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24 Cards in this Set

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Definition: changes in behavior over time, e.g. reflexes, gross/fine motor skills
Neurodevelopmental
When do the majority of newborn reflexes disappear by?
4-6 months
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How is ADHD diagnosed?
CLINICALLY
-diagnosis requires at least 6 criteria from inattentiveness, 6 from hyperactivity/impulsiveness, or both
-symptoms must be seen by 7 years of age, last at least 6 months, be observed in MORE THAN 1 SETTING, be more than age appropriate, & IMPAIR FUNCTION
What are some complications of ADHD?
1. Antisocial personalities
2. Alcohol & drug abuse

**about 1/2 of pts with ADHD have normal adult lives
**Aggressive, defiant children tend to do worse as adults
What drugs are used to treat ADHD?
Methylphenidate
Dextroamphetamine
Pemoline
TCA
Clonidine
Bupropioin

**Diets have absolutely NO VALUE in ADHD
When is day & night bladder control usually attained?
by 5 years of age
What are the risk factors/etiology of Enuresis?
Incidence declines with age

Stron genetic predisposition for Primary Nocturnal Enuresis
Define the 2 major types of Enuresis
Primary = pt has never achieved dryness for any significant period of time

Secondary = previously continent child becomes incontinent
What is Secondary Enuresis usually secondary to?
Emotional difficulties
-birth of sibling
-significant loss
-family discord
What are the subdivisions of Primary Enuresis?
Nocturnal only

Diurnal only = during day

Nocturnal/Diurnal
What is Nocturnal Enuresis associated with?
Maturational developmental delay of the bladder and may be a disorder of sleep & arousal
What is Diurnal Enuresis associated with?
waiting too long to void, UTI's, constipation, diabetes, stress incontinence
What drugs are commonly used for Enuresis?
Imipramine & Desmopressin (ADH)
Define Encopresis
Fecal incontinence after the age of 4 years
What are the Risk factors/Etiology of Encopresis?
*occurs more commonly in boys (5:1)

1. Toilet phobia
2. overly aggressively management of constipation
3. starting toilet training too early
4. painful defecation after diarrhea, fissures, or severe perianal rashes
What are the presentation & treatment for Encopresis?
Presentation = secondary to stool retention, resulting in leakage of loose stools around the obstruction

Treatment: counseling for the child & parents; cleaning of impacted stool out of the colon
Developmental disorder characterized by impaired social relatedness, deficits in verbal & nonverbal communication, & unusual responses to the environment
Autism
Autism develops before ______ of age. The cause is unknown. It is more common in ______
30 months

boys
What is the clinical presentation of Autism?
1. failure to attach as an infant
2. delayed/absent social smile
3. delay in verbal & nonverbal communication skills
4. Stereotypical movements & a need for sameness
5. Outbursts of anger are common as well as self-injurious behavior

**75% of patients are mentally retarded
Describe Rett Syndrome
1. Inheritance
2. Boys or Girls?
3. Disease progress
1. X-linked dominant
2. Girls
3. Development is normal until 1 year of age, when language & motor milestones regress & an ACQUIRED MICROCEPHALY is seen. HAND WRINGING & SIGHING are characteristic