neurodevelopmental disorders Flashcards
(31 cards)
types of neurodevelopmental disorders
communication disorders
motor disorders
specific learning disorder
IDD
autism spectrum disorders
ADHD
communication disorders
speech- problems making sounds
language- difficulty understanding or in using words in appropriate context, may be evident by inability to follow directions, expressive language disorders( inability to communicate verbally or understand sign language)
social communication disorder (problems communicating socially, interrupting others, or minimally verbal)
motor disorders
developmental coordination disorder
stereotypical disorder
tic disorder
developmental coordination disorder
impairments in motor skill development
coordination below the child’s developmental age
interferes with academic achievements or ADL’s, delayed sitting, walking, difficulty jumping, tying shoes
TX: PT/OT
stereotypic movement disorders
repetitive, purposeless movement for 4 weeks or more
hand flapping, waving, rocking, head banging, nail biting, teeth grinding that interferes with ADL’s
TX: helmets, mittens, behavioral therapy using habit reversal
tic disorders
sudden nonrhythmic and rapid motor movements and vocalizations
tongue protrusions, hopping, skipping, twirling, touching, squatting, verbal tics and sounds
3 types of tic disorders
Tourette’s (most severe)
persistent motor or vocal tic disorder- one than 1 year
provisional tic disorder- less than 1year
treating tic disorders
behavioral- habit reversal
relaxation strategies- to reduce and control tics
onset usually between 4-6, symptoms peak early adolescents and sometimes resolves by adulthood
meds: antipsychotics, clonidine, klonopin, fluoxetine and sertraline
DBS
specific learning disorders
dyslexia (reading)
dyscalculia (math)
dysgraphia (written expression)
*identified during school years, get IEP through special ED
IDD
more in males than females
deficits in intellectual functioning, social functioning, daily functioning (school, work, selfcare)
cognitive and social stimulation can increase levels of functioning if begun before 5 years
motivational support
early identification and intervention increases quality of life
application of the nursing process for IDD
assess for delays
assess for signs of potential abuse or neglect
diagnosis ( RF injury, ineffective impulse control)
outcome: use spoken language, express in simple social interactions and accepts assistance without frustration, refrains from acting on impulses, harming self or others
implementation: psychosocial interventions: social skills training and therapy
autism
deficits in social interactions and relationships
stereotypical repetitive speech and/or behaviors
obsessive focus on specific objects
over adherence to routines and rituals
hyper or hypo-reactivity to sensory input
extreme resistance to change
appears normal in early childhood
*manage behaviors based on effect on environment and others, if hand flapping is not causing problems let it be.
when does autism develop and causes
develops 1st 3 years of life
more common in males
if occurs in females its more severe
potential causes: advanced maternal age, genetic mutation, low birth weight, valproic acid during pregnancy
NOT vaccination related
Nursing process with Autism
assessment- intellectual or developmental delays, communication, social, and behavioral skills, parent-child relationship, abuse, stereotypical behavior
diagnosis- early identification is key, lead and hearing screen, CARS and M-CHAT scales
LEAD poisoning mimics autism
outcomes- cooperation, consideration, sensitivity to others, accurately interpreting and/or exchanging messages
implementation- psychosocial interventions: treatment programs, behavior mgmt, parent teaching, PT/OT/Speech
evaluation- are there improvements and use of services
effective treatment programs for Autism
build on child’s interest
predictable schedule
teach tasks as a series of simple steps
actively engage
highly structured activities (beginning, middle, end)
regular positive reinforcement
early communication/social interaction skills
involve parents
social skills training- helps recognize social cues, reduce stress, role-playing to help play like peers
speech and language therapy
ADHD
persistent pattern of inattention, hyperactivity, and impulsiveness that is persuasive and inappropriate for developmental level in at least 2 settings for at least 6 months before age 12
3 types: Hyperactivity-impulsivity type, inattentive type, combined type
males more than girls, some cases go into adulthood
possible causes: low birthweight, premature, TBI, maternal smoking, drinking during pregnancy, lead paint
ADHD impulsivity type
present for at least 6 months
Hyperactivity behaviors:
fidgets, squirms, cant sit still
leaves seat before excused
runs/climbs excessively
difficulty playing quietly
on the go, “driven by a motor”
Impulsivity behaviors:
blurts out answer before question is finished
interrupts or intrudes on others
problems with waiting their turn
ADHD inattentive type
present for at least 6 months
behaviors of inattention:
doesnt give attention to detail, makes repeated careless mistakes
trouble keeping attention on tasks or activites
doesnt seem to listen when spoken to directly
trouble organizing activities
loses things, distracted, or forgetful
easily bored
disorganized
combined type ADHD
has behaviors from hyper, impulse and inattentive
ADHD treatment
self regulation, social functioning, concentration
behavioral management + meds
hospitalization only if danger to self
parent training
group therapy 8-12 weekly sessions with therapist
CBT not as affective
Play therapy
stimulants 1st line treatment
non-stimulants- 2nd line
ADHD meds
improved attention and focus
decrease hyperactivity
begin low and increase dose
NOT weight dependent
if 1 stimulant is not affective try 2nd…3rd…
long acting stimulants duration of 8-12 hours, useful for school
long acting stimulants for ADHD
dextroamphetamine/amphetamine
lisdexamfetamine
dexmethylphenidate
methylophenidate (Daytrana, Metadate CD, Ritalin LA, Concerta
Ritalin LA can be opened and sprinkled on food
intermediate acting stimulants for ADHD
dextroamphetamine
methylphenidate ( Ritalin SR, Methylin ER, Metadate ER)
short acting stimulants for ADHD
methylphenidate (Ritalin)
dexmethylphenidate
dextroamphetamine
amphetamine sulfate
Ritalin can be crushed or chewed
