Disorders Usually First Dianosed In Infancy, Childhood, And Adlolescents

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Mental Retardation - three criteria must be met:

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1 significantly subaverage intellectual functioning 70 or below
2 concurrent deficits or impairments in adaptive functioning in at least two areas
3 ONset prior to 18

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Mild mental retardations
Moderate
severe
profound

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1 IQ 55- 70
2 IQ 40- 55
3 IQ 25-40
4 IQ 20-25

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Etiology of Mental Retardation

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5% are heredity
30% early alterations of embryonic development (down syndrome)
10% to grenency and perinatal problems
5% to general medical condition
15-20% environmental factors
Etiology is unkown in 30-40% of cases

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PKU

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rare recessive gene syndrome that involves an inability to metabolize the amino acid phenylanine - high protien foods. if untreated produces moderate to profound retardation - impaired motor and languade development.

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Down Syndrome (trisomey 21)

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exra chromosome and is estimated to be caue of 10-30% of all cases of moderate to severe retardation.

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Boarderline Intellectual Functioning

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appropriate diagnosis for people with IQ 71-84

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Learning Disorders

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when mperson's achievement is substantially lowere then age and level of inteligence and the discrepancy cannot be fully explained by sensory deficit.

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Substancially below - learning disability

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more then two standard deviations seperatiting IQ and achievment

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Stuttering

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disturbance in normal fluency and time patterning of speech. starts between ages 2 to 7, more common in males. 60% remits spontaneously

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Treating Stuttering

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reducing psychlogical stress at home. Parents instructied to stop reprimanding child when stutters.regulate breating

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Pravasive Developmental Disorders

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presence of steroeotyped behaviors, impairment in communication

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Communication Disorders

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stuttering, language disorder expressive langueage disorder, mixed receptive-expressive laanguae disorder

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Autistic Disorder - diagnosis

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presence of at least six characteristics symptoms, some prior to age three

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Autisitc Disorder - Qualitative impairment
Qualitative impairment communication
Restrictied, repetitive, and stereotyped behavior

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qualitative impairment - marked impairemtn in nonverbal behavior, abscence of developmentally appropriate peer relationships
Qualitative impairment delay or total lack, of the develpment of spoken lagnuage

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Autism - Course/prognosis

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refuse to cuddle- may be misinterpreted has hearing impairment.
Prognosis generally poor. one third some degree of partial independence as adults.

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Etiology - Autism

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structural brain abnormalities - reduced cerebellum and enlarged ventricles. abnormal norepinephrine, serotonin, and dopamine.

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Treatment - Autism

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enhancing daily living, communication, and social skills and reducing undesirable behaviors. Behavioral tech - most effective.

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Rett's Disorder

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characteristic pattern of symptoms following a period of normal development for five months or more. Head growth decelaeration, loss of purposeful hand skills and the stereotypical hand movements, los of interest in the social environemtn, impaired language and psychomoter retardations. Only in females

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Childhood Disintegrative Disorder

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poor distinct patter of develpmental regression in at least two areas of fnctionig, skills, play, social skills, ore adaptive behavior, language) following a least two yeas of apparently normal development

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Aspergers Disorder

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severe impairments in social interactions and restricte repertoir of behaviors, intersts and activities. usually normal level of intellegence, maybe misinterpereted as being stubborn

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Attention-Deficit/Hyperactivity Disorder
Inattention
Hyperactivity-impulsivity

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inattention - difficulty sustainging attention to tasks
Hyperactivity - fidgeting or squirming in seat, often leaves seat inappropriate times

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Three types of ADHD

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Predominantly Inattentive Type
Predominanatnly Hperactive-Impulsive Type
Combined Type

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ADHD Associated features

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low IQ even though intellegence is higher
all some achedemic difficulties 20-30% have reading or other learning diabilities, social adjustment
Conduct Disorder co-diagnosis common.50% also have learning disorder.

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ADHD Prevelance

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3-7% in school age. 7.8% of children 4-8 recieve adhd diagnosis. Adults estimate 1-5 %

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Gender ADHD

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more common in boys. more equal with Predominatnly inattentive type

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Etiology - ADHD

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genetic omponent. brain abnormalities. lower-than normal activity in the frontal cortex and basal ganlia and a smaller-than normal caudate nucleas, globus pallidus, and prefontal cortex.

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When adhd symptoms most common

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familiar, highly repetivte, boring, or highy structured situations and situations in which regular feedback is not available.

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ADHD treatment

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Methylphenidate (ritalin)and other central nervous system stiumulants. not really paradoxical affect others without ADHD have similar effects with low doses. combine pharmacotheroayp and psychosocial treatment

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Conduct Disorder

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persistent pattern of behaviors that vilate the rights of others. tend to blame others for their own misbehavior and show little or no guilt or remorse. presence of at least three characteristic syptoms during the past 12 months. eventual diagnosis of Antisocial

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Moffit - two types of Conduct Disorder

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Life Course Persistent - begins early pattern of incerasingly serious transgressions continue into adulthood - neurological impairments, difficult tempterament, adverse environmental circumstances.
Adlolescence-limited - temporary form of antisocial behavior - maturity gap - between adolescents biolgocial matruation and lack of opportunities for adult privileges and rewards.

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Treatment of Conduct Disorder

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effective when they target preadolecents and when they include a family intervention. Parent management gaining, teaches rewarding positive behaviors

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Oppesitional Defiant Disorder

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recurrent pattern of negativistic, defiant, and hostile behaviors towards authority figures.

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Pica

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persistent eating of nonnutritive substances - paint, insects - for at least one month. onset 12-24 months; occassionally found in pregnant woment

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Tic Disorders - Tourette's Disorder

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sudden, rapid, recurrent, nonrhythmic, stereotyped motor movement or vocalization.
Tourette's Disorder - at least one vocal tic and multiple motor tics that appear simulataneously or diffent times - prior to 18. Obsessive-cumpulsive behaviors higher for them. Hyperactivity, impulsivity, and distractiblity are also common.

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Tourette's Disorder Treatment

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includes pharmacotherapy. antipsychotic drugs have been most effect in 80% of cases.

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Elmination Disorders
Eneresis

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Not due to medical condition
Eneresis - repeated voiding of urine during the day or night into bed or clothes at least twice a week for three or mor months. - usually involuntary, but can be inentional.

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Elimination Disorder - treatment

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Night Alarm and behavioral treatment.

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Separation Anxiety Disorder

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developmentally inappropriate, excessive anxiety related to separation from home or attachment figures. Must be at least four weeks, before age 18. often come from close warm families.
sometimes manifests as school refusal. manifests three different ages first start, change school and 14

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Reactive Attachment Disorder of Infanc or Early Childhood

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markedly disturbed and develomentally inapproproate social relatedness in most setting sthat begins prior to age five. neglect by cargivers. Inhibited type failure to intiate and respond to most social situations

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Behavioral Pediatrics

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concerned with psychological aspets of medical issues. recognition rates of certain mental disorers are hgiher amoung children with serious physical conditions

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Disclosure - Behavioral Pediatrics

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open communicaiton about illness with child. Must be developmentally-appropriate language.

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Medical Procedures - Behavioral Pedicatrics

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Multipcomponent cognitive-behavioral reduce anxiety about procedures.

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Hospitalzation - Behavioral Pedicatrics

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at risk for emotional and beahviral disorders. recognizing impact of separation.

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Compliance - Behavioral Pediatrics

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lack of compliance to medical regimine common. usually related to fear of peer acceptance.

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School Adjustment - Behavioral Pediatrics

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higher rates of school related problems. cancer treatment neurological problems