LECT: Difficult behaviours in CYP Flashcards
1
Q
Disorders Of Intellectual development - describe
A
- A group of etiologically diverse conditions originating during the developmental period
- Characterised by significantly below average intellectual functioning and adaptive behaviour that are approximately two or more standard deviations below the mean (approximately less than the 2.3rd percentile)
- Based on appropriately normed, individually administered standardized tests.
- Where appropriately normed and standardized tests are not available, diagnosis requires greater reliance on clinical judgment based on appropriate assessment of comparable behavioural indicators.
2
Q
What are the classificaitons or disorders of intellectual development
A
- Mild = 2-3 SD below mean, often difficulties in acquisition and comprehension of complex language concepts + academic skills. Most master basic self care, domestic etc.and generally independent living + employment but support
- Moderate = Approx 3-4SD below mean, language+capacity for cquisition of academic skills affeted but geenrally limited to basic skills. SOme may master domestic etc. Most need considerable support for independent living + employment
- Severe = 4or+ SDs below mean. V limited language + capacity academic skills. May have motor imapirments and need daily support in supervised palce for enough care etc. On basis of behaviour differences as tests can distinguish.
- Profound = Approx 4+ SDs below mean.V limited communicaiton abilities and capacity for academic. May have co-occuring motor + sensory impairmets and typically need daiy support in supervised environment for adequate care. Based off behaviours as tests dont distinguish ones this severes.
3
Q
What is autism spectrum disorder
A
- Persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication
- Range of restricted, repetitive, and inflexible patterns of behaviour, interests or activities that are clearly atypical or excessive for the individual’s age and sociocultural context.
- Onset during the developmental period, typically in early childhood, but symptoms may not become fully manifest until later, when social demands exceed limited capacities.
- Deficits sufficiently severe to cause impairment in personal, family, social, educational, occupational or other important areas of functioning
- Pervasive feature of the individual’s functioning observable in all settings, although they may vary according to social, educational, or other context.
- Exhibit a full range of intellectual functioning and language abilities.
4
Q
What is ADHD - diagnosis
A
- Persistent pattern (at least 6m) inattention and/or hyperactivity-impulsivity
- DIrect negative impact on academic, occupational or social functioning
- Evidence of signficiant inattention and/or hyperactivity-impulsivity symptoms prior to age 12, typically by early to mid childhood, though some individuals may first come to clinical attention later.
- Degree of symptoms outside limits of nromal variation expected for age an dlevel of intellectual functioning.
Balance of inattention, hyperacitvity, impulsiveness varies and may change. Must be multiple settings but varies depending. SYmtpoms not better accounted for by another mental, behaviour or neurodevelopmental disorder and not due to the effect of a substance or medication.
5
Q
3 main characteristics ADHD
A
- Inattention = significant diffiuclty in sustaining attention to tasks that do not provide high level of stimulation or frequent rewards, distractibility and problems with organisation
- Hyperactivity = excessive motor activity and difficulties with remaining still, most evident in sturctures situations that require behavioural self contorl
- Impulsivity = tendeny to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences.
6
Q
Whta is oppositional defiant disorder
A
- Perisstent pattern (eg 6m_) or markedly defiant, disobedient, provocative or spiteful behaviour
- More frequently than is typicall observed in individuals of comparable age and developmental level
- Not restricted to interaction with siblings
- May manifest in revailing, persistent angry or irritable mood, often accompanied by severe temper outbursts or in headstrong, argumentative and defiant behaviour.
- SUfficient severity to result in signficant imapirment in personal, family, social, educational, occupationl or other important areas functioning.
7
Q
COnduct-dissocial disorder
A
- Repetitive and persistent pattern of behaviour
- Basic rights of others or major age-appropriate societal norms, rules, or laws are violated e.g. aggression towards people or animals; destruction of property; deceitfulness or theft; and serious violations of rules.
- Sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning.
- Behaviour pattern must be enduring over a significant period of time (e.g., 12 months or more).
- Isolated dissocial or criminal acts are thus not in themselves grounds for the diagnosis.
8
Q
Challenigng behaviour
A
- Some people with LD display behaviour that challenges
- ‘behaviour that challenges’ is not a diagnosis.
- I tis challenging to service,s family etc and may serve a purpose for the perosn with a leanrign diffiuclty (eg, by provding sensory stimualtion)
- Often results from interaction beween personal and environmental factors
- Includes: aggression, self injury, sterotypuc behaviour, withdrawal and disruptve or destructive behaviour. Cna also include violence, arson or sexual abuse, and may brin the perosn into contact with criminal justic system.
9
Q
Prevalence of Learnign disbailtiies
A
- Prevalence rates are around 5–15% in educational, health or social care services for people with a learning disability.
- Rates are higher in teenagers and people in their early 20s, and in particular settings (for example, 30–40% in hospital settings).
- People with a learning disability who also have communication difficulties, autism, sensory impairments, sensory processing difficulties and physical or mental health problems (including dementia) may be more likely to develop behaviour that challenges.
10
Q
Patterns of learning dififculties
A
- May appear in only certain environments, and the same behaviour may be considered challenging in some settings or cultures but not in others.
- It may be used by the person for reasons such as creating sensory stimulation, getting help or avoiding demands.
- Some care environments increase the likelihood of behaviour that challenges. E.g. those with limited opportunities for social interaction and meaningful occupation, lack of choice and sensory input or excessive noise.
- Also care environments that are crowded, unresponsive or unpredictable, those characterised by neglect and abuse, and those where physical health needs and pain go unrecognised or are not managed.
11
Q
Interventions for leanrign disabilities
A
- Multiple factors are likely to underlie behaviour that challenges.
- To identify these, thorough assessments of the person, their environment and any biological predisposition are needed, together with a functional assessment.
- Interventions depend on the specific triggers for each person and may need to be delivered at multiple levels (including the environmental level).
- The aim should always be to improve the person’s overall quality of life.
12
Q
Assessment of learning disabilities
A
Systematic approach for all 3. Minimum is:
- Home - developmental history, problems, interaction, behaviour, functional performance (telling time, money, self-care etc)
- School - academic performance, social function, behavioural/disciplinary issues
- Social - interests, friends, activities, risks, forensic history
FOrmualtion: 5P = Bio psycho social .
- When, onset, pattenrt iming
- ABC - antecedent-behaviour-consequence analysis
- WHy now
Other DDx - Modo disorders, trauma, neglect, family/parental issues (behaviour management, discord, MH problems, aggression).
