Classification and Diagnosis of Childhood Disorders <\/strong><\/p>\n

\n
• Developmental psychopathology<\/strong> = focuses on the disorders of childhood within the context of lifespan development, enabling us to identify behaviours that are considered appropriate at one stage but not at another<\/li>\n<\/ul>\n

  Most childhood disorders fall under either: a) Neurodevelopmental disorders & b) Disruptive, impulse-control, and conduct disorders \uf0b7 Defined in 2 broad domains:<\/p>\n

  o Externalizing disorders<\/strong> = more outward-directed behaviours, such as aggressiveness, noncompliance, over-activity, and impulsiveness<\/p>\n

  \n
  • Includes ADHD, conduct disorder, and oppositional defiant disorder o Internalizing disorders<\/strong> = more inward-focused experiences and behaviours, such as depression, social withdrawal, and anxiety<\/li>\n
  • Childhood anxiety, and mood disorders<\/li>\n<\/ul>\n
    \n
    1. Attention-Deficit\/Hyperactivity Disorder <\/strong>(ADHD)<\/li>\n<\/ol>\n

       DSM-5 Criteria<\/p>\n

       \n
       • 1) Either A or B:\n
         \n
         • A) 6+ manifestations of inattention present for at least 6 months to a maladaptive degree and greater than what would be expected given a person\u2019s developmental level (e.g. careless mistakes, not listening well, not following instructions, easily distracted, forgetful in daily activities)<\/li>\n
         • B) 6+ manifestations of hyperactivity-impulsivity present for at least 6 months to a maladaptive degree and greater than what would be expected given a person\u2019s developmental level, e.g. fidgeting, running about inappropriately (in adults, restlessness), acting as if \u201cdriven by a motor\u201d, interrupting or intruding, incessant talking<\/li>\n<\/ul>\n<\/li>\n
         • 2) Several of the above present before age 12<\/li>\n
         • 3) Present in two or more settings<\/li>\n
         • 4) Significant impairment in social, academic, or occupational functioning<\/li>\n
         • 5) For people age 17 or older, only 5 signs of hyperactivity-impulsivity are needed to meet the diagnosis<\/li>\n
         • Overestimate their ability to navigate social situations with peers<\/li>\n
         • Vicious cycles \u2013 3 domains: poor social skills, aggressive behaviour, overestimation of one\u2019s social abilities \u2013 predict decline in these abilities at follow-up<\/li>\n
         • Age of onset was changed from under 7 to under 12 & adults only need to show symptoms in 5 domains = more diagnoses<\/strong><\/li>\n<\/ul>\n

            <\/p>\n

           \n
           • \uf0b7 3 specifiers:\n
             \n
             • 1) Predominantly inattentive<\/strong> = children whose problems are primarily those of poor attention\n
               \n
               • More difficulty with focused attention or speed of information processing<\/li>\n
               • Problems with DA and prefrontal cortex<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                 o\u00a0 \u00a02) Predominantly hyperactive-impulsive<\/strong> = children whose difficulties result primarily from hyperactive\/impulsive behaviour<\/p>\n

                 \n
                 • \n
                   \n
                   • 3) Combined<\/strong> = children who have both sets of problems ***majority\n
                     \n
                     • More likely to develop conduct problems & oppositional behaviour, be placed in special classes and have difficulties interacting with peers<\/li>\n<\/ul>\n<\/li>\n
                     • Frequently comorbid with conduct disorder *ADHD associated more with off-task behaviour in school, cognitive and achievement deficits, and a better long-term prognosis<\/li>\n
                     • Also comorbid with anxiety and depression (30%), 15-30% have a learning disorder<\/li>\n
                     • Hyperactive symptoms predict substance use<\/li>\n
                     • 8-11% prevalence *increase could be due to factors other than increase in the actual disorder o Over diagnosis due to assessments that are too brief to properly judge & differing educational policies<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                       3x as common in boys than girls ADHD in Adulthood<\/p>\n

                       \n
                       • 65-80% of children with ADHD still have symptoms associated with impairments in adolescence<\/li>\n
                       • Most adults with ADHD are employed and financially independent (generally lower SES) \uf0b7 15% still meet criteria at age 25, 60% still experience impairment from symptoms Etiology<\/strong><\/li>\n<\/ul>\n

                         Genetic Factors<\/p>\n

                         \n
                         • Genetic component to ADHD, heritability estimate of 70-80%<\/li>\n
                         • Number of candidate genes found as suggested to causing ADHD *related to NTM DA (DRD4, DRD5,<\/li>\n<\/ul>\n

                           DAT1) o Only associated with risk if have particular environmental factors **prenatal nicotine\/alcohol use<\/p>\n

                           \n
                           • SNAP-25 \u2013 gene that codes for protein that promotes plasticity of neuron synapses also associated with ADHD<\/li>\n<\/ul>\n

                             Neurobiological Factors<\/p>\n

                             \n
                             • Brain areas linked to DA may be different in structure\/function\/connectivity<\/li>\n
                             • Dopaminergic areas: caudate nucleus, globus pallidus, frontal lobes *smaller in kids with ADHD *less frontal activation<\/li>\n
                             • Perform poorer on neuropsychological tests requiring frontal lobes \uf0b7 Perinatal and Prenatal Factors:\n
                               \n
                               • LBW is a predictor *less of an impact with maternal warmth \uf0b7 Environmental Toxins:<\/li>\n
                               • Additives and artificial colours in foods upset that nervous system of children who are hyperactive<\/li>\n
                               • View that refined sugar can cause ADHD is not supported by research<\/li>\n
                               • Higher blood-lead levels may associate with hyperactivity symptoms and attention problems<\/li>\n
                               • Maternal smoking *nicotine* may play a role in development of ADHD<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                                 Family Factors<\/p>\n

                                 \n
                                 • Parent-child relationship interacts with neurobiological factors to contribute to ADHD symptoms \uf0b7 Many parents of ADHD children have ADHD themselves<\/li>\n<\/ul>\n

                                   Treatment<\/strong><\/p>\n

                                   Stimulant Medications<\/p>\n

                                   \n
                                   • Examples: methylphenidate, Ritalin \u2013 prescribed since 1960s, others: Adderall, Concerta, Strattera<\/li>\n
                                   • 80% of ADHD patients take stimulants, includes 10% of all adolescent boys<\/li>\n
                                   • Drugs reduce disruptive behaviours and impulsivity and improve ability to focus attention<\/li>\n
                                   • Short-term improvements in goal0directed activity, classroom behaviour, social interactions with parents\/teachers\/peers, reductions in aggressiveness and impulsivity in 75%<\/li>\n
                                   • Drugs interact with DA system<\/li>\n
                                   • Combined treatment of medication and therapy is superior, followed by medication alone o Combined treatment also didn\u2019t require as high a dose of Ritalin & more social skills improvement<\/li>\n
                                   • Medication more effective for children with ADHD<\/li>\n
                                   • Stimulant side effects: loss of appetite, weight loss, stomach pain, sleep problems, cardiovascular risks<\/li>\n<\/ul>\n

                                     Psychological Treatment<\/p>\n

                                     \n
                                     • Parent training & changes in classroom management<\/li>\n
                                     • Children\u2019s behaviour monitored at home and school, reinforced for behaving appropriately<\/li>\n
                                     • Point system and daily report cards<\/li>\n
                                     • Focus: improving academic work, completing household tasks, learning specific social skills \uf0b7 May be as effective as Ritalin Conduct Disorder<\/strong><\/li>\n
                                     • Intermittent explosive disorder<\/strong> (IED) = recurrent verbal or physical aggressive outbursts that are far out of proportion of the circumstances o Aggression is impulsive and not preplanned toward other people<\/li>\n
                                     • Oppositional defiant disorder<\/strong> (ODD) = child does not meet criteria for conduct disorder, most especially, extreme physical aggressiveness, but exhibits such behaviours as losing his\/her temper, arguing with adults, repeated refusing to comply with requests from adults, deliberately doing things to annoy others, and being angry, spiteful, touchy or vindictive o ODD and ADHD frequently occur together *different since defiant behaviours not thought to arise from attentional deficits or impulsiveness\n
                                       \n
                                       • Children with ODD are more deliberate<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                                         \uf0b7DSM-5 Criteria:<\/p>\n

                                         \n
                                         • 1) Repetitive and persistent behaviour pattern that violates the basic rights of others or conventional social norms as manifested by he presence of 3+ of the following in the previous 12 months and at least one of them in the previous 6 months:\n
                                           \n
                                           • Aggression to people and animals (e.g. bullying, initiating physical fights, physical cruelty to people or animals, forcing someone into a sexual activity)<\/li>\n
                                           • Destruction of property (e.g. fie-setting, vandalism) o C. Deceitfulness or theft (e.g. breaking into another\u2019s house or car, conning, shoplifting) o D. Serious violation of rules (e.g. staying out at night before age 13 in defiance of parental rules, truancy before age 13)<\/li>\n<\/ul>\n<\/li>\n
                                           • 2) Significant impairment in social, academic, or occupational functioning<\/li>\n
                                           • 3-4x as common in boys than girls<\/li>\n
                                           • Behaviour marked by: callousness, viciousness, and lack of remorse<\/li>\n
                                           • Limited prosocial emotions<\/strong> \u2013 diagnostic specifier for children who have callous and unemotional traits\n
                                             \n
                                             • Lack of remorse\/empathy\/guilt and shallow emotions<\/li>\n
                                             • Traits associated with more severe course, more cognitive deficits, more antisocial behaviour, poorer response to treatment<\/li>\n<\/ul>\n<\/li>\n
                                             • Often comorbid with substance abuse and internalizing disorders (15-45% comorbidity with anxiety\/depression) o Conduct disorder tends to precede anxiety\/depression *except specific phobias and social anxiety<\/li>\n
                                             • 7% of preschoolers exhibit symptoms *important to assess early, not just manifestations of typical developmentally disruptive behaviours \uf0b7 2 courses:\n
                                               \n
                                               • Life-course-persistent pattern of antisocial behaviour, begin to show conduct problems by age 3 and continue to commit serious transgression into adulthood<\/li>\n
                                               • Adolescent-limited \u2013 typical childhoods, high levels of antisocial behaviour during adolescence, typical, non-problematic adulthood\n
                                                 \n
                                                 • Result of maturity gap between adolescent physical maturation and opportunity to assume adult responsibilities and obtain rewards usually accorded such behaviour<\/li>\n
                                                 • Continue to have substance use, impulsivity, crime and mental health problems in mid 20s<\/li>\n<\/ul>\n<\/li>\n
                                                 • 6-9.5% prevalence, more common in boys<\/li>\n
                                                 • Incidence and prevalence of serious law breaking peak at age 17, drop in young adulthood Etiology <\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                                                   Genetic Factors<\/p>\n

                                                   \n
                                                   • Some genetic factors of conduct disorder are shared with other disorders (ADHD, depression) others are specific to CD<\/li>\n
                                                   • Criminal and antisocial behaviour is accounted for both by genetic and environmental factors<\/li>\n
                                                   • 40-50% of antisocial behaviour is heritable<\/li>\n
                                                   • Aggressive behaviour is more heritable than other delinquent behaviour<\/li>\n
                                                   • Age of onset is related to heritability<\/li>\n
                                                   • MAOA gene \u2013 located on the X chromosome, releases MAO enzyme which metabolizes NTMs (DA, 5-<\/li>\n<\/ul>\n

                                                     HT, NE) o Maltreated children with low MAOA activity more likely to develop conduct disorder<\/p>\n

                                                     Brain Function, Autonomic Nervous System, and Neuropsychological Factors \uf0b7 Deficits in brain regions supporting emotions **empathetic responses o Difficulty perceiving distress and happiness on others, no difficulty perceiving anger<\/p>\n

                                                     \n
                                                     • Reduced amygdala and prefrontal cortex activation<\/li>\n
                                                     • Do not learn to associate behaviour with reward\/punishment as easily as others (amygdala\/ventral striatum)<\/li>\n
                                                     • ANS abnormalities associated with antisocial behaviour in adolescents o Low levels of resting skin conductance and heart rate *lower arousal o May not fear punishment as much<\/li>\n
                                                     • Poor verbal skills, problems with executive functioning, problems with memory \uf0b7 IQ 1 SD lower if developed at early age *not due to low SES or school failure<\/li>\n<\/ul>\n

                                                       Psychological Factors<\/p>\n

                                                       \n
                                                       • Deficient in moral awareness, lacking remorse for wrongdoings *prominent in antisocial personality disorder and psychopathy<\/li>\n
                                                       • Interpret ambiguous acts as hostile intent (e.g. being bumped in line)<\/li>\n<\/ul>\n

                                                         Peer Influences<\/p>\n

                                                         \n
                                                         • 1) Acceptance or rejection by peers o Rejection by peers is causally related to aggressive behaviour *specifically in combination with ADHD\n
                                                           \n
                                                           • Can predict later aggressive behaviour<\/li>\n<\/ul>\n<\/li>\n
                                                           • 2) Affiliation with deviant peers o Increases likelihood of delinquent behaviour<\/li>\n<\/ul>\n

                                                             Treatment<\/strong><\/p>\n

                                                             Family Intervention<\/p>\n

                                                             \n
                                                             • Intervening early has an impact<\/li>\n
                                                             • Family checkup treatment<\/strong> (FCU) = 3 meetings to get to know, assess, and provide feedback to parents regarding their children and parenting practices<\/li>\n
                                                             • Parent management training<\/strong> (PMT) = parents are taught to modify their response to their children so that prosocial rather than antisocial behaviour is consistently rewarded o Parents taught to use positive reinforcement, and time-outs and loss of privileges o Most efficacious intervention<\/li>\n<\/ul>\n

                                                               Multisystemic Treatment (MST)<\/p>\n

                                                               \n
                                                               • = Delivering intensive and comprehensive therapy services in the community, targeting the adolescent, the family, the school, and in some cases, the peer group<\/li>\n
                                                               • Conduct problems influenced by multiple factors<\/li>\n
                                                               • Incorporates behavioural, cognitive, family-systems and case management techniques \uf0b7 Emphasizes individual family strengths Prevention Programs<\/li>\n
                                                               • Fast Track <\/strong>\u2013 designed to help children academically, socially, and behaviourally, focusing on areas that are problematic in CD including peer-relationships, aggressive and disruptive behaviour, social information processing, and parent-child relationships o Treatment for 10 years, more intensive in years 1-5\n
                                                                 \n
                                                                 • Benefits dwindled as children got older<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                                                                   III. Depression and Anxiety in Children and Adolescents <\/strong><\/p>\n

                                                                   \n
                                                                   1. A) Depression<\/li>\n<\/ol>\n
                                                                      \n
                                                                      • Ages 7-17 show following same symptoms as adults:\n
                                                                        \n
                                                                        • Depressed mood, inability to experience pleasure, fatigue, concentration problems, suicidal ideation<\/li>\n<\/ul>\n<\/li>\n
                                                                        • Show more guilt, lower rates of early-morning wakefulness, early-morning depression, loss of appetite & weight loss<\/li>\n
                                                                        • Recurrent symptoms<\/li>\n
                                                                        • Occurs in 2-3% of school-aged children under age 13<\/li>\n
                                                                        • By adolescence, rate rises to from 6-16% for girls and 4-7% for boys (2x as common among adolescent girls) o Less gender differences in symptoms *no gender difference until adolescence \uf0b7 Comorbid with anxiety<\/li>\n
                                                                        • Role of genetic factors (with depressed parent, have 4x risk of developing depression)<\/li>\n
                                                                        • Gene-environment interactions predict onset: short-allele of serotonin gene & interpersonal stress<\/li>\n
                                                                        • Interpersonal factors especially important in predicting depression in girls<\/li>\n
                                                                        • Early adversity predicts depression for ages 15-20 or rejection by parents<\/li>\n
                                                                        • Cortisol in people with depression is associated with small volume of hippocampus<\/li>\n
                                                                        • Cognitive distortions and negative attributional style (consistent with Beck\u2019s theory and hopelessness theory)<\/li>\n
                                                                        • Attributional style doesn\u2019t appear to be stable until early adolescence *does not predict child depression \uf0b7 Treatment<\/strong>:\n
                                                                          \n
                                                                          • Treatment for Adolescents with Depression Study (TADS) \u2013 efficacy of antidepressants<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                                                                            (Prozac)<\/p>\n

                                                                            \n
                                                                            • Combined treatment of Prozac with CBT most effective, more than either alone<\/li>\n
                                                                            • Similar relapse rates for all 3 treatment groups o Side effects: nausea, diarrhea, sleep problems, agitation, suicidality concerns o Girls more likely to relapse than boys, especially with comorbid anxiety (both genders) o CBT in school setting is more effective than family\/supportive therapy o CBT most effective for Caucasian adolescents, those with good coping skills \uf0b7 Prevention<\/strong>: o Selective \u2013 target particular youth based on family risk factors, environmental factors, or personal factors<\/li>\n
                                                                            • More effective<\/li>\n<\/ul>\n
                                                                              \n
                                                                              • Universal \u2013 targeted toward large groups, typically in schools, seek to provide education and information about depression B) Anxiety<\/li>\n<\/ul>\n
                                                                                \n
                                                                                • Common fears that get outgrown: fear of the dark, imaginary creatures, fear of being separated from parents<\/li>\n
                                                                                • Reported more often in girls than boys<\/li>\n
                                                                                • In order to meet criteria, functioning must be impaired *don\u2019t need to regard fear as excessive\/unreasonable<\/li>\n
                                                                                • 3-5% prevalence in children\/adolescents *specific phobias and social anxiety disorder are most common<\/li>\n
                                                                                • Separation anxiety disorder<\/strong>:\n
                                                                                  \n
                                                                                  • Characterized by constant worry that some harm will befall their parents or themselves when they are away from their parents<\/li>\n
                                                                                  • Often first observed when children begin school<\/li>\n
                                                                                  • 1) Excessive anxiety that is not developmentally appropriate about being away from people to whom one is attached, with at least 3 symptoms that last for at least 4 weeks\n
                                                                                    \n
                                                                                    • Repeated & excessive distress when separated, excessive worry that something bad will happen to an attachment figure, refusal\/reluctance to go to school\/work\/elsewhere, refusal\/reluctance to sleep away from home, nightmares about separation from attachment figure, repeated physical complaints when separated from attachment figure<\/li>\n<\/ul>\n<\/li>\n
                                                                                    • Changes: moved into anxiety chapter, age of onset prior to 18 was removed **can be diagnosed in an adult<\/li>\n<\/ul>\n<\/li>\n
                                                                                    • Social Anxiety Disorder: 1-7% prevalence, higher rates in adolescents *care more what others think of them<\/li>\n
                                                                                    • 5% meet criteria for PTSD o 4 categories of symptoms for children older than 6:\n
                                                                                      \n
                                                                                      • 1) Intrusively re-experiencing the traumatic event (nightmares, flashbacks, intrusive thoughts)<\/li>\n
                                                                                      • 2) Avoiding trauma-related situations or information and experiencing a general numbing of responses (detachment)<\/li>\n
                                                                                      • 3) Negative changes in cognitions or mood related to traumatic event<\/li>\n
                                                                                      • 4) Increased arousal and reactivity, which can include irritability, sleep problems and hypervigilance<\/li>\n
                                                                                      • Separate criteria for younger than 6 *presented in more developmentally appropriate ways<\/li>\n<\/ul>\n<\/li>\n
                                                                                      • OCD prevalence: from less than 1-4%, similar symptoms as in adulthood o Common obsessions in children: dirt\/contamination, aggression, Adolescence: sex, religion o More common in boys as children, more common in women as adults \uf0b7 Etiology<\/strong>:\n
                                                                                        \n
                                                                                        • Heritability estimate of 29-50% o Parenting practices parental control and overprotectiveness, more than parental rejection o Social anxiety: over-estimate danger in many situations, under-estimate ability to cope\n
                                                                                          \n
                                                                                          • Anxiety interferes with social interactions, avoid social situations<\/li>\n
                                                                                          • Behavioural inhibition is an important risk factor o PTSD:<\/li>\n
                                                                                          • Requires exposure to trauma (experienced or witnessed)<\/li>\n
                                                                                          • Risk factors: level of family stress, coping styles of family, past experiences with trauma \uf0b7 Treatment<\/strong>:<\/li>\n<\/ul>\n<\/li>\n
                                                                                          • Major treatment focus is exposure *modified for children by including more modeling and more reinforcement<\/li>\n
                                                                                          • CBT is effective: Coping Cat<\/strong> \u2013 focuses on confrontation of fears, development of new ways to think about fears, exposure to feared situations and relapse prevention\n
                                                                                            \n
                                                                                            • Effective short-term and long-term o Family CBT more effective than individual CBT when both parents have anxiety disorder, and both are more effective than psychoeducation<\/li>\n<\/ul>\n<\/li>\n
                                                                                            • Combination of CBT and medication (Sertraline *Zoloft) more effective than either alone<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                                                                                              *results are more immediate o Group therapy effective for social anxiety disorder<\/p>\n

                                                                                              \n
                                                                                              • For OCD, CBT more effective than medication, and combination *unless severe, then combination is best<\/li>\n
                                                                                              • Other methods: bibliotherapy and computer-assisted therapy\n
                                                                                                \n
                                                                                                • Bibliotherapy<\/strong> \u2013 parents given written materials and are the therapist with their children<\/li>\n<\/ul>\n<\/li>\n
                                                                                                • Reduces anxiety, but not as effective as CBT Autism Spectrum Disorder<\/strong><\/li>\n
                                                                                                • Not formally included in DSM until 3^{rd<\/sup> edition, rates have been rising<\/li>\n}
                                                                                                • 4 categories from DSM-IV-TR are combined into autism spectrum disorder<\/strong> (ASD) o 1) Autistic disorder, 2) Asperger\u2019s disorder, 3) Pervasive developmental disorder not otherwise specified, 4) Childhood disintegrative disorder<\/li>\n
                                                                                                • All shared similar clinical features and etiologies, only varied in severity<\/li>\n
                                                                                                • DSM-5 \u2013 different clinical specifiers relating to severity and extent of language impairment<\/li>\n<\/ul>\n

                                                                                                  Social and Emotional Disturbances<\/p>\n

                                                                                                  \n
                                                                                                  • Rarely approach others, look through\/past people, turn their backs on others, few initiate play, usually unresponsive when being approached<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

                                                                                                    Number of children diagnosed\/treated has increased over the years (ADHD diagnoses increased 41% 2003-2012) Controversial medication treatment Classification and Diagnosis of Childhood Disorders Developmental psychopathology = focuses on the… Continue Reading Disorders of Childhood<\/span><\/a><\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[104],"tags":[],"_links":{"self":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4203"}],"collection":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/comments?post=4203"}],"version-history":[{"count":2,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4203\/revisions"}],"predecessor-version":[{"id":4896,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4203\/revisions\/4896"}],"wp:attachment":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/media?parent=4203"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/categories?post=4203"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/tags?post=4203"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}