Child and Adolescent Disorder Flashcards
What is resiliency
What influences it?
How well a person gets back up/bounce back from a situation.
Influence: positive factors and experiences
Developmental assessment
growth and development chart, noticing any abnormalities
Mental status assessment
depression and anxiety. Withdrawn
Denver II developmental screening test
look at developmental issues. Looking at kids in specific ages and the norms for their age.
Definition of Attention Deficit Hyperactivity Disorder
Pattern of inattention, memory deficits, learning, speech, and hearing disabilities. not recognized until child enters school
Types of ADHD
Combined presentation, predominantly inattentive presentation,
predominantly hyperactive/impulsive presentation
Biological influences for ADHD
Genetics
Biochemical: neurotransmitters
Anatomical changes: < volume and activity in prefrontal cortex
Prenatal, perinatal, and postnatal factors that influence ADHD
maternal smoking, intrauterine exposure to toxic substances, fetal alcohol syndrome, maternal infections. Low birth weight, trauma, early infancy infections, or other insults to the brain, maternal hypertension, prematurity
Environmental influences of ADHD
elevated serum levels of lead, food dyes, and additives, preservatives, and sugar
Psychosocial influences of ADHD
disorganized or chaotic environments, young maternal age at birth, paternal history of antisocial behavior, and maternal depression
S&S of ADHD
impulsive, hyperactive, functional impairments, restlessness, disorganization, insomnia
Treatment of ADHD
Utilize parents and child therapy, school interventions, and medications
Medications for ADHD
CNS stimulants: dextroamphetamine (addictive) , methylphenidate
Nursing interventions for ADHD
Encourage self-worth, allowing breaks during classes
Definition of oppositional defiant disorder
Persistent pattern of angry mood and defiant behavior & interferes with social, education, and occupational of functioning
Biological influences of ODD
Temperament
Family influences of ODD
Power struggle between parent and child
Hx of abuse, neglect, or other traumas
How is someone diagnosed with ODD
has to happen outside of the family unit
S&S of ODD
fighting siblings, running away from home a lot, disrespectful for adults. Passive-aggressive behaviors: stubbornness, procrastination, disobedience, negativism
Viewpoint of someone with ODD
Do not see themselves as being oppositional but view the problems as arising from others whom they believe are making unreasonable demands on them. Perceive human relationships as negative and unsatisfactory
Nursing interventions of ODD
Encourage feelings of self-worth, take responsibility for actions, encourage cooperation with family, assist with the develop of socially appropriate behaviors, setup structures and boundaries
Understand that there are consequences to their behaviors
Definition of 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
Biological influences of conduct disorder
Biological influences: genetics, irritable temperament, poor compliance, inattentiveness, and impulsivity, unstable families.
Psychosocial influences of CD
poor academic performance and social maladaptation, engaging in risk-taking behaviors
Family influences of CD
parental rejection, neglect, or severe physical and verbal aggression, parental sociopathy, inconsistent or harsh punitive discipline, lack of parental supervision, frequent changes in residence, economic stressors, parents with antisocial personality disorder, marital conflict and divorce
S&S of CD
engaging in fighting, bullying on crack, intimidating people and deliberately destroying property. Stealing, lying, and truancy. Low self esteem. low level of academic achievement
CD could lead to
Antisocial personality disorder, mood disorders, learning disabilities, substance abuse, participation in sexual activities
Nursing interventions of CD
Develop empathy
Definition of Autism spectrum disorder
Withdrawal of the child into the self and into a fantasy world of his or her own creation. Abnormal or impaired dev. in social interaction and communication and restricted activity and interests
Level 1 of autism
high functioning. Require some organizational social deficits. Trouble bonding with other children. Speech and language is normal. No social skills
Level 2 of autism
Social impairments. Repetitive behavior. Some language and speech barriers
Level 3 of autism
Severe language and speech barriers. Might not be even verbal, repetitive behavior
Prenatal and perinatal influences of autism
Advanced parental age, fetal exposure to valproate, gestational diabetes, and gestational bleeding
Low birth weight, obstetrical complications, hyperbilirubinemia, congenital malformation, exposure to environmental toxins
Neurological implications of autism
Enlarged size of amygdala, striatum and total brain volume
S&S of autism
Impairment in social interaction
Show little interest in people and often do not respond to others
Aversion to affection and physical contact
Lack of spontaneity manifested in less cooperative play, less imaginative play, and fewer friendships
Inability to accurately process others’ feelings or affect
S&S of autism
Impairment in communication and imaginative activity
Verbal: absent or immature structure or idiosyncratic utterances
Nonverbal: Absent facial expressions or gestures
Overreact to sound or other stimuli
Play is restricted and repetitive
S&S of autism
restricted activities and interests
Attachment or extreme fascination with objects that move or spin, stereotype body movements and verbalizations, only eating specific foods, self-injurious behavior
Treatment of autism
yearly checkups, CBT, early intervention program,
Medications of autism
Goal
antipsychotic, SSRI/beta blocker
relief of targeted irritability symptoms: aggression
Definition of intellectual disability
Intellectual and adaptive functioning deficits in conceptual, social, and practical domains.D
Diagnosis of intellectual disability
IQ tests. Presence of deficits in intellectual and adaptive domains
Genetic factors of intellectual disability
inborn errors of metabolism, chromosomal disorders, single-gene abnormalities
Pregnancy and perinatal factors of intellectual disability
fetal malnutrition, prematurity, trauma to the head during process of birth
maternal ingestion of alcohol, maternal illnesses and infections during pregnancy, complications of pregnancy
General medical conditions acquired in infancy or childhood that causes intellectual disability
meningitis and encephalitis, poisonings, physical trauma
Sociocultural factors and other mental disorders that cause intellectual disorder
deprivation of nurturance and social stimulation and to impoverished environment
Levels of Intellectual disability
Mild 50-70
Moderate 35-49
Severe 20-34
Profound < 20
ADL capabilities of Intellectual disability
Mild: independent
Moderate: perform some activities independently
Severe: Elementary hygiene skills. Require supervision
Profound: Require aid & supervision. ADL inability
Cognitive/educational capabilities Intellectual disability
Mild: 6th grade level
Moderate: 2nd grade level
Severe: Unable to benefit
Profound: Understand if one-to-one relationship, may respond
Social/Communication capabilities Intellectual disability
Mild: Dev. social skills
Moderate: Some limitations in speech. Difficulty adhering to social convention
Severe: minimal verbal skills, acting-out behavior
Profound: little. no capacity for socialization
Psychomotor capabilities
Intellectual disability
Mild: not affected, problems with coordination
Moderate: Fair, unskilled gross motor
Severe: poor psychomotor dev. Able to only perform simple tasks
Profound: lack of ability for fine or gross motor
Treatment of Intellectual disability
physical therapy, ot, speech therapy, counseling, no meds
Definition of Tourette’s disorder
Presence of multiple motor tics and one or more vocal tics, which may appear simultaneously or a t different periods during the illness. May cause distress or interfere with social, occupational, or other important areas of functioning
Causes/Risk factors of Tourette
Genetics: ADHD and OCD
Biochemical factors: abnormalities in dopamine and norepinephrine
Structural factors: abnormalities in frontal lobes
Environmental factors of Tourette’s disorder
Maternal alcohol use, low birth weight, complications during childbirth, and infection
Vocal tics of Tourette’s disorder
Squeaks, grunts, barks, sniffs, snorts, coughs, and uttering of obscenities
Palilalia, echolalia, repeating certain words or phrases out of context
Simple motor tics
neck jerking, shoulder shrugging, and facial grimacing
Complex motor tics
squatting, hopping, skipping, tapping, and retracing steps
S&S of Tourette’s disorder
Motor tics
Vocal tics
Difficulties with reading, writing , and arithmetic
Treatment of Tourette’s disorder
Anti psychotics: control of tics and vocal utterances. EPS symptoms
Atypical anti psychotics: less side effects
Alpha agonist: anithypertensive agents
Behavioral therapy
Positive reinforcement encourage repetition of desirable behaviors, and aversive reinforcements discourage repetition of undesirable behaviors
Family therapy
Parents should be involved in designing and implementing treatment plan and involved in all aspects of treatment
Group therapy
Provides children and adolescents opportunity to interact with peers of similarity
Psychopharmacology
Used in conjunction with therapy
