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212 Cards in this Set
- Front
- Back
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Excessive stressors or disruptive environmental stimuli that result in insomnia
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Adjustment sleep disorders
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What is one way to cure adjustment sleep disorders?
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If stressor or stimuli is removed, sleep returns to normal within 3-6 months.
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What the effects of adjustment disorders
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Insomnia (onset or night wakings)
Daytime sleepiness Daytime irritability Concentration problems |
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Daily habits or activities that are not conducive to good sleep
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Indadequate sleep hygiene
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What are the daytime efffects of inadequate sleep hygiene?
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Can relate to:
Daytime mood disturbances Fatigue Attention and concentration problems |
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Parental failure to enforce bedtimes or consenting to child control of bedtimes, resulting in stallking, refusing, and/or tantrums
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Limit setting disorder
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What daytime variables can the limit setting disorder be related to?
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Irritability
Decreased attention Learning problems in school Separation anxiety |
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When (age) does the limit setting disorder usually occur?
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After 2 yrs when the child can verball stall and is removed from the crib
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Breathing cessation during sleep
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Obstructive sleep anea
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Obstructive
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Upper airway obstruction
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Primary or Central sleep apnea
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Cession or decrease in breathing; CNS shuts it down
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Symptoms of Obstructive sleep apnea
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Snoring
Coking Snorting Gasps Violent body movements at end of apnea episode Daytime mouth breathing Dry mouth Agitated arousals and morning headaches Excessive sleepiness (obstructive) Sleeping with neck hyperextended |
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What daytime variables are associated with obstructive sleep apnea
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Obsesity
Enuresis Inattention Poor concentration Poor articulation Daytime anxiety Depression Developmental delays Upper respiratory infections Impatience |
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Define echolalia
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The use of words in an uncommunicative manner
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What are the two types of echolalia?
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Immediate
Delayed |
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What are the characteristics of Immediate echolalia?
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More advanced speech structure than typically used
Perservative speech Stereotypy Same intonation Parrot speech |
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What are the characteristics of Delayed echolalia?
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Repeats something heard in the past (swearing, TV, etc...)
Out of context More advanced speech structure Stereotypy Same intonation |
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Why do people use echolalia?
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Doesn't understand words shouldn't be spoken when doing a command
Doesn't understand a command or how to answer a question (Escape from task) Self-instruction Attention (swearing) |
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What are the consequences of echolalia?
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Interaction w/learning
Decrease in social interactions |
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What are treatments for echolalia?
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Reinforcement for appropriate speech
Prompt and fading Cue-Pause-Point (from Foxx video) Reductive procedures |
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What type of reinforcement procedure is used for echolalia?
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DR fro echoing answers to questions and not the questions themselves
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What types of Prompt and prompt fading are used for treatment of echolalia?
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Time delay
Fading of words in a phrase |
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What types of Reductive procedures are used in the treatment of echolalia?
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Response cost
Verbal reprimands |
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Define disruptive vocalizations
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Unintelligible sounds, words, phrases, or sentences which can result in a variety of negative effects
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In what population is disruptive vocalization is more in: Autism or MR?
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Mild MR
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What are Expressive Disruptive Vocalizations characterized by?
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Repetition
Perservation |
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Describe Loud Disruptive Vocalizations.
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High volume
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Decribe Negative Disruptive Vocalizations.
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Complaints
Threats Taunting/teasing Swearing |
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What are the consequences of disruptive vocalizations.
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Interference w/learning
Ecape Removal from work and social situations Interference w/adaptive communication |
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What would be the appropriate treatment if the function of disruptive vocalizations is auditory stimulation?
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Sensory extinction
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What would be the appropriate treatment if the function of disruptive vocalizations is imitation?
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Change environment/tasks
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What would be the appropriate treatment if the function of disruptive vocalizations is R+?
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DR + extinction
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What would the appropriate treatment if the function of disruptive vocalizations is R-?
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Change tasks
Variety of demands and R+ Escape prevention Communication training |
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Review General treatments of DV from study guide.
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See study guide!
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Define Mouthing Behaviors.
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Contact of mouth with other objects
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What are the two types of mouthing behaviors?
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Hand mouthing
Object mouthing |
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What does object mouthing result in?
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Getting hands and face wet with saliva
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Define drooling.
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Presence of saliva outside of mouth
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Define Polydipsia.
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Excessive water or fluid intake
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Define Rumination
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Chronic regurgitation
Rechewing Swallowing food |
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Define Pica
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Repeated eating of a nonnutritive substance for at least 1 month
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Chapped, wet, wrinkled, red or white, calloused hands or face are seen in what type of mouthing behaviors?
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Drooling
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Permanent difigurement, loss or fingernails or fingers are seein in what type of mouthing behaviors?
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Hand mouthing
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Aspriation, pneumoni, and choking can be seen in what type of mouthing behaviors?
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Rumination
Pica |
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Swollen lips, teeth problems can be seen in what type of mouthing behaviors?
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Rumination
Mouthing Pica |
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Malnutrition can be seen in what type of mouthing behaviors?
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Pica
Polydipsia Rumination |
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Review the consequences of water intoxication from study guide!
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See study guide!
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Bad odor can be seen in what type of mouthing behaviors?
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Drooling
Malnutrition |
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Skin lesions (infections) can be seen in what type of mouthing behaviors?
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Drooling
Mouthing |
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Gagging and vomiting can be seen in what type of mouthing behaviors?
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Drooling
Mouthing Pica Rumination |
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Interference with adaptive behaviors occurs in what type of mouthing behaviors?
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Drooling
Mouthing Rumination |
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What is the appropriate treatment of the function of mouthing behavior is sensory?
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Increase stimulation in a boring environment
Medical problems and CP |
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What mouthing behaviors are seen in cerebral palsy?
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Drooling
Polydipsia Pica |
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What treatments should NOT be done for mouthing behaviros?
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DRO
Ignoring Social Disapproval |
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What is the appropriate treatment if the cause of hand and object mouthing is medical problems?
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Address medical problems.
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What is the appropriate treatment if hand and object mouthing is maintained by sensory stimulation?
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Restrain
Alternative stimulation DRI |
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What is the appropriate treatment if hand and object mouthing is maintained by R+?
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DRI
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What is the appropriate treatment if hand and object mouthing is maintained by R-?
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Combination of delecerative and reinforcement:
Screening Water mist Response interruptions Restraint Overcorrection Reprimands |
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What is the appropriate treatment if the cause of drooling is medical problems?
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Address medical problems:
Medication Removal of gland Lip sensorys |
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What is the appropriate treatment if drooling is maintained by sensory stimulation?
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Swallow response training (R+)
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What is the appropriate treatment if drooling is maintained by R+?
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Reinforce dry mouth
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What is the appropriate treatment if drooling is maintained by R-?
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Overcorrection and R+
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What could be the medical causes of polydipsia?
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Edocrine disorders
Smoking Medication-induced |
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What are the treatments of polydipsia
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Check for med problems
Fluid restriction Reinforce no water weight gain and fluid refusal Timeout for inappropriate fluid intake |
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Describe fluid restricition as used in treatment for polydipsia.
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Minimize opportunities for sneaking fluids.
Guidlines for fluid intake and restriction |
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Describe treatments for rumination.
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Reduce medical problems
Punishment DRO Increase enviornmental stimulation |
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In what ways can you increase environmental stimulation in the treatment of rumination?
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Change eating rate, intake
Provide more food (low calorie, high fiber) Add after meal activities (R+ appropriate behavior) |
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What are the treatments for pica?
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Assess and treat health hazards
Increase appropriate oral stimulation Exctinction (for attention and escape/avoidance) Punishment Restrict access |
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How do you assess and treat health hazards for the treatment of pica?
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Increase nutritional foods
Reduce vitamin deficiencies or chemical dependency |
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In what way can we increase appropriate oral stimulation for the treatment of pica?
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Provide chewing gum
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What punishment procedures have been used in the treatment of pica?
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Overcorrection
Timeout Visual screening Water mist |
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How do you restrict access to pica items?
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Clean rooms
Use response blocking |
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Define functional enuresis.
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Repeated voiding or urine during day or night into bed or clothes, whether involuntary or intensional
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Review diagnostic criteria for enuresis.
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See study guide!
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Define functional encopresis.
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Repeated passage of feces into places not appropriate for that purpose, whether involuntary or intensional
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Review the diagnostic criteria for encopresis.
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See study guide!
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What is primary encopresis?
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Not really toilet trained
Not preceded by a period of 1+ yr of no soiling |
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What is secondary encopresis?
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Preceded by 1 yr of no soiling
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What are the consequences of elimination disorders?
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Medical
Extensive use of staff time Social isolation |
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What are the medical consequences of elimination disorders?
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Rashes
Soreness Skinbreakdown Bed sores Bowel damage (impaction) Diarrhea |
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What are the physiological treatments of elimination disorders?
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Stool softner
Increase fluid intake (encopresis) Fiber Restrict fluids (near bedtimes) for enuresis |
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Review treatment of elimination disorders.
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See study guide
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What are the components of the Bell and Pad treatment for enuresis?
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Positive practice
Restitution R+ |
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Review norma weight increases in study guide.
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See study guide!
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Define pediatric feeding problems.
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A child's inability or refusal to eat or drink sufficient quantities to maintain nutritional status, regardless of etiology
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Review types of feeding problems from study guide!
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See study guide!
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What physical issues should be analzed in the treatment of feeding disorders?
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Oral motor delays
GER Allergies Fine motor skills |
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What antecedents treatments could be used in treating in feeding problems?
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Conditioned aversion
Looking for patterns |
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Explain how conditioned aversion could happen in feeding problems?
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Pairing with painful medical conditions
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What could FA of behavior in feeding problems result in?
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Spits food out
Hits utensils or foodd away before it gets to the mouth Vomits |
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Review FA of Consequences in feeding problems
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See study guide!
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If feeding problems result from grazing, what should the treatment be?
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Don't allow snacks.
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If feeding problems result from distractions in the environment, what should the treatment be?
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Minimize other activities in the area.
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If feeding problems result from the fact that the child is a slow eater, what should the treatment be?
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Set meal times (timer).
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If feeding problems result from issues with the texture of foods, what should the treatment be?
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Gradually increase textures (using shaping)
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If feeding problems result from issues with the types of foods, what should the treatment be?
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1st present foods not completely refused.
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If in feeding, child pushes food away, what should the treatment be?
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Do not remove food until child is quiet or eating.
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If in feeding, child spits food out, what should the treatment be?
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Check for physical problems.
Represent food Reinforce taking a bith with "liked" food |
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If feeding problems are maintained by R+, what should the treatment be?
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Give reinforcement for increasing the number and size of bites.
Give toys, preferred, foods, etc... for eating |
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If feeding problems are maintained by R-, what should the treatment be?
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Always end mealtimes with success.
Do not allow escape for not eating. |
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What do adjustment sleep disorders result in?
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Insomina (onset or night wakings)
Daytime sleepiness |
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In the treatment of adjustment disorders, what can be done to return the sleep to normal?
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Remove stressor or stimuli
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In adjustment disorders, if stressor or stimuli is removed, how long does it take for sleep to return to normal?
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3-6 months
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In what age group is inadequate sleep hygiene not diagnosed?
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Prepubescent children
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Requirement of a specific environmental stimulus to fall asleep (excessive for developmental level).
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Sleep-onset association disorder
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What age group is sleep-onset association disorder not uncommon for?
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Children aged 6 months to 3 yrs
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At what time does sleep-onset association disorder most often occur?
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In the middle of the night
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Under what conditions is sleep-onset association disorder most likely to occur?
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Co-sleeping
Transition from sleeping environments (crib to bed) |
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In sleep-onset association disorder, what causes rapid return to sleep?
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Reintroduction of the stimulus.
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What daytime variables are effected by the sleep-onset association disorder?
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Separation anxiety
Day-time irritability |
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What daytime variables are associated with the limit-setting disorder?
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Irritability
Decreased attention Learning problems in school Separation anxiety Family stress |
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What daytime variables are associated with Obstructive sleep apnea?
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Obseity
Enuresis Inattention Poor articulation Daytime anxiety Depression Developmental delays Upper respiratory infections Impatience Aggression Low growth rate Hyperactivity Morning headaches Irritability |
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Repeated naps during the day with rapid transition into REM sleep
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Narcolepsy
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What can narcolepsy occur with?
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Cataplexy
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What is cataplexy?
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Loss of muscle tone
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In what mucles is cataplexy common in?
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Knees
Face Neck |
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How severe can cataplexy be?
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Ranges from weakness to total loss of msucles tone
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What can narcolepsy result in?
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Automatic behavior
Loss of muscle tone Memory lapses Blurred vision Hynagogic hallucinations Increased BMI increases occurence |
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What is the onset age for narcolepsy?
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after 5 yrs
Typically between 15-25 |
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What daytime variables are associated with narcolepsy?
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Weight gain
School and job failure Depression Social avoidance |
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Failing to get enough sleep to be alert during the day; voluntary sleep deprivation
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Behaviorally Induced Insufficient Sleep Syndrome
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What can Behaviorally Induced Insufficient Sleep Syndrome co occur with?
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Sleep paralysis
Hypnagogic hallucinations |
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During what age is Behaviorally Induced Insufficient Sleep Syndrome more commonly seen?
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Adolescence
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What daytime variables is Behaviorally Induced Insufficient Sleep Syndrome associated with?
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Irritability
Concentration Attention problembs Withdrawal from social situations |
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Delayed sleep times (more than 2 hours) beyound what is expected for a child's age
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Delayed Sleep Phase
(Delayed sleep onset) |
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During what age does Delayed sleep onset begin?
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During adolescence
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What does Delayed Sleep Onset resulted?
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Confused or drunk appearance upon waking
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What can Delayed Sleep Onset be associated with?
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Mental illness
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Confusion upon arousal from sleep
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Confusional arousal
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During what time of the night does Confusional arousal typically occur?
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During first part of night (deep sleep)
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What does Confusional Arousal result in?
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Aggression, thrashing, combativeness upon arousal
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What night time variables is Confusional arousal associated with?
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Sleepwalking
Enuresis Sleep terrors Periodic leg movement Obstructive sleep apnea Sleep deprivation |
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What age is Confusional arousal quite frequent?
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before 5 yrs
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What daytime variables is Confusional Arousal associated with?
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Poor school attendance
Poor academic achievement Social problems |
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Leaving the bed and wlaking during sleep
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Sleep Walking
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What are the characteristics of sleepwalking?
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Difficult to arouse
No memory of event |
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During night time, when does sleep walking typically occur?
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During sleep, but not during REM, not during dreaming
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What is sleep walking associated with?
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Medical illness
Obstructive sleep apnea Night terrors |
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Between whate ages does sleep walking peak?
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Between 4-8 yrs
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What daytime variables are associated with sleep walking?
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Social avoidance (no sleep-overs)
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Intense screaming and other behaviors resembling fear; occurring during slow wave sleep
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Sleep terrors
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When are sleep terrors most likely to occur?
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During the first half of the night (deep sleep)
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What are the characteristics of sleep terrors?
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Awakening with a piercing scream
Other indications of intense fear |
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How long do sleep terrors typically last?
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3-5 mins
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How long does it take for sleep terrors to end?
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End spontaneously
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What other sleep disorders are sleep terrors associated with?
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Obstructive sleep apnea
Sleep walking |
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What gender are sleep terrors more common in?
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Boys: Normal for young boys to have; but they grow out of them
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What is the onset age for sleep terrors?
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Around 4 yrs old (rarer after 10 yrs old)
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What daytime variables are associated with sleep terrors?
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Social embarrassment
Accidents Injuries |
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Inability to move while falling asleep or awakening
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Recurrent Isolated Sleep Paralysis
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How long does Recurrent Isolated Sleep Paralysis last?
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Only a few minutes
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What is Recurrent Isolated Sleep Paralysis associated with?
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Hallucinations
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At what age is onset for Recurrent Isolated Sleep Paralysis?
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Mostly in adolescence
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What daytime variables are associated with Recurrent Isolated Sleep Paralysis?
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Anxiety
Depression Bipolar disorder |
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Is Recurrent Isolated Sleep Paralysis more common in girls or boys?
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Equal among sexes
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If a child was to inherit Recurrent Isolated Sleep Paralysis, from which parent would he/she inherit it from?
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Mother
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Frighteningly vivid dreams that usually awaken the child
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Nightmare disorder
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What what time of the night are nightmares most likely to occur?
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Morning hours (REM sleep)--when dreaming occurs
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Does the child remember a nightmare?
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Yes
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How common are vocalizations in nightmares?
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Rare
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What is the best way to comfort a child who has just seen a nightmare?
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Parental comfort
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For children 3-6 yrs of age, what is the duration of nightmares?
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Short
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What daytime variables are associated with nightmares?
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Post Traumatic Stress
Mood disorders Depression Social problems Implusive and self-destructive Substance abuse |
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Recurrent involuntary urination during sleep
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Sleep enuresis
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Bedwetting is common until what age?
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5
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What gender is sleep enuresis more common in?
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Males
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What effect does sleep enuresis have on daytime bladder control?
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None. Daytime bladder control can be normal.
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What things conditions can be related to sleep enuresis?
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Apnea
Irritable bladder related to mlik Diabetes Urinary track infections |
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What daytime variables are associated with slee enuresis?
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Social problems (activity restriction)
Anxiety ADHD |
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Complaints of a strong urge move the legs while resting
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Restless Leg Syndrome
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What can Restless Leg Syndrome be misdiagnosed as?
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Growing pains
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What daytime variables are associated with Restless Leg Syndrome?
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Reduced energy
Depression Anxiety |
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In Restless Leg Syndrome, what subsides the urge to move the legs?
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Movement
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What is characteristic trait of Restless Leg Syndrome?
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Jerking or twitching movement of legs
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Repitive arm or leg movements during sleep (typically the legs)
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Periodic Limb Movement Disorder
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What can Periodic Limb Movement Disorder co-occur with?
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Restless leg sydrome
Narcolepsy |
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What daytime variables is Periodic Limb Movement Disorder associated with?
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Depression
Memory problems Attention deficits Oppostional behavior Fatigue Excessive daytime sleepiness |
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What could be medical causes of Periodic Limb Movement Disorder?
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Some medications (ex. antidepressants)
Low iron levels |
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Grinding or rhythmic clenching of the teeth during sleep
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Bruxism
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What is the onset age for Bruxism?
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~10.5 yrs
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During what time in life is Bruxism typical?
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Childhood
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What problems are related to bruxism?
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Dental wear, damage, and pain
Headaches Anxiety |
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Stereotypic body movements while falling asleep:
Body rocking Head rolling Head banging |
Sleep Related Rhytmic Movement Disorder
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What does Sleep Related Rhytmic Movement Disorder sometimes resemble?
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SIB
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How many typically developing children show symptoms of Sleep Related Rhytmic Movement Disorder?
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2/3
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When does the stereotypic body movements such as those characteristic to Sleep Related Rhytmic Movement Disorder become classified the disorder?
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Only a disorder if it disrupts sleep or daytime behavior
Or Causes injury |
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By what age does Sleep Related Rhytmic Movement Disorder typically resolve?
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5 yrs
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What could Sleep Related Rhytmic Movement Disorder be related to?
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Lack of environmental stimulation
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What medical issues can Sleep Related Rhytmic Movement Disorder be associated with?
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Brain damage
Cataracts |
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Talking during sleep
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Sleep talking
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Describe the kind of talking that occurs during Sleep talking.
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Typically incoherent: can hear tones best, not really speech
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Is the person aware of talking in sleep upon awakening?
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No
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During when does sleep talking usually occur?
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Childhood
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What other sleep disorders does sleep talking usually co-occur with?
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Sleep terrors
Confusional arousals Sleep walking |
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Environmental disturbances that causes insomnia or daytime tiredness
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Environmental sleep disorder
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What other sleep disorders can Environmental sleep disorder cause?
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Insomnia
Hypersomnias Parasomnias |
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What daytime variables can Environmental sleep disorder associated with?
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Attention
Learning Depressed mood Social withdrawal |
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How does the rhythm of sleep switch as age progresses?
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Rhythm of sleep swtiches from mainly daytime sleep to mainly night sleep.
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By age 9 yrs, how many hours of sleep a night does a typical child get?
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10 hrs
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What is the prevalence of sleep problems in children with autism?
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56-83%
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How do sleep problems affect behavior?
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Over-activity
Attention problems Disruptive behavior Aggression Stereotypic behavior |
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How do sleep problems affect social behavior?
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Social difficulties
Difficulties with breaking a routine Withdrawal Anxiety Depression |
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How does establishing bedtime routines help in behavioral treatment of sleep problems?
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Establishes routines related to sleep
Incorportates chaining and shaping techniques |
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What are the bedtime procedures for nongraduated extinction?
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Follow bedtime routine.
Say "good night." Leave the room. Ignore child's tantrum or crying. |
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What are the night time procedures for nongraduated extinction?
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Ignore crying.
If child leaves bedroom, return child to room. |
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What are the procedures used in graduated extinction?
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Follow bedtime routine.
Ignore child's crying for pre-set time period. Settig child (with minimal attention). Ignore cries for progressively longer time period. |
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What are the procedures for faded bedtimes w/out response cost?
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Calculate avg. bedtimes.
Add 1/2 hr to avg bedtime. If asleep in15 mins, fade bedtime in 1/2 hr increments. If not asleep, asleep in 15 mins, add 15 mins to bedtime. |
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What are the procedures used in faded bedtimes w/response cost?
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Follow same steps as faded bedtime w/out response cost.
If not asleep in 15 min, remove chidl from bed and keep awake for 1 hr (in boring environment). Return to appropriate step in faded bedtime routine. |
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Explain the scheduled awakening procedure.
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Record baseline data for when the child typically awakens during the night.
Awaken the child before this time. |
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What are the advantages of scheduled awakening?
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Reinforces sleep rather than waking.
Awakens the child before full arousal. |
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What behavioral treatment for sleep disorders does the research show full support for for children w/autism?
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Non-graduatede extinction
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Do parents also support non-graduated extinction?
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Yes
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