childhood disorders powerpoint
TRANSCRIPT
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EMOTIONAL DISORDERS OFCHILDHOOD
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FOCUS OF PRESENTATION
BEHAVIORAL DESCRIPTION OF FIVEDISORDERS OF CHILDHOOD
CURRENT THINKING ON ETIOLOGIES
EFFICACIOUS TREATMENTS
PRACTICAL INTERVENTIONS TAILOREDTO NURSES IN A VARIETY OFSETTINGS
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FIVE DISORDERS DISCUSSED
ANXIETY DISORDERS
DEPRESSION
ATTENTION DEFICIT HYPERACTIVITYDISODER
CONDUCT DISORDER/OPPOSITIONALDEFIANT DISORDER
AUTISM/PERVASIVE DEVELOPMENTALDISORDERS
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Types of Anxiety Disorders
Broad overview of all anxiety disorders
Prevalence
Most common in children:
Separation Anxiety Disorder
Generalized Anxiety Disorder (GAD)
(formerly Overanxious Disorder)
Specific Phobia
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Recognizing ChildhoodAnxiety
Problems associated with
recognizing anxiety includedifferentiating anxiety
from normal childhood fears
and the presentation of anxiety
as somatic complaints
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GAD versus SeparationAnxiety
Generalized AnxietyDisorder
Marked Unrealisticworry about avariety of situations
Worries usuallyfocus on futureevents
Concerns about
competence
Separation AnxietyDisorder
Anxiety is focusedon separation fromsignificant othersand home
Worry about harmto self or parents
May include school
refusal
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Separation Disorder
Diagnostic criteria
Developmentally inappropriate worry
The duration of the disturbance must lastfor at least four weeks
The disturbance causes clinically significant
distress or impairment in social, academic,or other important areas of function
The disturbance is not associated withPPD, Schizophrenia, or other Psychotic
disorders (DSM IV)
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Risk Factors for SeparationAnxiety
Causes of childhoodanxiety remain
poorly understood Offsprings of adults
with anxietydisorders are more
likely to bediagnosed
Attachment and
temperament play arole
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Treatments: SeparationAnxiety
Behavioral Treatment: including a planfor separation that includes behavioral
techniques, systematic desensitization,modeling and operant techniques
Family interventions
Cognitive therapy for the child
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Approaches in your practicesetting
Gently question the child about theextent and content of their worries
Determine the intensity, autonomy,duration and extent disabling
Map patterns of somatic complaints
Discuss concerns and observations withparents
Do not try and cheer child out of worry,
but examine evidence for worry
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CHILDHOOD DEPRESSION;ESSENTIAL FEATURES
Depressed Feelings
Inability to have fun
Lowered self esteem
Additional Criteria Sleep Difficulties Guilt
Excessive fatigue Social Withdrawal Cognitive Impairment Appetite change
Psychomotor agitation Somatic Complaints
Morbid/suicidal ideation
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Recognizing a depressed child
Questions to ask regarding:
Self esteem
Depressed feelings
Social Withdrawal
Suicide: Past attempts/methods used thoughts about hurting self-how often
feeling alone
perceived options
drug or alcohol use.
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Current treatment
Medications: Use of SSRIs
Cognitive therapy
Interpersonal Therapy
How treatment ties to model of etiology
-Links between how we think and howwe feel; The cognitive thought record.
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Disruptive Behavior Disorders
ADHD
Oppositional Defiant Disorder
Conduct Disorder
Associated with Socioeconomic status
Learning Disabilities
Family History of Disorder
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Attention-Deficit Hyperactivity
Diagnostic Criteria
InattentionHyperactivity
Impulsivity
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Clinical Presentation
Expected pattern: achild who
fidgets runs excessively
on the go
talks excessively
blurts out answers
difficulty waiting turn
interrupts andintrudes
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More Subtle Dimension
Inattention
makes careless
mistakes fails to pay close
attention in school
seems not to listen
difficulty organizingself
forgetful in dailyactivities
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Ritalin: Facts and Controversy
History of Ritalin
How Ritalin helps the ADHD child
Critics of the medication
Controversy surrounding the overuse
Judicious use of Ritalin
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Other Treatments for ADHD
Behavioral Techniques
Parent training
Social Skills groups
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Techniques to help in yourpractice setting
Help the child problem solve
Control stimulation
Role model alternatives
Support parents
Be an educator on the disorder Help parents evaluate treatmentrecommendations
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Oppositional Defiant Disorder
DSM IV criteria
Loses temper
Argues with adults
Defies adult requests
Blames others, angry, resentful, spiteful
Behavior causes a significant impairment insocial or academic functioning
Does not occur during a psychotic disorder
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CONDUCT DISORDER
A PERSISTENT PATTERN OF BEHAVIORWHICH VIOLATES THE BASIC RIGHTS
OF OTHERS OR AGE-APPROPRIATESOCIETAL NORMS
AGGRESSION TO PEOPLE OR ANIMALS
DESTRUCTION OF PROPERTY DECEITFULNESS OR THEFT
SERIOUS VIOLATION OF RULES
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ETIOLOGY OF AGGRESSION
GENETIC COMPONENT
COERCIVE PATTERN TO FAMILY
INTERACTIONS
SOCIAL INFORMATION PROCESSINGDEFICITS
REACTIVE AGGRESSION: RESPONDINGTO FRUSTRATION
PROBLEM GENERATED BY SOCIETAL
FACTORS
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TREATMENT OPTIONS
PARENTING TRAINING
SOCIAL SKILLS TRAINING
PROBLEM SOLVING
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APPROACHES IN YOURPRACTICE SETTING
OBSERVE ANTECEDENTS OF BEHAVIORAND TYPICAL PATTERNS TO
ESCALATION HELP THE CHILD SELF REGULATE,
LABEL AND DIFFERENTIATE AFFECTS,
CONNECT AFFECTS TO THOUGHTSAND PERCEPTIONS
BE AVAILABLE TO FAMILY FOR
PROBLEM SOLVING AND SUPPORT
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Pervasive DevelopmentalDisorders
Aspergers Disorder
PPD- Not Otherwise Specified
Autistic Disorder
Defining Characteristics (film)
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Identifying Autism
No two autistic children look the same
DSM criteria
qualitative impairment in at least two ofthree categories:
Social Interaction
Communication Restricted/repetitive patterns of behavior
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Basic Principles of Intervention
Behavioral Reinforcement schedules
Finding meaningful enforcers
Using paired associations
Patterning of behavior