| What therapeutic approach is recommended for families contributing to a child's condition? | Family therapy for dysfunctional / discordant families | • Evaluate and manage severe behavior disorders – severe ADHD, ODD, and CD, if necessary on short-term inpatient basis • Multi-modal management with clear individualized plan • Trial of Methylphenidate in moderate / severe ADHD under expert supervision • Recognize and treat comorbid disorders such as bipolar disorder, substance use disorder, and internalizing disorders and manage • Pharmacological management of older children / adolescents with severe aggression / impulsivity with Risperidone and/or Lithium • Family therapy for dysfunctional / discordant families, contributing to child’s condition • Management of children in difficult circumstances with mental health issues (children in need of care and protection; children in conflict with law) • Review and reassess diagnosis (clinical evaluation using Rutter’s multi-axial system) and all the pointers given above • If failed trial of Clonidine/ Moderate ADHD: T. | 515 | summary | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725952332_psychiatry_child_behavioral_disorder.pdf | • Evaluate and manage severe behavior disorders – severe ADHD, ODD, and CD, if necessary on short-term inpatient basis • Multi-modal management with clear individualized plan • Trial of Methylphenidate in moderate / severe ADHD under expert supervision • Recognize and treat comorbid disorders such as bipolar disorder, substance use disorder, and internalizing disorders and manage • Pharmacological management of older children / adolescents with severe aggression / impulsivity with Risperidone and/or Lithium • Family therapy for dysfunctional / discordant families, contributing to child’s | 1 | page=1,block=35 | 0.700 | valid |
| What activities are suggested to engage with a child to address alcohol and substance abuse? | playing games, discussing interesting things or doing activities together | Alcohol and substance abuse • Analyse the problem behaviors and understand patterns : time of occurance, triggers, duration and consequencies • Engage with child in mutually enjoyable, pleasurable activities (playing games, discussing interesting things or doing activities together) • Set clear do’s and don’ts and explain to child in clear, simple, short instructions the consequencies (like withholding privileges following misbehavior; use star-charting (contingency management) and rewards based on number of stars earned • In children with ADHD, develop clear daily routines, supervise activities and appreciate on completion of taks • Limit screen time/ monitor use of electronic devices | 209 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725952332_psychiatry_child_behavioral_disorder.pdf | Alcohol and substance abuse • Analyse the problem behaviors and understand patterns : time of occurance, triggers, duration and consequencies • Engage with child in mutually enjoyable, pleasurable activities (playing games, discussing interesting things or doing activities together) • Set clear do’s and don’ts and explain to child in clear, simple, short instructions the consequencies (like withholding privileges following misbehavior; use star-charting (contingency management) and rewards based on number of stars earned • In children with ADHD, develop clear daily routines, supervise |
| What are some aggressive behaviors linked to Conduct Disorder? | angry, abusive, fights, hits or hurts people, bullies other children, damages articles | OPPOSITIONAL DEFIANT DISORDER (ODD) • Doesn’t obey or listen, back-answers, rude behaviors • Demanding, stubborn, throws tantrums when demands are not met CONDUCT DISORDER • Aggressive – angry, abusive, fights, hits or hurts people, bullies other children, damages articles • Stealing, lying, threatening or misbehaving with people, truant (keeps away from school without parents’ knowledge), runs away from home, bad company, cruelty to animals ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) • Restless, always on the move / running, can’t sit in a place,talkative • Can’t focus attention on a task, poor concentration, gets easily distracted, disorganized, does not complete school work • Too mischievous, can’t be left alone, troubles people or damages things, or gets injured • Impatient, always in a hurry, can’t wait for his turn, does not care for danger, acts without thinking ALL 3 DISORDERS Poor or erratic school performance and / or complaints about behaviour from school • Symptoms are present and persistent over several months • Attempt further classification into ADHD, ODD and CD (ADHD may be present with or without ODD and CD | 187 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725952332_psychiatry_child_behavioral_disorder.pdf |
| What are some behaviors associated with Oppositional Defiant Disorder (ODD)? | Doesn’t obey or listen, back-answers, rude behaviors • Demanding, stubborn, throws tantrums when demands are not met | OPPOSITIONAL DEFIANT DISORDER (ODD) • Doesn’t obey or listen, back-answers, rude behaviors • Demanding, stubborn, throws tantrums when demands are not met CONDUCT DISORDER • Aggressive – angry, abusive, fights, hits or hurts people, bullies other children, damages articles • Stealing, lying, threatening or misbehaving with people, truant (keeps away from school without parents’ knowledge), runs away from home, bad company, cruelty to animals ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) • Restless, always on the move / running, can’t sit in a place,talkative • Can’t focus attention on a task, poor concentration, gets easily distracted, disorganized, does not complete school work • Too mischievous, can’t be left alone, troubles people or damages things, or gets injured • Impatient, always in a hurry, can’t wait for his turn, does not care for danger, acts without thinking ALL 3 DISORDERS Poor or erratic school performance and / or complaints about behaviour from school • Symptoms are present and persistent over several months • Attempt further classification into ADHD, ODD and CD (ADHD may be present with or without ODD and CD | 38 | list | 0.820 |
| What are some developmental issues assessed during a parent interview? | Developmental problems, emotional disturbances and stress | ASSESSMENT (History From Multiple Sources) PARENT INTERVIEW • Symptoms- onset, duration, type(ODD, Conduct, ADHD-as above) and severity • Developmental problems, emotional disturbances and stress • Alcohol and substance use /misuse • Impact on child and family FAMILY SITUATION • Health (including mental health) and wellbeing of family members • Cohesion, mutual understanding and harmony in the family • Parenting and childrearing practices: caring and disciplining, criticism, unfair comparison and physical punishments, mutual blaming of parents for child’s problem • Attendance • Performance • Learning problems, • Classroom behaviors • Recent changes in syllabus and/or school CHILD INTERVIEW • Develop rapport( discuss neutral topics; avoid direct tackling of misbehaviors) • Observe: - Features of ADHD (restless, fidgety, easily distracted, attention keeps shifting) - Speech and language ability, intelligence, academic skills and mood • Enquire about any stress or difficulties child is facing at home, school, and with peers and anger control | 138 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725952332_psychiatry_child_behavioral_disorder.pdf | ASSESSMENT (History From Multiple Sources) PARENT INTERVIEW • Symptoms- onset, duration, type(ODD, Conduct, ADHD-as above) and severity • Developmental problems, emotional disturbances and stress • Alcohol and substance use /misuse • Impact on child and family FAMILY SITUATION • Health (including mental health) and wellbeing of family members • Cohesion, mutual understanding and harmony in the family • Parenting and childrearing practices: caring and disciplining, criticism, unfair comparison and physical punishments, mutual blaming of parents for child’s problem • Attendance • Performance • |
| What are some non-aggressive behaviors associated with Conduct Disorder? | Stealing, lying, threatening or misbehaving with people, truant (keeps away from school without parents’ knowledge), runs away from home, bad company, cruelty to animals | OPPOSITIONAL DEFIANT DISORDER (ODD) • Doesn’t obey or listen, back-answers, rude behaviors • Demanding, stubborn, throws tantrums when demands are not met CONDUCT DISORDER • Aggressive – angry, abusive, fights, hits or hurts people, bullies other children, damages articles • Stealing, lying, threatening or misbehaving with people, truant (keeps away from school without parents’ knowledge), runs away from home, bad company, cruelty to animals ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) • Restless, always on the move / running, can’t sit in a place,talkative • Can’t focus attention on a task, poor concentration, gets easily distracted, disorganized, does not complete school work • Too mischievous, can’t be left alone, troubles people or damages things, or gets injured • Impatient, always in a hurry, can’t wait for his turn, does not care for danger, acts without thinking ALL 3 DISORDERS Poor or erratic school performance and / or complaints about behaviour from school • Symptoms are present and persistent over several months • Attempt further classification into ADHD, ODD and CD (ADHD may be present with or without ODD and CD | 276 | list |
| What are some symptoms assessed during a parent interview for a child? | onset, duration, type(ODD, Conduct, ADHD-as above) and severity | ASSESSMENT (History From Multiple Sources) PARENT INTERVIEW • Symptoms- onset, duration, type(ODD, Conduct, ADHD-as above) and severity • Developmental problems, emotional disturbances and stress • Alcohol and substance use /misuse • Impact on child and family FAMILY SITUATION • Health (including mental health) and wellbeing of family members • Cohesion, mutual understanding and harmony in the family • Parenting and childrearing practices: caring and disciplining, criticism, unfair comparison and physical punishments, mutual blaming of parents for child’s problem • Attendance • Performance • Learning problems, • Classroom behaviors • Recent changes in syllabus and/or school CHILD INTERVIEW • Develop rapport( discuss neutral topics; avoid direct tackling of misbehaviors) • Observe: - Features of ADHD (restless, fidgety, easily distracted, attention keeps shifting) - Speech and language ability, intelligence, academic skills and mood • Enquire about any stress or difficulties child is facing at home, school, and with peers and anger control | 72 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725952332_psychiatry_child_behavioral_disorder.pdf |
| What are some traits of Attention Deficit Hyperactivity Disorder (ADHD) related to physical activity? | Restless, always on the move / running, can’t sit in a place,talkative | OPPOSITIONAL DEFIANT DISORDER (ODD) • Doesn’t obey or listen, back-answers, rude behaviors • Demanding, stubborn, throws tantrums when demands are not met CONDUCT DISORDER • Aggressive – angry, abusive, fights, hits or hurts people, bullies other children, damages articles • Stealing, lying, threatening or misbehaving with people, truant (keeps away from school without parents’ knowledge), runs away from home, bad company, cruelty to animals ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) • Restless, always on the move / running, can’t sit in a place,talkative • Can’t focus attention on a task, poor concentration, gets easily distracted, disorganized, does not complete school work • Too mischievous, can’t be left alone, troubles people or damages things, or gets injured • Impatient, always in a hurry, can’t wait for his turn, does not care for danger, acts without thinking ALL 3 DISORDERS Poor or erratic school performance and / or complaints about behaviour from school • Symptoms are present and persistent over several months • Attempt further classification into ADHD, ODD and CD (ADHD may be present with or without ODD and CD | 496 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725952332_psychiatry_child_behavioral_disorder.pdf |
| What are the causes of a child’s behaviours as explained in psychoeducation? | lack of self-regulation, and adverse environment | • PSYCHOEDUCATION - Explain the child’s behaviours are not intentional - Not child’s fault, do not blame the child - Multifactorial causes-lack of self-regulation, and adverse environment - Can be improved with proper management - Parents can directly contribute to the child’s improvement • Help parents deal with their own worries and stress (listening, giving space to ventilate, validate and empathize their difficulties, reassure) • Recognize and manage mental health problems such as depression and alcohol problem in parents • Parent management training* • Avoid advice • Anger management ( count from 10 -1 backwards, move away from situation, deep breaths, relax, self-talk to cool down) • Children with ADHD: “stop-think-act” or “halt and proceed” technique • Severe and persistant aggression: - T. | 139 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725952332_psychiatry_child_behavioral_disorder.pdf | • PSYCHOEDUCATION - Explain the child’s behaviours are not intentional - Not child’s fault, do not blame the child - Multifactorial causes-lack of self-regulation, and adverse environment - Can be improved with proper management - Parents can directly contribute to the child’s improvement • Help parents deal with their own worries and stress (listening, giving space to ventilate, validate and empathize their difficulties, reassure) • Recognize and manage mental health problems such as depression and alcohol problem in parents • Parent management training* • Avoid advice • Anger management ( |
| What aspects of a family's health are considered in the assessment of a child's situation? | Health (including mental health) and wellbeing of family members | ASSESSMENT (History From Multiple Sources) PARENT INTERVIEW • Symptoms- onset, duration, type(ODD, Conduct, ADHD-as above) and severity • Developmental problems, emotional disturbances and stress • Alcohol and substance use /misuse • Impact on child and family FAMILY SITUATION • Health (including mental health) and wellbeing of family members • Cohesion, mutual understanding and harmony in the family • Parenting and childrearing practices: caring and disciplining, criticism, unfair comparison and physical punishments, mutual blaming of parents for child’s problem • Attendance • Performance • Learning problems, • Classroom behaviors • Recent changes in syllabus and/or school CHILD INTERVIEW • Develop rapport( discuss neutral topics; avoid direct tackling of misbehaviors) • Observe: - Features of ADHD (restless, fidgety, easily distracted, attention keeps shifting) - Speech and language ability, intelligence, academic skills and mood • Enquire about any stress or difficulties child is facing at home, school, and with peers and anger control | 280 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725952332_psychiatry_child_behavioral_disorder.pdf |