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Child and Adolescent Mental Health

Child and Adolescent Mental Health. Donna Poole RN, MSN, CS . Growth and Development in Adolescents. Three phases of Adolescents Early- 10 to 13 Middle- 14 to 17 Late- 17 to 21. Onset of Puberty. Female-lasts 4 years with age of onset from 9 -13.4 Average age is 11.2

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Child and Adolescent Mental Health

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  1. Child and Adolescent Mental Health Donna Poole RN, MSN, CS

  2. Growth and Development in Adolescents • Three phases of Adolescents • Early- 10 to 13 • Middle- 14 to 17 • Late- 17 to 21

  3. Onset of Puberty • Female-lasts 4 years with age of onset from 9 -13.4 Average age is 11.2 • Growth spurt 1 year prior to breast bud development • Peak height achieved 1 year after breast development • Menarche begins 1 year after height • Epiphyseal closure occurs

  4. Male Puberty • Males onset of puberty is 11.6 years of age with a range of 9.5-13.5 • Puberty lasts 3 years • First sign is testicular enlargement • Males have a 2 year delay in epiphyseal closure

  5. Cognitive development • Moves from concrete thinking to “formal operations” Abstract thinking • Level of thinking allows the person to transfer information from one situation to another, deal efficiently with complex problems, and plan realistically for the future.

  6. Early adolescents • Daydream, spend time in front of a mirror • View world as a stage in which they star • Very egocentric; see fame and fortune • Preoccupied with separation from the family • Worry if they are “normal”

  7. Middle Adolescents • Less grandiose about what they will be • Can be issue for “at risk” kids; feel hopeless • Not so worried about “normal” • Concerned about attractiveness, dating • Feelings of omnipotence- reckless behaviors • Experiment with morals in both phases

  8. Late adolescents • Develop a sense of self “Who am I” • “At Risk” youth may dissociate from family • Try on different roles; change majors– etc • Gains a sense of perspective, be able to problem solve • Consider all aspects of a problem • Delay gratification

  9. Mental Health Problems of school Age Children • 10-13% of children have serious MH problems • 655,000 Texas children • Case Study • The Children’s Partnership

  10. Etiology of MH Problems • Genetics: strong for depression, Anxiety, OCD, Tic disorders, ADHD, bipolar • Environment: Abuse and neglect, fetal Alcohol Syndrome, Brain damage • Neurological Anomalies • Developmental disorders- MR-IQ below 70 • Pervasive developmental disorders-Autism, Asberger’s, PPD-NOS, Etc.

  11. Developmental disorders and Disruptive behavior disorders • Specific Developmental disorders • Learning disorders-dyslexia 3to5% Nonverbal .1 to 1% • Communication disorders • Disruptive Behavior disorders • ADHD; Most common behavoral disorder • Oppositional Defiant disorder • Conduct disorder

  12. Attention-deficit Hyperactivity Disorder • AD/HD; Classic type • ADD without hyperactivity(couch Potato) • ADD, Over focused Type(tend to get stuck) • ADD, Limbic(negative and irritable • ADD, Temporal lobe(Violent, explosive, dark thoughts)

  13. Treatment ADHD • Problem in the Frontal lobe, which is responsible for planning, attention, regulation of motor activity-Brain under active • Medication: Stimulants Ritalin, Dexdrene, Cylert, Adderall • Common side effects:Anorexia, weight loss, Tics, abnormal movements, labile mood

  14. Interventions • Keep it simple, structured, and re-enforce good behavior • “It is unsafe to jump down stairs 2 at a time” “You walked down the stairs in a safe way” • “It is not OK to grab a toy from another child, you must ask” • Daily routine & short term rewards/re-enforcers

  15. More Interventions • Simple instructions; Don’t say-”Clean your room” say- “Put the dirty clothes in the hamper”, Then,” Make your bed” • Teaching the family about ADHD • Assess family HX and how successful • Listen, support groups, books • Communicate with teachers, School

  16. Tic Disorders • Tourette’s Syndrome-Movement disorder defined by the presence of motor and phonic tics: Rare 1 to 2 per thousand • Motor Tics-rapid, jerky movements of eyes, face, neck, and shoulders • Phonic tics: grunting, throat clearing, and repetitive noises • Can be words’ obscenities

  17. Psychotic disorders • Childhood Schizophrenia-2 cases per 100,000 • Adolescents-Bipolar, and Schizophrenia

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