Managing Behaviour - Chris Elliot
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This document discusses managing child behavior from a pediatric perspective. It emphasizes taking a holistic approach that involves mapping a child's environment and abilities, understanding family goals, formulating hypotheses, and empowering families. The role of a pediatrician is to conduct thorough assessments, synthesize information from various sources, generate hypotheses to guide further inquiry, and advocate for the child within their family and schools. Key parts of the process include building a map of the child, discovering family goals, utilizing tools to fill information gaps, and identifying allied professionals to help address issues outside one's own expertise. The goal is to adopt a strengths-based approach rather than just focusing on diagnoses and interventions.
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Assignment Assessing and Treating Patients With ADHDNot onl.docx
Assignment: Assessing and Treating Patients With ADHD
Not only do children and adults have different presentations for ADHD, but males and females may also have vastly different clinical presentations. Different people may also respond to medication therapies differently. For example, some ADHD medications may cause children to experience stomach pain, while others can be highly addictive for adults. In your role, as a psychiatric nurse practitioner, you must perform careful assessments and weigh the risks and benefits of medication therapies for patients across the life span. For this Assignment, you consider how you might assess and treat patients presenting with ADHD.
To prepare for this Assignment:
Review this week’s Learning Resources, including the Medication Resources indicated for this week.
Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with ADHD.
The Assignment: 5 pages
Examine
Case Study: A Young Caucasian Girl with ADHD.
You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.
At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.
Introduction to the case (1 page)
Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
Decision #1 (1 page)
Which decision did you select?
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #2 (1 page)
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and referenc.
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- 1. MANAGING BEHAVIOUR Dr Chris Elliot Consultant Paediatrician www.drchriselliot.com.au Paediatrics.online December 2016
- 2. OBJECTIVES WHAT’S MY ROLE? WHERE’S MY MAP? WHO ARE MY ALLIES?
- 3. ALL BEHAVIOUR IS COMMUNICATION “DON’T FORGET BEFORE AND AFTER”
- 4. THE TECHNICIAN’S APPROACH 5 diagnoses ADHD Autism Oppositional Defiant Disorder Anxiety Trauma 5 interventions Stimulant medication Risperidone Anxiolytics Clonidine Discharge to psychologist
- 5. WHAT’S MY ROLE? Medical assessment and management Discovering child and family goals Synthesising disparate views Formulating the issues Hypothesis generation Making a plan Empowering the family with a strengths- based approach Advocating for the child Within the family With other providers With school and other organisations
- 6. MEDICAL ASSESSMENT A thorough medical history as normal … … but I’m still lost…
- 7. WHERE’S MY MAP? Build a map of the child in their environment. Happens over one or several visits Helps clarify what we know and what we need to find out
- 8. A MAP OF THE CHILD IN THEIR ENVIRONMENT Vision Hearing Health Sleep Diet IQ / Learning Attention Social Communication / Interest Behaviour Sensory Profile Anxiety Fine Motor Gross Motor / Tone Language Attachment Temperament Self Esteem Resilience Family Environment School Environment Body Brain Wellbeing Practice
- 9. CASE FORMULATION AND HYPOTHESIS Formulation and hypotheses Hypotheses help you know your limits What do I know? What am I missing? Who can help me? Find missing information Manage problems I don’t have experience in
- 10. WHAT’S MY ROLE? Medical assessment and management Discovering child and family goals Synthesising disparate views Formulating the issues Hypothesis generation Making a plan Empowering the family with a strengths- based approach Advocating for the child Within the family With other providers With school and other organisations
- 11. CHILD AND FAMILY GOALS Six ‘F’s of a Fullfiling Life Family Friends Function Fitness Fun Future [click here for the original article by Rosenbaum P and Gorter JW]
- 12. TOOLS TO HELP FILL IN THE GAPS We have a map with some gaps We know what the goals are Helps prioritise what else we need to know SNAP-IV parent and teacher report ASQ-3 Functional Behaviour Analysis Psychometric / Academic testing Other testing eg: Griffiths / ADOS
- 13. WHO ARE MY ALLIES? School Colleagues Psychologist Speech pathology Occupational therapy Medical specialists Physiotherapists - How do i find them? - How do i communicate with them?
- 14. BE A DOCTOR NOT A TECHNICIAN History Empathy Tools Allies Hypotheses Advocacy Limits