Topic 5: Neurocog/Neurodev Flashcards
Autism Spectrum Disorder
a disorder that appears in childhood and is marked by significant deficiencies in communication and social interaction, and by rigidly fixated interests and repetitive behaviors
social reciprocity
how the child responds or reciprocates when socially interactive (may not have social cues)
joint attention
wanting to share an interest (may not be interested in showing)
nonverbal communication
ability to use or interpret nonverbal cue
social relationships
making and maintain relationships
repetitive behavior
example: putting on shoes in the same order
fixed routines
example: same route to daily destination
restricted thinking
specific, detailed knowledge of a certain topic of interest
ASD severity level 1
*Speaks in full sentences, difficulty with conversations
*Difficulty changing activities, organization & planning difficulties
ASD severity level 2
*Notable deficit in verbal & nonverbal social communication, does not initiate social interactions
*Repetitive behaviors are observable
*Change in routine leads to distress
ASD severity level 3
*Few spoken words
*Rarely interacts with others
*Very resistant to change
*Interferes with daily life
medication treatment for reducing aggressive and self harm behaviors in ASD
atypical antipsychotics (Risperidone)
medication treatment for obsessive or anxious symptoms in ASD
SSRIs or B-Blockers
Attention deficit hyperactivity disorder (ADHD)
based on symptoms that have occurred over the past 6 months; issues with concentration, making careless mistakes, difficulty remaining focused, easily distracted, struggle with time management, inattentiveness
diagnostic method for ADHD
Vanderbilt Assessment Scale
medications for ADHD
stimulant and non-stimulant medications
stimulant medications for ADHD
*methylphenidate
*dexmethylphenidate
*mixed amphetamine salts (Adderall)
*lisdexamfetamine (Vyvanse)
non stimulant medications for ADHD
*atomoxetine (Strattera)
*clonidine
*guanfacine
methyphenidate (Ritalin) administration
needs to be given 6-12 hours before bed (stimulant medication for ADHD)
atomoxetine (Strattera) can…
can stunt growth (non stimulant medication for ADHD
enuresis
Repeated URINARY incontinence
*Involuntary or intentional voiding in clothing, bed, etc.
*Nocturnal, diurnal, or both
encopresis
Repeated incontinence of FECES into inappropriate places
*Involuntary or intentional voiding (places may include clothing, on floors, in waste receptacles, etc.)
enuresis disorder intervention
*Parent education
*Toileting schedules (even during the night for enuresis)
*limit fluid prior to bedtime
*Bell and pad method
*Bladder training
*Medication
medications for enuresis
*imipramine
*desmopressin
*oxybutynin
*indomethacin
*SSRIs
encopresis interventions
*Parent education
*Referral to gastroenterologist (if indicated)
*Increase dietary fiber and fluid intake
*Toileting schedule
*Enhanced toilet accessibility
*Cognitive behavioral therapy
*Medications (stool softeners/laxatives, enema)
delirium
ACUTE mental confusion, ALWAYS SECONDARY to other conditions and REVERSIBLE
sundown syndrome
symptoms and problem behaviors become more pronounced in evening/night
what is an early sign on dementia?
mild cognitive impairment (MCI)
Mild Cognitive Impairment (MCI)
main symptoms include
forgetfulness (important events/appointments)
difficulty following convo
trouble navigating familiar places
overwhelmed by a previously easy task
cognitive impairment defense mechanisms
*Denial
*Confabulation
*Perseveration
*Avoidance
confabulation
making-up stories or answers to maintain self esteem when something is forgotten
denial
hiding memory deficits
preservation
repetition of phrases or behavior
avoidance
avoid answering questions
______ often mimics s/s of dementia
depression
The 4 A’s
amnesia
aphasia
apraxia
agnosia
aphasia
initially has difficulty finding correct word, then only uses a few words, finally babbling or mutism
apraxia
loss of purposeful movement (walking)
agnosia
loss of ability to recognize sounds, objects and individuals
amnesia
memory impairment
(Mild) Early Stage Alzheimer’s
Forgets words or names.
Can’t remember names of new people met.
Struggles with tasks at work or social gatherings.
Forgets recently read information.
Loses valuable items.
Has trouble planning or organizing.
Example: May forget a coworker’s name during a meeting or lose their house keys.
Key Points:
*The individual can still function independently.
*Memory lapses are noticed, but they’re not severely disruptive to daily life.
(Moderate) Middle Stage Alzheimer’s
Key Points:
*Symptoms are noticeable and disrupt daily life.
*The individual requires more assistance from others.
*Mixes up or forgets words, gets easily upset or angry.
*Acts unusually, like refusing to bathe.
*Forgets personal history or important events.
*Becomes moody or pulls away from social activities.
*Can’t remember the address, phone number, or where they went to school.
*Gets confused about location and date.
*Needs help picking appropriate clothes.
*Sleep patterns change; may sleep during the day and stay awake at night.
*May wander off and get lost.
*Might act suspicious, see things that aren’t there, or repeat certain behaviors.
Example: May wear winter clothes in summer, forget their children’s names, or become upset easily.
(Late) Severe Alzheimer’s
Key Points:
*The individual loses the ability to respond to the environment and communicate effectively.
*They require around-the-clock assistance.
*There’s a significant loss in physical abilities and increased vulnerability to infections.
*Needs constant help with daily activities and personal care.
*Loses track of recent experiences and what’s happening around.
*Can’t walk, sit, or swallow over time.
*Struggles to communicate and may only say a few words or phrases.
*Can’t express when in pain.
*Might undergo personality changes.
*Vulnerable to infections.
Example: May need help with eating, using the toilet, and may not recognize family members.
dementia interventions
*Always introduce yourself and refer to client BY THIER NAME
*Speak slowly, short, simple words and phrases
*MAINTAIN 1 or 2 arms distance between you and the client
When dementia client is delusional:
acknowledge client’s feeling and REINFORCE REALITY
When dementia client is verbally aggressive:
acknowledge client’s feelings and CHANGE TOPIC
what are the two major NT implicated in alzheimers
acetylcholine and glutamate
what medications are used for Alzheimer’s?
“grandma doesn’t remember me”, = galantamine, donepezil, rivastigmine, memantine
which alzheimer drug inhibits glutamate?
memantine (Namenda)
which alzheimer drug inhibits acetylcholine?
donepezil (Aricept)
rivastigmine (Exelon)
galantamine (Razadyne)
which drugs treat mild to moderate AD?
*donepezil
*rivastigmine
*galantamine
which drugs treat moderate to severe AD?
*memantine
*donepezil
Mirtazapine (Remeron) may cause
weight gain and sedation (drug for depression)
donepezil, rivastigmine, galantamine SE
GI effects
