Child Behavior

Question 1

Behavior of a newborn?

Answer 1

1. Sleeps 16-20 hours per day
   - Periods of 1-4 hours asleep followed by 1-2 hours awake
2. Feeds every 2-3 hours
3. Near-sighted (20-30 cm)
4. Psychological relationship between parent and child
5. Looks at and studies parent when awake; looks in parent’s eyes when being held
6. Calms when picked up; responds differently to soothing touch

Question 2

Behavior of 1-3 months old baby?

Answer 2

1. Develops social smile
2. Becomes more communicative and expressive with face and body
3. Enjoys play time
4. Self-soothing behaviors begin around 1 month (putting hands to mouth)
5. Different cries for hunger, tiredness
6. Sensitive to environment
7. Recognizes familiar objects and faces

Question 3

What is colic?

Answer 3

excessive crying for no apparent reason
- begin in 2nd or 3rd week

Question 4

When does colic occur and for how long does it last?

Answer 4

• in an otherwise healthy and well-fed infant <3 months of age
• begins in 2nd or 3rd week
• paroxysms last for ≥3 hours per day and occurs on ≥3 days per week
• May persist until 3-4 months of age

Question 5

Causes of colic?

Answer 5

Unknown etiology
- Possible GI vs neuro vs psychosocial factors

Question 6

Treatment of colic?

Answer 6

Encourage “5 S’s:”
1. Swaddle (wrap in garments/clothing)
2. Swing
3. Suck
4. Shush (soft sound)
5. Side or stomach position (while awake)

Question 7

Behaviour of a 8-12 month old child?

Answer 7

1. Develops object permanence
2. Has stranger anxiety and cries when caregiver leaves
3. Enjoys imitating people in play and in gestures
4. Starts testing parental response
5. Explores objects in different ways
6. First words

Question 8

Behavior of a 12-18 month old child?

Answer 8

1. Separation anxiety
2. Learns by imitating caregivers, older children
3. Individualization and autonomy developing
4. Looks to parent for approval
5. Engages with others for play
6. Explores independently but will check in with caregiver

Question 9

Describe the behavior of a 12-18 month child with secure attachment?

Answer 9

attachment will use the parent as a secure base from which to explore independently. Proud of her or his accomplishments, the child illustrates Erikson’s stage of autonomy and separation
Note: The toddler who is overly controlled and discouraged from active exploration will feel doubt, shame, anger, and insecurity

Question 10

Problems in behaviour of a 12-18 month child?

Answer 10

1. Infants/toddlers who avoid their parents at times of stress may be insecurely attached
2. Young children who, when distressed, turn to strangers rather than parents for comfort are particularly worrisome.
   - The conflicts between independence and security manifest in issues of discipline, temper tantrums, toilet training, and changing feeding behaviors

Question 11

Behaviour of a 18-24 month old child?

Answer 11

1. Shows signs of independence
   - Says “No”
2. Begins to show difficult behavior
3. Finds it hard to wait
4. Temper tantrums begin around 18 months
5. Can understand others’ emotions
6. More comfortable with strangers
7. Enjoys being around other children
8. Make-believe (symbolic) play begins around 18 months

Question 12

Describe normal toddler feeding?

Answer 12

1. After one year of age, growth rate slows and appetite declines
2. Food preferences develop
3. As the child develops autonomy, may use eating or not eating as a means of defiance
   - This usually improves by age 3

Question 13

When do temper tantrums begin?

Answer 13

• Begin between 12-18 months
• Worsen at 2-3 years, then improve

Question 14

What leads to temper tantrums?

Answer 14

During the toddler years, there is a change in how children process information.
1. They suddenly become more aware that their world can change.
2. They realize they won’t always getwhat they expect or want.
3. Their young minds are easily overwhelmed, and they don’t know how to cope with change or how to dealwith not getting their way

Question 15

When do temper tantrums occur?

Answer 15

1. Do not understand what you are saying or asking
2. Are upset when others cannot understand them
3. Do not know how to tell you how what they feel orwhat they need
4. Do not know how to solve problems on theirown
5. Are anxious or uncomfortable
6. Are reacting to stress or changes at home
7. Are hungry, tired
8. Are jealous, want what other children have, orwant the attention others receive
9. Are not be able to do as much as they think they can, such as walking, running, climbing, drawing, or making toys work

Question 16

Managing temper tantrums?

Answer 16

1. Encourage parents to stay calm and let the tantrum end itself
2. Ignore minor non-dangerous displays of anger
3. Allow ”cooling off” period after tantrum
4. Positive reinforcements during non-tantrum times

Question 17

What are breath holding spells?

Answer 17

Benign paroxysmal nonepileptic disorder occurring in healthy children 6 to 48 months of age

Question 18

What causes a breath holding spell?

Answer 18

Spell triggered by an event (temper tantrum, fear, or even sudden injury like falling down)

Question 19

Describe a breath holding spell?

Answer 19

• Child holds breath to the point of turning blue and/or passing out
• Normal breathing starts again in less than 1 minute. Becomes fully alert in less than 2 minutes.
• Only happens when child is awake, never when asleep

Question 20

Describe how to achieve discipline in a child?

Answer 20

• Important to match parents’ expectations to developmentally normal behaviors
• Discipline as a tool for teaching/correcting rather than punishing
• Positive reinforcements work well
• Modify environment to avoid tantrums
• Routines are key

Question 21

Describe toddler sleep?

Answer 21

May still awaken at night

Question 22

Anticipatory guidance for parents in regards to toddler sleep?

Answer 22

1. Establish bedtime routines
2. Put to bed when drowsy
3. If awakens, may give brief reassurance

Question 23

Describe toilet training?

Answer 23

• The average time for toilet training issix months for daytime urinary continence and six to seven months for stool continence
• Females typically complete toilet training faster than males
• The first child typically takes longer to complete toilet training
• Nighttime bladder control is achieved months to years later and is not expected until five to seven years of age

Question 24

What is enuresis?

Answer 24

Involuntary leakage of urine
1. diurnal (daytime)
- may have organic pathology, requires evaluation from 4 years of age
2. nocturnal (nighttime)
- primary nocturnal enuresis common in 5 year olds, typically resolves

Question 25

Causes of enuresis?

Answer 25

1. Delayed maturation of the cortical mechanisms that allow voluntary control of the micturition reflex 2. Reduced ADH hormone production at night, resulting in an increased urine output (nocturnal polyuria) 3. Genetic factors 4. Bladder factors (lack of inhibition, reduced capacity, overactive) 5. Constipation 6. Organic factors: UTI, obstructive uropathy, or sickle cell anemia nephropathy 7. Sleep disorders 8. Sleep-disordered breathing secondary to enlarged adenoids 9. Psychogenic factors

Question 26

Types of enuresis?

Answer 26

1. Primary - child has never attained full continence 2. Secondary - develop enuresis after a dry period of at least 6 months - Often related to a stressful event

Question 27

Describe the behavior of a preschool age child?

Answer 27

1. Imitates adults and playmates 2. Show affection for familiar playmates 3. Can take turns in games 4. Understands "mine" and "his / hers" 5. Pretend play, may have imaginary friends 6. Developing independence and self-confidence 7. Curious and asks many questions

Question 28

Behaviour of a school age child (6-11 years)?

Answer 28

1. Separate from caregivers 2. Developing self-esteem 3. Start to desire to conform to norms around them 4. Seek acceptance from teachers, other adults, peers

Question 29

Conditions that impact school performance?

Answer 29

1. Mood disorders 2. Developmental delays 3. Attention deficit hyperactivity disorder (ADHD) 4. Autism spectrum disorder 5. Trauma or stressors 6. Concurrent illness e.g HIV

Question 30

DSM V criteria definition of ADHD?

Answer 30

1. Must have symptoms and/or behaviors for at least 6 months in at least 2 settings (home, school, church). 2. These symptoms negatively impact academic, social, and/or occupational functioning. 3. Must have at least 6 symptoms 4. Symptoms present prior to age 12 5. Symptoms are not better accounted for by a different psychiatric disorder

Question 31

Inattention criteria type for ADHD?

Question 32

Hyperactivity/impulsivity type criteria for ADHD?

Question 33

Behaviour of adolescents?

Answer 33

1. Seeking independence, which sometimes leads to pushing boundaries 2. Increased need for privacy 3. Pubertal changes may lead to insecurity or anxiety 4. Early adolescents have concrete thinking: either right or wrong 5. Egocentrism common in early adolescence 6. Exploration of romantic and/or sexual relationships

Question 34

What is egocentrism in adolescents?

Answer 34

excessive interest in oneself and concern for one's own welfare or advantage at the expense of or in disregard of others

Question 35

Causes of Risk taking behavior in adolescents?

Answer 35

- The frontal lobes are the last areas of the brain to mature―development is not complete until a person is well into their 20s - The frontal lobes play a big role in coordinating complex decision making, impulse control, and being able to consider multiple options and consequences - Middle adolescents are more able to think abstractly and consider "the big picture," but they still may lack the ability to apply it in the moment

Question 36

Eating disorders?

Answer 36

1. anorexia nervosa 2. bulimia nervosa 3. avoidant/restrictive food intake disorder

Question 37

What is anorexia nervosa?

Answer 37

restriction of energy intake that leads to a low body weight, intense fear of gaining weight or becoming fat (or persistent behavior that prevents weight gain), and distorted body image

Question 38

What is bulimia nervosa?

Answer 38

recurrent episodes of both binge eating and inappropriate compensatory behavior to prevent weight gain

Question 39

What is avoidant/restrictive food intake disorder?

Answer 39

avoiding or restricting food intake leading to a persistent failure to meet nutritional/energy needs, with association of either weight loss/poor growth, nutritional deficiency, need for supplementation, or impaired psychosocial functioning

Question 40

Causes of avoidant/restrictive food intake disorder?

Answer 40

may be related to lack of interest, sensory characteristics of foods, conditioned negative response e.g. after choking episode