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Vanderbilt used for what and by who?
- for ADHD
- used by parent and teacher
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Sits alone for 30 seconds
6-8mo
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Says mamma or dadda
10-12mo
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75% of speech able to be understood by others
3-4yo
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Infant assessment & young children interview used what?
- Puppets or obs of play
- Denver test
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School-age assessment used how?
- do they know why they are at visit? NOT in trouble
- Use a doll or draw
- Direct question to doll and ask child how they think they would feel
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3 phases of adolescents
- Early 10-13
- Middle 14-17
- Late 18-21
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Psychosocial assessment tools
- Home
- Education (skipping, grades)
- Activities (tv<2hours)
- Drugs (normalize, "many of my pts...)
- Drinking
- Sex & Sexuality
- Suicidality
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Screening test for adolescents substance abuse
- CRAFFT--> pos if 2+ yes answers
- Car-ever been in a car with someone who was high/etoh
- Relax-use it to relax
- Alone-use while byself
- Forget-forget things
- Friends-tell you to cut down
- Trouble- ever been in trouble
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At what age can substance abuse tx occur without parents
12-14yo
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STD tx without parents
anytime
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gender ratio for boys and girls
then adults
- 2:1 boys vs girls
- 1:1 in adults
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Neurochemicals involved in ADHD and what area of the brian
- Dopamine and NE
- prefrontal coretex
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When CAN remission occur
12-20yo
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Types of ADHD and criteria
- inattentive, hyperactive/impulsive, and combined
- 6 sxs for 6mo+ in 2 or more settings
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For tic disorder what do we went to avoid regarding meds
high doses of dextroamphetamine
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1st line meds for ADHD; class and MOA
- CNS stimulants:
- methylphenidate to increase DA and NE
- dextroamphetamine/amp salts to release DA, NE, and 5HT
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When are stimulants contraindicated
Cardiac abnorm, hx of drug abuse, glaucoma, concurrent use with MAOI, hyperthyroid, HTN, tics, and anxiety
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What med used if substance abuse
amoxetine
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Therapy used first at what age
<5yo or minimal sxs
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Management of ADHD
wait and watch, growth charts, 1-2 weeks then 1-3 months
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When do we do a drug holiday?
- if ht or wt cross 2% lines
- small growth risks
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ODD onset
early as 3yo and about 8yo
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Conduct disorder onset
Prior to 10yo
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ODD risk factors
controlling or overreation by parents
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ODD criteria
4+ sxs for 6 mo
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Conduct disorder criteria
- 4 criteria aggression to animals, des to property, theft, serious violation of rules
- basic rights 6-12 months
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ODD treatment
therapy best --> meds for ADHD
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Conduct disorder tx
- SGA AP (clonidine)
- maybe SSRIs and ADHD meds
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Disruptive Mood Dysregulation criteria and onset
- chronic 12mo+
- severe tempers of 3x/wk
- onset before 10yo
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Intellectual disability IQ and borderline
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Autism criteria
- 2 core domains
- social-emotional, non-verbal comm, relationships, repetitive movements, fixated interest
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Overall tx and Pharm tx for ASD
- comorbid psych disorder
- start low & go slow
- Atypical AP: Risperidone and Aripriprazole
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Reactive attachment disorder criteria
- emotionally withdrawal towards adults caregivers
- rarely seeks comfort
- min social
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Disinhibited social engagement disorder
- interacts with unfam adults
- over familiar of verbal/physical behavior
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Criteria for anorexia
- refusal to maintain weight, fear of gaining weight, dis of body image, amenorrhea 3 cycles
- 2 subtypes: restrictive no binging or purging
- binge eating:regular
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Criteria for bulimia
- eating excessive amount of food in small time frame
- lack of control for over eating in episode
- laxative, exercise, diuretics
2x/wk for 3 months
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Binge eating disorder criteria
3sxs for 1/wk for 3 months
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Medical complications for anorexia but no bulimia
hypothermia, lanugo, dependent edema, cardiac, amenorrhea
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Medical com in both anorexia and bulimia
electrolytes, bradycardia, hypotension
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Highest mortality rate
anorexia ~18% of all psych disorders
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Meds for bulimia and anorexia and what time for initiation
SSRIs and after wt gain is achieved
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Avoid what med in eating disorders and what meds not indicated or used often
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Tic disorder criteria
- prior to 18yo
- wax and wane
- 1+ year
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Tx for tic disorder
Haloeridol, abilify, clonidine
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Encopresis criteria and tx
- feces after 4yo
- laxative, CBT
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Enuresis criteria and tx
- bedwetting after 5yo
- restrict fluids
- desmopression
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most common child psych disorder and 1st line, 2nd line
- anxiety
- therapy
- SSRIs and Venlafaxine XR
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Separation anxiety disorder
- 4wks and before 18yo
- physical sxs
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