Chapter 10 - Psychiatric and Cognitive Disorders Part 2 Flashcards
Oppositional defiant disorder
Negativistic, hostile, and defiant behaviors that result in functional impairment. Begins in early childhood, the course/prognosis depends on the severity of behaviors, the presence of other disorders, and the intactness of the family.
Will progress into a conduct disorder if there is aggression
Conduct Disorder
Disregard for the rights of others, leading to aggression toward people and animals, destruction of property, deceitfulness, theft, or serious violation of rules.
Severe conduct disorder is often associated with the development of other disorders and substance abuse later in life.
Disruptive Behavior Disorder, NOS
Children who do not meet the criteria for conduct disorder or oppositional defiant disorder, but they display significant functional impairment and conduct/oppositional behaviors are present.
Convenient diagnosis for children who display problematic, disruptive behaviors yet do not fit into any other category.
Autism (1)
Impaired social interaction and in most cases cognitive disabilities: impaired nonverbal behaviors, difficulty relating to others and forming relationships at an age appropriate level, lack of spontaneous social seeking behavioral interactions with others and lack of awareness of others who are seeking interaction, lack of social reciprocation due to decreased ability to infer feelings and intentions of others
Autism (2)
Difficulty with communication: lack of initiation, reflection, development of spoken language of alternative means for communication, if speech is developed, difficulty in initiating or engaging in conversation and lack of appropriate context, stereotyped echolalia and/or use of indiscernible language, lack of spontaneous pretend, imitative or exploratory play
Autism (3)
Repetitive and stereotyped behaviors and movements in one or more of the following:
ritualistic nonfunctional routines, preoccupation, rigid observance of nonfunctional routines or behavioral patterns, repetitive motor action, restrictive fixation on parts of a whole (wheel on toy car)
Asperger’s Disorder
Individuals with normal IQ and high level social skills appear to have a good prognosis, although they tend to be socially uncomfortable and demonstrate illogical thinking.
Difficulty with social interaction, restricted interests, and behaviors, clumsy, delayed developmental motor milestones, differentiated from autism by adequate language and the level of social interaction and engagement in activities with others
Rett’s Syndrome
Motor and social skills are age appropriate from 6mo -2yr, when development of physical growth and head circumference plateau resulting in progressive encephdopathy. Only girls, and may live past 10 years after onset.
Loss of purposeful hand movements, stereotypical hand movements, delayed social communication/language, muscle tone hypo then hypertonic, breathing irregular, possible seizures.
Pervasive Developmental Disorder, NOS
Impairments are evident in social interaction, communication, motor behavior, interests and activities; however they cannot be classified as indicative of a PDD since not all criteria are met.
Reactive Attachment Disorder (RAD) of Infancy or Early Childhood
Poor experiences with caregivers, will communicate with anyone (Disinhibited) or with nobody (inhibited).
Exhibit challenging behaviors: frequent lying, increased need for control, overly affectionate with strangers, hoarding food with no physical need, denial of responsibility, projecting blame for their actions on others.
Attention Deficit/Hyperactivity Disorders
The presence of 6 or more symptoms in inattention, hyperactivity-impulsivity, or both, present before 7 and affecting 2 settings:
Inattention: lack of attention to detail, poor listening, limited follow through of tasks, difficulty with organization, and avoidance of tasks that require sustained attention, tendency to lose things, distractibility and forgetfulness
Hyperactivity: fidgeting, inability to remain seated, inappropriate activity level for a given situation, difficulty with quiet sedentary activities, frequent movement and excessive talking
Impulsivity: Answering Qs that haven’t been fully stated, difficulty with turn-taking, and interrupting the convos or activities of others.
Mild Intellectual Disability
IQ range of 55-69, focus is placed on the individual acquiring social and vocational skills to function independently in desired occupational roles, minimal support is required
Moderate Intellectual Disability
IQ range of 40-54, focus placed on the individual acquiring independence in routine daily skills and skills necessary to perform in desired occupational roles with supports and structures (sheltered workshop)
Limited A and support may be required in specific areas on a daily basis, but S living is required
Severe Intellectual Disability
IQ range from 25-39, focus is placed on the individual acquiring communication skills and some basic health habits, A required for performance of most tasks in all areas of occupation on a daily basis, S living is required
Motor function and physical development are typically impaired
Profound Intellectual Disability
IQ below 25, Motor function and physical development are typically impaired, A and ongoing S required for basic survival skills
Autism (other)
Prior to 3 years of age: delay or impairment in social interaction, language, or play, not better described as Rett’s or childhood integrative disorder, difficulty with sensory processing, unanticipated mood swings, temper tantrums, lack of ability to focus, insomnia, and bed-wetting (enuresis), deficits tend to be more severe in verbal sequencing and abstraction vs abilities in visuospatial and rote memory skills (musical or calculation abilities)
Allen Cognitive level stitches
Running stitch - level 2
(then 2 running stitches, level 3)
whip stitch - level 4
single cordovan stitch with trial and error - level 5
single cordovan stitch with deductive reasoning - level 6
Level 1: automatic reactions
cog disabilties
Individual: Impaired awareness but conscious and has reflexive responses. Able to perform only very basic habits (eating, drinking)
Therapist: Use 1 word commands, provide familiar cues
Level 2: postural actions
cog disabilities
Individual: Aware of movements of their own muscles and joints, watches movements of others, seeks pleasurable or comfortable movements, may be resistive or easily agitated
Therapist: Imitate actions while providing simple verbal commands: focus is on GM movements
Level 3: manual actions
cog disabilities
Individual: Able to attend to the external environment, particularly tactile cues. Can use hands to manipulate materials. May include seemingly purposeless actions - easily distracted
Therapist: Imitate manipulation of objects - brushing teeth; provide repetitive practice of routine tasks, use manually guided instruction
Level 4: Goal directed actions
cog disabilities
Individual: Can respond to visual motor cues, attention is directed toward 1 cue at a time. Actions are more goal directed, can attend to a 1 hour group
Therapist: Provide visual demonstration, limit instruction to 1 step at a time. Make all objects clearly visible and provide visual comparisons
Level 5: exploratory actions
cog disabilities
Individual: Concrete relations are understood, has trouble with abstraction, uses exploratory actions. Trial and error problem solving; does not anticipate problems
Therapist: Accompany visual demonstration with verbal explanation. Select or modify tasks to reduce problem solving requirements. Use concrete explanations and examples - assist with planning ahead
Level 6: planned actions
cog disabilities
Individual: Can make sense of symbolic cues and abstraction, can plan ahead and anticipates errors; engages in mental problem solving
Therapist: Use verbal and written instruction, diagrams and drawings. Can carry out instructions from previous sessions.
