Week 11 - Important Concepts Flashcards
What is a shared feature in neurodevelopmental disorders?
Shared feature is significant developmental delay and/or deficit along pathways.
There needs to be a marked disruption in these factors.
personal, social, academic, occupational
Classification in DSM-V
- Neurodevelopmental disorders referenced in _______ categories
- Communication disorders, learning disorders, ASD, ADHD, motor disorders
several
Disorganized pattern of intellectual strengths and weaknesses
Marked impairment of development in social interaction and communication with a restrictive repertoire of activity and interest
Autism
Describe rigidity in autism.
Describe sameness.
Rigid - change-intolerant, set in their ways
sameness - they like their routine to be the same to a ridiculous level of detail
What are some concurrent diagnoses often seen in ASD?
ADHD or specific communication or language disorders
What are some stereotypical behaviours of children with ASD?
Hand flapping, rocking, head-banging, echolalia
ASD epidemiology:
- ____/1000
- more common in ______ BUT (continue the thought)
- 50% comorbid with _______ disability
- 25% comorbid with _______ disorder
11.4 (although sharp increase)
More common in males, but more severe in females
50% comorbid with intellectual disability
25% comorbid with seizure disorder
What are some risk factors for the developmental of ASD?
Genetics
Microbiota
Perinatal complications
(NOT vaccines)
There are some characteristics that may lead to early diagnosis of ASD:
- Lack of ______ or gestures at 12 months
- lack of _____ words at 16 months
- lack of ___ word combinations at 18 months
Lack of response to _____
unusual/absent ___ contact or _____ expressions
Marked _______ impairment
_______/skill regression
babbling single two name eye contact, facial expressions social language
What are diagnostic criteria for ASD?
Persistent social deficits across multiple contexts
Persistent, repetitive patterns of behaviour, interests, and activities
(sameness, stereotypical motor movements, fixed intersts; hypo/hyper-reactivity to sensory stimuli)
Early onset of symptoms
Symptoms cause significant impairment in functioning
Disturbances not explained by differential diagnosis
The spectrum title captures previously separate disorders ______ and _______ ______ disorder.
Asberger’s
Pervasive developmental
What are the three levels of severity for ASD?
Requiring support
Requiring substantial support
Requiring very substantial support
What is the issue with using the terms high and low functioning with ASD patients?
High functioning - we dismiss them
low functioning - the opposite
What do the severity levels primarily determine?
Level of support that child needs to live
Deficits in verbal and nonverbal language
abnormal responses
difficulty coping with change
Requiring substantial support
Difficulty initiating social interactions
Significant interference with functioning in 1 or more activities
Difficulty switching between activities
Requiring support
Very limited social response and minimal response
Extreme difficulty coping with change
Great distress with change
Requiring very substantial support
What are the medications for autism?
there are none
When would medications be used for ASD?
To alleviate frequency/intensity of behavioural disturbances
Antipsychotics to reduce aggression
Risperidone has some efficacy in treating the core social-cognitive and stereotype behaviours
DO NOT TREAT THE ACTUAL AUTISM ITSELF
What is an important limitation for ASD patients in the biologic domain?
Nutrition - sameness concept really limits it
Common goals for all families with children of autism?
for them to be successful, have friends, etc.
Describe structured activities.
Helps family understand that setting the child up for success is the goal and that the child may not respond to normal ways of learning
Child’s needs are often overlooked in this area.
But, this is particularly important for this group instead.
Spiritual domain
often more pertinent for parents of child
Continuum of care for ASD:
- ______ care needs
- Care needs can be very ____, ___-time attending
- Interaction with the world is different
- _____-as-client
- Fit the _______ to the client, not the client to the _________
diverse high, full family experience experience
Therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills
educational/behavioural interventions
Persistent pattern of inattention, hyperactivity, and impulsiveness that interferes with functioning or development
ADHD
What are the types of ADHD presentations?
Predominantly hyperactive-impulsive
predominantly inattentive
Mixed/combined
ADHD symptoms occur consistently in at least two different environments, these are?
Some, but not all symptoms must be present by age ___.
Symptoms must be present for at least __ months.
home and school
12 years old
6 months
The diagnosis for ADHD comes from ______ and taking a _______.
observation, history
A physical exam must rule out differential diagnosis for ADHD such as?
Hearing/vision problems
ADHD is more prevalent in?
What is the impetus for seeking help?
boys
Disruption (often in school)
What are the three core symptoms of ADHD?
Inattention, hyperactivity, impulsivity
What are the risk factors for ADHD? What is important to note about the risk factors?
Genetics
Omega-3 FA deficiency, OB complications
Psychosocial factors - interparental discord, childrearing disagreements
More important is the number of risk factors, not just which ones
Some proponents argue that ADHD is a ______ _______ behaviour that is the problem.
stimulus seeking - thus the reason that stimulants work to treat ADHD
Due to impulsivity, ADHD clients are at a large risk for ______ issues.
safety
Describe the paradox of structured environments.
A very rigid environment may help ADHD patients from being all over the place
Do kids grow out of ADHD?
Studies show that symptoms persist into adulthood
Manifestation may change however, due to compensatory mechanisms in adulthood
The nursing assessment for children with ADHD is often done with whom>
the parents
Comorbidities with ADHD may be?
Autism and seizures
Nursing interventions in the psychological domain may include strategies to improve ______ and _______ at home. (ADHD)
structure and predictability
Boundaries and reward systems can be used for this.
ADHD
What is the bottom line of treatment for ADHD?
Decrease symptoms
improve functionality
Promote the well-being of the child and their support network
