Week 7 Flashcards
What type of psychiatric disorders occur in children and Adolescents?
- Mental Retardation
- Learning Disorders
- Motor Skills Disorders
- Communication Disorders
- Pervasive Developmental Disorders
- Attention Deficit & Disruptive Behaviour Disorders
- Feeding & Eating Disorders of Infancy & Early Childhood
- Tic Disorders
- Elimination Disorders
- Other Disorders of Infancy, Childhood & Adolescence
- Other Disorders observed in adult clients
Mental retardation/intellectual Disability
- Mental retardation varies in the level of impairment, categorised by the level of the client‟s intelligence quotient. (I.Q)
- 2 - 3% of general population diagnosed with Mental Retardation.
- Sub average intellectual functioning is an IQ score below 70.
- Mild (50 – 70) ~ 85%
- Moderate (35 – 50) ~ 10%
- Severe (20 - 35) ~ 5%
- Profound (below 20).
Aetiology and Mental Retardation
•Approx. 50% due to organic causes.
•Approx. a third of all clients disability arising from genetic abnormalities.
(Dykens, Hodapp & Finucane, 2000)
•Approx. 30 – 40% no clear aetiology.
•Down Syndrome.
•Hereditary factors – Tay-Sachs disease or Fragile X chromosome syndrome
•Environmental factors – deprivation of nurturing or lack of stimulation
•Alteration in embryonic development – Foetal alcohol syndrome
•Gestation or perinatal problems – malnutrition, hypoxia, viral infections
•Medical problems – postnatal – infection, trauma.
What is dual disability?
Dual Disability‟ refers to the client having an identified mental illness & concurrently an intellectual disability.
Figures for clients with dual disability
Figures of clients with a dual disability are
•14% had an anxiety disorder.
•8% had a depressive disorder.
•1.3% had a psychotic disorder.
Why do clients with intellectual Disabilities have a higher incidence of problems?
Clients with intellectual disabilities have a higher incidence of mental illness, due to communication, cognitive & social skill difficulties.
Dual disability statistics
•AIHW analysis of the Australian Bureau of Statistics (A.B.S.) 2003 survey of disability, ageing & carers, displayed;
- 39% young people, 15 – 24 years old had an intellectual or other mental disorder. (A.D.H.D., Autism & learning disorders)
- 35.9% young people , 15 – 24 years old had a psychiatric condition.
- 8% = 20,000 people with a disability were unable to work due to disability.
What is the leading cause of mental illness for males?
- Anxiety / Depression
- Schizophrenia
- Suicide
- Illicit drug use
- Alcohol use
- Personality Disorders
- Bi-polar Affective Disorders
What is the leading cause of mental illness for females?
- Anxiety / Depression
- Schizophrenia
- Personality Disorders
- Bulimia Nervosa
- Bi-polar Affective Disorder
- Anorexia
What type of assessment is required as a result of complex presentations?
Due to complex client presentations, multiple assessment methods are required to ensure accuracy of assessment, provide a holistic assessment and to provide baseline data from which a nursing care plan is formulated. Based on the assessment findings, the multidisciplinary team collaborate with the client and family when providing client centred care.
What are the factors affecting the assessment of a child with a psychiatric disorder?
- Client‟s chronological age (3 – 18).
- Client‟s ability to articulate / express their concerns.
- Clinical setting (client‟s home, clinic or hospital).
- Presence of a parent / carer / support person.
- Parental / Carer expectation of assessment.
- Mandatory reporting / Legal Acts / Consent.
Assessment of children and adolescents
•Demographic data. •Socio-cultural data. •Precipitating events – why now? •Expectations of treatment. •Goals for the client. •Psychiatric history. •Developmental History. Physical Health status / Substance use &/or misuse. •Behaviour observed / Behaviour reported. •Mental Status Examination. •Risk Assessment •Relationships with family members Relationship with peers Sense of self
formulation of the clients presentation
- Precipitating Factors – What triggered the problem?
- Predisposing Factors – What factors increase the client‟s vulnerabilities to the problem?
- Perpetuating Factors – What factors maintain or continue with the problem?
- Protective Factors – What positive factors enhance client / family in the recovery process & reduce the impact of associated distress?
What are the core features of ADHD?
- The persistent inattention / distractibility and hyperactivity / impulsivity that is developmentally inappropriate for the client‟s age and creates impairment in two or more areas of functioning. i.e. Common areas are home and school.
- Symptoms of inattention, hyperactivity or impulsivity are often present from three years & typically observed before the age of seven years old & cause impairment in social, academic or occupational functioning.
DSM-4 TR Criteria of ADHD inattentive type
A1. Six or more of the following symptoms of inattention have persisted for at least 6 months that is maladaptive with development level:
a) Fails to give close attention to detail or makes careless mistakes in school, work, or other activities.
b) Often has difficulties sustaining attention in tasks or play activities.
c) Often does not seem to listen when spoken to directly.
d) Often does not follow through on instruction and finish school work, chores or duties in the workplace (not due to oppositional behaviour or failure to understand instructions).
e) Often has difficulty organizing tasks or activities.
f) Often avoids, dislikes or is reluctant to engage in tasks that require sustained mental effort (school work or home work).
g) Often loses things for task / activities (toys, school assignment, books or tools)
h) Is often easily distracted by external stimuli.
i) Is often forgetful in daily activities.
