Cognitive and Psychosocial Impairment

3 yo at WCC with "sleep problems." Parents divorced 2 months ago; now "clingy" to mom; wants "more stories and goodnight kisses" at bedtime, taking longer to get to sleep; started to have nightmares. the BEST recommendation is for this mother to

• allow her son to sleep in her bed until he has adjusted to his father’s absence

• continue to keep the same bedtime routine through this adjustment period

• stay with her son until he falls asleep and then go to her own bedroom

• vary the bedtime and bedtime routine according to how her son is doing

7 yo has difficulty in school. Lacks effort in schoolwork. Pt says "school is boring." He is at a 5th-grade reading level, IQ testing reveals IQ 140. Parents want to know what to do. The BEST response is that their son will most likely

• Be advanced in all areas of development

• Benefit from grade advancement

• Need educational enrichment activities

• Require treatment with methylphenidate

A 12 mo F is a former 25 week preemie with multiple chronic conditions. Seen in multispecialty clinic. A student asks how the role as primary care provider within a medical home is different in a child with a complex medical history who is seen by multiple specialists compared to the role for a child who is otherwise healthy. The BEST response is that this arrangement will

• Decrease communication between providers

• Decrease the quality of the care provided by minimizing the role of the subspecialists

• Improve the overall quality of care

• Provide a set location for vaccinations and development checks only

A 16 yo F c epilepsy has been well controlled for years, but had breakthrough seizure last month at a sleepover. Pt now more withdrawn, tearful about not being able to get driver's license, refuses to go out with friends, states "no one understands me." Now with daily HAs, too, resolved with NSAIDs, has "missed school" due to them. There is NO SI. The BEST next step for this patient is

• changing her antiepileptic medication

• counseling to develop coping strategies

• magnetic resonance imaging of the brain

• urgent referral to a psychiatrist for depression

Research on autism spectrum disorders has resulted in a cure for the disease.

• true

• false

There is no medical test available to diagnose autism spectrum disorders.

• true

• false

The risk for ASD is five times higher in males than females.

• true

• false

Eating _________ foods and __________has a positive effect on all parts of human behavior, but no study has related poor diet and lack of exercise as a cause of ADHD.

• Fatty, sleeping
• Sugary, studying
• Fried, drinking alcohol
• Nutritious, exercising 

What is the leading known cause of developmental delay in Western civilization today?

• Down syndrome

• Prenatal exposure to alcohol

• prenatal exposure to illicit drugs

• folic acid deficiency

• prematurity?

What causes fetal alcohol syndrome (FAS)?

• Alcohol in the bloodstream contracts her blood vessels and prevents her from providing the fetus adequate nutrition

• Alcohol in the bloodstream crosses the placenta in the unborn fetus' system and disrupts its ability to get enough oxygen for normal growth and development

• Alcohol in the bloodstream makes the mother reckless and more likely to fall or otherwise cause injury to the fetus

• Alcohol in the bloodstream makes her irritable and irrational, and her bad temper affects the fetus' development

• Alcohol in the bloodstream upsets her hormonal balances and prevents her from delivering the right amounts of testosterone to a male fetus or estrogen to a female fetus