ABPN CAP cheat sheet

Piaget: sensorimotor (0-2 years; object permanence), preoperational (2-7; symbolic play, egocentrism), concrete operational (7-11; conservation), formal operational (11+; abstract reasoning).

Erikson: trust vs mistrust (infancy), autonomy vs shame/doubt (1-3), initiative vs guilt (3-6), industry vs inferiority (6-12), identity vs role confusion (adolescence).

Language milestones: cooing by 2 months, babbling by 6 months, first words by 12-16 months, 50-word vocabulary and two-word phrases by 24 months.

Attachment: secure, insecure-avoidant, insecure-resistant/ambivalent, and disorganized patterns in the Strange Situation; stranger anxiety appears at 6-9 months and separation anxiety peaks at 10-18 months.

Gross motor: sits unsupported by 6-8 months, walks independently by 12-15 months, runs by 18-24 months, alternates feet on stairs by 3 years, hops by 4 years.

Toilet training readiness usually appears at 18-24 months; daytime bladder control typically by 2-3 years and nighttime control by 3-5 years.

Equifinality = different pathways to the same outcome; multifinality = one risk factor producing different outcomes; developmental psychopathology uses risk, protective, and transactional models.

Developmental red flags: no babbling by 12 months, no gestures by 12 months, no single words by 16 months, no two-word phrases by 24 months, or loss of skills at any age.

DSM-5-TR uses categorical criteria and specifiers; the DSM-5 multiaxial system was removed, and ICD-11 is the alternative classification system.

Developmental history covers pregnancy, birth, milestones, medical history, school functioning, peer relations, family history, trauma, and prior treatment.

Mental status exam domains: appearance, behavior, speech, mood, affect, thought process/content, perception, cognition, insight, and judgment.

Multi-informant assessment uses caregiver, teacher, and youth reports; discrepancies are common and are interpreted by context and observability.

Common screens: CBCL for broadband problems, Vanderbilt/Conners for ADHD, SCARED for anxiety, CDI for depression, and M-CHAT for toddler autism.

Cognitive testing uses WISC or WPPSI; adaptive behavior uses Vineland; academic achievement uses WIAT or school testing.

Biopsychosocial formulation integrates predisposing, precipitating, perpetuating, and protective factors and rules out medical, substance, and environmental causes.

Guardian consent and child assent apply to assessment and treatment; confidentiality limits include danger to self or others, abuse, and court orders.

Preschool assessment relies on observation, play, caregiver-child interaction, and developmental testing more than self-report questionnaires.

ADHD: at least six inattentive and/or hyperactive-impulsive symptoms before age 12 for children under 17 (five for age 17+), in multiple settings with impairment; stimulants are first-line medication.

Autism spectrum disorder: social communication deficits plus restricted/repetitive behaviors; M-CHAT screens, diagnostic evaluation confirms; behavioral and developmental interventions are core.

Anxiety disorders: separation, social, and generalized anxiety; CBT is first-line, and SSRIs are used for moderate-severe impairment.

Major depression: irritability is common in youth; CBT or IPT-A and fluoxetine or escitalopram are evidence-based; monitor suicide risk.

OCD: exposure and response prevention plus an SSRI; comorbid tics and severity guide medication choice and augmentation decisions.

ODD/CD: parent management training and family therapy are first-line; conduct disorder requires age-appropriate legal and safety assessment.

Tic disorders: Tourette = multiple motor plus at least one vocal tic for >1 year; CBT/HRT and alpha-2 agonists or antipsychotics are options.

Eating disorders: anorexia nervosa requires medical stabilization and family-based treatment; bulimia nervosa uses CBT and may use fluoxetine.

Trauma/PTSD: trauma-focused CBT is first-line; assess safety, caregiver support, and avoidance/hyperarousal symptoms.

Pediatric psychopharmacology: start low, titrate slowly, prefer monotherapy, obtain baseline vitals/weight/labs, and document informed consent and monitoring plan.

Stimulants: common adverse effects are appetite loss, insomnia, headache, and BP/HR increase; avoid in uncontrolled cardiac disease and monitor growth.

SSRIs: boxed warning for suicidality in youth; fluoxetine and escitalopram are FDA-approved for depression, sertraline for OCD; monitor activation and serotonin toxicity.

Second-generation antipsychotics: risk of weight gain, dyslipidemia, hyperglycemia, EPS, tardive dyskinesia, and prolactin elevation; monitor BMI, BP, A1c/glucose, and lipids.

Lithium: narrow therapeutic index; monitor serum level, renal and thyroid function, calcium, and hydration; toxicity risk rises with dehydration or interacting drugs.

Valproate: hepatotoxicity, pancreatitis, thrombocytopenia, and teratogenicity; avoid in females of childbearing potential when alternatives exist.

Alpha-2 agonists (guanfacine, clonidine): used for ADHD and tics; adverse effects include sedation, hypotension, and bradycardia; abrupt discontinuation can cause rebound.

Neurologic considerations: seizures, TBI, and headaches can produce psychiatric symptoms; review anticonvulsant interactions and ictal/postictal behavioral changes.

Somatic symptoms and substance use: functional neurologic symptoms are genuine; avoid unnecessary testing, and screen adolescents for substance use and withdrawal risk.

CBT components: psychoeducation, cognitive restructuring, exposure, behavioral activation, and relapse prevention; strong evidence for pediatric anxiety, depression, and OCD.

Parent management training: reinforce prosocial behavior, use consistent consequences, planned ignoring, and structured routines; first-line for ODD and adjunctive for ADHD.

Family therapy assesses hierarchy, boundaries, alliances, and communication; family-based treatment is first-line for adolescent anorexia nervosa.

Play therapy uses play as the child's communication medium; psychodynamic and nondirective forms require developmental adaptation and caregiver involvement.

Motivational interviewing uses OARS (open questions, affirmations, reflections, summaries) and rolls with resistance rather than confronting it.

Trauma-focused CBT includes psychoeducation, coping skills, gradual exposure, trauma processing, and caregiver participation.

Consultation-liaison psychiatry clarifies the referral question, assesses medical-psychiatric interactions, communicates recommendations, and supports the medical team.

School consultation uses functional behavioral assessment, IEP/504 accommodations, and teacher-collaborator communication; consent and confidentiality apply.

Systems interventions address family, school, peers, culture, and community; mandated reporting and safety planning override usual confidentiality limits.