Unit 7 Childhood and Neurodevelopmental Disorders ADHD and Autism Chapter 11 Flashcards
Characteristics of a mentally healthy child
- Trusts others and sees his or her world as being safe and supportive
- Correctly interprets reality and makes accurate perceptions of the envi- ronment and one’s ability to influence it through actions (e.g., self-
determination) - Behaves in a way that is developmentally appropriate and does not violate
social norms - Has a positive realistic self-concept and developing identity
- Adapts to and copes with anxiety and stress using age-appropriate behav-
ior - Can learn and master developmental tasks and new situations
- Expresses self in spontaneous and creative ways
- Develops and maintains satisfying relationships
Different types of Therapy for children
Play Therapy(BEST WAY TO INTERVIEW CHILDREN
* Aide in expressing feelings, gaining insight through literature
Bibliotherapy
* Nonverbal means of expressing difficult emotions
Expressive art therapy
* Expressing feelings, setting and evaluating goals
Journaling
* Can be used to improve physical, psychological, cognitive, behavioral and social functioning.
Music therapy
* Help the family to develop goals, provide education, gain insight
Which of the following activities is used best when conducting an interview on a pediatric patient?
A. direct approach
B. Therapeutic games
C. high activity games
D. competitive games
B. Therapeutic games
Nurses use play activities such as therapeutic games, drawings, and puppets for younger children who have difficulty responding to a direct approach.
Interventions
◦ Teamwork = safety
◦ Least restrictive interventions first
◦ Verbal de-escalation(#1 intervention especially when you see a patient pacing or agitated)
◦ Offering medications to help re-gain control
◦ Time-out/quiet room(utilize time out no more than 10 minutes
◦ Seclusion and Restrain(ALWAYS LAST RESORT)
What is the best example of the least restrictive interventions?
A. holding the child down due to hyperactivity
B. asking the patient what is causing this anger
C. verbally shouting that if they don’t stop misbehaving we will call security
D. call doctor for physical restraints
Less restrictive interventions include discussion (e.g., asking if the patient would like to talk about his anger), offering medication to help him gain control, and suggesting a time-out (e.g., his room or other quiet area).
What is an example of the MOST restrictive restraint
Finally, as a last resort, seclusion or restraint may be considered. In general, seclusion is viewed as less restrictive than restraint, where all movement is constrained.
Benefits of quiet room
A unit may have an unlocked room for a child who needs an area with decreased stimulation for regaining and maintaining self-control.
The child is encouraged to express freely and work through feelings of anger or sadness in privacy and with staff support.
What is Receptive Language disorders
Difficulty understand, following directions
MOST SEVERE, difficulty learning
Other children may have receptive problems where they experi- nce difficulty understanding or are unable to follow directions. Receptive impairment results in a poorer prognosis than does expressive impairment.
How would a patient with Receptive Language disorders present?
Their mom tells them to get her purse upstairs in her room but the child is not able to understand the instructions.
What is Expressive language disorders
Difficulty communicating, finding the right words, forming sentences
Common in adults after a stroke, pt’s can understand ,best intervention have them write down or point to picture
Children may have an expressive problem that results in difficulty in finding the right words, forming clear sentences, and using the right gestures and verbal signals.
How would a patient present with Expressive language disorders
The child has cut his knee by falling off his bike accident and is unable to form the right words to explain to his mother how it happened.
What is Social communication disorder
◦ Problems using verbal and nonverbal means for social interaction
While some children have no problem with language and no problem speaking, they may have problems relating with other people.
unable to undertstand the concept of personal space
In social communication disorder, children have problems using verbal and nonverbal means for interacting socially with others. Impairments are also evident in written communi- cation when the child is trying to relate to others.
How would a patient present with Social Communication Disorder
For example, some children don’t use gestures like waving to say “goodbye” or extending arms to be picked up. Or, they may shake their head “no” when they mean “yes.”
What is Developmental coordination disorder
impairment in motor skill development, coordination below developmental age,
problems interfere academically
How would a patient present with Developmental coordination disorder
Symptoms include delayed sitting or walking or difficulty jumping or performing tasks such as tying shoelaces.
not walking at 1 years old or not sitting up by 9 months , or having headlag at 10 months
Serious impairments in skills development or coordination are usually obvious. Less severe impairments may be less notice- able. They may be identified by the child’s avoidance of certain tasks or activities. These children typically make comments like, “I hate to draw” or “I don’t want to play kickball.”
What Is Tic disorder?
Tics are sudden, nonrhythmic, and rapid motor movements or vocalizations. Motor tics usually involve the head, torso, or limbs, and they change in location, frequency, and severity over time.
Motor tic example
Other motor tics are tongue protrusion, touching, squatting, hopping, skipping, retracing steps, and twirling when walking.
Motor tics usually involve the head, torso, or limbs, and they change in location, frequency, and severity over time.
Vocal tic example
Vocal tics are spontaneous production of words unre- lated to conscious communication and sounds such as sniffs, barks, coughs, or grunts.
Are tics stationary?
A. Yes
B. No
B. No, they are involuntary movements that can be motor or vocal
What are the 3 types of Tic disorders
THEY ARE ORGANIZED FROM LEAST INVASIVE TO MOST INVASIVE
- Provisional tic disorder: Single or multiple motor and or vocal tics for less than 1 year.
2.Persistent motor or vocal tic disorder: Single or multiple motor or vocal tics but not both for more than 1 year.
- Tourette’s disorder: Multiple motor tics and at least one vocal tic for more than 1 year.
What is Provisional tic
Provisional tic disorder: Single or multiple motor and or vocal tics for less than 1 year.
What is Persistent motor or vocal tic disorder
Persistent motor or vocal tic disorder: Single or multiple motor or vocal tics but not both for more than 1 year.
What is Tourette’s disorder
Multiple motor tics and at least one vocal tic for more than 1 year.
In reality, coprolalia—the involuntary outburst of obscene words or socially inappropriate and derogatory remarks—occurs in fewer than 10% of cases
Effects that Tic Disorders have on children
A child or adolescent with tics may have low self-esteem as a result of feeling ashamed, self-conscious, and rejected by peers and may severely limit public appearances for fear of displaying tics.
What type of technique can reduce tic expressions, comprehensive behavior intervention for tics (CBIT). How does it work?
Behavioral techniques can reduce tic expression
** They are referred to as habit reversal, and the most prom- ising form is called comprehensive behavior intervention for tics (CBIT).**
It works by helping the patient become aware of the building up of a tic urge and then using a muscular response in competition to or incompatible with the tic.
Tourette Disorder
Often co-occur with depression, OCD, & ADHD
◦ CNS stimulants can increase severity of tic
◦ Comprehensive behavior intervention for tics (CBITS) “habit reversal)
◦ Pt becomes aware of the building up of tic urge, then utilizing a muscular
response in competition to or incompatible with the tic
◦ Deep Brain stimulation
◦ When conservative tx fails
◦ Fine wire threaded to affected area that delivers electrical impulses
◦ Turn on to control tics, off while sleep
