Chapter 33: Childhood & Adolescence Flashcards
*****Intellectual Developmental Disorders
Intellectual Disability
(IDD/ID)
Diagnosed through clinical assessment of behaviors, history, and performance on standardized tests.
Significantly below-average intelligence accompanied by impaired adaptive functioning.
The degree of severity is identified by IQ level
1 mild
2 moderate
3 severe
4 profound
Autism Spectrum Disorder (ASD)
A disorder that is characterized by impairment in social interaction skills and interpersonal communication and a restricted repertoire of activities and interests
Hyperactivity
Excessive psychomotor activity that may be purposeful or aimless, accompanied by physical movements and verbal utterances that are usually more rapid than normal. Inattention and distractibility are common with hyperactive behavior.
Impulsiveness
The trait of acting without reflection and without thought to the consequences of the behavior. An abrupt inclination to act (and the inability to resist acting) on certain behavioral urges.
Temperament
Personality characteristics that define an individual’s mood and behavioral tendencies. The sum of physical, emotional, and intellectual components that affect or determine a person’s actions and reactions.
attention-deficit/hyperactivity disorder (ADHD)
May exhibit symptoms of inattention or hyperactivity and impulsiveness or a combination of the two.
Genetics plays a role in the etiology.
Neurotransmitters that have been implicated include dopamine, norepinephrine, and serotonin.
Maternal smoking during pregnancy has been linked to hyperactive behavior in offspring.
CNS stimulants, alpha agonists, atomoxetine, and bupropion are commonly used for treatment.
Tourette’s disorder
The presence of multiple motor tics and one or more vocal tics.
Common medications used include haloperidol, pimozide, clonidine, guanfacine, and atypical antipsychotics such as risperidone, olanzapine, and ziprasidone.
Oppositional defiant disorder
Characterized by a pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures that occurs more frequently than is usually observed in individuals of comparable age and developmental level.
Conduct disorder
Repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated.
Separation anxiety disorder
Excessive anxiety concerning separation from the home or from those to whom the person is attached.
May have temperamental characteristics present at birth that predispose them to the disorder.
Therapeutic approaches for kids
Behavior therapy, family therapy, group therapies (including music, art, crafts, play, and psychoeducation), and psychopharmacology.
In an effort to help the child with mild to moderate intellectual developmental disorder develop satisfying relationships with others, what nursing interventions is appropriate?
Set limits on behavior that is socially inappropriate.
What group is commonly used for drug management of the child with ADHD?
CNS stimulants (e.g., methylphenidate [Ritalin])
What medications is used to treat Tourette’s disorder?
Haloperidol (Haldol)
General intellectual functioning
measured by a person’s performance on IQ tests.
Adaptive functioning
refers to the person’s ability to adapt to requirements of activities of daily living and the expectations of his or her age and cultural group
Five major predisposing factors to IDD
- Hereditary factors
- Early changes in embryonic development
- Pregnancy and perinatal factors
- General medical conditions acquired in infancy or childhood
- Environmental influences and other mental disorders
*****Assessment IDD
- Assess and focus on each client’s strengths and individual abilities.
- Knowledge regarding level of independence in the performance of self-care activities is essential to the development of an adequate plan for the provision of nursing care.
*****emotional problem
exists if behavioral manifestations:
- Are not age appropriate
- Deviate from cultural norms
- Create deficits or impairments in adaptive functioning
*****Autistic Disorder / Autism Spectrum Disorder
-Early onset: before 30 months
-Disturbance in social relations
-Clinical symptoms
Withdrawal into self and fantasy world
Abnormal development in social interaction and communication
Restricted activity and interests.
Delayed language, or concrete thinking
Pronoun reversals and abnormal intonation
*****Stereotypical Autistic behavior
Repetitive rocking
Hand flapping
Insistence on sameness
Self-injurious behavior
ADHD
- Inattention
- Hyperactivity
- Impulsiveness that is pervasive and inappropriate for developmental level
- 6% of school-aged children
- Boys more affected than girls
*****ADHD Assessment
- Difficulties in performing age-appropriate tasks
- Highly distractible
- Extremely limited attention spans
- Impulsivity
- Have difficulty forming satisfactory interpersonal relationships
- Demonstrate behaviors that inhibit acceptable social interaction
- Disruptive and intrusive in group endeavors
- “Perpetual motion machines”
- Accident prone
*****ADHA Implementation
- Educating the family about treatment and behavioral strategies
- Helping families cope
- Managing developmental and academic issues
- Teaching social skills
- Improving self-esteem
