AOTA-Developmental Disorders Flashcards
What 3 key factors lead to an intellectual disability diagnosis?
- ** Psychoeducational assessment scores more than 2 SD below in one area; or 1 SD below in two areas**
- Onset before 18
- Impaired adaptive abilities necessary for ADL/IADLs.
What are the levels of intellectual disabilities?
Mild (IQ 55-70; 7th grade), moderate (IQ 40-55; 2nd grade), severe (IQ 25-40; some ADLs), profound (IQ below 25; requires caregiver assistance)
What are the common causes of intellecutal disabilities?
Problems acquired in childhood through trauma, toxins, or infections
Problems of fetal development and birth
Chromosomal problems
CNS malformations
Congenital anomalies
Metabolic, neurocutaneous, and endocrine disorders
Comorbidities:
Speech problems
Ambulation problems
Seizures
Visual problems
Chronic conditions (e.g., heart disease, diabetes, anemia, obesity, and dental problems)
What are the early indicators of intellectual disabilities?
- Delays in motor/speech milestones
- Unresponsiveness to handing and physical contact
- Reduced alertness
- Limited reactions to play
- Feeding difficulties
- Neurological soft signs (deficits in bal., motor asymmertry, perceptual-motor skills, FM skills)
Autism Assessment Tools to address sensory processing/modulation disorders
- SIPT
- SP
- SPM (home/school environment)
Autism Spectrum Disorder (ASD)
characterized by severe and complex impairments in social interaction and communication skills and by the presence of stereotypical behaviors, interests, and activities; onset 3 y/o
Repetitive behaviors driven by sensory needs; behavioral issues; cognitive deficits (difficulty with empathy/theory of mind, inflexible); difficulties with motor skills (dyspraxia or poor motor planning abilities); GM/FM; social skills
Autism Spectrum Disorder- Interventions
Interventions include sensory integrative therapy, highly structured and specialized education programs, and visual supports (e.g., picture checklists, communication boards).; social skills training
sensory processing/modulation; hypersensitivity; underresponsitivity
4 S’s : SI, structure, support for visuals, social skills
Rett syndrome
a progressive neurological disorder caused by a genetic mutation that is found almost exclusively in girls; type of ASD; development appears normal for first 6 mos.; non ambulatory and non verbal by late childhood
Comorbidities (mircrocephaly, spasticity, and seizures)
Rett syndrom-Symptoms
- head growth slows down
- loss of hand skills, poor coordinated trunk and gait
- Loss of social skills (but can reemerge)
- hand-wringing; repetitive behaviors
- waking hyperventilation
What is the frontal lobe responsible for?
responsible for inhibition and attention control (ADHD)
ADHD-Assessments
- clinical observation in various settings
- interview
- assessment tools
ADHD- Assessment tools
- Assessment of Motor and Process Skills
- COPM
- SFA
- Short Child Occupational Profile
- SP
- SPM
ADHD-Interventions
- CBT [challenging automatic thoughts, reducing cognitive distortions, challenging underlying belief and assummptions, mental imagery, controlling recurrent thoughts and behaviors]
- behavioral modification
- educational interventions (safety awareness)
- social skills training
- modify environment/organzation
- self-management techniques
Purpose of ADHD interventions
- enhance sensory modulation
- support organizational routines
Zones of Regulation-RED
high state of alert/arousal; intesnse emotions
Zones of Regulation-Yellow
less arousal; heightened state of alertness
stress, anxiety, nervousness, feeling extremely silly
Zones of Regulation-Green
optimal state of alertness; ready to learn, work or play; calm, but attentive
Zones of Regulation-Blue
less than optimal state
Sad, illness, boredom, or fatigue
Learning disabilities- Interventions for early childhood
- sensory integration
- perceptual-motor integration
- writing skills
- play
- socialization
Learning disabilities- Interventions for School age
- sensory integration
- perceptual-motor integration
- writing skills
Learning disabilities-Interventions for early adolescence
- independent living skills
- social skills
- development of compensatory and adaptive techniques
Down syndrome
- Chromosomal disorder trisomy 21
- short stature, small heads, flat nose, slack jaw tongue protrusion, broad, short fingers/toes; single crease in hands
Why would a child with down syndrome require clearance for sports?
They may have atlantoaxial instability, which can lead to permanent spinal cord damage (neurological issues).
Precaution: do not hyperflex neck; do not perform front rolls.
Learning Disability-Interventions for early childhood
- sensory integration
- play
- perceptual-motor integration
- writing skills
Down syndrome-Evaluation
- interviews
- educate on child’s unquie development trajectory
- clinical observations
- standardized assessment tools
Down syndrome-Intervention
- feeding support
- education/family training
- motor planning
- cognitive development
- self-determination skills/prevocational training
- ADL/IADLs
- educational interventions
Patau’s syndrome
- Chromosomal Trisomy 13
- Survival rate 20%- survive up to 12 mo.
- They have multiple anomalies affecting their eyes, ears, nose, lip, palate, and digits; microcephaly and neural tube
- Cleft lip and palate, abnormally small eye(s), dec. distance btwn eyes
Turner’s syndrome
- **webbing of the neck, congenital edema of the extremities, **and cardiac problems.
- short, may develop obesity, and may lack secondary sexual characteristics
- NO intellectual disabilities, but has difficuties with visual perception
Cri du chat syndrome
- weak and “catlike” cry in infancy.
- microcephaly, down-slanting eyes, cardiac abnormalities, and failure to thrive.
- intellectual disability, hypotonia, and feeding and respiratory problems.
Klinefelter’s syndrome
- Extra X chromosome
- Learning disabilities
- emotional/behavioral problems
- tall, slim, small genitalia, unable to father children
Fragile X syndrome
- intellectual disabilities
- cranial deformities, elongated faces, prominent jaws forehead, large ears, high-arch palates, pes planus (flat feet), and hypermobile joints
Neurofibromatosis
- multiple tumors on the central and peripheral nerves, café-au-lait birthmarks, and vascular and visceral lesions
- mild intellectual impairments or learning disabilities, speech disorders, short stature, and skeletal anomalies
Prader-Willi syndrome
- Trisomy 15
- moderate intellectual disabilities
- food-seeking behaviors
- hypotonia, poor thermal reg. underdev. sex organs
- long faces with slanted eyes
Williams syndrome
- cerebral and cardiovascular abnormalities
- intellectual disabilities, but also affinity (natural liking) for music, social skills, and writing
- common facial characteristics
- difficult with visual, spatial, and motor skills
Phenylketonuria (PKU)
- an inborn** error in processing an amino acid **in proteins.
-
blond hair and blue eyes
3.** If untreated, children with this condition have severe intellectual and behavioral difficulties and may present as though they have autism.**
Phenylketonuria (PKU)-Primary treatment
Primary treatment: Diet.
Condition may resolve around age 10 if followed consistently
Galactosemia
- disorder involves the inability to convert milk sugar to glucose, which could result in spleen and liver dysfunction.
- Symptoms include** jaundice, vomiting, diarrhea, lethargy, cataracts, and systemic infections. If not treated, it can lead to death.**
What happens when galactosemia is left untreated?
- Treatment involves avoidance of milk products and breast milk.
- Without treatment, learning difficulties, perceptual problems, tremors, choreoathetosis, and ataxia may be present.
Lesch-Nyhan syndrome
- a progressive neuromuscular disease that is a result of ** difficulty metabolizing purines**
- Only in biological males
- infant appears normal in 1st yr, then they begin to regress.
Lesch-Nyhan syndrome- Presentation
- intellectual disabilities
- neuromotor degeneration
- spasticity
- **nail-biting
- face-rubbing compulsions (can be damaging)**
Lesch-Nyan syndrome-treatment
Treatment involves preventing self-injurious behavior
Developmental Coordination Disorder-Symptoms
(aka DD motor function/ developmental dyspraxia/congenital maladroitness)
- EARLY: delayed self care, delayed motor milestones
- SCHOOL-AGE: FM/GM difficulties (handwriting and ball skills)
- Social skills and academics difficulties d/t dec. motor coord.
- Disorder of speech and language commonly co-occur
Developmental Coordination Disorder- Treatment
- improve occup. performance across contexts
- modifications/ accommodations for written language (keyboard)
- support in PE
- promote safe practice of motor skills
- support for self-esteem
- For some children, provide individual intervention so that they can master skills before being asked to perform them in front of a large group
Developmental Coordination Disorder-Assessment
Cognitive Orientation to daily Occupational Performance (CO-OP)
Cognitive Orientation to daily Occupational Performance (CO-OP)
A client-centered problem-solving approach used to coach the child through self-discovery devise solutions for everyday life situations that are affected my motor performance.
GOAL: helps child formulate and select goals and work on ways to generalize skills to other contexts.
[cooperative relationship btwn OT and pt.]
Developmental Coordination Disorder-Outcome of intervention
Outcome of intervention
1. skill
2. acquisition
3. generalization
4. transfer
5. positive gains in self-efficacy
6. independent strategy development
Diabetes
A metabolic condition that involves the pancreas producing insufficient amounts of insulin
Diabetes Type 1
- onset: around age 10
- acute and requires administration of insulin
- [ AUTOIMMUNE REACTIONpancreas does not make insulin, because the body’s immune system attacks the islet cells in the pancreas that make insulin. ]
- Early symptoms include weight loss, thirst, polyuria, and dehydration
- At risk for developing retinopathy leading to blindness, nephropathy, and peripheral n. damage.
- Treatment includes diet and exercise
Diabetes Type 2
- onset: around age 40
- [pancreas makes less insulin than used to, and the body becomes resistant to insulin]
- risk factors: excess weight and lack of exercise
- treatment includes diet, exercise and insulin
Infections transmitted from mother to child is know as _________.
“STORCH” infections
-syphilis
-toxoplasmosis
-other infections
-rubella
-cytomegalovirus
-herpes simplex virus 2
___________ is transmitted during the third trimester of pregnancy or during delivery.
The infant requires isolation and is treated with penicillin.
a] syphilis
b] toxoplasmosis
c] rubella
d] cytomegalovirus
e] herpes simplex virus 2
a] Syphilis
Early-state _______________ leads to hepatitis, failure to thrive, and neurological involvement. After the infection is treated, the child may develop osteochondritis at the joints and other bone abnormalities, dental anomalies, and visual and auditory deficits.
a] syphilis
b] toxoplasmosis
c] rubella
d] cytomegalovirus
e] herpes simplex virus 2
a] syphilis
_________ is contracted through handling of cat feces or eating of raw meats. Stillbirths are commonly associated with this condition.
a] syphilis
b] toxoplasmosis
c] rubella
d] cytomegalovirus
e] herpes simplex virus 2
b] Toxoplasmosis
Children born with _________ have intellectual disabilities, hydrocephalus, and chorioretinitis. Other common comorbidities include cerebral palsy, seizures, cardiac and liver damage, and gastrointestinal problems.
a] syphilis
b] toxoplasmosis
c] rubella
d] cytomegalovirus
e] herpes simplex virus 2
b] toxoplasmosis
_________ can be very harmful if it is contracted in the first trimester. Many fetuses will not survive the duration of the pregnancy.
a] syphilis
b] toxoplasmosis
c] rubella
d] cytomegalovirus
e] herpes simplex virus 2
c] Rubella
When babies are born after their mother has contracted _______, they often have intellectual disabilities, hearing loss, microcephaly, congenital heart defects, seizures, and problems with their liver and spleen.
a] syphilis
b] toxoplasmosis
c] rubella
d] cytomegalovirus
e] herpes simplex virus 2
c] rubella
________ is transmitted before, during, or after birth. Because the virus may be dormant, therapists need to use universal precautions when working with children who have been exposed to ______.
a] syphilis
b] toxoplasmosis
c] rubella
d] cytomegalovirus
e] herpes simplex virus 2
d] Cytomegalovirus (CMV)
Children exposed to ____________ may have low birth weight, hearing loss, microcephaly, spleen and liver damage, and neurological deficits.
a] syphilis
b] toxoplasmosis
c] rubella
d] cytomegalovirus
e] herpes simplex virus 2
d] cytomegalovirus
___________ is contracted during delivery. Infants will often develop skin lesions within 1 week to 10 days of birth. Internal organ lesions and CNS damage may develop.
a] syphilis
b] toxoplasmosis
c] rubella
d] cytomegalovirus
e] herpes simplex virus 2
e] Congenital herpes (herpes simplex virus 2)
Early red flags of ________ include fever, lethargy, poor feeding, and vomiting. Cesarean sections can often be used to stop transmission.
a] syphilis
b] toxoplasmosis
c] rubella
d] cytomegalovirus
e] herpes simplex virus 2
e] Congenital herpes (herpes simplex virus 2)
Acquired immunodeficiency syndrome (AIDS)
- caused by HIV
- HIV can be transmitted to infants from mother; diagnosed bwtn age 1-6 mo.
- progression varies; if child has a positive test, must test every 3 mo.; colds must be monitored closely d/t impact on immunity
Acquired immunodeficiency syndrome (AIDS)- Presentation
- chronic respiratory illness, skin infections, and diarrhea
- ataxia, spasticity, rigidity, tremor, and seizures
- Developmental delays may include those to speech and language, motor skills, and independent skills.
Acquired immunodeficiency syndrome (AIDS)-Treatment
Intervention:
1. developmental assessment
2. educational support
Encephalitis + S&S
An inflammation of the brain caused by bacteria, spirochetes, or a viral infection.
S&S: fever, headache, dizziness, stiff neck, nausea, vomiting, tremors, and ataxia.
Encephalitis/Meningitis-Treatment
Neurorehabilitation
1. limit disability
2. compensatory strategies
Meningitis + S&S
An infection of the tissue that covers the brain and the spinal cord, caused by bacteria (common)
S&S: headache, fever, and stiff neck.
Neuromotor, visual, and auditory disturbances; seizures; and learning disorders may all persist after meningitis has resolved.
Neoplasm
a new or abnormal tissue growth or tumor.
Histoid
abnormal tissue growth/tumor in which the growth resembles the tissue around it
Malignant
a growth that does spread, metastasize, and infiltrate other tissue (cancer)
Mixed neoplasm
a growth that is made up of two layers
Treatment for ID (Early years)
- support to meet developmental milestones
- enriching the environment
- supporting parents
Treatment for ID (School age)
- supporting development of functional skills
- collaboration with special educators and others
- aquisition of student role
Treatment for ID (Adolescence)
supporting development of vocational interests and skills, social skills, sex ed, and community mobility skills
What are some general adaptation of the environment for a child with ID?
- assistive tech. with a specific strategy for implementation
- Switches or communication devices (e.g. Dynavox)
- Mobility devices such as scooters and walkers
Treatment for ID (Early years)
- support to meet developmental milestones
- enriching the environment
- supporting parents
Treatment for ID (School age)
- supporting development of functional skills
- collaboration with special educators and others
- aquisition of student role
