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Flashcards in Early Onset Disorders Part 1 Deck (62)
1

Intellectual-Mental Retardation

Symptoms

Population

  • Symptoms
    • Significant sub-average on general intellectual functioning
    • Concurrent deficits in adaptive behavior
  • Onset <18 YO
  • 3% of school-age children
  • Boys > girls 

2

Intellectual-Mental Retardation

Causes

Treatment

  • Causes
    • Lack of stimulation
    • Inadequate nutrition
    • Exposure to toxins (lead)
    • Chromosomal or metabolic abnormality (25%)
      • Down Syndrome, Fragile X
      • Phenylketonuria
    • Pregnancy trauma
      • Drugs, radiation, toxemia, alcohol
      • Infection (German measles)
    • Infections (encephalitis)
  • Treatment
    • Parental support/guidance
    • Special programs 

3

Developmental: Pervasive Development Disorders

Symptoms

Types (2)

  • Distortions in timing, rate, sequence of many basic psychological functions involved in the development of social skills & language 
  • Types
    • Autism
    • Asperger's Disorder

4

Autism

Characteristics

Causes

  • Characteristics
    • Impaired non-verbal behaviors (eye contact, gestures)
    • Failure to develop age appropriate peer relations
    • Lack of social reciprocity
    • Delay or lack of spoken language
    • Lack of make-believe play
    • Restricted stereotyped patterns of behavior
  • Causes: genetics, infections

5

Asperger's Disorder

Characteristics

Treatment 

  • Characteristics
    • Impaired social interaction
    • Restricted, stereotyped patterns of behavior
  • Treatment
    • Parental support
    • Special programs 

6

Specific Developmental Disorders (Learning Disorders)

Symptoms

Population

Treatment 

  • Symptoms
    • Delay in rate of learning a specific function so that children behave as though they are passing through an earlier normal developmental stage substantially below expected for chronologic age
    • May be one or more in areas of arithmetic, expressive writing, reading, articulation, expressive language, receptive language, coordination
  • 10% of children
  • Boys > girls
  • Treatment: remedial work 

7

Unclassified Speech Disfluencies

Symptoms

Cause 

Treatment 

  • Symptoms
    • Stuttering (sound & syllable repetition)
    • 3-4 YO
  • Cause: developmental
  • Treatment
    • Ignore
    • 1% persists & require speech therapy 

8

Behavioral: Oppositional Defiant Disorder

Symptoms

Pattern of negativistic, hostile & defiant behavior

(at least 6 mo)

  •  + Signs
    • Often loses temper
    • Often argues w/ adults
    • Defied or refuses to comply
    • Deliberately annoys
    • Blames others
    • Resentful, spiteful & vindictive 

9

Behavioral: Oppositional Defiant Disorder 

Population

Cause

Treatment 

  • Children & adolescents
  • Boys > girls
  • Cause
    • Environmental (parents over-assert control)
  • Treatment
    • Parent training program
    • Psychotherapy
    • Social skills training
    • Cognitive behavior therapy 

10

What are the symptoms of Attention Deficit Disorder?

  • Fidgety or restless
  • Unable to sit for a long time
  • Always on the go
  • Easily distracted
  • Can’t concentrate well on work
  • Impulsively acting before thinking
  • Forgetting what was said or not listening
  • Difficulty finishing work on time
  • Often losing personal things
  • Difficulty waiting in lines or jumping ahead of others 

11

Attention Deficit Disorder

Population

Causes

  • 5% of children
  • Many times children w/ ADD have other learning problems
  • Often starts in kindergarten or 1st grade & continues for years
  • Causes
    • Children are born w/ ADD & can’t control symptoms easily
    • Often runs in families (hereditary)
    • Not caused by allergies or too much sugar 

12

How is Attention Deficit Disorder treated?

What happens if ADD is untreated?

  • Medications
    • Ritalin (methylphenidate), Metadate, Concerta, Dexedrine (dextroamphetamine), Adderall, Cylert (pernoline), Pamelor (nortriptyline), Norpramin (desipramine), Catapres (clonidine), Strattera
  • Psychotherapies
    • Behavioral therapy
    • Parent management training
    • Family therapy
  • Educational
    • Special education classes
  • Untreated
    • Can lead to difficulty w/ learning, classroom behavior, making friends, following rules at home
    • Many children don’t outgrow ADD when they get older & benefit from long-term medication 

13

What are the symptoms of Conduct Disorder?

  • Frequent lying, stealing, truancy
  • Running away from home
  • Frequent fighting/bullying
  • Property destruction
  • Fire-setting
  • Being mean to animals or people
  • Breaking & entering into someone’s house or car 

14

What is the population of Conduct Disorder?

  • Older children & teenagers
  • Boys > girls
  • Most children w/ CD have other problems
    • ADD
    • Depression
    • Alcohol abuse
    • Family problems 

15

What are the causes of Conduct Disorder?

What are teenagers at risk of?

  • Causes
    • Exact cause unknown
    • Many factors may contribute to behavioral problems
      • Drugs
      • Family problems
      • Low self-esteem
      • Physical abuse
      • Impulsivity
  • Teenagers at risk…..
    • Dropping out of school
    • Being seriously injured in flights
    • Getting hooked on street drugs
    • Trouble w/ the police 

16

What is the treatment for Conduct Disorder?

What happens if untreated?

Without treatment, many children/teenagers continue to have similar problems as adults (may become imprisoned)

  • Medication
    • Meds for depression
    • Lithium for aggressive & impulsive behavior
  • Psychotherapy
    • Behavioral therapy
    • Group therapy
    • Family therapy
  • Special programs
    • Probation programs
    • Residential programs 

17

What are the symptoms of Generalized Anxiety Disorder (GAD)?

  • constant worrying
  • unable to relax
  • aches & pains (headaches, stomachaches)
  • self-consciousness
  • nightmares about the same things that cause worry 

18

What are the symptoms of Separation Anxiety Disorder (SAD)?

  • unable to leave parents b/c of worries that something bad may happen to them
  • fear of going to sleep
  • reluctant to go to school
  • fear of being kidnapped 

19

GAD & SAD

Population

Causes

  • Children & teenagers
    • SAD = younger children (7-10 YO)
    • GAD = teenagers (12-15 YO)
  • Causes
    • Exact cause unknown
    • Tendency to develop severe anxiety runs in some families (hereditary)
    • Stress can play a role (death, parent’s illness, another medical problem, learning problems)

20

How are GAD & SAD treated?

  • Medications
    • Tofranil (imipramine)
    • Xanax (alpraxolam)
    • BuSpar (Buspirone)
    • Paxil (paroxetine)
    • Zoloft (sertraline)
  • Psychotherapy
    • Behavioral therapy
    • Cognitive behavioral therapy
    • Family therapy 

21

What are the symptoms of Obsessive Compulsive Disorder (OCD)?

  • Obsessions – thoughts or images (memories/pictures) that keep coming into one’s mind even though the person wants the thoughts to stop
  • Compulsions – actions & behaviors that one feels need to be done over & over again; one can’t stop doing them
  • Worries & anxiety occur if one tries to stop the obsessions or compulsions 

22

Obsessive Compulsive Disorder

Population

Causes

  • Children & teenagers (1%)
  • Causes
    • Exact cause unknown
    • Some parts in the brain don’t seem to work well in OCT (basal ganglia) post strep infection 

23

How is OCD treated?

  • Medication
    • Anafranil (clomipramine)
    • Prozac (fluoxetine)
    • Zoloft (sertraline)
    • Luvox (fluvoxamine)
  • Psychotherapy
    • Behavioral therapy
    • Cognitive behavioral therapy 

24

What are the symptoms of Panic Disorder?

Periods of extreme anxiety or fear that begin suddenly (min to hrs)

  • Shortness of breath
  • Feeling dizzy or faint
  • Racing heartbeat
  • Feeling shaky
  • Stomach upset
  • Sweating
  • Thinking one may lose control
  • Big fear of getting another period of anxiety 

25

What is the typical population of Panic Disorder?

  • Rare in young children
  • More frequent in teenagers
  • Tendency to have PD runs in families (hereditary)

26

What causes Panic Disorder?

  • In a very frightening situation, the symptoms of panic attack (extreme anxiety or fear) would be normal or expected
  • In people w/ PD, the part of the brain that controls anxiety (locus coeruleus) reacts for no apparent reason, giving the person extreme anxiety even though he/she is not in a frightening situation 

27

How is Panic Disorder treated?

  • Medication
    • Tofranil (imipramine)
    • Xanax (alprazolam)
    • Paxil (paroretine)
  • Psychotherapy
    • Cognitive behavioral therapy 

28

What are the symptoms of Post-Traumatic Stress Disorder (PTSD)?

  • Nightmares or flashbacks (re-experiencing the trauma in one’s mind, along w/ a sudden feeling of fear that the trauma is happening again)
  • Avoid situations that bring the trauma back into memory
  • Difficulty remembering the trauma
  • Losing interest in things
  • Hopelessness (the future doesn’t look good)
  • Constant fear about not being safe
  • Severe anxiety & depression 

29

People w/ PTSD have had a very bad experience (physically or sexually abused, natural disasters, seriously injured), which leads to intense & continuing feelings of _____& ________. 


PTSD may also be seen in ______ who have witnessed a serious accident or saw someone get badly injured


Anyone, of any age, who has lived through a traumatic event might show ______________. 

threat, helplessness 

children 

PTSD symptoms 

30

What are the causes of PTSD?

  • Trauma that caused PTSD is so intensely frightening that the fears & memories are present for a long time
  • It is almost as if some parts of the brain, such as the parts involved in remembering things, become over-charged & stay too active
  • It is not clear why some people who experience trauma get PTSD & why others don’t 

31

Post-Traumatic Stress Disorder 

How long do symptoms last?

What happens if untreated?

Treatment?

  • Range of symptom length
    • Weeks – months
    • Years
  • Untreated PTSH can lead to…
    • Depression
    • Substance abuse
    • Aggressive behavior
    • Personality changes
  • Treatment
    • Treatments used for depression or anxiety may be useful 

32

What are the symptoms of Depressive Disorders?

  • Depressed (feeling sad)
  • Losing interest in things
  • Sleep problems (difficulty staying or falling asleep, or sleeping too much)
  • Changes in appetite or weight
  • Difficulty concentrating
  • Feeling slowed down
  • Feeling worthless (like you’re a bad person)
  • Feeling that life is not worth living
  • Hopelessness 

33

What is the population of Depressive Disorders?

  • People of all ages can have depression
  • Teenagers > children
  • 5% of teenagers in teenage yrs 

34

What are the causes of depressive disorders?

  • Some types inherited
  • Certain people under a lot of stress can develop depression
  • Stress can include…
    • Losing someone important
    • School problems
    • Frequent arguments w/ family
    • Having been abused
    • Medical problems
  • At other times, the part of the brain that keeps the mood happy (brain chemicals – serotonin & NE) doesn’t function well 

35

When not treated, depression in children & teenagers might last for _________. 


A person who has had one episode of depression might _______ _______ at a later time


Teenagers who have serious depressions may be at risk of developing ______ ____________in the future (substance abuse or suicide attempts) 

months to years 

develop another 

other psychiatric problems

36

How are Depressive Disorders treated?

  • Tricyclic anti-depressant medications
    • Norpramin (desipramine)
    • Pamelor (nortriptyline)
  • SSRIs
    • Prozac (fluoxetine)
    • Celexa (citalopram)
    • Zoloft (sertraline)
    • Luvox (fluvoxamine)
    • Paxil (paroxetine)
  • MAOIs
    • Nardil (Phenelzine)
    • Parnate (tranylcypromine)
  • Psychotherapy
    • Cognitive therapy
    • Interpersonal therapy
    • Family therapy 

37

What are the symptoms of Bipolar Disorder?

Depressive symptoms at some times & manic at other times

  • Depressive symptoms (see previous card)
  • Manic symptoms
    • Abnormally “high” mood (euphoria, feeling too good)
    • Extreme irritability
    • Impulsive behavior
    • Abnormally high self-esteem
    • Racing thoughts & talking more than usual
    • Decreased need for sleep
    • High energy level
    • Inability to concentrate well 

38

Bipolar Disorder

Population

Cause

  • Relatively uncommon in young children
  • More common in older teenagers
  • Tendency to develop mania runs in some families
  • Overall, much less frequent than depression
  • BP believed to be due to a chemical imbalance
  • The part of the brain that keeps the mood stable isn’t working well
  • Most people w/ BP go through cycles of depression, mania & normal mood
  • Many times, it’s a lifelong problem, but can respond well to medication 

39

What are some things that Bipolar Disorder can progress to?

  • Depression
    • Substance abuse
    • Suicide attempts
    • Anxiety
  • Mania
    • Violence
    • Making bad decisions
    • Exhaustion 

40

How is Bipolar Disorder treated?

  • Medications
    • Eskalith CR (lithium)
    • Tegretol (carbamazepine)
    • Anti-psychotic medication
      • Trilafon (perphenazine)
      • Depakene or Depakote (valproate)
      • Klonopin (clonazepam)
      • Lamictal (Iamotrogine)
      • Zyprexa (olanzapine)
  • Psychotherapy
    • Supportive therapy
    • Cognitive treatment for depression
    • Family therapy 

41

What are the symptoms of Psychosis?

  • Hallucinations
    • Hearing or seeing things that are not there
    • “mind is playing tricks on you”
  • Delusions
    • Beliefs that are impossible or unrealistic
    • Other people don’t believe
    • Convinced that these beliefs are really true
  • Difficulty organizing thoughts & actions
  • Other people may have a hard time understanding what you are saying/doing 

42

Schizophrenia always has ________ as a symptom. 

psychosis

43

Psychosis

Population

Causes

  • Children & adolescents can have psychosis
  • Not a disorder, but a symptoms that can happen in many disorders
  • Some disorders, like depression or bipolar, can happen w/ or w/o psychosis 
  • Intoxication w/ stress drugs can produce a temporary psychosis
  • Causes
    • Some brain parts may be too active in psychosis
    • Dopamine (NT) may be overproduced 

44

How long does Psychosis last?

  • Very brief (hrs or days) or very long (yrs)
  • Can happen only once or come back many times
  • Some people require hospitalization 

45

How is Psychosis treated?

  • Medication
    • Trilafon (perphenazine)
    • Haldol (haloperidol)
    • Mellaril (Thioridazine)
    • Thorazine (chlorpromazine)
    • Risperdol (resperidone)
  • Psychotherapy
    • Supportive therapy
    • Family therapy 

46

What are the symptoms of Elimination Disorders?

  • Elimination of urine or feces in inappropriate places (clothing) whether involuntary of intentional
  • Encopresis – passage of feces (constipation + overflow incontinence or w/o constipation)
  • Enuresis – passive of urine (nocturnal only or diurnal only) 

47

Elimination Disorders

Population

Causes

  • Both genders can have an elimination disorder
  • Boys > girls
  • Encopresis: age 4
  • Enuresis: >5 YO
  • Causes
    • Not due to laxatives or diuretics
    • Neurological disease (seizure, spina bifida)
    • Medical condition (infection, diabetes)

48

What may happen to children as a result of an elimination disorder?

Parental frustration w/ subsequent child abuse, humiliation, teasing 

49

How are Elimination Disorders treated?

  • Physical exam
    • Encopresis (laxatives, stool softener, restraining)
    • Enuresis (retraining, pad & bell, behavior therapy)
  • Medication
    • Impreamine
    • DDAVP 

50

Reactive Attachment Disorder

Symptoms

Population

  • Symptoms
    • Inhibited, withdrawn
    • Hypervigilant or excessive & inappropriate sociability w/ strangers
    • Limited eye contact
  • Children up to age 5

51

What are some causes of Reactive Attachment Disorder?

  • Maltreatment
  • Deprivation
  • Repeated changes in primary caregivers
  • Impaired parenting (retardation, depression, substance abuse)

52

Reactive Attachment Disorder 

What may happen

Treatment 

  • What may happen to children
    • May spontaneously remit
    • May have malnutrition, infection or death
    • Long term behavior changes
    • Short stature, low IQ
  • Treatment
    • Medical care
    • Nutrition
    • Foster
    • Work w/ parents 

53

What are the symptoms of Anorexia?

  • losing a lot of weight through diet/exercise
  • thinking one is fat despite weight loss
  • afraid of gaining weight
  • may stop having monthly period 

54

What are the symptoms of Bulimia?

  • brief periods during which an enormous amount of food is eating (binging)
  • feeling like one cannot control eating
  • trying not to gain weight by exercising, dieting, pills, vomiting
  • lot of worries about weight 

55

Eating Disorders

Timeline

Causes

  • Mostly girls, usually start having problems during teenage years 
  • Few weeks/months → long time & more serious 
  • Death can result from starvation in anorexia
  • Many people w/ bulimia suffer from depression
  • Causes
    • Different factors may play a role
    • Brain parts (hypothalamus) involved in controlling appetite & hunger may not work well
    • Other factors: stress, belief that it’s important to be thin  

 

56

How are Eating Disorders treated?

  • Medication
    • Anorexia + depression: anti-depressants
    • Bulimia: Tofranil (imipramine), Prozac (fluoxetine)
  • Psychotherapy
    • Cognitive behavioral therapy
    • Family therapy 

57

What are the symptoms of Tourett's Disorder?

  • Quick body movements (tics) that one can’t control
  • Making sounds (like grunts) or saying words (sometimes swear words) w/o thinking & w/o being able to control it 

58

Tourett's Disorder

Population

Causes

  • Most children are boys (but can happen in girls)
  • Starts at 7-10 YO
  • Many times children have other problems
    • ADHD or OCD
  • Causes
    • Exact cause unknown
    • Some parts of the brain (basal ganglia) that control movements are not functioning well 

59

Tics may come & go, but are usually a ______ problem


People w/ tics may be ___________ b/c they are embarrassed about their symptoms & avoid social contacts. 

lifelong

socially disabled

60

How is Tourett's Disorder treated?

  • Medications
    • Haldol (haloperidol)
    • Orap (pimozide)
    • Inversine (mecamylamine HCl)
  • Psychotherapy
    • Support therapy
    • Family therapy 

61

What are the symptoms of Tic Disorder?

What can result from this?

  • Single or multiple motor or vocal tics
  • Sudden, rapid, recurrent, non-rhythmic, stereotyped motor movements or vocalizations 
  • What may happen: teasing, humiliation

62

Tic Disorder

Causes

Treatment 

  • Causes
    • Unknown
    • Not due to Huntington’s chorea, Wilson’s disease, post-viral encephalitis or medication (stimulants)
  • Treatment
    • Psychotherapy
    • Behavior modification
    • Medication