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Cheatography

Child Psych Cheat Sheet (DRAFT) by

Created to record Child Psych info for quick review

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Milestones

3 mo
Social smile
6 mo
Sit up, babble & coo
9 mo
Stranger anxiety, pull-up & cruise, pincer grasp
12 mo
Walk, First Words
18 mo
15+ words
2 yrs
Parallel play/ 2 word phrases/ climb stairs (1 foot at a time)
3 yrs
3 word phrases, rides tricycle, draws triangle and
4 yrs
Draws and
5 yrs
Knows name & address/ hops & jumps/ counts to 10+

Neuropsych testing

IQ tests
Verbal IQ= learned facts
Perfor­mance IQ=visuo­/motor skills
WAIS-III
IQ test for adults
WISC-V
IQ for age 5-15
WPPSI-R
IQ for pre-sc­hoolers
Achiev­ement tests
for school age
Woodcock -Johnson Psychoed Battery
reading, math, writing
IDs learning disability
Wide Range Achiev­ement
WRAT-3
screens for deficits in academic skills
Vineland Adaptive
Behavioral Scales
evals commun­ica­tion, living skills, social, & motor

Person­ality Tests

Objective Tests
MMPI
10 scales/ can detect maling­ering
Millon Clinical Multiaxial
"most helpful to confirm person­lality do"
Sctruc­tured Assess­ments
Beck Depression
brief screening in office
Hamilton Rating scale for depression
Yale-Brown for OCD
Y-BOCs
Projective Tests
Rorschach
ink blot
Thematic Apperception Test
shown pic & asked to describe scene
Word- Associ­ation
Jung, free associ­ation
Draw a Person
repres­ent­ation of self/ kids

Cognitive Tests

Executive Fxning
Wisconsin Card Sorting
abstract reasoning & flexib­ility
cards sorted thru trial & error
Trail Making
concen­tration & executive fxning*
conect letters & #s in sequence
Visuomotor
Bender Gestalt
Copy designs w/ & w/o visual­izing design
Receptive & Expressive Lang
Token Test
compre­hension of instru­ctions, grammar & attention
Boston Naming
verbal confro­ntation & naming
Alzheimer's vs depression

Genetic

Fragile X
FMR1
X-link­ed...3-5% of ASD pts
Angelman
15q11-q13 MATERNAL
"­coc­ktail person­ali­ty", happy, excitable, hand flapping, ataxia, seizures
Prader­-Willi
15q11-q13 PATERNAL
OCD, hypoth­alamic insuff, overeating
Veloca­rdo­facial
22q11.2
genetic risk for SCZ
Rett syndrome
MECP
girls, regression of intellect & motor
Huntington Dz
Autosomal Dominant
CAG repeats
FKBP5
trauma
glucoc­ort­icoid signaling
SERT/ SLC6A4
Alzheimer, MDD, PTSD
serotonin transport
ApoE2
Alzheimer
AKT1
MJ psychosis

Risk/Devpt of Substance Use

Imbalance in devpt...
sub-co­rtical= bottoms up
reactive to stimuli/ curvil­inear devpt
pre-fr­ontal= top down
linear pattern of devpt
Thus, kid brains
vulnerable to reward props of subs
 

Develo­pmental Theories

Attachment

Attachment Theorists

Harry Harlow
1950s
Contact comfort research
 
infant monkeys preferred
 
cuddly surrogate to
 
wire w/ food
John Bowlby
1960s
Attachment=connection betwn 2 indiv overtime
 
secure base-c­are­giver is "home base" to explore enviro­nment
Mary Ainsworth
1970s
"­strange situat­ion­"
 
involves introd­ucing stranger
 
to child/mom then observing

John Bowlby

Mary Ainsworth- attachment styles

Secure
Child distressed composes self
Anxious-
ambivalent
Distressed unable to compose
Anxious- avoidant
Avoids parentno distress when they leave
Disorg­anized
Lack of attachment behavior

Reactive Attachment Disorder

-1st presents under 5 yr
-child doesn't seek/r­espond to comfort
-unexp­lained irrita­bil­ity­/sa­dne­ss/fear
-limited positive affect
CAUSES
-Social neglec­t/d­epr­ivation
-Freq changes in caregivers (e.g. foster care)
-Care doesn't allow for primary attachment (e.g. instit­utions w/ low caregi­ver­:child ratio

Anxiety

Anxiety

Separation, Generalized,
Selective Mutism
1) Psychotx x 12 wks
 
2) then FLUOXETINE
Exposu­re-­Based CBT
OCD in kids/adol
PCIT=Paren­t-Child Intera­ctive Tx
-empirical support for kids w/ anxiety & disruptive bx
-parent wears earpiece while tx observ­es/­directs intera­ctions w/ the child
SCARED
Screening tool for Child & Anxiety Related DO
Tx'ing anxious parents= kids less anxious
 

Sleep EEG

EEG

Spike & slow wave
Epilep­togenic
High-a­mpl­itude slowing
Normal in kids
Global suppre­ssion
Enceph­alo­pathy

Neuro

Upper motor lesion
BABINSKI,HYPERtonia, spastic
Lower motor lesions
Fascic­ula­tio­n/f­ibr­ill­ation, HYPOtonia,

ADHD

Highly genetic
71-90% in mono/d­i-z­ygotic twin sudies
Maternal smokin­g=risk factor
Response inhibition
temper­o-p­arietal & inf frontal
Pre-school
behav tx= 1st line
School-age
Stimul­ant=1st line
consider EKG if family hx of cardiac
Hypera­cti­ve/­imp­ulsive
Alpha Agonist
Inatte­ntion
Atomox­etine
Depression
Buproprion

Autism Spectrum Disorder

Def in Social & Comm
+ Restri­cted, repetitive interests
 
-hearing test
 
-screen for Fragile-X
Tools to dx & screen:
Autism Diagnostic Observ­ation Scale
ADOS-2= gold standard for dx
CHAT- Checklist for Autism in Toddler
peds use for screeening
Tx= ABA
Applied Behavioral Analysis
 
considered gold standard
Social-Pragmatic
Communication Disorder
= social & comm deficits
w/o restricted interest

Bipolar DO in kids

Same criteria as adults
1-2% prevalence
ADHD
50% co-mor­bidity
ASD
20% co-mor­bidity
Twin Studies
60-90% variance
Mania in high-risk off-spring
2-7%
FDA tx for BPAD
Olanzapine
13+
Lithium
12+
Risper­idone
10+
Aripip­razole
10+
Quetiapine
10+
TEAM (Tx of Early Age Mania Study)
Atypical AP
68.5%
Divalproex
40%...but not FDA approved for mania in kids
Li response
35.6%

Disruptive Mood Dysreg­ulation Disorder- DMDD

Criteria:
severe temper outbursts
 
3x/ wk .... 2/3 settings
 
irrita­ble­/angry mood in between
 
onset before 10 yo
Can't co-exist w/ ODD, Int Explosive or Bipolar
Tx targets symptoms of aggres­sio­n/i­rri­tab­ility

MDD in kids

Same criteria as adults
May see more irrita­bility, anger & somatic sx
Rating Scales:
PHQ-9, CES-DC, CDI
TADS (Tx of Adol Depression Study)
CBT+SS­RI>­CBT­>SSRI
SSRI
Black box warning= re increased risk of SI
TORDIA(Tx of Res Dep in Adol)
failed 1st SSRI
switched to 2nd SSRI
vs Venlaf­axine (VFL)
vs CBT+SSRI
vs CBT+VFL
TORDIA outcome
CBT+med= Best outcome
2nd SSRI=VFL
VFL= increased SE
CBT+Inter­per­sonal TX (IPT)
Best evidence from RCTs in adol
FDA black box SSRI/SNRIs
increased risk of SI in adol & young adults