Childhood and Neurodevelopmental Disroders Flashcards
what are the general principles of child interventions?
behavioral interventions- reward positive
play therapy- best way to express something
family interventions
CBT/group therapy
disruptive behavior management- principal of least restrictive intervention
what are some aspects within the disruptive behavior management?
time out
quiet room
therapeutic hold
last resort would be seclusion/restraint
what is self-reflection and self-control?
time-out
what is unlocked room with less stimulation?
quiet room/sensory room
what are the top early signs of autism?
not babbling
no more than one word by 16 months
echolalia
inappropriate in laughing or giggling
difficulty in mixing with other kids
no eye following
no eye contact
spin objects
not wanting to be touched
does not smile when smiled at
what is autism spectrum disorder?
deficits in social communication and interaction
before age 3
what are the deficits in social communication and interaction with those with autism spectrum disorder?
no back and forth reciprocity
verbal and nonverbal abnormalities- may not understand when people are uncomfortable
relationship deficits
what are the stereotypical restricted/repetitive behaviors for those with autism spectrum disorder?
motor movements/speech- echolalia
insistence on sameness- rigid- over adherence to routines or rituals
fixated interests
hyporeactivity or hyperreactivity to sensory input- overstimulated easily
which gender has the higher diagnosis for autism spectrum disroder?
males
what are the risk factors for autism spectrum disroder?
exact cause unknown
genetic abnormality leading to altered neurologic development
having a sibling with autism spectrum disorder
having older parents
having certain genetic conditions- people with conditions such as Down syndrome, fragile X syndrome, and Rett syndrome are more likely than others to have autism spectrum disorder
very low birth weight
what are the assessment for the autism spectrum disorder?
well child visit- assess for developmental delays; if screening is abnormal- refer to neuropsychologist
communication skills
parent-child bonding
abuse- screening
what are some nursing diagnosis for autism spectrum disorder?
impaired social interaction
activity intolerance
ineffective impulse control
risk for self-mutilation
impaired verbal communication
what are some interventions for autism spectrum disorder?
therapeutic programs
reward systems- shape and modify behavior
structure/consistency in rules at home and school
physical, occupational, and speech therapy- can be done at home, in school, or after school activities
what are simple strategies for communication with those with autism spectrum disorder?
use interests
prepare for what’s coming up
use visuals
provide time
speak simply and clearly
can utilize iPads with specific apps to help communicate
what is recommend for short term treatment of aggressive behaviors such as temper tantrums/self injurious behaviors?
pharmacological intervention in those with autism spectrum disorder
what are the pharmacological interventions for those with autism spectrum disorder?
risperidone (Risperdal)
aripiprazole (Abilify)
SSRIs
stimulantsw
what medication should be taken after age 5 and older for autism?
risperidone
what medication should be taken after age 6 and older for autism?
aripiprazole
what medication are paradoxical/have opposite effect in children?
stimulants
what are attention-deficit hyperactivity disorder (ADHD)?
in appropriate degree of inattention, impulsiveness, and hyperactivity
what is the criteria age for ADHD?
before age 12 and last at least 6 months
what are the inattention criteria for ADHD?
fails to pay close attention/careless mistakes
difficulty sustaining attention in task
does not listen, even when spoke directly to
no follow through
difficulty organizing tasks- poor time management
lose things- frequently/forgetful
easily distracted by external stimuli
what are the hyperactivity and impulsivity criteria for ADHD?
often fidgets- hands, feet, tapping
leaves seat in situations where they are expected to remain sitting
unable to play quietly
often “on the go” or “driven by motor”
talks excessively/interrupts others/blurts out answers
difficult to wait their turn
what are the risks factors for ADHD?
genetic link- parent, siblings, concordant twin studies
increased dopamine/norepinephrine, and serotonin
lead
diet/dye- studies refuted too much sugar leads to it
psychosocial- chaotic environment- helps to rule it out
what is part of the assessment of ADHD?
gather data from parents, teachers, or other adults
social skills, friendships, problem-solving skills and school performance
data on eating and sleeping
depression/anxiety/learning disorders
what are some nursing diagnosis for ADHD?
risk of injury due to impulsivity and not understanding danger
ineffective impulse control
impaired social interaction
situational low self-esteem
what are the nursing and psychosocial interventions for ADHD?
CBT
manage disruptive behaviors
unconditional positive regard- reward positive behavior
safety
what are the psychopharmacology interventions for ADHD?
stimulants
nonstimulants
antidepressants
what are stimulants for ADHD?
amphetamine- lisdexamfetamine (Vyvanse)
amphetamine mixtures- dextromamphetamine (Adderall)
methylphenidate (Ritalin)
what are nonstimulants for ADHD?
atomoxetine (Strattera)
clonidine (Kapvay)
guanfacine (Intuniv)
what are antidepressants for ADHD?
bupropion (wellbutrin)
desipramine (norpramin)
notriptyline (Pamelor)
imipramine (Tofranil)
what are the antipsychotics for ADHD?
divalproex (Depakote)
what are the evaluation for ADHD?
educate patient/family to monitor patient for side effects:
insomnia
anorexia
upset stomach
prevent tolerance- supervised drug holiday
what is oppositional defiant disorder?
angry and irritable mood
defiant- argumentative
vindictive behavior- spiteful
social issues/conflicts with authority figures/academic issues
passive aggressive behavior
see others as making unreasonable demands
does recognize others have rights and there are rules
all of above to point where impairs life, makes difficult to attend school, have friends, function in a family
