Developmental Disorders Part 2 Flashcards
Intellectual disabilities are?
Type of developmental disability that must occur before the age of 18 and be characterized by significant subaverage general intellectual function and limitations in adaptive functioning
What percentage of the general population have intellectual disabilities?
2.5-3%
When do intellectual disabilities begin?
18 years or younger
What is the IQ score range for someone with an intellectual disability?
70-75
What are the severities of ID?
Mild, moderate, severe, profound
What percentage of individuals with ID have mild ID?
80%
What is the IQ level of someone with mild ID?
50-75
What percentage of individuals with ID have moderate ID?
10%
What is the IQ level of someone with moderate ID?
35-55
What percentage of individuals with ID have severe ID?
3-4%
What is the IQ level of someone with severe ID?
20-40
What percentage of individuals with ID have profound ID?
1-2%
What is the IQ level of someone with profound ID?
20-25
Etiology of ID
Genetic Conditions:
Down syndrome, Fragile X syndrome, and other chromosomal abnormalities
Prenatal Factors:
Maternal infections, substance abuse during pregnancy, and exposure to
toxins
Perinatal Factors:
Complications during labor and delivery, such as oxygen deprivation
Postnatal Factors:
Infections, head injuries, or severe malnutrition during early childhood
Oral manifestations observed in patients
with ID
- Self-biting
- Bruxism
- Thick, flaccid lips
- Microdontia
- Malocclusion
- Delayed tooth eruption
- Dental attrition and sensitivity
- TMJ disorder
- Periodontal Disease
- Heavy plaque accumulation
Health-related characteristics of ID
- Less physical stamina
- Delayed physical development
- Speech
- Poor motor control
- Poor vision
- Poor hearing
- Overweight/underweight
Mental and motor ability characteristics of ID
- Short memories
- Inability to concentrate or see differences
or likeness - Limited speech
- Lack of organized skills
Social and emotional ability characteristics of ID
- Imitate others
- Aggressiveness towards others
- Property destruction
- Self injury
Self-injurious behavior (SIB) characteristics of ID
- Head-banging
- Self-biting
- Bruxism
Visual, hearing, and speech disabilities occurring in those ages 15 + statistics
- 6 mil sight difficulties
- 6.8 mil hearing difficulties
- 2.1 mil speech difficulties
Visual disabilities can range from?
partial sight to total blindness
Common causes of visual disabilities include?
- cataracts
- glaucoma
- macular degeneration
- diabetic retinopathy
How many people worldwide have vision problems?
285 mil
What are treatments for visual impairments?
- Corrective lenses (glasses or contacts)
- Surgery (cataract surgery or corneal
transplants) - Low vision aids (assistive technology)
- Orientation and mobility training
Hearing disabilities can vary from?
mild hearing loss to profound deafness
Causes of hearing impairment include
age-related hearing loss, exposure to loud
noises, infections, and genetic factors
How many people worldwide experience hearing loss?
Over 466 million
Treatment for hearing loss includes?
- Hearing aids
- Cochlear implants
- Speech therapy
- Sign language
Speech disabilities include?
- Difficulties with articulation, fluency, or
voice quality - Conditions like stuttering, dysarthria, and
aphasia
When are speech disabilities often identified?
Early childhood
Treatment for speech disabilities include?
- Speech therapy
- Augmentative and alternative
communications (comm. boards or apps) - Behavioral therapy
- Medical intervention (Botulinum toxin
injections are used to treat spasmodic
dysphonia (voice box spasms) by
temporarily paralyzing the
affected muscles)
Learning disabilities
neurological disorders that
affect the brain’s ability to receive,
process, store, and respond to
information
Many people with LD have above average intelligence, true or false?
True
What percentage of the population is affected by LD?
5-15%
Psychiatric disorders
mental health disorders, encompass
a wide range of conditions that affect mood, thinking, and behavior
Statistically how many people are affected by mental illness annually?
1 in 5 adults
Symptoms of a psychiatric disorder may include?
- Changes in mood (e.g., persistent sadness
or irritability) - Altered thinking (e.g., paranoia or
distorted reality) - Changes in behavior (e.g., withdrawal or
changes in sleep and appetite) - Difficulty concentrating or making
decisions - Increased anxiety or fear responses
Treatment of psychiatric disorders include?
- Psychotherapy (cognitive behavior therapy, dialect behavior therapy, exposure therapy)
- Medications (antidepressants, antipsychotics, mood stabilizers)
- Support groups
- Psychoeducation
- Crisis support
Cognitive Behavioral Therapy (CBT)
Focuses on changing negative thought patterns and behaviors
Dialectical Behavior Therapy (DBT)
Often used for borderline personality disorder; combines cognitive-behavioral techniques with mindfulness
Exposure Therapy
Particularly effective for anxiety disorders and PTSD
Spinal Bifida
Congenital condition that occurs when
the spinal column doesn’t close completely around the spinal cord during early fetal development
Most common
permanently disabling
birth defect in the U.S. is?
Spinal Bifida
Spina Bifida Occulta
The mildest form, where there’s a small defect in the spine that often goes unnoticed. It may cause no symptoms or only minor issues (15-20% of people)
Meningocele
Involves a sac of fluid that protrudes through the opening in the spine, but
the spinal cord remains in place. This may require surgery
Myelomeningocele
The most severe form,
where both the spinal cord and nerves protrude through the opening. Causes neurological impairment and requires surgical intervention
Symptoms of spinal bifida are?
- Physical disabilities (varying
levels of mobility) - Bladder and bowel issues
- Learning difficulties
- Hydrocephalus (accumulation
of fluid in the brain)
Etiology of spinal bifida
- Genetic factors
- Nutritional deficiencies
- Maternal health
- Environmental factors
Genetic factors in spinal bifida
A family history of neural tube
defects
Nutritional deficiencies in spinal bifida
Lack of folic acid during pregnancy
Maternal health factors in spinal bifida
- Conditions like diabetes or
obesity can increase risk - High temperatures in early pregnancy (i.e.,
prolonged fevers and hot tub use)
Environmental factors in spinal bifida
- Certain medications
(antipsychotics) and exposure to harmful
substances - Previous NTD (neural tube defect) -
affected pregnancy increases a woman’ s
chance to have another NTD-affected
pregnancy by approximately 20 times
Treatment for spinal bifida
- Surgery
- Rehabilitation
- Supportive care
Fetal alcohol syndrome
Condition resulting from alcohol exposure during pregnancy. It is part of a spectrum of disorders known as Fetal Alcohol Spectrum Disorders (FASDs), which can lead to a range of physical, behavioral, and cognitive issues in the affected child
How many infants are affected by FAS each year?
40k
What is the 3rd most common intellectual disability worldwide
FAS
Seen on every part of the body, including brain, face, eyes, ears, heart, kidneys, and bones
FAS
FAS symptoms
- Distinctive facial features, including small
eyes, an exceptionally thin upper lip, a
short, upturned nose, and a smooth skin
surface between the nose and upper lip - Heart defects
- Deformities of joints, limbs, and fingers
- Slow physical growth before and after
birth - Vision difficulties or hearing problems
- Small head circumference and brain size
- Poor coordination
- Sleep problems
- Intellectual disability and delayed
development - Learning disorders
- Abnormal behavior, such as a short
attention span, hyperactivity, poor
impulse control, extreme nervousness,
and anxiety
Epilepsy
Seizure disorder in which the excessive abnormal neuronal discharges from cerebral functions disturbances are recurrent. The specific underlying brain dysfunction causing the seizure disorder can be identified only in approx. half of childhood-onset and adult-onset seizures
Statistics of those who have epilepsy
3.4 million people in the U.S., and over 65 million people worldwide
Tonic-Clonic Seizures (grand-mal)
Most common
- Several Phases:
- Aura: occurs hours to days before seizure
- Tonic: body stiffness
- Clonic: Convulsions
- Loss of bladder
Absence (Petit Mal) Seizures
Familial
- Occur exclusively in childhood (3-12yrs)
- Seizure consists of brief (10-30 seconds)
altered states
of consciousness
- Vacant stare/Eyelid blinking/ Lip smacking
- Child has no recollection of seizure and
goes back to normal
Status Epilepticus
- Defined as a single seizure lasting for at least 30 minutes OR recurrent generalized seizures without regaining of consciousness between the seizure episodes
*** Life- threatening medical emergency that can lead to irreversible neurologic damage and requires prompt intensive therapy
Seizure causes
- Genetic: Inborn errors of metabolism
- Congenital abnormalities: Maldevelopment of brain
- Perinatal: Anoxia, ischemia, hemorrhage
- Central nervous system infections: Encephalitis, meningitis, abscess
Trauma: Penetrating wound, closed-head injury, surgery - Neoplastic: Primary gliomas, metastatic
- Vascular: Infarction, hemorrhage, arteriovenous malformations
- Toxic: Alcohol or cocaine use, alcohol and sedative drug withdrawal
- Metabolic: Hypoglycemia, hypocalcemia, high fever
- Degenerative: Alzheimer disease, Creutzfeldt- Jakob disease
What classification of ASA is someone who has seizures?
IV
NO2 should not be used in patients who experience what?
Seizures, it can invoke them
Alzheimer’s disease
Brain degenerative disorder that gradually destroys the ability to remember,
reason, learn and imagine
What is the most common type of dementia?
AD
What is the 6th leading cause of death in the US?
AD
How long from the first onset of symptoms of AD does someone usually have to live?
8 years
What are some medication treatments to slow the progression of AD?
Acetylcholine drugs are used to improve cognition. Their effects are not permanent
CVA/stroke
occurs when blood flow to a
part of the brain is interrupted or
reduced, depriving brain tissue of
oxygen and nutrients. When brain cells
are deprived of oxygen, they begin to die
within minutes, potentially leading to
long-term neurological impairments or
death if not treated swiftly
What is the major cause of serious, long-
term disabilities in adults
CVA
Ischemic Stroke
This is the most
common type, accounting for about
87% of all strokes. It occurs when a
blood clot blocks or narrows an
artery leading to the brain, often
due to atherosclerosis (buildup of
plaque in the arteries)
Hemorrhagic Stroke
This type results from hemorrhage or rupture of a brain vessel, which causes
leakage of blood into the brain
tissue, the ventricles, or the space
between the brain and skull
Transient Ischemic Attack
(TIA)
Often called a “mini-stroke,” a
TIA occurs when blood flow to the
brain is briefly interrupted. While
symptoms may resolve within
minutes, a TIA is a serious warning
sign of a potential future stroke.
Followed by a complete clinical
recovery
Symptoms of a stroke
- Weakness or numbness, often on one
side of the body (face, arm, or leg) - Difficulty speaking or understanding
speech - Vision problems in one or both eyes
- Severe headache, sometimes
accompanied by vomiting or dizziness - Difficulty with balance or coordination
What does FAST stand for?
Face drooping
Arm weakness
Speech difficulties
Time to call
The side of the face and body affected by stroke is opposite that of the brain injury, true or false?
True, because the sensory and motor neurons cross as they go to/from the cerebral cortex
RIGHT SIDE BRAIN DAMAGE
- Paralyzed left side
- Spatial or perceptual deficits
- Impaired thought process
- Quick, impulsive behavior
- Patient cannot use a mirror
- Difficulty preforming tasks: ex. Toothbrushing
- Memory deficits
- Neglect of left side
LEFT SIDE BRAIN DAMAGE
- Paralyzed right side
- Language and speech problems
- Decreased auditory memory
- Can’t remember long instructions
- Slow, cautious, disorganized behavior
- Memory deficits- language based
- Anxiety
Treatment for ischemic stroke is?
Treatment typically includes clot-busting
drugs (thrombolytics) like tissue plasminogen activator (tPA),
which is most effective if given within the first 3-4.5 hours.
Treatment for hemorrhagic stroke is?
Treatment may involve surgery to
repair blood vessel damage, reduce pressure in the brain, or
stop bleeding.
Long-term management after stroke make include?
Rehabilitations and lifestyle modifications
After a CVA patients must wait 6 months for elective treatment, true or false?
True
Using the minimum amount of EPI in anesthetic for CVA patients is important because?
It can increase bleeding
Amyotrophic Lateral Sclerosis (ALS) aka Lou Gehrig’s disease
a progressive neurodegenerative
disorder that affects motor neurons in the brain and spinal cord. ALS
leads to muscle weakness, loss of voluntary movement, and ultimately
paralysis, as the brain loses its ability to initiate and control muscle
function. Although cognitive functions are typically preserved, ALS
severely impacts a person’s physical abilities over time
“Progressive Degeneration” refers to?
cell death of the motor neurons
(debilitates the brains ability to initiate and control muscle movements
Caucasian men are at a higher risk than women of any other ethnicity for ALS, true or false?
True
How does ALS work?
ALS specifically targets motor neurons, which are nerve cells responsible
for controlling muscle movement. As these neurons degenerate and die,
they stop sending signals to muscles, leading to atrophy (muscle wasting)
and weakness.
Types of ALS are?
Sporadic or familial
Sporadic ALS
The most common form, accounting
for 90-95% of cases. It occurs randomly without a clear family history
Familial ALS (FALS)
Occurs in about 5-10% of cases and is
inherited genetically. Several gene mutations, including those in the SOD1 and C9orf72 genes, are associated with
familial ALS
50% of familial ALS
individuals can produce
offspring with the gene
mutation and cause the
disease, true or false?
True
Sporadic ALS usually occurs in people 50-65 years of age, true or false?
True
Stages of ALS
Early, middle, late, end
Treatment to slow progression of ALS
Riluzole (Rilutek) is currently the
ONLY FDA approved medication
to slow the progression of ALS
Multiple Sclerosis
chronic autoimmune
disease that affects the central
nervous system, particularly the
brain and spinal cord. In MS, the
immune system mistakenly attacks
the protective sheath (myelin)
covering nerve fibers, causing
inflammation and damage that
disrupts communication between
the brain and the rest of the body
When does multiple sclerosis usually begin?
Early childhood with a mean age of 33
Who is primarily affected by multiple sclerosis?
Caucasian females
Multiple sclerosis is more common in what type of climate?
Cold climates with higher altitudes
Relapsing-Remitting MS (RRMS)
The most common form,
characterized by episodes of new or worsening symptoms
(relapses) followed by periods of partial or complete recovery
(remissions)
Primary-Progressive MS (PPMS)
Marked by a steady worsening of
symptoms without distinct relapses or remissions
Secondary-Progressive MS (SPMS)
Often follows RRMS, with
gradual progression over time and fewer or no relapses
Types of multiple sclerosis
Relapsing-remitting, primary-progressive, secondary progressive
Etiology of MS
Exact cause unknown, thought to be genetic and environment factors (smoking, obesity, location), or infections and immune system dysfunction (Epstein-Barr virus)
LA-DRB1 gene on
chromosome 6, have been strongly associated with what?
MS
Oral symptoms of MS
- TMJ pain
- Trigeminal neuralgia
- Loses muscle coordination
- Tongue and facial muscles interfere with
self-cleansing mechanisms in oral cavity - Oral hygiene becomes difficult
- Facial pain
- Xerostomia
- Gingival Enlargement
Parkinsons disease
Chronic progressive
neurodegenerative disorder
primarily affecting movement. It
occurs due to the gradual loss of
dopamine-producing neurons in
the substantia nigra, a part of the
brain that regulates movement
Etiology of Parkinsons
No cause for the
destruction of dopamine-
producing neurons
One of the most common brain
disease (second to Alzheimer’s
Disease) is?
Parkinsons
600,000 people in the US
diagnosed each year with what?
Parkinsons
Parkinsons has a peak onset age of what with a higher incidence in men than women?
50-60 years
Motor Symptoms of Parkinsons
Tremors (usually starting in
one hand), muscle rigidity, bradykinesia
(slowed movement), and postural instability
Non-Motor Symptoms of Parkinsons
These can include depression, cognitive decline, sleep disturbances, and autonomic dysfunction, such as blood pressure fluctuations or constipation
How many stages are there of Parkinsons
5
Medications for Parkinsons
Levodopa is the primary treatment, as it
is converted to dopamine in the brain, alleviating motor symptoms. Other medications, such as dopamine agonists, MAO-B inhibitors, an
Deep Brain Stimulation (DBS) for Parkinsons is what?
A surgical option for
patients who do not respond to medication. DBS involves implanting electrodes that provide electrical impulses to targeted brain areas, reducing motor symptoms
“Masked face” is a common symptom of?
Parkinsons
What are special considerations for Parkinsons?
- Safety
- Orthostatic hypotension
- Xerostomia
- Decreased dexterity
