[Exam 3] Chapter 22: Neurodevelopmental Disorders Flashcards
(112 cards)
1
Q
What the essential feature of intellectual disability?
A
Below-average intellectual functioning (IQ < 70) accompanied by significant limitations in areas of adaptivie functioning such as communication, self-care, and home-living.
2
Q
What are the degrees of disability?
A
Mild, moderate, severe, or profound
3
Q
What heredity condiitons contribute to intellectural disability?
A
Tay-Sachs disease or fragile X chromosome syndrome
Early alterations in embryonic development like trisomy 21 or mternal alcohol intake
Fetal malnutrition, hypoxia, infections
4
Q
What medical conditions contribute to intellectual disability?
A
Infection or lead poisoning
5
Q
What environmental influences lead to intellectual disability?
A
deprivation of nurturing or stimulation
6
Q
What degree of intellectual disability receive tx in their home?
A
Mild-to-moderate
7
Q
Autism Spectrum Disorder: what is this?
A
Characterized by pervasive and usually severe impairment of reciprocal social interaction skills, communication deviance, and restricted stereotypical behavioral patterns
8
Q
Autism Spectrum Disorder: What does this include?
A
Disorders previously categorized as different types of a pervasive developmental disorder (PDD)
9
Q
Autism Spectrum Disorder: What are some examples of previous ppds?
A
Rett Disorder
Childhood Disintegrative Disorders
Asperger Disorder
10
Q
Autism: Prevalent in which gender?
A
5x more prevalent in boys,
11
Q
Autism: When autism identified?
A
By 18 months and no later than 3 years of age
12
Q
Autism: What problems do children with autism have?
A
Persistent deficits in communication and social interaction accompanied by restricted, stereotyped patterns of behavior and interests/activites
13
Q
Autism: Eye/facial contact here?
A
Little eye contact and make few facial expressions toward others
14
Q
Autism: How will they act toward peers?
A
LAck spontaneous ennjoyment, express no moods or emotional affect, and may not engage in play or make believe with toys. Little intelligible speech.
15
Q
Autism: They perform stereotyped motor behaviors which are what?
A
Hand flapping, body twisting, or head banging
16
Q
Autism: Behaviors common for 1 year?
A
Not responding to own name
17
Q
Autism: Behaviors common by 14 months?
A
Doesn’t show interest by pointing to objects or people
18
Q
Autism: Behaviors common by 18 months?
A
Doesn’t play pretend games
19
Q
Autism: Common behaviors seen here?
A
Avoids eye conact
Prefers to be alone
Delayed speech and language skills
Obsessive intereests (gets stuck on idea)
20
Q
Autism: Percentage of kids with this at infancy?
A
80%
21
Q
Autism: How does this affect children as they grow up?
A
Start to improve as children acquire and use language to communicate with others.
22
Q
Autism: If behavior deteriorates in adolescence, why is this?
A
May reflectefects of hormonal changes or difficulty meeting increasingly complex social demands
23
Q
Autism: Manifestations seen in adults?
A
Little speech and poor daily living skills throughout life to adequate social skills that allow independent functioning
24
Q
Autism: When is short term inpatient tx indicated?
A
Used when behaviors such as head banging or tantrums are out of control
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Autism: Goal of treatment of children?
Reduce behavioral symptoms and to promote learning and development, particularly the acquisition of language skills
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Autism: Comprehensive and individualized treatment include what?
Special education and laguage therapy, as well as cognitive behavioral therapy for anxiety and agitation.
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Autism: What type of drugs would be used?
Antipsychotics
Combo Antipsychotics
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Autism: What antipsychotics will beused?
Haloperidol (Haldol)
Risperidone (Risperdal)
Aripiprazole (Abilify)
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Autism: What do antipsychotics target?
Temper tantrums, aggressiveness, self-injury, hyperactivity, and stereotyped behaviors
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Autism: what other medications can be used?
Naltrexone (ReVia)
Clompipramine (Anafranil)
Clonidine (Catapres)
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Autism & Related Disorders - Tic Disorders: What is a tic?
Sudden, rapid, recurrent, nonrhythmic, stereotyped motor movement or vocalizations
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Autism & Related Disorders - Tic Disorders: Examples of motor tics?
blinking, jerking the neck, shrugging the shoulders, grimacing, and coughing
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Autism & Related Disorders - Tic Disorders: Example of vocal tics?
Repeating words or phrases out of context, coprolalia (use of socially unacceptable words, obscence), palilalia (repeaitng ones own sounds or words) and echolalia (repeating the last heard sound)
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Autism & Related Disorders - Tic Disorders: Complex motor tics include what?
facial gestures, jumping, or touching or smelling an object
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Autism & Related Disorders - Tic Disorders: What plays a part in tic disorders?
Abnormal transmission of the neurotransmitter dopamine
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Autism & Related Disorders - Tic Disorders: How are tic disorders treated?
Risperidone (Risperdal) or Olanzapine (Zyprexa) which are atypical antipsychotics
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Autism & Related Disorders - Tic Disorders: What is tourette disorder?
Involves multiple motor tics and one or more vocal tics, which occur many times a day for more than 1 year
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Autism & Related Disorders - Chronic Motor or Tic Disorder: How does this differ from Tourette disorder?
In that either the motor or vocal tic is seen, but not both.
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Autism & Related Disorders - Chronic Motor or Tic Disorder: What is a transient tic disorder?
May involve single or multiple vocal or motor tics, but the occurrences last no longer than 12 months
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Autism & Related Disorders - Learning Disorders: When is this diagnosed?
When a child's achievement in reading, mathematics, or written expression is below that expected for age, formal education, and intelligence.
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Autism & Related Disorders - Motor Skills Disorders: Essential feature of developmental coordination disorder is what?
impaired coordination severe enough to interfere with academic achievement or activites of daily living
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Autism & Related Disorders - Motor Skills Disorders: When does this become evident in children?
As they attempt to crawl or walk or as an older child tries to dress independently or manipulate toys like blocks
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Autism & Related Disorders - Motor Skills Disorders: What is stereotypic movement disorder?
Characterized by rhythmic, repetitive behaviors such as hand waving, rocking, head banging, and biting that appears to have no purpose
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Autism & Related Disorders - Motor Skills Disorders: When does stereotypic movement disorder onset begin?
At age 3 years and usually persists into adolescence. More common in those with intellectual disability
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Autism & Related Disorders - Communication Disorders: What does this involve?
Deficits in language, speech, and communication and is diagnosed when deficits are sufficient to hinder development, academic achievement or activites of daily living
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Autism & Related Disorders - Communication Disorders: What are language disorder?
Involves deficits in language production or comprehension, causing limited vocabulary and an inability to form sentences or have a conversation
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Autism & Related Disorders - Communication Disorders: What is speech sound disorder?
Difficulty or inability to produce intelligible speech, which precludes effective verbal communication
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Autism & Related Disorders - Communication Disorders: What is stuttering?
Disturbance of fluency and patterning of speech with sound and syllable repetitions
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Autism & Related Disorders - Communication Disorders: What is social communication disorder?
Involves inability to observe social rules of conversation, deficits in applying context to conversation, inability of tell story in an understandable manner
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Autism & Related Disorders - Elimination Disorders: What is Encopresis?
Repeated passage of feces into inappropriate places such as clothing or the floor by a child who is at least 4 years of age or older. Involuntary often.
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Autism & Related Disorders - Elimination Disorders: What is Enuresis?
Repeated voiding of urine during the day or night into clothing or bed by a child at least 5 years of age
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Autism & Related Disorders - Elimination Disorders: How can enuresis be treated?
With Imipramine (Tofranil), an antidepressant with a side effect of urinary retention
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Autism & Related Disorders - Elimination Disorders: Both elimination disorders respond to behavioral appracohes such as what?
Pad with a warning bell and to positive reinforceent for coninence.
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Autism & Related Disorders - Elimination Disorders: What is sluggish cognitive tempo (SCT)?
Includes daydreaming, trouble focusing and paying attention, mental fogginess, staring, sleepiness, little interest in physical activity, and slowness in finishing tasks
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ADHD: What is this?
Characterized by inattentiveness, overactivity, and impulsiveness
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ADHD & Onset/Clinical: How are infants described?
As often fussy and temperamental and have poor sleeping patterns
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ADHD & Onset/Clinical: How are toddlers described?
As "always on the go" and "into everything", at times dismantling toys and cribs.
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ADHD & Onset/Clinical: Why do peers perceive them as more aggressive, bossier, and less likable?
Perception results form the child's impulsivity, inability to share or take turns, tendency to interrupt, and failure to listen to and follow directions
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ADHD & Onset/Clinical: Secondary complications of ADHD?
Low self-esteem and peer rejection
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ADHD & Onset/Clinical: Approximately 70-75% of adults with ADHD have at least one coexisting psychiatric diagnosis, such as
social phobia, bipolar disorder, major depression, and alcohol dependence.
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ADHD & Etiology: What increases the likelihood of ADHD?
Combined factors such as environmental toxins, prenatal influences, herediy, and damage to brain structure.
Prenatal exposure to alcohol, tobacco, and lead, and severe malnutrition
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ADHD & Etiology: Brain images of people with ADHD suggest what?
decreased metabolism in the frontal lobes, with are esential for attention, impulse control, organization, adn sustained goal-directed acitivty.
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ADHD & Etiology: Glucose in the brain?
It is decreased usage in the frontal lobes
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ADHD & Etiology: What is the genetic link for ADHD?
Abnormalities in catecholamine and possibly serotonin metabolism.
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ADHD & Etiology: Risk factors for ADHD?
Family history of ADHD, male relatives with antisocial personality disorder or alcholism, female relatives with somatization disorder, lower socioeconomic status
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ADHD & Cultural Considerations: What is the Child Behavior Checklist, Teacher Report Form, and Youth Self Report?
For those 11-18, are rating scales frequrntly used to determine problem areas and competencies
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ADHD & Cultural Considerations: What is the ADHD-FX?
Proven to be a valid, reliable and culturally appropriate measure of functional impairment of at risk students
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ADHD & Psychopharmacology: Medications often effective in doing what?
decreasing hyperacativity and impulsiveness and improving attention, enabling child to partcipate in school and family life
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ADHD & Psychopharmacology: Most common medications?
Methyphenidate (Ritalin) and Ampheamine compound (Adderall).
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ADHD & Psychopharmacology: How effective is methylphenidate?
70-80% of children, reducing hyperactivity, impulsivity, and mood lability and helps child pay attention more
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ADHD & Psychopharmacology: What stimulants used to treat ADHD?
Dextroamphetamine (Dexedrine) and Pemoline (Cylert)
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ADHD & Psychopharmacology: Common side effects of Dextroamphetamine and Pemoline?
Insomnia, loss of appetite, and weight loss or failure to gain weight
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ADHD & Psychopharmacology: What forms are methyphenidate, dextroamphetamine, and amphetamine available in?
Sustained release form taken once daily
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ADHD & Psychopharmacology: How else is methyphenidate available ?
In transdermal patch
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ADHD & Psychopharmacology: Which drug is least likely to be prescribed?
Pemoline, because it can cause liver damage
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ADHD & Psychopharmacology: When stimulants are not effective, what drug is used then?
Antidepressants. Atomoxetine (Strattera). It is a selective norepinephrine reuptake inhibitor
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ADHD & Psychopharmacology: Side effects of atomoxetine?
decreased appetite, nausea, vomiting, tiredness and upset stomach
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ADHD & Psychopharmacology: What can atomoxetine cause?
Liver damage as well.
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ADHD & Psychopharmacology: Dosage of methyphenidate?
10-60 mg in 3-4 divided doses
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ADHD & Psychopharmacology: Dosage of sustained release mathylphenidate?
20-60 mg/day in monring
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ADHD & Psychopharmacology: Dosage of dexotramphetamine?
5-40 mg/day in 2-3 doses
If sustained, 10-30 mg/day in morning
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ADHD & Psychopharmacology: Dosage of Amphetamine?
5-40 mg/day in 2-3 divided doses.
If sustained, 10-30 mg/day in morning
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ADHD & Psychopharmacology: Dosage of Atomoxetine?
40-80 mg/day in 1 or 2 divided doses
84
ADHD & Strats for Home/School: Effective approaches include what?
Providing consistent rewards and consequences for behavior, offering consistent praise, and using time-out and giving verbal reprimands
85
ADHD & Strats for Home/School: What happens in therapuetic play?
Play techniques are used to understand the child's thoughts and feelings and to promote communication
86
ADHD & History: How will parents report their children?
As fussy and having problems as infant. May have difficulties in major life areas such as school or play?
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ADHD & General Appearance & Motor: How will they do motor wise?
Cannot sit still in chair and squirms and wiggles while trying to do so.
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ADHD & General Appearance & Motor: Speech here?
Unimpaired but child cannot carry on a conversation.
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ADHD & Mood / Affect: Mood here?
Labile, even to point of verbal outbursts. Anxiety, frustration, and agitation are common.
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ADHD & Sensorium and Intellect: What is impaired here?
Ability ot pay attention or concentrate. Attention span may be as litle as 2-3 seconds or 2-3 minutes.
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ADHD & Judgement/Insight: Judgement here?
Poor judgement and often do not think before acting. They fail to perceive harm and danger.
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ADHD & Interventions: How can nurse provide childs safety?
Stop unsafe bhaviors
Provide close supervision
Give clear directions about acceptable and unacceptable behavior
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ADHD & Interventions: Improved role performance how?
Give positive feedback for meeting expecations
Manage the environment
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ADHD & Interventions: How so simplify instructions/directions
Get childs full attention
Break complex tasks into small steps
Allow breaks
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ADHD & Interventions: How to allow structured daily routine?
Establish a daily schedule
Minimize changes
96
ADHD & Self Concept: How is self-esteem in child?
Low. Because they are not successful at school, may not have many friends ,and have trouble getting along at home.
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ADHD & Roles: How are roles?
Unsuccesful because frequently disruptive and intrusive at home.
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ADHD & Intervention - Ensuring Safety: What do do if child potentially engaged in dangerous activity?
Stop behavior. Involves physical intervention if child runing into street or jumping form a hihg place.
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ADHD & Intervention - Ensuring Safety: How should adult talk to child about bad behavior?
Use short and clear words. Should not assume that childs knows acceptable behavior
"It's unsafe to do that. Do this instead now".
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ADHD & Intervention - Improving Role Performance: What is important here?
To give child specific positive feedback when he or she meets stated expectations.
"You did a good job of asking to play with guitar and waiting until it was your turn">
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ADHD & Intervention - Improving Role Performance: How does managing the environment help?
Helps child imrpove their ability to listen, pay attention, and complete tasks
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ADHD & Intervention - Simplifying Instructions: How do you do this?
Break up tasks. This prevents overwhelming child. Instead of saying clean up your room, you can now say to put your dirty clothes in the hamber.
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ADHD & Intervention - Promoting Structured Daily Routine: What does this promote?
Child accomplishing getting up, dressing, doing homework, playing, and going to bed.
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ADHD & Intervention - Providing Family Education and Support: What does this include?
Include parents in planning
Focus on childs strengths
TEach proper medicine administration.
Assist identifying behavioral approaches
Help achieve balance of praising child and correct behavior
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ADHD & Mental Health Promotion: What assessment tool can be used?
SNIP-IV Teacher and Parent Rating Scale can be used for initial evaluation in many areas of convern
106
Psychiatric disorders are more difficult to diagnose in children than adults why?
Because childrens basic development is incomplete and they may lack ability to recognize or to describe what they are experiencing
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Disorders of childhood and adolescnce most often encourntered in mental health settings is what?
ASD and ADHD
108
Intellectual disability below 70 is accompanied by what signs?
significant limitations in adaptive functioning, such as communication, self-care, self-direction, academic achievement, work, adn health and safety
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Most commont tic disorder?
Tourette disorder
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Tic disorders are treated succesfully with what?
Atypical antipsychotic meds
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elimination disorders cause impairment for child based on what?
response of parents, level of self-esteem, and degree of ostracism by peers
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asd includes a continuum approach to developmental disorders characterized y what?
Severe impairment of reciprocal social interaction skills, communication deviance, and restricted and stereotyped behavioral patterns
