigating for possible causes. Treatment focuses on managing symptoms while prevention centers around screening for infections and nutritional supplementation.
This document provides an overview of evaluating and managing short stature in children. It discusses evaluating a child's growth pattern, examining family history and performing physical exams. Key factors that can cause short stature are discussed, including familial, constitutional growth delay, chronic diseases, psychosocial, chromosomal, genetic syndromes and endocrine disorders. Investigations discussed include growth charts, bone age assessments, blood tests and other tests depending on symptoms. Management depends on the underlying cause, such as counseling for familial short stature, disease management for chronic illnesses, growth hormone therapy for deficiencies.
This document discusses precocious puberty in a 3 year old girl. On examination, she had breast enlargement and pubic hair development consistent with Tanner stages B3 and Ph2. Lab tests found elevated LH and FSH. Ultrasound showed enlarged uterus and ovaries. The document then reviews physiology of puberty, Tanner staging of breast and pubic hair development, defines precocious puberty, and discusses causes and treatment options like GnRH agonists or surgery.
This document discusses pediatric obesity, including its definition using BMI, epidemiology, causes, complications, treatment, and prevention. Regarding definition and BMI, obesity in children is defined as excess body fat that negatively impacts health, and is diagnosed using BMI centiles where overweight is >91st centile and obese is >98th centile. The document then reviews the rising global rates of pediatric obesity and risk of obesity continuing into adulthood. Causes discussed include genetic predisposition and obesogenic environmental factors that promote overeating and sedentary behaviors. Complications can impact nearly every organ system, while treatment involves lifestyle changes and may include multidisciplinary programs depending on severity. Prevention strategies incorporate breastfeeding, appropriate portion sizes,
This document discusses prematurity and its management. It defines prematurity as infants born before 37 weeks gestation. The main causes of prematurity include fetal, placental, uterine and maternal factors. Key aspects of management include antenatal corticosteroids to aid lung development, careful temperature and fluid regulation, early nutrition including breastmilk, and monitoring for respiratory, cardiac and neurological complications which are common in premature infants. The goal of management is to provide supportive care until organs are developed enough for survival outside the womb.
Hypothyroidism in children can be congenital or acquired. Congenital hypothyroidism is present from birth and is usually caused by thyroid dysgenesis or iodine deficiency in high-risk areas. It presents with poor feeding, constipation, large tongue, and delayed development. If not treated early with thyroxine replacement, it can cause intellectual disability. Acquired hypothyroidism develops later in childhood and may be caused by autoimmune thyroiditis, iodine deficiency, or rare genetic disorders. Hypothyroidism is diagnosed through clinical features, low thyroid hormone levels, and high TSH. Treatment involves lifelong thyroxine replacement to prevent complications of delayed growth and intellectual development
Rickets is a disease characterized by softening and weakening of bones in children, caused by a vitamin D deficiency or impaired metabolism of calcium or phosphorus. It most commonly affects children between 6-24 months old and can lead to fractures and bone deformities. While historically more prevalent, rickets decreased in developed countries in the 20th century but remains common in developing nations and populations with dark skin where access to vitamin D-fortified foods is limited. Treatment involves increasing dietary intake of calcium, phosphorus and vitamin D through supplements, exposure to sunlight, or vitamin D-fortified foods and formula. Physical therapy can help reduce bone and muscle pain through stretching and strengthening exercises.
The document discusses diabetic ketoacidosis (DKA), a life-threatening complication that occurs most often in patients with type 1 diabetes. DKA is characterized by hyperglycemia, metabolic acidosis, and ketosis. It results from a lack of insulin and excess counterregulatory hormones that cause fat and protein breakdown. This leads to ketone accumulation and high blood glucose levels. Treatment involves insulin, intravenous fluids, electrolyte replacement, and monitoring for complications like cerebral edema.
constipation in children , pediatric constipation , management of constipation in children , understanding constipation , causes of constipation in children , functional constipation in children , treatment of constipation ,approach to constipation in children ,constipation in infants
This document discusses chronic kidney disease in children. It defines chronic kidney disease as either kidney damage or a glomerular filtration rate below 60 ml/min/1.73m2 for over 3 months. Causes in children include congenital abnormalities, glomerulonephritis, cystic kidney diseases, and inherited disorders. Chronic kidney disease progresses through 5 stages and can cause complications affecting multiple organ systems. Treatment aims to replace kidney function, slow progression, and manage complications through measures like fluid/electrolyte control, nutrition, anemia treatment, bone disease management, and slowing kidney damage progression.
This document defines intellectual disabilities and describes their causes, characteristics, and treatment approaches. Intellectual disabilities originate before age 18 and involve deficits in both intellectual functioning and adaptive behaviors. Common causes include genetic syndromes like Down syndrome, fetal alcohol syndrome, and fragile X syndrome. Symptoms vary depending on severity but may include impaired language, cognition, memory, and behavioral issues. Treatment focuses on developing skills through education, training programs, managing medical issues, and supporting independence.
Marrie, a 24 month old, presented with severe deficits in social engagement including ignoring others and increasing physical distance. She had poor memory, difficulty transitioning between tasks, low self-esteem, and was easily overwhelmed. Doctors noticed delays in language, motor skills, self-care, and sensory processing. Autism is a developmental disorder appearing in the first 3 years, affecting social and communication skills through impaired communication, language, motor skills, and thinking abilities. It has a strong genetic basis and higher prevalence in males.
Mental retardation, also known as intellectual disability, is a condition characterized by limited mental abilities and lack of skills necessary for daily living. It is caused by genetic conditions, problems during pregnancy or birth, or health issues after birth. The degree of mental retardation ranges from mild to profound based on IQ scores. Diagnosis involves assessing development, intelligence, and ability to learn. Management focuses on assessment, education, training in life skills, vocational skills, and community involvement to help individuals live as independently as possible.
This document discusses the use of the Diagnostic and Statistical Manual of Mental Disorders (DSM) in diagnosing autism spectrum disorder (ASD). It provides a history of ASD diagnoses and criteria from the DSM-IV to the current DSM-5. The DSM-5 consolidated several ASD diagnoses into one category of autism spectrum disorder. It also modified some diagnostic criteria, such as removing language impairment and adding sensory issues as criteria. The document reviews early signs of social, communication, and cognitive delays that differentiate ASD from other developmental disorders.
1) Autism is a neurodevelopmental disorder characterized by difficulties in social interaction and communication, as well as restricted and repetitive behaviors. It is part of a spectrum of conditions known as autism spectrum disorder (ASD).
2) ASD is diagnosed based on difficulties in social interaction, communication, and restricted or repetitive behaviors observed before age 3. There are different classifications of ASD including autistic disorder, Asperger's syndrome, and others.
3) Treatment for ASD is multidisciplinary and includes behavioral training, education supports, and sometimes medical interventions. However, there are significant challenges to diagnosis and support for those with ASD in Sri Lanka due to lack of awareness, services, and
This document defines autism spectrum disorder and its characteristics according to the Individuals with Disabilities Education Act. It discusses the major subcategories of autism including Asperger's disorder, autistic disorder, and pervasive developmental disorder. The document outlines the characteristics associated with autism spectrum disorder in the areas of social interaction, communication, and restricted or repetitive behaviors. It also summarizes the various educational supports used by special education teachers to help students on the autism spectrum academically, behaviorally, and socially.
The document discusses Asperger's syndrome, which is a type of autism spectrum disorder characterized by difficulties with social skills and restricted, repetitive behaviors. Specifically, it provides information on the history and diagnosis of Asperger's, typical symptoms such as struggles with social interaction and narrow, intense interests, and statistics on prevalence. It also gives examples of how Asperger's may present in individuals.
This document provides an overview of several childhood disorders. It discusses mental retardation, learning disorders, motor skills disorders, communication disorders, pervasive developmental disorders including autism, attention deficit hyperactive disorder, feeding and eating disorders of infancy, tic disorders, elimination disorders, oppositional defiant disorder, conduct disorder, separation anxiety disorder and other disorders. It provides definitions and diagnostic criteria for each disorder and describes symptoms, characteristics, causes and treatments when available.
Mental retardation{intellectual disability} is a condition of arrested or incomplete development of mind, which is specially characterized by impairment of skills manifested during the developmental period, which contribute to the overall level of intelligence, i.e cognitive, language, motor and social abilities.
Prevalence of mental disorders is 4-5 times higher in person with intellectual disability
CAUSES-
GENETIC
ENVIORNMENTAL/SOCIO-CULTURAL
PRENATAL,PERINATAL AND POSTNATAL FACTOR
COMBINED Behavior management
Monitoring the child’s development needs & problems.
Programs that maximize speech, language, cognitive, psychomotor, social, self-care, & occupational skills.
Ongoing evaluation for overlapping psychiatric disorders, such as depression, bipolar disorder, & ADHD.
Family therapy to help parents develop coping skills & deal with guilt or anger.
Provide day schools to train the child in basic skills, such as bathing & feeding.
This document discusses child and adolescent mental health. It defines mental health as the capacity to achieve psychological well-being. Some key points include that untreated mental illness in children can lead to poor academic performance, substance abuse, criminal behavior, and suicide. Common mental disorders in children include anxiety, depression, ADHD, and autism. The document also discusses specific disorders like OCD, learning disabilities, and the impact of HIV/AIDS on child mental health. It emphasizes the importance of prevention through parental training, life skills education, and addressing social stigma.
Autism is a neurological disorder characterized by difficulties with social interaction and communication, as well as restricted and repetitive behaviors. It is diagnosed based on observations of these characteristics. There are different types of autism that vary in symptoms and severity. While the specific causes are unknown, autism is generally thought to involve abnormalities in brain development and genetics. Therapies aim to help those with autism improve communication, social, and life skills.
Education and Awareness in the Workplace: A Key to a Dementia Friendly CommunityTheChamber
The document discusses education and awareness about dementia in the workplace. It aims to make communities more dementia-friendly. The presentation covers basic dementia statistics, types of dementia, warning signs, strategies to improve brain health like exercise and social activity, acknowledging dementia in the workplace, communicating with those who have dementia, and creating a dementia-friendly community.
This document discusses behavior therapy for teenagers and young adults with autism spectrum disorders. It begins by providing credentials for the author, Daniel C. Marston, who has over 15 years of experience providing behavioral health services to individuals with neurological disorders. It then discusses autism spectrum disorders and the diagnostic criteria for autism, Asperger's disorder, and pervasive developmental disorder based on the DSM-IV. The document discusses empirically-based practice in psychology and core principles. It covers neurological and psychological aspects and theories of autism based on research. Finally, it discusses psychological effects of autism, including personality traits, quality of life, gender differences, and anxiety/mood problems in adolescents with autism.
This document defines mental retardation and hearing impairment, and discusses their prevalence, causes, characteristics, history, classification, and treatment. It states that mental retardation involves below-average intellectual functioning and adaptive deficits that manifest before age 18. About 2-3% of the population has mental retardation. Causes include genetic factors in 30% of cases as well as prenatal/childhood illnesses and environmental factors. Treatment focuses on developing skills and providing support across disciplines to improve functioning.
The document discusses intellectual disability as defined by the Rights of Persons with Disabilities Act of 2016 in India. It defines intellectual disability as significant limitations in both intellectual functioning and adaptive behavior, and outlines the criteria for determining the severity of intellectual disability based on IQ and adaptive behavior scores. It also provides guidance on goals, methods, and components of conducting a clinical history and mental status examination for individuals with suspected intellectual disability.
common psychiatric disorders hab.pptx revssuser49ebb6
The document discusses several common mental health disorders in children and adolescents. It begins by providing epidemiological data, noting that 11.3% of US children have a mental disorder with ADHD being most prevalent. It then categorizes disorders and provides more detail on selected categories including neurodevelopmental disorders like intellectual disability, autism spectrum disorder, and attention deficit hyperactivity disorder. It discusses symptoms, diagnosis, treatment and prognosis for these conditions. The document also covers anxiety disorders like separation anxiety disorder and selective mutism.
Autism Spectrum Disorder (ASD) is a developmental disability that affects communication and social skills. Symptoms typically appear before age 3 and may include lack of eye contact, difficulties with social interactions, repetitive behaviors, and sensitivities to sensory stimuli. ASD is caused by genetic factors and affects individuals differently in terms of symptoms and severity. Treatments aim to improve social, communication, and daily living skills through therapies such as applied behavior analysis, speech therapy, and occupational therapy.
The document discusses the diagnostic criteria and clinical features of autism. It notes that autism is diagnosed based on impairments in social interaction and communication, as well as restricted and repetitive behaviors. Common early signs include lack of eye contact and abnormalities in social engagement and play. Screening tools can help detect autism early, and a comprehensive evaluation is needed for diagnosis, involving assessment of development, cognition, language, hearing and neurological functioning. Physical exams may also check for physical indicators associated with other conditions.
This document discusses the diagnostic criteria and clinical features of autism. It notes that autism is diagnosed based on impairments in social interaction and communication, as well as restricted and repetitive behaviors. Common early signs include lack of eye contact and pretend play skills. Diagnosis involves screening tools to identify at-risk children followed by comprehensive evaluation by a multidisciplinary team. Brain imaging studies have shown differences in brain structure and growth in autistic individuals. Early diagnosis allows for early intervention services.
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
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Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
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Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
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2. Mental Retardation
General Information
• Mental Retardation Is An Axis II Disorder
• Wechsler Intelligence Tests
– Wechsler Intelligence Scale For Children – IV
– Wechsler Adult Intelligence Scale - III
• Mean = 100, Standard Deviation = 15
• IQ of 70
• --Two Standard Deviations Below The Mean
– 1% of the Population
3. Mental Retardation
Diagnostic Criteria
• Low Intellectual Functioning
– I.Q. Less Than Or Equal to 70
• Deficits In At Least Two Domains Of Adaptive Behavior
- Self Care (your awareness and ability to shower, clean your body, toilet yourself.
If person has IQ 65 you look at that willingness to take care of their body)
-Communication (your ability to communicate your needs and wants)
- Social Skills (persons ability to follow social graces. Like move into ppl and say
excuse me; when someone sneezes you say bless you. When talk to someone you
make eye contact)
-Use of Community Resources (use of bus system; doesn’t know how to use the
bus; they are pretty slow )
That’s all consistent with low IQ.
4. Ranges of Mental Retardation
• Mild MR
• Moderate MR
• Severe MR
• Profound MR
5. Ranges of Mental Retardation
• Mild Mental Retardation
– IQ:50/55-70
– Can Learn Academic Skills Up To 6th Grade
– Social Learning (reading books with pics, writing- organizing little paragraphs out of
sentences. 6th grade writing) (Ability to learn from observation, they can see things and do it)
– Social Conformity(evidence that you have social learning skills. You see cute
shoes and you want to wear those shoes, you observed it in terms of appearance and want it so you go
get yourself a pair.)Evidence of to learn from their environment.
– Awareness of Differences(they are aware they are not doing certain things
in life like others. Aware of diff. btw themselves and more functioning others)
– (for some highest academic performance might be 4th grade,5th, or 6th grade. With help they might be
able to do simple balancing of a check book as long as the money is not too big. That would be highest
end, might have to do it with supervision.
– They have the ability to learn by observation, by simple modeling.
6. Ranges of Mental Retardation
• Moderate Mental Retardation
– IQ: 35/40-50/55
– Can Learn Academic Skills Up To 2nd Grade
– Trainable In Social and Occupational Skills (with
lots of practice they can learn social and occupational skills. For ex: like stuffing envelopes. They are
trainable
– Independent Behavior In Familiar
Environments (familiar environment to him, he’s going to have the independence to
ask for a hall pass to go bathroom, go there and come back. Negative- lack of independent behavior in
unfamiliar environments like for ex: taking them to Walmart and tell them go find the vacuum aisle.
People with moderate MR will not be able to find it because it’s a unfamiliar place for them.)
7. Ranges of Mental Retardation
• Severe Mental Retardation
– IQ: 20/25-35/40
– Can Learn To Talk or Communicate
– Can Learn Basic Self Care (With many repetitions. Practice a
hundred times a day. Johnny this is how to brush your teeth, now you do it. Now after 6 months or a
year he might be able to do it right.)
• Toileting
• Feeding
• Comb Hair
• Brush Teeth
8. Ranges of Mental Retardation
• Profound Mental Retardation
– IQ:Below 20/25
– Some Motor Development May Be Present
– May Respond To Training In Self Care Skills
– All in Developmental Centers. They don’t communicate verbally or even have the ability to
sign for many things. They are unable to walk, follow directions. They have to be fed like a
little infant.
9. Mental Retardation
Incidence
• 1% of Population Has Mental Retardation
• MR Is More Common In Males
10. Origins of Mental Retardation
• Down Syndrome (Trisomy 21) (they have 47 chromosomes.They have different physical
look, they tend to be shorter, square face, small ears and further back, congenital problems with their hearts so shorter
lives)
– Mild to Moderate MR
– Early Dementia (thinking skills get lower in their 30s, die from heart problems by their 50s)
• Phenylketonuria (PKU)(ppl. conceived with PKU they have the inability (33:36)
– Gene X Environment Interaction
– Fetus/Person Unable To Use Phenylalanine, An Amino Acid in Many
Foods
– Increased Phenylalanine Level Causes Neural Damage/MR
• Tay-Sachs Disease (higher rate in Jewish folks)
• Fragile X Syndrome
– Severe MR, Especially in Males
11. Origins of Mental Retardation
Environmental Origins
• Problems During Gestation
– Substances/ Toxins
• Alcohol
– Fetal Alcohol Syndrome
» 1 In 1000 Births
» Mild to Severe MR
» Physical Characteristics If Mom Drank In 1st Trimester
» Cognitive Deficits Possible If Mom Drank In Any
Trimester
• Cocaine
– Increased MR Rates
– Reduced Head Circumference And Reduced Birth Weight
– Maternal Malnutrition During Gestation
– Maternal Infection During Gestation
• Rubella (German Measles) During 1st Trimester (high risk)
12. Origins of Mental Retardation
Environmental Origins (cont.)
• Problems During Delivery
– Infections
– Anoxia (can result to brain damage)
– Brain Injury During Birth (Forceps)
• Problems During Early Development
– Poor Nutrition
– Poor Nurturing
• “Failure To Thrive” Children
– Impaired Cognitive and Physical Development In
Kids Who Receive Little Nurturance
13. Treatments for Mental Retardation
• Education
– Mainstreaming vs. Special Schooling
• Mainstreaming
– Including Children With Cognitive And Physical Impairments In
Mainstream Classrooms
– Public Law 94-142
» Passed In Early 1970s
» States That Special Needs Children Must Be Educated With
Their Normal Peers To the Greatest Extent Possible
– Practical Limit Of Mainstreaming = 1:1 Teaching Aide
– Special Schooling
• Lower Student – Teacher Ratio
• Only Disable Children in the Classroom
14. Treatments for Mental Retardation
• Behavioral Treatment
– Targets
• Motor Development (e.g., Button Your Coat)
• Language Development (e.g., Functional Language First)
• Social Development (Social Introduction, Social Perception)
• Cognitive Development
– Strategies
• Positive Reinforcement (R+) For Desired Behaviors
• Negative Punishment (P-) For Undesirable Behaviors
• Parent Training (A-B-C, Task Analysis, R+, P-)
• Direct Reinforcement of Other Behavior (DRO)
15. Pervasive Developmental Disorders
Common Features
• Severe Impairments In Socialization
• Severe Impairments In Communication
• Unusual Behaviors, Activities, And/Or
Interests
16. Specific Pervasive
Developmental Disorders
• Rett’s Disorder
– Occurs Only In females
– Incidence:1 in 10,000
– Onset: 5 months- 4 years
– Loss of motor skills (Handholding And Impaired
Gait)- walking
– Severe language Impairments
17. Specific Pervasive
Developmental Disorders
• Childhood Disintegrative Disorder
– Occurs In Males and Females
– Incidence: 1 in 10,000
– Onset: 2 to 10 years old
– Severely Impaired Communication*
– Severely Impaired Socialization*
– Unusual Behaviors, Activities, And/Or Interests*
– Loss Of Bowel and Bladder Control
– Impaired Motor Coordination
18. Specific Pervasive
Developmental Disorders
• Autistic Disorder
– Onset Of Symptoms Prior To Age 3 (Must see the symptoms when they are little, present prior to age 3)
– Incidence: 2 to 5 in 10,000 (4 Males: 1 Female) (Mainly Men)
– Severe Impairment In Socialization* (2 Or More) (Autism- to not care whats around you, be interested in yourself)
• Lack Of Reciprocal Facial Gestures
• Avoidance of Eye Contact
• Impaired Peer Relations (Profound Asociality) (they would almost always want to do things by themselves)
• Lacking Awareness of Others (Theory Of Mind) (they don’t care what others think, they would do things we would
find awkward to do in public)
• Lack Of Sharing Of Interests/Achievements
• Lack Of Social/Emotional Reciprocity
• Impaired Emotion Recognition (empathy. Do “Omg you look sad” They don’t identify emotions from facial
expressions, gestures)
– Severe Impairment In Communication* (1 or more)
• Delayed Language
• Inability To Maintain A Conversation
• Stereotyped Language (Echolalia- autistic repeats back part or all of the sentence that he/she just heard), Pronoun
Reversal- it goes to their lack of abstraction. Their memory skills are good, but their abstract thinking is very
impaired. They take it too literally)
• Lack Of Pretend Play (they don’t put thoughts and feelings into humans, you cant do pretend play unless you have
theory of mind)
– Unusual Behaviors, Activities, Or Interests* (1 or more)
• Obsessive Preoccupations
• Inflexibly Adherence To Nonfunctional Routines (Need For Sameness) (They have a need for sameness like for ex:
schedule, environment. Like if mom has long hair and then cut it into a bob they say who is this person? They might
identify her by her hair.
• Stereotyped Motor Behaviors (Hand Flapping, Hand Gazing, Grimacing)(They are doing things to discharge their
arousal)
19. Specific Pervasive
Developmental Disorders
• Features Associated With Autism
– Aggression (Some ppl with Autism will be aggressive. If don’t have
skills to communicate wants and needs they will be aggressive. They just hit
and their needs get met.
– Self Injurious Behaviors(They may punch themselves in the
face, slam their head to the floor, bite themselves so severely that sometimes to
the bones. When doesn’t want to do something they’re are told you they would
bite themselves.
– Toileting Delays(Until age 5-7 they start urinating in the toilet. That
could lead to outplacement.)
– Self Stimulatory Behaviors(the stereotype behaviors. Hand
flapping, Body rocking are overly stimulated.
20. Specific Pervasive
Developmental Disorders
• Asperger’s Disorder
– Severely Impaired Socialization (they have a
profound deficit in social
– Unusual Interests, Activities, or Behaviors
– Normal Communication Skills
– Better Cognitive Functioning Than Autism
• 95% Of Asperger’s D/O Persons Have IQs greater or
equal to 75
• 25% Of Autistic Persons Have IQS greater or equal to
75
21. Biological Theories of Autism
• Autism Is A Neurodevelopmental Disorder
• Genetics
– 92% Concordance Between Monozygotic (identical) Twins
– Relatives Have Higher Rates Of Deficits In Communication,
Social Skills, And Cognition
• Brain Structures (Males)
– Larger Ventricular Volume
– Smaller Corpus Callosum (Have trouble transferring info. from
one hem. to another. Have difficulty labeling emotions)
22. Psychological Theories of Autism
• Refrigerator Mother (Old Theory) Autism was developed in 1941.
• Parent Stress
– Very High
– Factors
• Ambiguity of Outcome (things are less clear. 40% of autism kids can be normal with lots
of effort in classroom or after school program. This causes tremendous stress though- ambiguity
of outcome)
• High Caretaking Demand (there awareness of dangers at the age of 16 will be like for a 2
yr. old.
• Extreme Therapeutic Effort (parents know if they work really hard, their child will be
more normal.
• Aggression
• Lack Of Reciprocated Affection (she works so hard. Comes home from work tired,
then trains child to be more normal. What she gets? A punch in the face, lack of affection
• Duration
23. Treatment of Autism
• Parent Training
– Functional Analysis (A-B-C)(Antecedents, Behavior, Consequences)
– R+ and P-
• Parent Support
– Respite Care (Skilled babysitting)
– Support Group
• Discrete Trials Training (Lovaas)
• Aversive Conditioning(Positive punishment, only used with kids you have
severe dysfunctions.
– Reduce Extreme Self-Injury and Aggression
24. Learning Disorders (“Learning Disabilities”)
Diagnostic Criteria
• Academic Achievement (As Measured By Standardized
Achievement Tests And Classroom Performance) Is
Substantially Below Expectations Given Cognitive
Development (As Measured By Intelligence Tests)
• Academic Skill Performance At Least One Standard Deviation
Below Expectations Given Intellectual Ability (2-3 Grade
Levels below Expectations)
25. Types of Learning Disorders
• Mathematics Disorder
– Difficulty With Math Concepts and Calculations
• Disorder Of Written Expression
– Poor Spelling
– Errors In Grammar and Punctuation
– Disorganized Paragraphs
• Reading Disorder (“Dyslexia”)
– Individual Omits, Distorts, Or Substitutes Words When
Reading
– Causes Reading To Be Slowed and Hating
26. Incidence Of Learning Disorders
• 5% of School Children Are Diagnosed With A
Learning Disorder
• Estimates Suggest That The Incidence Of
Learning Disorder May Be as High as 10%
• Equal Gender Distribution, But Mostly Boys
Are Identified And Diagnosed Due To Their
More Frequent Disruptive Behavior
27. Possible Negative Consequences Of
Learning Disorders
• Academic Dysfunction
– 40% of Persons With Learning Disorder Drop Out Of High School
• Poor Self Image
– Due To Multiple Academic Failures And Ridicule From Others, Many Persons
With Learning Disorder Harbor Strong Feelings Of Inferiority
• Impaired Socialization
– Struggling Academically And Ridiculed by Peers, Adolescents With Learning
Disorder Often Associate With Other Troubled Teens And May Engage In
Delinquent Behavior
• Underemployment
– An Otherwise Intelligent Person With A Learning Disorder May Lack The
Functional Reading, Writing, or Math Skills Required By Many Jobs
28. Attention Deficit Hyperactivity Disorder
• Diagnostic Criteria
– Onset Of Sxs Prior To Age 7
– Symptoms Cause Impairment In At Least Two Settings
– Duration: Minimum 6 Months
– Symptoms Of Inattention (6 or more)
• Careless Mistakes Or Fails To Attend To Details
• Poor Sustained Attention
• Does Not Listen When Spoken To
• Does Not Follow Through On Instructions and Responsibilities
• Difficulty In Organizing Tasks or Activities
• Avoids Tasks Requiring Sustained Mental Effort
• Loses Items Necessary For Tasks
• Easily Distracted
• Often Forgetful
29. Attention Deficit Hyperactivity Disorder
• Diagnostic Criteria (Cont.)
– Symptoms Of Hyperactivity-Impulsivity (6 or more)
• Hyperactivity
– Often Fidgets or Squirms
– Often Leaves Seat Inappropriately
– Often Runs About or Climbs About When Inappropriate
– Often Has Difficulty Playing or Engaging in Leisure Activity
– Frequently “On The Go” As If “Driven By A Motor”
– Often Talks Excessively
• Impulsivity
– Often Blurts Out Answers Before Question Has Been Completed
– Often Has Difficulty Waiting His Or Her Turn
– Often Interrupts Conversations Or Intrudes On Interactions
30. Types of ADHD
• ADHD, Predominately Inattentive Type
– 6 or More Symptoms Of Inattention
– Less Than 6 Symptoms Of Hyperactivity- Impulsivity
• ADHD, Predominately Hyperactive- Impulsive
Type
– 6 Or More Symptoms Of Hyperactivity-Impulsivity
– Less Than 6 Symptoms of Inattention
• ADHD, Combined Type
– 6 Or More Symptoms of Inattention
– 6 Or More Symptoms Of Hyperactivity-Impulsivity
31. ADHD Facts
• Incidence Of ADHD
– 5% of Children in the U.S.
– Although Symptoms Are Often Present Much Earlier, Most
Children Diagnosed With ADHD Are First Diagnosed After
Entering the School System
• Course Of ADHD
– ADHD Persists Throughout Childhood, Often Into
Adolescence, And Sometimes into Adulthood
• Comorbidity
– About 15% Of Children With ADHD Also Have A
Learning Disorder
32. Consequences of ADHD
• Behavior Problems
– According To Russell Barkley, By 5 to 8 Years Old, Between 45 And 70 %
Of Kids With ADHD Have Significant Problems With
• Resistance to Parental Authority
• Hostility/ Aggression Toward Others
• Quick- Temperedness
• Social And Emotional Consequences
– Social Rejection
– Banished To “Bad Boy” Group (Learn “Bad Boy” Behaviors)
– Higher Incidence Of Adolescent And Adult Psychopathology
– Increased Legal Problems
• Increased Substance Abuse Problems
• Increased Interpersonal Problems
33. ADHD: Biological Factors
Genetics
• General Population: Incidence Rate = 5%
• Parent With ADHD: Incident Rate = 50%
Brain Structure And Activity
• Frontal Lobes (Attention, Impulse Control)
– Reduced Activity
– Reduced Size
Nicotine (Prenatal Exposure)
• Study
– 22% of Mothers’ Of ADHD Kids Smoked When Pregnant
– 8% Of Mothers’ With Normal Kids Smoked When Pregnant
34. ADHD: Psychological Factors
• Bi-Directional Relationship
– ADHD Behaviors -> Parent Behaviors
– ADHD Behaviors <- Parent Behaviors
– Negative Parent Behaviors (Yelling, Negativistic Statements)
Decrease When Child Receives Stimulant Medication
– Child ADHD Behaviors Decrease When Parent Receives
Parenting Skills Training
• Modeling
– Parents Who Have ADHD Spectrum Behaviors Model ADHD
Behaviors
35. Treatment Of ADHD
Medications
• Stimulants (Ritalin, Cylent)
– Prescribed To About 5% of All Children And About 25% of Children In Special
Classrooms
– Temporary Therapeutic Effects
– Administration: TID Or Slow Release
– Side Effects
• Temporary Growth Suppression (Relieved with Drug Holidays)
• Sleep Problems
• Reduced Appetite
– Nonadherence
• Due To Parental Ambivalence, Nonadherence Rates Range From 20-70%
• Antidepressants (Stratera: Norepi Reuptake Inhibitor)
36. Treatment Of ADHD
Behavior Therapy
• Train Parents And Teachers In Operant Principles
– Functional Analysis (A-B-C)
– Positive Reinforcement
• Catch them being good
– Negative Punishment
• Time Out (Time out from Reinforcement)
• Token Economy (Star Chart)
• Varied Settings
– Classroom
– Home
37. Oppositional Defiant Disorder
Developmental Considerations (Interacting with the bad kids. Whoever tries to tell them what they have to do, they
won’t do it.)
• Most Children And Adolescents Have Periods Of Negativistic And Defiant Behavior ; However, Youths With
Oppositional Defiant Disorder Are Negativistic And Defiant Of Authority Figures Most Of The Time
Diagnostic Criteria
• Impairments Due To A Pattern Of Ne Behavior That Lasts At Least 6 Months
• 4 of the Following 8 Symptoms
– Often Loses Temper
– Often Argues With Parents
– Often Defies Or Refuses To Comply With Requests And Rules Of Adults
– Often Deliberately Annoys Others ( They enjoy getting on others nerves and at the same time if someone
teases them they get annoyed and upset)
– Often Blames Others For His/Her Mistakes Or Misbehavior
– Easily Annoyed by Others
– Often Angry And Resentful
– Often Hateful and Vengeful
38. Facts About Oppositional Defiant Disorder
Onset
• Generally Between 8 to 12 Years Old (Prior to puberty its more common in males, after puberty it’s a equal gender
distribution)
Gender Differences
• More Common In Preadolescent Boys
• Equally Common In Adolescent Boys And Adolescent Girls
Consequences Of Oppositional Defiant D/O
• Peer Rejection (He’s going to be pushed away, that’s going to affect his self-esteem. His self-esteem is low bc of
neglection and hard punishment from the parents)
• Low Self Esteem (Begins in the family, he takes these obnoxious to the community
• Anti- authority Attitudes (Nearly every interaction they have with their teachers is negative. The people he’s aware of
they are going to be more strict with him.)
– Exclusively Negative Interactions With Authority Figures
39. Psychological Factors
Poor Parent-Child Relationship
• Three Possible Causes
– Neglect (Not being around enough; not paying attention)
– Lack of Affection (not enough hugs and kisses, i love you going around)
– “Unjust” Discipline (Neglect combined with extreme punishment for something the kid does all the time)
Developmental Course Of Opp Def Disorder
Poor Parent-Child Relationship
-> Hatred of Parents (those 3 potential causes are coming together that lead to hatred of parents. Bc he cant
love and respect his parents he can love and respect his teachers, others.)
-> Hatred of all Authority Figures
40. Treatment Of Oppositional Defiant Disorder
Parent Training (You work with parent, child. You look to repair emotional bonds
• Train Parent(s) To Be
– Be Attentive
– Be Affectionate
– Reinforce (Praise) Prosocial Behavior
– Punish (Negative) Undesirable Behavior
– Maintain A 10:1 Ratio Of Reinforcement To Punishment
41. Conduct Disorder: Diagnostic Criteria
Repetitive And Persistent Pattern Of Behavior That Violates The Rights Of Others And Social Norms As Evidenced By
Behaviors In At Least Three Of The Following Four Domains (3 Of 4)
I. Aggression Against Humans And/Or Animals
• Bullies, Threatens, Intimidates
• Often Initiates Physical Fights
• Has Used A Weapon
• Has Been Physically Cruel to People
• Has Been Physically Cruel to Animals (Has all this anger instead that looking to torture animals)
• Has Stolen While Confronting A Victim (Mugging)
• Has Forced Someone Into Sexual Activity (Coercive Or Physical Rape. Coercive Rape- like a blackmail. If you don’t do
this then i’ll tell mom)
II. Destruction Of Property
• Has Set Fires To Cause Serious Damage (Fire-Setting With Intent.)
• Has Destroyed Others’ Property (vandalism)
42. Conduct Disorder: Diagnostic Criteria
III. Deceitfulness Or Theft
• Has Broken Into A House, Building, or Car
• Often “Cons” Others By Lying In Order To Gain Goods Or Favors
• Has Stolen, As in Forgery or Shoplifting
IV. Serious Violations of Rules
• Beginning Prior To Age 13, Stays Out All Night Despite Parental Prohibitions
• Has Run Away From Home Overnight At Least Twice
• Beginning Prior to Age 13, Is Often Truant From School
43. Facts About Conduct Disorder
Oppositional Defiant Disorder -> Conduct Disorder
• Most Youths With Conduct Disorder Have Histories Of Oppositional Defiant Behavior
Incidence
• 6 to 16% of Males Under 18
• 2 to 9% of Females Under 18
Adult Outcome (1966 Study)
• Followed Conduct Disorder Boys Into Adulthood
• Antisocial Tendencies Are Very Stable Over Time
• Very High Rates Of:
– Marital Difficulties
– Reduced Economic And Occupational Opportunities
– Poor Social Relationships
– Heavy Substance Use
• Only 1/6th Of The Boys With Conduct Disorder Were Free Of Psychopathology In Adulthood
• More than 25% Of The Boys Met Criteria For Antisocial Personality Disorder In Adulthood
44. Conduct Disorder: Biological Factors
• Genetics
– Mixed Findings
– Aggressive Behavior Is Clearly Heritable
– Less Evidence For The Heritability Of Behaviors Such As Stealing, Running Away, And Truancy
45. Conduct Disorder: Psychological Factors
Impaired Moral Development
• Family Environment Lacks The Qualities That Produce Children With A Strong Sense of Morality
– Parents Who Are Affectionate With Their Children And with Each Other
– Parents Who Clearly Express Moral Principles And Clearly Expect That Their Children Will Uphold Them
– Parents Who Punish Justly And Consistently
– Parents Who Use Reasoning And Explanations As Part Of Their Parenting Style
Social Learning Theory (Bandura)
• Children Learn Aggressive Behavior From The Aggressive Behavior Modeled By Their Parents, Siblings, and Media
Operant Conditioning
• Aggression Is Reinforced Because It Is Often An Effective Means of Achieving A Goal
• Lack Of Negative Consequences For Aggressive Behavior
46. Conduct Disorder: Psychological Factors
Coercion Theory (Gerry Patterson)
• Coercive Behaviors (Whining, Complaining) Are Reinforced During Young Childhood
• Aggressive Behavior Is Reinforced During Sibling Interactions As Parents Are Neglectful, Inattention, and
Ineffectual
Cognitive Theory (Ken Dodge)
• Aggressive Children Make Aggressive Attributions Regarding Ambiguous Interpersonal Events
• Aggressive Attributions Lead to Aggressive Behavior, Which Causes Others To Behave More Aggressively
Toward Them, Further Angering The Already Aggressive Children And Continuing The Cycle Of of Rejection
And Aggression (See Figure)
• Cycle of Aggressive Cognitions and Behaviors
• Validation of Aggressive Event
• Belief System
47. Treatment of Conduct Disorder
Parental Management Training (Gerry Patterson)
• Train Parents To Modify Their Responses To The Child So That Prosocial Rather Than Antisocial Behavior Is Consistently
Rewarded
• Parents Are Taught Positive Reinforcement Techniques
– Praising Desired Behaviors
– “Catch’em Being Good”
• Parents Are Taught To Use Negative Punishment Techniques In Response To Aggressive or Antisocial Behavior
Anger-Control Training
• Aggressive Children Are Taught To Consider Benign Attributions To Ambiguous Interpersonal Interactions
• Aggressive Children Are Taught To Self-Control Techniques (“Just Walk Away”) That Are To Be Used In Anger-Producing
Situations
• Training In Distraction Techniques
– Serial 7s, Serial 3s
• Techniques Used By Child During Role Play In Which A Peer Provokes Or Insults Him
48. Separation Anxiety Disorder
• Developmental Considerations
– _________________________________
• Diagnostic Criteria For SAD
– _______________________
– ________________________________________ Concerning Separation From Home Or Primary Caretakers For At
Least 4 Weeks
– Three Or More Of The Following Eight Symptoms (_________)
• Recurrent Excessive Distress When Separation From Home Or Caretakers Is Anticipated
• ___________________________________________________
• Worry That __________________, Such As A Kidnapping, Will Cause _______________________
• ________________________________, Such As School, Because Of ______________________ From
Caretakers
• _________________________ Or Without The Caretakers
• Reluctance Or Refusal To Go To Sleep Without Being Near Caretakers
• Repeated Nightmares With Separation Theme
• Repeated Complaints Of ____________________ When Separation From Attachment Figures Is Anticipated
49. Theories of Separation Anxiety Disorder
Biological
• _____________
– The Rate Of Panic D/O In The_______________________ With SAD __________ Than The Rate Of Panic D/O In
The General Population
– ______________________________________________________
Psychological
• ________________
– _________________ Of Unexpected Separation
• Modeling (_________________)
– _____________ Modeled By Parents Regarding Separation
• ______________________________
– ________________________ By Attachment Figures
– e.g., ___________________________
50. Treatment Of Separation Anxiety Disorder
Behavioral Treatments
• _____________________
• _____________________
• Modeling
• Contingency Management
– __________________________
– Punishment For _________________
• Teach Child To React More Competently To _________
_________________________________
Cognitive Treatments
• Positive Statements ______________________
– “_________________” “I Can Sleep In My Room By Myself”
• ____________________
– To Address Family Member Behaviors That May Be Maintaining The Separation Anxiety