cognitive impairment Flashcards
general nc
identify, develop and implement IEP and work with school system, educate child and fam, promote optimum dev, promote independent self help skills
identifying CI
dysmorphic features, irritability or non responsiveness to contact, abnormal eye contact during feeding, gross motor delay, decreased alertness to voice or movement, lang difficulties or delay, feeding difficulties
educate family
difficulty discriminating between 2+ stimuli, short term mem, motivation, technology, early intervention programs
promote optimum dev
communicate, discipline, socialization, sexuality, play and exercise
consistency!
promote independent self help skills
feeding, toileting, dressing, grooming
break down skills step by step
down syndrome nc
support fam, assist in preventing physical problems, promote dev progress, assist with genetic counseling
ASD nc
therapy from multiple sources
positive reinforcement, increase social awareness, tech verbal communication skills, decrease unacceptable behavior
STRUCTURED ROUTINE
use communication tools - charts, ipads, etc
show skills on trusted object or person in patient’s env, may not understand body lang, facial expression, vocal tone but simple non verbal communication is helpful (pointing); dim lighting, few people, ask parent how child communicates, use few words, no figures of speech, concrete wording
adhd tm
1st line (4-5 yr): behavior and psychotherapy
pharm therapy: psychostimulants - methylphenidate, others - tricyclic antidepressants
ADHD - med considerations
stimulant SE: weight loss, abd pain, decreased appetite, sleeplessness, HA, growth velocity
usually at bfast and noon, immediate release on empty stomach, avoid caffeine, insulin may nee adjust, no drug holidays, freq eval effectiveness
see every 6 mo to monitor SE
ADHD nc
focus on strengths not weaknesses
env: consistency, organizational charts, decrease distractions during
maybe modify school - IEP, testing
monitor SE
down syndrome cm - physical
inner epicanthal folds, depressed nasal bridge, small nose (stuffy, hard time expectorating, high risk of resp infection, humidifier, blow nose, suction), excess/lose skin on back of neck, atlantoaxial instability, high arched palate, large protruding tongue (feeding difficulties), simian crease, decreased muscle tone (excess neck support, swaddle, thermoregulation), wide space between big and 2nd toe (wider stance so fall risk)
down syndrome cm - cognitive
lower intelligence, social dev delay, cognitive anomalies, sensory problems, height and weight reduced bu weight is high for height (obese), sex dev often delayed
down syndrome complications
feeding difficulties, obesity, constipation, congenital heart defects, acute otitis media, leukemia, hypothyroidism, upper resp infections
asd cm
not vaccines
social interactions: abnormal eye contact, failure to smile, orient to name; lack of imitation, interactive play, gesture use or joint attentiveness (point/wave)
communication: absent to delayed speech, atypical lang - hum or grunt for extended periods, laugh inappropriately, use of echolalia
behavior: repetitive, impulsive, restrictive, obsessive; rock, flap hands, head nod, spin, twirl, difficulty with change, self injury (bite, band head, pick at skin), fixate on spinning object
asd associated illnesses
GI, epilepsy, feeding, disrupted sleep, ADHD, anx, depression, OCD, schizophrenia, bipolar
