Week 7: Early childhood Part 2 Flashcards
true or false: disorders in children are often noticed first by a parent or well child check up
true
is nursing care directed at
parent support
appropriate referral to services/supports/allied health or other clinicians
effective communication and documentation
yessss of course munch
what is an asd and what is it defined as?
asd = autism spectrum disorder and is defined as a complex neurodevelopment disorder with unknown etiology
what is this describing? Characterized by deficits in social interactions and communication, unusual behaviours (e.g. Fixed interests, inflexibility, repetitive behaviours and/or unusual sensory responses).
autism spectrum disorder
what is one of the hallmarks of asd?
failure of social interaction
communication development
true of false regarding asd: Common core deficits are noted primarily in social interactions. (e.g., abnormal eye contact, decreased response to own name, decreased imitation)
true
what is autism regression?
normal development followed by sudden regression frequently displayed in expressive language.
what are some nursing care management for asd?
Providing a structured routine for the child is critical
If hospitalized, parents are essential to planning care and, ideally, should be present as much as possible.
should a nurse be doing this with a patient diagnosed with asd? Decreasing stimulation by using a private room, avoiding extraneous auditory and visual distractions, and encouraging the parents to bring in possessions the child is attached to may lessen the disruptiveness of hospitalization.
TRUE
true or false regarding ASD:
Children with ASD must be introduced quickly to new situations, with visits with staff caregivers kept short whenever possible.
false; slowly
what are some next steps for a diagnosis of ASD?
Any child who does not display language skills such as babbling or gesturing by 12 months old, single words by 16 months old, and two-word phrases by 24 months old is recommended for hearing and language evaluation.
Assessment of communication by a registered speech and language pathologist
Mental health providers assess family dynamics, ability to cope, how dynamics can contribute to symptom aggravation and evaluate for co-existing disorders (e.g ADHD)
Physician for any underlying medical issue and,
Occupational therapists (OT) assess for tactile sensitivities and challenges in daily living (e.g dressing, eating and bathing)
what is Tourette syndrome?
A complex TIC disorder characterized by multiform, involuntary motor and vocal tics. (Tourette Syndrome Foundation of Canada, 2006).
is Tourette syndrome acute or chronic?
chronic
does genetic play a role in Tourettes?
yes it is generally transferred
is tourettes neurological or neurochemical?
it can be either or
how nursing care and management affects Tourettes?
no diagnostic test
criteria: presence of more than 2 motor tics and 1 or more phonic tics
ex. Limb jerking, frowning, abdominal tensing, lip pouting. Sucking sounds, barking, coughing or grunting
Nurse’s role is to document parents’ description of child’s behaviour including type of tic(s), duration in months, times per day demonstrated and any other symptoms are present
“Automatic Suppression”
what are some next steps with a child that has Tourettes?
family support
normal intelligence
Tics are worst during puberty and lessen over time
Tourette Syndrome is chronic but not degenerative
Referrals – neuro, OT, SLP
Treatments – meds., cognitive behavioural therapy, psychotherapy
select all that is true regarding Obsessive compulsive disorder
- 50% diagnosed in childhood adolescence
2/3 of children who have TS also have OCD
Includes “rituals” or “compulsions” e.g step back and forth three time before crossing a doorway and “obsessions” e.g unwanted, intrusive thoughts
all true!!
what are some of the characteristics of obsessive compulsive disorder?
Checking, counting, hand washing, symmetry or exactness, collecting and “looping” or “being stuck”
Can make children appear defensive, negative or “needy”
what are some nursing care and management with OCD?
Families of pediatric patients with OCD may have high levels of anxiety. Can create a vicious cycle and exacerbate the child’s condition.
Nursing role is to perform history and physical including:
* Parents account of concerning behaviour
* Any other co-morbidities including TS, ASD or mental health disorder in families and child
* Developmental delays observable or noted by caregivers or teachers
what are some patterns of adversity? what are the risk factors?
- Neglect (34%)
- Exposure to intimate
partner violence (34%) - Physical abuse (20%)
- Emotional maltreatment (9%)
- Sexual abuse (3%)
risk factors:
* Sociocultural Factors
* Characteristics of the
Child
* Characteristics of the Abuser
* Household Stressors
true or false: Childhood stressors, ranging from day-to-day maltreatment of traumatic events, that increase the risk of wide-ranging, negative health and social consequences over the life course
true
what is neglect?
Can lead to physical and chemical disruptions in the brain that can last a lifetime
Associated with wider range of damage than active abuse but receives less public attention, policy or practice
true of false: Neglect can disrupt emotions, cognition and behaviour
true
what are some risk of neglect?
significant risk of emotional and interpersonal difficulties
and risk for learning difficulties, poor school achievement
true or false regrading neglect:
Intervention needs to be appropriate and timely to reverse or reduce the negative consequences
Merely removing a child from neglect does not guarantee positive outcomes
Therapeutic intervention and highly supportive care is needed to mitigate adverse effects and assist with recovery
Children in these environments need to have their safety, control and predictability restored
all true
what is adverse childhood experiences?
No single factor contributes, but rather the presence of multiple variables increases chances
what are the outcomes of adverse childhood experiences ?
Exposure effect: the degree of intensity and duration of a stressor is
related to the intensity of the response
Toxic stress response: persistently elevated physiological arousal caused by strong, recurring, and/or unabated adversity
how can you prevent ACEs?
starts with education
identification of at risk families
vigorous enforcement of existing child abuse laws
reporting of abuse is MANDATORY in all provinces and territories
