4 - Special Needs Pop Flashcards
Neurodevelopmental disorder
-4 categories
Socializing
Language and communication
Problem solving
Physical
Autism spectrum disorder
-defined by…
A common set of behaviors and should be characterized by a single name according to severity
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
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
Autism spectrum disorder
-comorbidites (main point)
1/5 with ASD are dx with a psychiatric disorder by adulthood (anxiety, depression, ADHD, OCD, etc.)
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
Autism spectrum disorder
-examples of restricted repetitive patterns of behavior, interests, and activities
Lining up toys
Flapping hands
Fixed on routine
Restrictive thinking
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)
Autism spectrum disorder characteristics
-social difficulties (examples)
Relating to/expressing emotions
Limited eye contact, use/understanding of non-verbal gestures
Flat/limited facial expressions
Autism spectrum disorder characteristics
-communication
Very limited verbal comm
Primarily to have needs met, not socially
Late development of language
Autism spectrum disorder
-diagnosis (3)
Observe behaviors
Listen to caregivers’ observations
Given a severity score (1/mild - 3/severe)
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
Autism spectrum disorder
-pre-exam questions
—what is echololia
Repeat whatever you say
Autism spectrum disorder
-what to say during pt education
“Everything is normal for your child”
Intellectual disability
-describe
Previously “mental retardation”
Limitations in intellectual functioning, adaptive behavior
Onset before age 18
Intellectual disability
-epidemiology
~1% of population, 85% of those are mild
Males more likely
Intellectual disability
-IQ test basics
Major tool in measuring intellectual functioning
Below/around 70 indicates limited functioning
Intellectual disability: Down syndrome
-epidemiology
Most common chromosomal condn diagnosed in the USA
~6000 babies born annually (1/700)
Intellectual disability: Down syndrome -genetics —trisomy 21 —translocation —mosaic
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
Mother’s age
Intellectual disability: Down syndrome
-prenatal dx
—screening
—diagnostic
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
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
Mild = IQ 50-70 Severe = IQ 20-35
Static development
Impaired
Intellectual disability: Down syndrome
-associations (5)
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
