New finak: ASD, Psych, ADHD

What percent of children have a psychiatric disorder?

one out of 5 or 20%

Two biological and two psychological factors that may contribute to mental illness in children

two biological - genetic and neurobiological

two psychological - temperament and resilience

Most common form of child abuse

neglect

Meaning of "principle of least restrictive intervention"

restrictive intervention sshould only be used after attempting less restrictive interventions that have been unsuccessful

types of interventions for a child acting out, and how restrictive they are

-discussion

-offering meds

-suggesting a time out to a quiet area with decreased stimulation

*these are least restrictive

-seclusion

-physical restraints

*these are more restrictive, yet seclusion is less restrictive than a restraint

Compare and contrast vocal tics and motor tics

"Vocal tics are spontaneous production of words unrelated to conscious communication and sounds such as sniffs, barks, coughs, or grunts."

motor tics include the head, torsos, or limbs and they change in location, frequency, and severity overtime

vocal tics r a spontaneous production of words unrelated to conscious communication

-may include sounds like sniffing, barking, coughing, grunting

What is Tourette's Disorder?

having multiple motor tics and at least one vocal tic for more than 1 yr

Treatments for Tourette's syndrome (behavioral and medication)

comprehensive behavior intervention for tics - habit reversal

meds-

FGA like halodol and pimozide

SGA - aripiprazole and risperidone (RISP DOES NOT have FDA approval)

alpha 2 adrenergic agonists - guanfacine HTN but also tics, clonidine ADHD but also tics

benzo- clonazepam as a supplement w/ other drugs

botox to calm the muscle associated with tics

deep brain stimulation is used when other tx's fail (pacemaker 4 the brain)

What is autism spectrum disorder (ASD)?

a neurobiological and developmental disability that usually appears in a kids first 3 yrs of life that affects normal development, social interaction, and communication skills

DSM-5 criteria overview for ASD

A. Persistent deficits in social communication/interaction, including all of the following:

deficits in social communication/interaction INCLUDING

-probs w/ social-emotional back and forth interaction

-probs w/ nonverbal communication lie poor eye contact

-probs w/ relationships like it being hard to make friends and not being interested in peers

restricted and repetitive pattern behaviors (at least 2)

-repetitive motor movement like lining up toys and echolalia- repeating something said

-insistence on sameness so its hard to go off routine or deal with transitions

-restricted and fixated interests

-hyper or hypo-reactivity to sensory input

s/s begin in early development

s/s cause significant impairment in daily fx

s/s r not explained by intellectual disability BUT can co occur

What might an early intervention program for children with autism include?

an early intervention plan includes tx plan with behavior management with a reward system

teaching parents to provide

-structure

-rewards

-consistency in rules and expectation at home

children with autism may receive physical, occupation, and speech therapy as part of the care plan

Common comorbid disorders with ADHD

ODD

CD

DMDD- disruptive mood dysregulation disorder

specific learning disorder

Box 11.3 – techniques for managing disruptive behaviors (names with brief textbook definitions)

Behavioral contract: Agreement outlining expected behaviors and consequences/rewards

Collaborative & proactive solutions: Child + adult identify triggers and create shared solutions

Counseling: Talking, modeling, and role-play to teach appropriate behaviors.

Modeling: Demonstrating desired behavior for the child to imitate.

Role-playing: Practicing new behaviors or handling situations through acted scenarios.

Planned ignoring: Withholding attention from non-dangerous, attention-seeking behaviors.

Signals/gestures: Nonverbal prompts (eye contact, hand signal) to remind the child to use self-control.

Physical distance/touch control: Moving closer or placing staff between children to reduce conflict; gentle touch only if calming.

Redirection: Shifting the child from inappropriate behavior to an acceptable activity.

Additional affection: Providing emotional support or shared enjoyable activity to reduce distress.

Use of humor: Light, nonpersonal humor to defuse tension without shaming the child.

Clarification: Breaking down a situation so the child understands events, motives, and consequences.

Restructuring: Modifying the activity to reduce frustration or overstimulation

Limit setting: Clear, calm expectations or directions before or during behavior issues.

Simple restitution: Child repairs or corrects the impact of their behavior (clean up, apologize, restore).

Physical restraint: Mechanical or physical restriction used only when necessary to prevent harm.

Class of medications for ADHD and which are most widely used

Stimulant drugs

methylphenidate (ritalin and other)

mixed mixed amphetamine salts (adderall)

Common side effects of stimulants in children

insomnia

suppressed appetite

h/a

abdominal pain

lethargy

Non-stimulant SNRI FDA-approved for ADHD

non-stimulant selective norepinephrine reuptake inhibitor - atomoxetine (Strattera)

Most common side effects of atomoxetine (Strattera)

gi disturbances

urinary retention

dizziness

fatigue

insomnia