Developmentally Disabled Flashcards
DSM-V Disorders usually first diagnosed in infancy, childhood or adolescence.
Intellectual Disability Communication Disorders Autistic Spectrum Disorders Specific Learning Disorders Feeding and eating disorders of infancy or early childhood Tic disorders Separation Anxiety Disorder Attention-deficit and disruptive behavior disorders
Intellectual Disability
Deficits in intellectual functions such as reasoning, problem solving, planning, abstract thinking, judgment, academic learning, learning from experience confirmed by intellectual testing and clinical evaluation
Failure to meet developmental and sociocultural standards for independence and responsiblility
Onset in the developmental period and not due to a trauma or other organic cause
Levels of Intellectual Disability
Mild IQ of 50 to 55-70
Moderate IQ of 35 to 40-50 to 55
Severe IQ of 20 to 25-35 to 40
Profound - Level below 20 to 25
some inherited intellectual disabilities
Down’s Syndrome - Mainly trisomy 21 single palmar transverse crease, protruding tongue, flat facies, small ears, thick neck
Tay Sach, error on inborn metabolism
Untreated PKU
Fragile X Syndrome - FXS- Xq27 the fragile site Affects males more severely delayed cognitive abilities, behavior problems, hand flapping, large ears, elongated faces and enlarged testicles.
Clinical management of Intellectual Disability
Placement issues (mainstreaming) Supportive counseling and training in behavioral techniques for the family Medication management (if indicated)
Learning Disorders
Inability to achieve in a specific area of learning at a level consistent with the person’s overall IQ Includes: Reading Mathematics Written expression
Often comorbid with other disorders such as conduct disorder, oppositional defiant disorder, mood disorder, substance abuse, ADHD, and truancy.
Learning Disorders Treatment includes:
Remedial instruction
Supportive counseling for child and family
Autistic Spectrum Disorder
Impaired social interactions
Impaired ability to communicate
AND, a restricted range of activities and interests
Autism
Onset in the first 3 years of life
Prevalence of 10-15 cases per 10,000 individuals
Boys are 4X as likely to have autistic disorder than girls
No empirical evidence to link autism with environmental toxins, vaccines, etc.
Good prognostic indicators are higher IQ and better language and social skills
Asperger Syndrome
Relatively good verbal language
Milder nonverbal language problems
Restricted range of interests and relationships
Often engage in repetitive routines
Etiology of autism spectrum disorders
Theory is that it is a brain dysfunction with abnormalities in brain structure (including the cerebellum and cerebral cortex – frontal and temporal lobes),
And, abnormalities in neurotransmitters such as serotonin and dopamine
It is likely that genetic factors play a role
Autistic Spectrum Disorders Children with these disorders are helped by:
Well-structured classroom and home routines
Individualized instruction
Behavior modification techniques
Rett’s Syndrome
mainly in girls Normal development to age 4 then decreased social, verbal and cognitive skills Hand wringing Ataxia Decreased IQ
Childhood Disintegrative Disorder
rare condition
Normal development to age 2 to 10, then they lose those skills
More common in boys
Feeding and eating disorders of infancy or early childhood
Failure to eat adequately with failure to gain weight or loss of weight over at least one month
Not due to associated GI or other general medical condition
Not better accounted for by another mental disorder or lack of available food
Onset before age 6
May appear apathetic Parent-child interaction problems my contribute to or exacerbate the feeding problem Factors may include: - Temperament - Intrauterine growth retardation - Preexisting developmental impairments
Equally common in girls and boys
Research indicates about a 3% rate
Children with this disorder may develop to be smaller than their peers
Tic disorders
Includes:
Tourette’s Disorder
Chronic motor or vocal tic disorder
Transient tic disorder
Tourette’s Disorder
5-30 per 10,000 children have this disorder
Median age of onset is 6-7 years, but can be seen as early as 2 years
Seen more often in boys (3-5 X) than girls
Duration may be lifelong or may resolve with adulthood
Involuntary Motor Movements & Vocal Tics (Dopamine in Caudate Nucleus)
More frequently in boys: starts age 8
Vocal tics - barking, profanity, grunting
Motor tics - facial grimacing or blinking
Rule out pure Motor Tic Disorders or pure Vocal Tic Disorders
Treat with antipsychotics
Chronic motor or vocal tic disorder
Either motor or vocal tics, but not both
Probably Tourette’s and chronic motor or vocal are related genetically
Transient tic disorder
Presence of single or multiple motor or vocal tics, for no longer than 12 months
Essential features are the same as Tourette’s, except the duration must not surpass 12 months
Separation Anxiety Disorder: 4% of School Age Children
Also known as School Phobia or School Refusal
Fear of loss of a major attachment figure
They complain of physical symptoms so they do not have to leave their mom.
Treated with Selective Seratonin Reuptake Inhibitors, (antidepressants) & therapy with good results. Anxiety disorders are often in the family.
