4 - Special Needs Pop Flashcards by Elyse Kohl

Neurodevelopmental disorder

-4 categories

Socializing
Language and communication
Problem solving
Physical

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Autism spectrum disorder

-defined by…

A common set of behaviors and should be characterized by a single name according to severity

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Autism spectrum disorder

-prevalence

Greatly incr over last 20 years
-may be due to changes in the definition, incr awareness

Est. 1/59 children have

4-5x’s more likely in males

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Autism spectrum disorder
-etiology
—pathogenesis
—factors - genetic and environmental

Pathogenesis not completely understood

Genetics

may alter brain development
multiple genes responsible
MRI indicates ASD indiv use different patterns of connectivity, cognitive strategy, and brain areas to process info

Environmental
-little evidence

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Autism spectrum disorder

-comorbidites (main point)

1/5 with ASD are dx with a psychiatric disorder by adulthood (anxiety, depression, ADHD, OCD, etc.)

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Autism spectrum disorder

-deficits in social communication and interaction (4)

Social reciprocity - how actions of one affect others

Joint attention - wanting to share an interest

Nonverbal - using or interpreting

Social relationships - developing/maintaining friendships

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Autism spectrum disorder

-examples of restricted repetitive patterns of behavior, interests, and activities

Lining up toys

Flapping hands

Fixed on routine

Restrictive thinking

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Autism spectrum disorder characteristics

-sensory issues (examples)

Over/under-reacting to stimuli

Stereotyped body movements (hand flapping, rocking, bouncing)

Unusual behaviors (looks from angles, sniffs/licks objects, toe walks)

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Autism spectrum disorder characteristics

-social difficulties (examples)

Relating to/expressing emotions

Limited eye contact, use/understanding of non-verbal gestures

Flat/limited facial expressions

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Autism spectrum disorder characteristics

-communication

Very limited verbal comm

Primarily to have needs met, not socially

Late development of language

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Autism spectrum disorder

-diagnosis (3)

Observe behaviors

Listen to caregivers’ observations

Given a severity score (1/mild - 3/severe)

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Autism spectrum disorder

-examining children with ASD

Ask about triggers, what will keep them motivated during exam

Limit wait time

Offer quiet alternative if needed

Consider shortened exam or breaks

End on a positive note

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Autism spectrum disorder
-pre-exam questions
—what is echololia

Repeat whatever you say

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Autism spectrum disorder

-what to say during pt education

“Everything is normal for your child”

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Intellectual disability

-describe

Previously “mental retardation”

Limitations in intellectual functioning, adaptive behavior

Onset before age 18

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Intellectual disability

-epidemiology

~1% of population, 85% of those are mild

Males more likely

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Intellectual disability

-IQ test basics

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Major tool in measuring intellectual functioning

Below/around 70 indicates limited functioning

Intellectual disability: Down syndrome

-epidemiology

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Most common chromosomal condn diagnosed in the USA

~6000 babies born annually (1/700)

Intellectual disability: Down syndrome
-genetics
—trisomy 21
—translocation
—mosaic

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T21: ~95%, not hereditary, but spontaneous

Tr: ~3%, of these cases 1/3 have a hereditary component

M: ~2%, some cells have three copies of 21, others only two copies
-may have fewer features of the condn due to some cells having normal number of copies

Intellectual disability: Down syndrome

-only association that has been verified to be linked with DS

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Mother’s age

Intellectual disability: Down syndrome
-prenatal dx
—screening
—diagnostic

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S: estimates the chance, bloodwork and ultrasound

D: chronic villus sample (CVS) and amniocentesis, 1% risk of miscarriage but nearly 100% accurate

Intellectual disability: Down syndrome

-dx at birth

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Prescence of certain physical traits

low muscle tone
single, deep palm crease
slightly flattened facial profile
upward slanted eyes

Karyotype to confirm

Intellectual disability: Down syndrome

cognitive impairment
developmental delays
social skills

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Mild = IQ 50-70
Severe = IQ 20-35

Static development

Impaired

Intellectual disability: Down syndrome

-associations (5)

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Hearing loss
Otitis media
Obstructive sleep apnea
Congenital heart defects
Delayed dental eruption, hypodontia

Intellectual disability: Down syndrome -vision problems —frequency —common findings (6)

60% ``` Significant RE/need glasses (50%) Strab, pseudo strab/prominent epicanthal folds (47%) Nystagmus (33%) Brushfield spots (35-78%) Amblyopia Keratoconus ```

Intellectual disability: Down syndrome | -refractive error

Usually high astigmatism and hyperopia Rx to prevent amblyopia

Intellectual disability: Down syndrome | -glasses

Need to fit flat nasal bridge Brand Specs 4 Us

Intellectual disability: Down syndrome | -accommodation

Insufficiency May benefit from bifocal, reading glasses

Intellectual disability: Down syndrome | -brushfield spots

Multiple, round, focal areas on anterior surface of iris Appear beige or light brown/grey Areas of stromal HYPERplasia surr by relative HYPOplasia More common with lightly pigmented irises (Europeans) Not pathognomonic

Intellectual disability: Down syndrome | -reduced VA

May be normal to have between 20/30 and 20/60 BCVA Studies show reduced low contrast and Vernier acuity

Intellectual disability: Down syndrome | -cataracts

Congenital Cerulean - blue dot opacities in anterior and posterior capsule - bilateral - do not affect VA - stable, non-progressive

Intellectual disability: Down syndrome | -nystamus

Rapid, horizontal most common Latent next most common Can be assoc with decr acuity

Intellectual disability: Down syndrome | -strabismus

ET most common - congenital or infantile - accommodative - do not confuse with spasm of accomm

Intellectual disability: Down syndrome | -amblyopia

Iso or anisometropic Strabismic Important - avoid atropine penalization due to cardiac abnormalities (patching works)

Intellectual disability: Down syndrome | -keratoconus

Onset early adulthood Possible etiologies - incr eye rubbing - steeper K with higher astigmatism rate - genetic link to chromosome 21

Intellectual disability: cerebral palsy | -describe

Disorder of movement, muscle tone, or posture that’s caused by damage that occurs to the immature (often developing) brain, usually before birth Every case is unique to individual

Intellectual disability: cerebral palsy | -etiology

Caused by abnormality/disruption in brain development, usually before born Factors include - mutations - maternal infection - fetal stroke - infant infection - traumatic head injury - lack of oxygen (asphyxia)

Intellectual disability: cerebral palsy | -signs

Doesn’t usually present until infancy/childhood due to use of muscles ``` Impaired movement, abnormal reflexes Rigidity of limbs, trunk Abnormal posture Involuntary movements Unsteady walking ```

Intellectual disability: cerebral palsy - effect on functional abilities - may also occur (3) - commonly have eye...

Greatly varies Epilepsy, blindness, deafness Eye muscle imbalance

``` Intellectual disability: cerebral palsy -severity —mild —mod —severe ```

Mi: can move w/o assitance, daily activities not limited Mo: needs braces, meds, and adaptive technology for daily activities Se: requires wheelchair, significant challenges in daily acitivities

Intellectual disability: cerebral palsy | -locations (4)

Monoplegia (one limb, usually arm) Hemiplegia (R or L side) Diplegia (legs or arms) Quadriplegia

Intellectual disability: cerebral palsy -motor function —spastic —non-spastic

S: increased muscle tone (e.g. clenched wrist/hand) NS: decr or fluctuating muscle tone

4 - Special Needs Pop Flashcards

(42 cards)