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Bullying in Children and Adolescents (Peer and Sibling)
from – https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/abuse-and-violence/children-and-young-people/sibling-and-peer-bullying General Overview Clinical Practice Recommendations Definitions and Characteristics of Bullying Sibling Bullying vs. Rivalry Prevalence Risk Factors Table 10.1 Risk factors for peer and sibling bullying Risk factors Bullying Peer Reference Sibling Reference Individual Physical (eg overweight, disability, chronic illness) Moderate association 65–68 …
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Behavioral Regression in Children
Key Symptoms to Ask About: Cause Key Features Symptoms to Ask About Psychological/Emotional Stress – Trauma or Abuse Sudden behavioral changesfearfulnesswithdrawal from family and social interactionsbedwettingnightmares – Sudden changes in behavior or mood?– Bedwetting or regression in toilet training?– Fear of certain people or places?– Unexplained injuries or bruises?– Nightmares…
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Challenging Behaviours
gathered from – Ten things I wish you knew about your child’s mental health – Dr Billy Garvey Understanding Behavioural Difficulties: Addressing Behavioural Issues: Long-Term Impact of Emotional Difficulties: Understanding and Addressing Behavioural Issues Role of Paediatrician as a Detective: Behaviour as Communication: Identifying Triggers and Patterns: The Volcano Analogy:…
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Adolescent Patient
Engaging with and Assessing the Adolescent Patient Key Points Background Adolescent Health Care Considerations Assessment Psychosocial Interview Examination Management Transition to Adult Services
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Enuresis (bed wetting)
Enuresis Overview: types Epidemiology: Associated Conditions: Pathophysiology: History Much of the history should focus on voiding habits Examination Evaluation: Treatment/Management: Pharmacological Therapy Desmopressin: MinirinTM melt/tablet DOSING: Intranasal route is not recommended due to higher risk of hyponatraemia Prognosis: Complications: Consider referral to a general paediatrician or continence service when
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Asperger’s Disorders
Oppositional Defiant Disorder Patterns of behaviour Conduct Disorder Childhood onset: < 10 yo Adult onset: > 10 yo Developmental co-ordination disorder / dyspraxia Specific learning disorders Dyslexia
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Depression (kids)
Presentation MDD symptoms How symptoms may present in a child Depressed mood Irritable, temper outburst, cranky, unhappy, miserable Anhedonia/lack of interest Loss of interest in pleasurable activities (eg does not want to see friends, do usual activities) Somatic symptoms Stomach ache, headache, musculoskeletal pain, fatigue Sleep disturbance Change in sleep…
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Faecal incontinence/Encopresis
Diseases which mimic faecal incontinence 80% is retentive (secondary to constipation) and of this 95% functional and 5% organic (as below) Differentials retentive/ constipation: non-retentive Assessment Investigations Management
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Tourette’s
Management
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Tic Disorder
Sudden, non-rhythmic & repetitive movements and/or vocalisations >1 year Persistent tick disorder – either motor or vocal Provisional < 1 year Often mimic some aspect of normal behaviour ↑ if stressed or excited ↓ when calm or focused activities, & asleep Average onset 5-6 years Risks – genetics, ADHD< OCD,…
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Autism spectrum disorders
is a lifelong neurodevelopmental condition features of which become evident in early childhood They can be more difficult to assess because they communicate differently and may not tolerate an unfamiliar clinical environment Behavioural and communication difficulties act as significant barriers to these children accessing hospital care. Children with autism and…
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ADHD
Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder and is estimated to affect approximately 10% of children and 5% of adults. Males 5-10X in clinic referrals 2-3X in community settings Mean age at diagnosis 9 yrs (boys < girls) Heritability > 70% 1st degree relatives – 4-8…