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Parent-Baby
Neurodevelopment
Grab Bag
Child Psychiatry
Normal development
100

A mother’s capacity to understand her infant’s internal states, which is communicated by mirroring is called:

  1. Holding

  2. Internalization

  3. Rapprochement

  4. Identify diffusion

  5. Projective identification 

Holding

1. in the object relations theory of British psychoanalyst Donald Winnicott (1896–1971), that aspect of the mother experienced by the infant as the environment that literally—and figuratively, by demonstrating highly focused attention and concern—holds him or her comfortingly during calm states. This is in contrast to the mother who is experienced as the object of the infant’s excited states.

2. in psychoanalysis, any therapeutic space that allows an emotionally fragile or insecure person to deal with affects that might potentially be overwhelming.

100

In utero exposure to cannabis during neuronal development is associated with which of the following in the infant?

  1. Cognitive deficits

  2. Language delays

  3. Abstinence syndrome

  4. Slowed physical growth

  5. Congenital abnormalities

Cognitive deficits

In utero THC exposure effects : increased impulsivity, hyperactivity, and delinquent behaviors, as well as memory dysfunction and decreased IQ scores.

100

A father wants to know if he should allow his five-year-old to attend the funeral of her mother. The child expresses a desire to go. The help the child through the funeral, it will be important to do which of the following?

  1. Shield the child from viewing the body

  2. Make the child an active participate in the service

  3. Have someone familiar accompany the child

  4. Allow the child to attend the ceremony, but not the burial

  5. Seat the child in the back of the room in case the child starts to cry

Have someone familiar accompany the child


Youngest age to understand death is permanent : 10

100

A 12-year-old child is brought by an exasperated parent for psychiatric evaluation due to the child’s belligerent refusal to do chores and homework. The child constantly talks back, is described as irritable much of the time, and is easily annoyed by others. The child purposely annoys other children and, as a result, does not have any friends. Which of the following diagnoses best characterizes the child’s presentation. 

  1. Conduct disorder

  2. Bipolar disorder, type 1

  3. Oppositional defiant disorder

  4. Attention-deficit/hyperactivity disorder

  5. Disruptive mood dysregulation disorder 

Oppositional defiant disorder



100

At approximately 18 months, the typically developing child demonstrates which of the following language development milestones?

  1. Uses verbs in phrases

  2. Uses word combinations

  3. Produces meaningful words

  4. Speaks in complete sentences

  5. Makes repetitive vowel sounds

Uses word combinations

200

Which of the following attachment styles in infants is characterized by paying little over attention to the parent’s presence?

  1. Secure

  2. Avoidant

  3. Resistant

  4. Ambivalent

  5. Disorganized

Avoidant


200

From a neurodevelopmental perspective, the youngest age at which a child possesses sufficient cognitive ability such that the child is likely to meet the Appelbaum criteria for general healthcare decision-making is approximately:

  1. Four years

  2. Six years

  3. Twelve years

  4. Sixteen years

  5. Eighteen years

Sixteen years

Goodness of fit- compatibility of your temperament with your social environment

Applebaum criteria: Decisional capacity. 

Age for emancipation: 14-16 years. California: 14. 

200

Which of the following statements best describes current thinking about the relationship between ADHD in children and adults?

  1. They appear to be separate disorders, although there is some overlap

  2. Most adults with ADHD did not have significant symptoms as children

  3. A significant number of children with ADHD will go on to become adults with ADHD

  4. Adults can receive the diagnosis of ADHD even if they did not have symptoms as children 

A significant number of children with ADHD will go on to become adults with ADHD

200

Which of the following is the best predictor of later functional and adaptive outcomes in autism spectrum disorder?

  1. Age of onset

  2. Verbal ability at age five years

  3. Hyporeactivity to sensory output

  4. Presence of highly restricted, fixated interests

  5. Frequency of stereotyped or repetitive motor movements 

Verbal ability at age five years


Best established prognostic factors for ASD: Absence of associated ID and language impairment by age of 5 

Additional mental health problems is also associated with a poorer outcome. 


200

By the age of about 15 months, typically developing children begin to achieve which of the following milestones?

  1. Infer others’ emotions and intent

  2. Engage in reciprocal conversation

  3. Display social smile and gesture in peer interactions

  4. Understand that others have minds different from their own

Understand that others have minds different from their own

300

Which of the following areas of the hypothalamus have been reported to play a central role in maternal behavior of mothers towards infants?

  1. Arcuate

  2. Preoptic-

  3. Paraventricular

  4. Tubermamillary

  5. Suprachiasmatic

Preoptic

The medial preoptic area (MPOA) of the hypothalamus can regulate maternal responsiveness toward infant-related stimuli. 

Arcuate: contains DA neurons, inhibit PRL release

Paraventricular: Oxytocin and ADH production

Tuberomammillary: PRL, mammillary bodies involved in Wernicke encephalopathy

300

The cortical synaptic remodeling characteristic of normal adolescence is also believed to be associated with which of the following neurobiological changes?

  1. Increased brain glucose metabolism

  2. Increased overall electroencephalograph amplitude

  3. Predominant synaptic changes in the temporal cortex

  4. Preferential loss of excitatory synapses

  5. Loss of cortical volume in the parietal cortex

Preferential loss of excitatory synapses

300

When a child reaches the stage of formal operations, which of the following is a new cognitive capacity gained?

  1. Centration

  2. Abstraction

  3. Reversibility

  4. Egocentrism

  5. Object permanence 

Abstraction


300

Which of the following is the most commonly validated risk factor for autism?

  1. Birth order

  2. Vaccination

  3. Advanced parental age

  4. Low maternal education

  5. Low parental socioeconomic status

Advanced parental age


Risk Factors for ASD: Advanced paternal age, exposure to VPA, male gender, extremely preterm babies, FH, genetic dx such as Fragile X, Rette sx.

300

A typically developing three-year-old child should be capable of which of the following motor skills?

  1. Skipping

  2. Tandem walking

  3. Copying a triangle

  4. Pedaling a tricycle

  5. Following a three-step command

Pedaling a tricycle



400

A recently adopted three-year-old is brought for evaluation of inhibited, emotionally withdrawn behavior. The child rarely seeks or responds to comfort when distressed, and has limited positive affect and emotional responsiveness to others. What additional history is required for the most likely diagnosis?

  1. Serious neglect

  2. Restricted interests

  3. Ritualized behaviors

  4. Development delay

Serious neglect

RAD DSM 5: 

A ) consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers both of minimally seeking comfort or responding to comfort. 

  • A persistent social or emotional disturbance at least 2 of: 

  •  Minimal social and emotional responsiveness to others

  • Limited positive affect

  • Episodes of unexplained irritability, sadness when interacting w caregivers.

  • Experienced extreme insufficient care: Neglect, changes in caregivers

  • Age of onset : 9months - 5 years 

400

The neural tube is formed from which of the following?

     A) Somites

    B) Ectoderm

    C) Notochord

    D) Endoderm

    E) Mesoderm

Ectoderm



400

A typically developing child has recently begun to participate in social activities without parents, and has a best friend. The child can display empathy, but sometimes impulsively says things to friends that are not kind. How old is the child?

  1. Toddler

  2. Preschool-age

  3. Elementary school-age

  4. Middle school-age

  5. High school-age 

Elementary school-age

400

 An eight-year-old boy is reported by his teachers to be sexually seductive to other children, to openly display sexual behavior, and to sexualize play activities. This is most likely a manifestation of:

  1. Precocious puberty

  2. Previous sexual abuse

  3. Normal sexual behavior

  4. Borderline intellectual disability 

Previous sexual abuse

400

By what age does core gender identity typically form?

  1. Birth

  2. Eighteen months

  3. Three years

  4. Five years

  5. Ten years

Three years

500

Which of the following parental factors is more important for healthy child development?

  1. Patience

  2. Physical health

  3. Negotiating skills

  4. Level of education

  5. Emotional attunement 

Emotional attunement


The process of a parent feeling the child's feelings, absorbing those feelings, and reflecting them back to the baby, so the baby knows he has been seen, heard and understood.

500

Which of the following statements regarding the development of the central nervous system (CNS) in the first two years of life is correct?

  1. Myelination of the CNS is complete

  2. The forebrain, midbrain, and spinal cord are equally developed

  3. Cortical synaptic diversity is at its highest

  4. The motor cortex develops ahead of the sensory cortex

  5. The gonadotropin-gonadal axis is not yet functioning 

The motor cortex develops ahead of the sensory cortex

500

 Shortly after a five-year-old child enters kindergarten, the child’s parents report to the pediatrician that their child seems more emotionally reactive at home, displaying some regressive behavior and being more demanding of their attention. The child’s teacher describes no behavioral or academic concerns. Which of the following factors most likely accounts for the change noted by the parents?

  1. Modeling of immature behavior by peers

  2. An unrecognized learning disability in the child

  3. The effects of poor parent-school communication

  4. Incipient symptoms of separation anxiety disorder in the child

  5. Normative response to stress associated with the school transition

Normative response to stress associated with the school transition

500

A psychiatrist evaluates a seven-year-old child who was referred for having “emotional outbursts” at school. The parents describe the child as a generally well-behaved child. They cannot identify stressors in the home. Parents indicated that the child was initially excited about school, but has been increasingly reluctant to go in the morning, often complaining of stomach aches as school time approaches. Which of the following steps should the psychiatrist take next?

  1. Refer to a neurologist

  2. Recommend homeschooling

  3. Obtain neuropsychological testing

  4. Obtain a release to speak with the child’s teacher

  5. Suggest the family return at the end of the school year to re-evaluate 

Obtain a release to speak with the child’s teacher


To Understand the pattern if it exists at school setting in order to make a diagnosis such as trauma at school (bullying)

500

 Widening concern for the larger social system and differentiation of one’s own social, political, and historical system from others primarily occurs during which of the development transitions?

  1. Middle adulthood to old age

  2. Childhood to preadolescence

  3. Preadolescence to adolescence

  4. Adolescence to young adulthood

  5. Young adulthood to middle adulthood

Young adulthood to middle adulthood