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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

Child and Adolescent Mental Health

Donna Poole RN, MSN, CS

growth and development in adolescents
Growth and Development in Adolescents
  • Three phases of Adolescents
    • Early- 10 to 13
    • Middle- 14 to 17
    • Late- 17 to 21
onset of puberty
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
male puberty
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
cognitive development
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.
early adolescents
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”
middle adolescents
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
late adolescents
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
mental health problems of school age children
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
etiology of mh problems
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.
developmental disorders and disruptive behavior disorders
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
attention deficit hyperactivity disorder
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)
treatment adhd
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
interventions
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
more interventions
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
tic disorders
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
psychotic disorders
Psychotic disorders
  • Childhood Schizophrenia-2 cases per 100,000
  • Adolescents-Bipolar, and Schizophrenia
ad