Psychiatry Chapter 1: Children and Adolescents

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Questions and Answers

What is the prevalence rate of Prader-Willi Syndrome?

less than 1 in 10,000

Which syndrome is characterized by a characteristic cat-like cry?

Cat's Cry (Cri-du-Chat) Syndrome (correct)

Prader-Willi Syndrome

Rett Syndrome

Lesch-Nyhan Syndrome

Autism Spectrum Disorder affects only females.

False

Children with speech sound disorder have difficulty pronouncing speech sounds correctly due to omissions of sounds, distortions of sounds, or atypical ______.

pronunciation Signup and view all the answers

What are the core diagnostic impairments in autism spectrum disorder according to DSM-5?

Restricted and repetitive behaviors Signup and view all the answers

Children with severe autism spectrum disorder have difficulties putting meaningful sentences together.

True Signup and view all the answers

What percentage of children with autism spectrum disorder are intellectually disabled?

30% Signup and view all the answers

ADHD is characterized by a pattern of diminished sustained attention, and increased impulsivity or ____________.

hyperactivity Signup and view all the answers

Match the following characteristics with children with ADHD:

Hyperactivity = Characteristic behavior of frequent movement Memory and thinking deficits = Commonly cited characteristic Impulsivity = Action before thought, lack of organization Attention deficit = Short attention span, distractibility Signup and view all the answers

What are some areas of functioning that should be assessed in infants and young children?

Motor development and verbal communication Signup and view all the answers

At what age does nail-biting typically begin?

1 year of age Signup and view all the answers

Children can usually articulate their experiences verbally better than showing their feelings in a play situation.

False Signup and view all the answers

What is a characteristic of tics in Tourettes disorder?

Brief, rapid motor movements or vocalizations Signup and view all the answers

Separation and reunion can indicate problems in the ______ relationship or other psychiatric disturbances.

parent-child Signup and view all the answers

What information should be included in identifying data for a child?

gender, age, family constellation Signup and view all the answers

Depressive disorders affect only adults.

False Signup and view all the answers

Depressive disorders affect approximately 2 to 3 percent of ______ and up to 8 percent of adolescents.

children Signup and view all the answers

Which syndrome results from a mutation on the X chromosome at the fragile site, Xq27.3?

Fragile X syndrome Signup and view all the answers

Study Notes

Children and Adolescents Psychiatric Evaluation

Comprehensive evaluation includes interviews with parents, child, and other family members
Assesses current school functioning, intellectual level, academic achievement, developmental level, and neuropsychological factors
Court or child protective services may initiate psychiatric evaluation in some cases
Children can report on mood, psychotic symptoms, fears, anxiety but may have difficulty with symptom chronology
Very young children express experiences through play rather than verbally

Assessing Infants and Young Children

Interviews often start with parents present to assess parent-infant interaction
Infants may be referred for high irritability, feeding/sleep issues, withdrawn behavior, developmental delays
Assess motor, communication, play, problem-solving, relationships, social responsiveness

School-Age Children

Some are comfortable conversing, others may show fear, anxiety, poor verbal skills, or oppositional behavior
45-minute session is typical, with room setup to allow child to move around

Adolescents

Able to provide chronological account and distinct ideas about evaluation
Value hearing adolescent's perspective, avoid blame or judgment
Emphasize confidentiality, explore adolescent's beliefs about evaluation outcome

Mental Status Examination

Detailed observations of child's physical appearance, affect, speech, language, cognition, judgment, insight
Assess parent-child interaction, social relatedness, motor behavior

Neurodevelopmental Disorders

Intellectual disability due to genetic and environmental factors, with cognitive and adaptive impairments
Genetic disorders have characteristic behavioral phenotypes (e.g. Prader-Willi syndrome, fragile X, Rett syndrome)
Other acquired disorders include infections, head trauma, asphyxia, lead exposure

Autism Spectrum Disorder

Characterized by impairments in social communication and restricted/repetitive behaviors### Autism Spectrum Disorder
Autism spectrum disorder is a phenotypically heterogeneous group of neurodevelopmental syndromes with polygenic heritability
Before DSM-5, the spectrum included 5 overlapping disorders: autistic disorder, Asperger disorder, childhood disintegrative disorder, Rett syndrome, and pervasive developmental disorder not otherwise specified
These differed in severity, specific syndrome, and underlying pathology
Recent consensus has shifted to a continuum model where heterogeneity of symptoms is inherent
DSM-5 collapsed the core impairments into 2 domains: deficits in social communication, and restricted/repetitive behaviors
Aberrant language development is no longer a core feature but an associated feature in some individuals

Communication Disorders

Range from mild delays to expressive/mixed receptive-expressive disorders, phonological disorders, and stuttering
Language delay affects up to 7% of 5-year-olds, with rates up to 20% in 4-year-olds
Children must develop mastery of multiple language aspects to communicate effectively
DSM-5 includes Language Disorder and Speech Sound Disorder

Speech Sound Disorder

Difficulty pronouncing speech sounds correctly due to omissions, distortions, or atypical pronunciation
Includes omitting last sounds, substituting sounds, and distorting sounds due to interrupted airflow

Attention-Deficit/Hyperactivity Disorder (ADHD)

Neuropsychiatric condition with diminished sustained attention and increased impulsivity/hyperactivity
Biologic basis supported by family history, genotyping, and neuroimaging
Affects up to 5-8% of school-age children, with 60-85% persisting into adolescence and 60% into adulthood
Frequent comorbidities include learning disorders, anxiety, and mood disorders
Core characteristics: hyperactivity, attention deficits, impulsivity, memory/thinking deficits, learning disabilities, speech/hearing deficits

Motor Disorders

Developmental Coordination Disorder: Slower, less accurate, and more variable fine/gross motor coordination than peers
Stereotypic Movement Disorder: Repetitive, rhythmic movements that seem self-soothing but can cause self-injury
Tourette's Disorder: Tics characterized by brief, rapid motor movements or vocalizations

Depressive Disorders in Children and Adolescents

Prevalent and have long-term adverse effects on cognitive, social, and psychological development
Affect 2-3% of children and up to 8% of adolescents
Core features resemble adult major depression, but influenced by developmental level
Moderately heritable (40-50%), with environmental stressors and adverse events as significant contributors

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Description

Comprehensive evaluation of children and adolescents in psychiatry, including standardized measures and neuropsychological assessments. Learn about the importance of current school functioning and intellectual level in psychiatric evaluations.