Childhood Disorders Flashcards
- intellectual abilities significantly below average (less than 70)
- significant difficulty with cognitive, social, or self-care skills
intellectual disability
four classes of intellectual disability severity
mild, moderate, severe, and profound
epidemiology of intellectual disability
appx 1% of the population
etiology of intellectual disability
- exposure to toxins in utero (alcohol)
- maternal illness & infection (rubella)
- genetic conditions (Down’s syndrome)
- birth complications (umbilical cord wrapped around neck)
- exposure to toxins in childhood (lead poisoning)
- physical trauma in childhood (shaken baby syndrome)
nursing interventions for intellectual disabilities
- maintain a safe environment
- promote as much autonomy in self-care as possible
- when teaching self-care: Use simple, concrete speech. Focus on one learning need at a time. Teach one step at a time. Give positive reinforcements
- Try to learn nonverbal signs of client becoming upset & respond early
- Seek guidance from caregivers re: client’s nonverbal & idiosyncratic communication patterns
*“self”-ism - locked in their own world
autism spectrum disorder
the understanding that other people’s thoughts & feelings can be different from their own
theory of mind
characteristics of autism spectrum disorder
- little interest in others; rarely make eye contact; disliked being touched
- less likely to engage in imaginative play
- poor “theory of mind”
- may have impaired language skills and trouble interpreting nonverbal communication
- may have odd, repetitive behaviors
- many rigidly adhere to routines and become upset with changes
- may develop an intense fascination in unusual topics
- some are hypersensitive to sensory input; others seem indifferent to pain or temperature
- within the autism spectrum
- without the language impairment
- old term; this diagnosis is no longer used
- now classified as a mild form of autism
asperger’s disorder
epidemiology of autism spectrum disorder
- appx 2.5% in the US
- 4x more common in boys
- recent increase probably due to changes in diagnostic criteria and increased public awareness
etiology of autism spectrum disorder
effective treatments for autism spectrum disorder
pharmacotherapy for autism spectrum disorder
nursing interventions for autism spectrum disorder
- a combination of hyperactivity, impulsivity, inattention (present in varying degrees)
- behaviors present in multiple settings
- behaviors exceed normal childhood immaturity, causing significant impairment
attention-deficit/hyperactivity disorder (ADHD)
hyperactive-impulsive presentation of ADHD
inattentive presentation of ADHD
adult ADHD
epidemiology of ADHD
etiology of ADHD - biological
etiology of ADHD - environmental
effective treatments for ADHD
nursing interventions for ADHD
disorder that presents with multiple motor tics and at least one vocal tic, present for more than one year
tourette’s disorder
examples of common motor tics
blinking, shrugging, grimacing, head jerking
examples of common vocal tics
noises, grunting, coughing, obscene words (coprolalia), and repeating oneself (palilalia)
epidemiology of Tourette’s disorder
0.5% in the United States 4x more common in males average age of onset: 6 years usually declines as clients age comorbidity (ADHD, OCD, ODD) is common
etiology of Tourette’s disorder
exact etiology is unknown
combination of genetic, neuroanatomical, environmental, and social factors
effective treatments for Tourette’s disorder - psychotherapy
behavioral technique - Habit Reversal Training
teaches clients to recognize signs that a tic is about to occur; client learns to perform a voluntary movement that is incompatible with a particular tic
effective treatments for Tourette’s disorder - pharmacotherapy
nursing interventions for Tourette’s disorder
disorder in which clients demonstrate unusually high levels of anger and opposition to rules and authority figures; symptoms are present for greater than six months
oppositional defiant disorder
additional characteristics of oppositional defiant disorder (ODD)
- persistent state of annoyance
- spiteful and argumentative
- every mistake they make is someone else’s fault
- can be a precursor to conduct disorder
disorder in which clients are physically and verbally aggressive; more severe than/progression of ODD; present for at least 6 months
conduct disorder
additional characteristics of conduct disorder
- little regard for laws or the rights and feelings of others
- misbehaviors include destruction of other people’s property, lying, and theft
- they get into serious trouble at school and usually have encounters with the justice system
- can develop into Antisocial Personality Disorder in adults
epidemiology of oppositional defiant disorder
estimated between 2%-16%
much more common in males before puberty
after puberty, rates are roughly equal
epidemiology of conduct disorder
prevalence estimated to be 2%-10%
more common in males
etiology of ODD/CD - psychosocial factors
Ineffective parenting patterns:
- authoritarian parenting styles
- parental rejection
- lack of supervision
- inconsistent or harsh punishments
- affiliation with peers that teach/encourage delinquent behaviors
etiology of ODD/CD - biological factors
genetics likely play a role; precise mechanism is unknown
effective treatments for ODD/CD - psychotherapy
effective treatments for ODD/CD - pharmacotherapy
nursing interventions for ODD/CD
