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Intellectual Disability - What three diagnostic criteria must be met?
deficits in intellectual functioning (reasoning, problem solving, abstract thinking) that are confirmed by clinical assessment and individualized, standardized intelligence testing
Deficits in adaptive functioning that result in a failure to meet community standards of personal intelligence and social responsibility and impair functioning across multiple environments in one or more activities of daily life (communication, social participation, independent living)
The onset of intellectual and adaptive functioning deficits during the developmental period.
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Intellectual Disability - What are the four degrees of severity and what are they based on?
mild, moderate, severe, profound
adaptive functioning in conceptual, social, and practical domains
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Communication Disorders - Childhood-Onset Fluency Disorder
AKA stuttering
Characterized by a disturbance in normal fluency and time patterning of speech that is inappropriate for the person's age and involves sound and syllable repetitions, sound prolongations, broken words, word substitutions to avoid troublesome words, and/or monosyllabic whole-word repetitions.
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Communication Disorders - Childhood-Onset Fluency Disorder - when does this usually begin?
ages 2 - 7
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Communication Disorders - Childhood-Onset Fluency Disorder - what treatment is effective for older children and adults
habit reversal training
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Communication Disorders - Autism Spectrum Disorder - what must the person exhibit for a diagnosis?
Persistent deficits in social communication and interaction across multiple contexts as manifested by deficits in social-emotional reciprocity, nonverbal communication, and the development, maintenance, and understanding of relationships
restricted, repetitive patterns of behaviors, interests, and activities as manifested by at least two of the following: stereotypes or repetitive motor movements, use of objects, or speech; insistence on sameness, inflexible adherence to routines, or ritualized patterns of behavior; highly restricted, fixated interests that are abnormal in intensity or focus; hyper- or hyporeactivity to sensory input
symptoms during the early developmental period
impairments in social, occupational, or other area of functioning as the result of symptoms
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Communication Disorders - Autism Spectrum Disorder - what are the levels of severity?
level 1 - requiring support
level 2 - requiring substantial support
level 3 - requiring very substantial support
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Communication Disorders - Autism Spectrum Disorder - What is the best prognosis associated with?
communicate verbally by age 5 or 6
IQ over 70
Later onset of symptoms
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Attention-Deficit/Hyperactivity Disorder - What is it characterized by?
a pattern of inattention and/or hyperactivity-impulsivity that has persisted for at least six months, had an onset prior to 12 years of age, is present in at least two settings (e.g., home and school), and interferes with social academic or occupational functioning.
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Attention-Deficit/Hyperactivity Disorder - How many characteristic symptoms of inattention and/or hyperactivity-impulsivity must be met and how long must the be present for a diagnosis?
6 and 6 month
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Attention-Deficit/Hyperactivity Disorder - What are the three specifiers and the necessary criteria?
Predominantly inattentive - 6+ inattention symptoms, <6 hyperactivity-impulsivity
Predominantly hyperactive/impulsive - <6 inattention symptoms, 6+ hyperactivity-impulsivity
combined presentation - 6+ inattention symptoms, 6+ hyperactivity-impulsivity
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Attention-Deficit/Hyperactivity Disorder - What is the gender ration for adults and children?
children - 2:1 males
adults - 6:1 males
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Attention-Deficit/Hyperactivity Disorder - Brain abnormalities have been linked to what parts?
lower than normal activity and smaller than normal size in the caudate nucleus, globus pallidus, and prefrontal cortex
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A diagnosis of Intellectual Disability requires deficits in intellectual functions, deficits in ___________, and an onset during the _________. The DSM-5 distinguishes between four degrees of severity based on adaptive functioning in three domains - conceptual, social, and _________. The etiology of the disorder is inknown in about _______% pf all cases
adaptive functioning
developmental period
practical
30
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The onset of childhood-Onset Fluency Disorder (stuttering) is most often between the ages of ___________, and it may be effectively treated with __________ training which combines awareness, relaxation, motivation, competing response, and generalized training.
2 - 7
habit reversal
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A diagnosis of Autism Spectrum Disorder requires persistent deficits in ________ across multiple contexts; restricted, repetitive patterns of behavior, interests, and activities; symptoms during the early developmental period; and impairments in social, occupational, or other area of functioning. A better prognosis for this disorder is associated with the ability to communicate verbally by age ________, and IQ of _______ or above, and a later onset of symptoms. In terms of treatment, __________ were originally used by Lovaas and continue to be used to improve communication skills
social communication and interaction
5-6
70
shaping and discrimination training
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ADHD is characterized by a persistent pattern of ________ and/or hyperactivity-impulsivity that interferes with social, academic, or occupational functioning. The diagnosis requires an onset of symptoms prior to age ________ years and evidence of impairment in at least ________ different settings. It has been estimated that ______% of children with ADHD continue to meet the diagnostic criteria for the disrder in adolescence. Among adults, _______ predominates the symptom profile. According to the _________ hypothesis, ADHD is due to an inability to regulate one's behavior to fit the demands of the situation. The National Institute of Mental Health Multimodal Treatment Study of ADHD (MTA) found that, in terms of initial results, ___________ and combined medication and behavioral treatment produced a similar reduction in the core symptoms of the disorder
inattention
12
2
65-80
inattention
behavioral disinhibition
medication management
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Specific Learning Disorder - What are the diagnostic criteria, how many symptoms must be present, and for how long?
When a person exhibits difficulties related to academic skills, those skills are substantially below age expectations, interfere with academic or occupational performance or activities of daily living, began during school-age years, and are not better accounted for by another condition or disorder
1 characteristic symptom that persists despite interventions targeting the difficulty
6 months
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Specific Learning Disorder - What are the symptoms?
inaccurate or slow and effortful word reading
difficulty understanding the meaning of what is read
difficulties with spelling
difficulties with written expression
difficulties with mastering number sense, number facts, or calculation
difficulties with mathematical reasoning
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Specific Learning Disorder - What are the three subtypes and specifiers?
impairment in reading
impairment in written expression
impairment in mathematics
mild, moderate, severe
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Specific Learning Disorder - What is the most frequent comorbid disorder and the percentage of children who have both?
ADHD
20-30%
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Specific Learning Disorder - What is the male/female ratio?
2:1 - 3:1 Males
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Motor Disorders - Tic Disorders - define a tic
sudden, rapid, recurrent, nonrhythmic motor movement or vocalization
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Motor Disorders - Tic Disorders - Tourette's Disorder - what is it characterized by, how long must symptoms be present, and appear before what age?
The presence of at least one vocal tic and multiple motor tics that may appear simultaneously or at different times, that may wax and wane in frequency
1 year
before 18
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Motor Disorders - Tic Disorders - Persistent (chronic) Motor or Vocal Tic Disorder - what is it characterized by, how long must symptoms be present, and appear before what age?
involves one or more motor or vocal tics
1 year
before 18
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Motor Disorders - Tic Disorders - Provisional Tic Disorder - what is it characterized by, how long must symptoms be present, and appear before what age?
one or more motor and/or vocal tics
less than 1 year
before 18
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Motor Disorders - Tic Disorders - Tourette's Disorder - Most common associated symptoms?
obsessions and compulsions, Hyperactivity, impulsivity, and distractibility
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Motor Disorders - Tic Disorders - Tourette's Disorder - treatment
pharmacotherapy - antipsychotics --> haloperidol and pimozide, SSRI's to help with obsessions and compulsions
comprehensive behavioral treatment for tics (CBIT)
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What are behavioral pediatrics?
the branch of behavioral medicine that is concerned with the psychological aspects of children's medical illnesses.
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Behavioral Pediatrics - Disclosure
open communication about the illness is advisable but must involve developmentally appropriate language and procedures
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Behavioral Pediatrics - medical procedures - what intervention has been shown to reduce anxiety
cognitive-behavioral interventions based on the stress inoculation model which provide children with information about procedures and using techniques (filmed modeling, reinforcement, breathing exercises, emotive imagery/distraction, and behavioral rehearsal) to cope with anxiety and stress
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Behavioral Pediatrics - what age range have the most negative reactions to hospitalization?
1 - 4
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Specific Learning Disorder is diagnosed when a person exhibits difficulties related to academic skills as indicated by the presence of at least once characteristic symptoms that lasts for at least _________ despite the provision of interventions targeting those difficulties.
6 months
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The most comorbid disorder for Specific Learning Disorder is ___________.
ADHD
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_________ is diagnosed in the presence of at least one vocal tic and multiple motor tics that began prior to _______ years of age. Treatment for this disorder may include a(n) __________ drug
Tourette's Disorder
18
antipsychotic
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Research in the area of behavioral pediatrics has shown that open ___________ with a child about their illness is advisable and that multicomponent ___________ interventions are useful for reducing anxiety about the pain caused by medical procedures. The research has also confirmed that hospitalized children and children with physical disabilities are at increased risk for _____________. In terms of age groups, _________ have particular difficulty complying with medical regimens.
communication
cognitive-behavioral
emotional and behavioral problems
adolescents
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The DSM-5 uses a polythetic criteria set that:
A.requires a client to present with only a subset of symptoms from a larger list.
B.does not require a client to present with a subset of symptoms from a larger list.
C.allows for a nonaxial assessment system.
D.does not allow for a multiaxial system.
A
A polythetic criteria set requires that an individual meet only a subset of the criteria for a given disorder to qualify for that diagnosis. Consequently, people with somewhat different symptoms can be assigned the same diagnosis.
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With a diagnosis of Tourette's Disorder, the frequency and severity of tics:
A.often increase in adolescence or adulthood.
B.often decline in adolescence or adulthood.
C.typically remains the same in adolescence and adulthood.
D.typically increases in adolescence and decreases in adulthood.
B
Tourette's Disorder is a tic disorder that is diagnosed when an individual has at least one vocal tic and multiple motor tics. Tourette's Disorder is usually chronic; however, the frequency and severity of tics often decline in adolescence or adulthood.
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Which of the following best describes ADHD in adults?
A.Hyperactivity becomes less prominent while impulsivity and inattention stay the same or become more prominent.
B.Impulsivity becomes less prominent while hyperactivity and inattention stay the same or become more prominent.
C.Inattention becomes less prominent while hyperactivity and impulsivity stay the same or become more prominent.
D.Hyperactivity and impulsivity become less prominent while inattention stays the same or becomes more prominent.
D
The symptoms of ADHD vary somewhat over the lifespan. Hyperactivity and impulsivity decrease over time, while inattention predominates the symptom profile during adulthood. Common signs of inattention include inconsistency in the ability to concentrate, difficulty maintaining routines, and an inability to prioritize and complete important tasks.
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For a diagnosis of Tourette's Disorder, symptoms must have been present before ____ years of age.
18
Symptoms of Tourette's Disorder involve at least one vocal tic and multiple motor tics that may appear simultaneously or at different times. Tics must be present for more than one year and must begin before the age of 18.
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When using the DSM-5, the severity of a child's Intellectual Disability is determined by considering which of the following?
A.The child's score on an individual standardized intelligence test
B.The child's adaptive functioning in conceptual, social, and practical domains
C.The etiology of the child's disability
D.The discrepancy between the child's cognitive and adaptive functioning
B
The DSM-5 distinguishes between four levels of severity for Intellectual Disability: mild, moderate, severe, and profound. An individual's level of severity is based on his or her adaptive functioning in conceptual, social, and practical domains
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The best prognosis for Autism Spectrum Disorder is associated with:
A.an early onset of symptoms.
B.a precipitating factor.
C.verbal communication skills by age 6.
D.normal adaptive functioning.
C
The prognosis for Autism Spectrum Disorder is generally poor, although certain characteristics have been linked to a better prognosis, including the acquisition of verbal communication skills by age 5 or 6, an IQ of 70 or higher, and later onset of symptoms.
Answer A: In contrast, a later onset of symptoms is associated with a better prognosis for Autism Spectrum Disorder.
Answer B: Precipitating factors have not been associated with the best prognosis for Autism Spectrum Disorder.Answer D: Adaptive functioning is not one of the characteristics that have been associated with a better prognosis for Autism Spectrum Disorder.
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A child diagnosed with a Specific Learning Disorder is most likely to also receive a diagnosis of:
A.OCD.
B.Enuresis.
C.Intellectual Disability.
D.ADHD.
D
Individuals diagnosed with Specific Learning Disorder typically have an IQ in the average to above-average range but have higher-than-normal rates of other problems and disorders, with the most frequent comorbid disorder being ADHD.
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Difficulties in phonological processing have been linked to:
A.stuttering.
B.Intellectual Disability.
C.dyslexia.
D.Tourette's Disorder.
C
Phonological processing refers to the ability to process the phonological features of words (i.e., the ability to understand how sounds combine to form words). Problems in phonological processing have been linked to reading disabilities (e.g., dyslexia) and other learning disorders.
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