childhood disorders powerpoint

8/13/2019 Childhood Disorders Powerpoint

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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

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