Week 11 NCM 109 Lecture
Week 11 NCM 109 Lecture
Week 11 NCM 109 Lecture
Cabanatuan City
College of Nursing
INTELLECTUAL DISABILITY
Commonly defined as a “significant
subaverage” that is at least two or more
standard deviations below individual peers
average level.
Based on two criteria: intellectual
functioning significantly below average and
concurrent deficits in adaptive functioning
in conceptual, social, and practical domains.
IQ Testing assess intellectual functioning and
clinical evaluation assesses adaptive
functioning.
Diagnosis is specified as mild, moderate,
severe, or profound, defined based on
adaptive functioning.
ASSESSMENT
Early assessment is key and should be initiated as soon as health care providers or
parents become aware of a delay in motor , language or social milestone.
Early assessment and diagnosis allow parents to appreciate and understand the
needs of their children, adopt realistic expectations and identify and implement
appropriate resources and supports.
To aid in planning, parents need a realistic prognosis for their child.
AUTISM SPECTRUM DISORDER
Autism spectrum disorders (ASD) are a diverse group of conditions.
They are characterized by some degree of difficulty with social
interaction and communication. Other characteristics are atypical
patterns of activities and behaviours, such as difficulty with transition
from one activity to another, a focus on details and unusual reactions to
sensations.
The abilities and needs of autistic people vary and can evolve over time.
Characteristics of autism may be detected in early childhood, but autism
is often not diagnosed until much later.
People with autism often have co-occurring conditions, including epilepsy,
depression, anxiety and attention deficit hyperactivity disorder as well as
challenging behaviours such as difficulty sleeping and self-injury.
The level of intellectual functioning among autistic people varies widely,
extending from profound impairment to superior levels.
Available scientific evidence suggests that there
are probably many factors that make a child
more likely to have autism, including
environmental and genetic factors.
It is important that, once autism has been
diagnosed, children, adolescents and adults with
autism and their carers are offered relevant
information, services, referrals, and practical
support, in accordance with their individual and
evolving needs and preferences.
Signs of autism in children
not responding to their name.
avoiding eye contact.
not smiling when you smile at them.
getting very upset if they do not like a certain
taste, smell or sound.
repetitive movements, such as flapping their
hands, flicking their fingers or rocking their
body.
not talking as much as other children.
Children and adults with ASD often display unusual, repetitive behaviors or
mannerisms. These behaviors may manifest or increase in intensity when the
individual is upset, frustrated, scared, or anxious.
Diagnosing autism spectrum disorder (ASD) can be difficult because there is no medical
test, like a blood test, to diagnose the disorder. Doctors look at the child’s
developmental history and behavior to make a diagnosis.
TREATMENT: ABA-APPLIED BEHAVIOR ANALYSIS
SPECIFIC DEVELOPMENTAL DISOREDERS
Include learning disorder, communication disorders and
motor skills disorders with diagnoses at varying times
during childhood
Learning disabilities often affect academic skills in
reading, mathematics or writing.
Communication disorders involve problems of
speech(expressive production), language(form, function,
and use), phonologic disorders and stuttering, and
communication, both verbal and nonverbal.
Those conditions can lead to a lack of self-esteem unless a
child receives support and encouragement.
ATTENTION DEFICIT
HYPERACTIVITY DISORDER- ADHD
ADHD is one of the most common neurodevelopmental disorders of childhood.
It is usually first diagnosed in childhood and often lasts into adulthood.
Children with ADHD may have trouble paying attention, controlling impulsive
behaviors (may act without thinking about what the result will be), or be
overly active.
It is normal for children to have trouble focusing and behaving at one time or
another. However, children with ADHD do not just grow out of these
behaviors.
The symptoms continue, can be severe, and can cause difficulty at school, at
home, or with friends.
A child with ADHD might:
daydream a lot
forget or lose things a lot
squirm or fidget
talk too much
make careless mistakes or take unnecessary risks
have a hard time resisting temptation
have trouble taking turns
have difficulty getting along with others
The cause(s) and risk factors for ADHD are unknown, but current research shows that genetics
plays an important role. Recent studies link genetic factors with ADHD.
In most cases, ADHD is best treated with a combination of behavior therapy and medication. For
preschool-aged children (4-5 years of age) with ADHD, behavior therapy, particularly training for
parents, is recommended as the first line of treatment before medication is tried. What works
best can depend on the child and family. Good treatment plans will include close monitoring,
follow-ups, and making changes, if needed, along the way.
There are three different ways ADHD presents itself, depending on which types of
symptoms are strongest in the individual:
Predominantly Inattentive Presentation: It is hard for the individual to organize or
finish a task, to pay attention to details, or to follow instructions or conversations.
The person is easily distracted or forgets details of daily routines.
Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a
lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller
children may run, jump or climb constantly. The individual feels restless and has
trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab
things from people, or speak at inappropriate times. It is hard for the person to wait
their turn or listen to directions. A person with impulsiveness may have more
accidents and injuries than others.
Combined Presentation: Symptoms of the above two types are equally present in the
person.
THERAPEUTIC MANAGEMENT:
1. ENVIRONMENTAL MODIFICATION-stable learning environment
2. FAMILY SUPPORT
3. MEDICATION-stimulants
OPPOSITIONAL DEFIANT DISORDERS
ODDs
Tics can sometimes be diagnosed at a regular checkup after the doctor gets a full
family history, a medical history, and a look at the symptoms. No specific test can
diagnose tics, but sometimes doctors will run tests to rule out other conditions
that might have symptoms similar to tics.
TOURETTE SYNDROME
TOURETTE SYNDROME-is a inherited syndrome of motor and one or more
phonic vocal tics.
Occurs three times more frequently in males than females
Family often have history of movement disorder
Onset age is between 4 to 6, peaking at 10 to 12 years.
Complex vocal tics- repeated use of words or phrases out of context-
specifically,
(coprolalia- use of socially unacceptable words, usually obscenities),
(palilalia-repeating one’s own words),
(echolalia-repeating others words)
Some children with this syndrome have non specific electroencephalographic
abnormalities and soft neurologic signs that aid in diagnosis.
Treatment: CBIT-comprehensive behavioral intervention therapy
Depression, Psychiatric And Bipolar And
Related Disorders Affecting Children
It's not known what causes childhood schizophrenia, but it's thought that it
develops in the same way as adult schizophrenia does.
Researchers believe that a combination of genetics, brain chemistry and
environment contributes to development of the disorder. It's not clear why
schizophrenia starts so early in life for some and not for others.
Early identification and treatment may help get symptoms of childhood
schizophrenia under control before serious complications develop. Early
treatment is also crucial in helping limit psychotic episodes, which can be
extremely frightening to a child and his or her parents. Ongoing treatment can
help improve your child's long-term outlook.
Elimination Disorders
Encopresis
Encopresis sometimes called fecal incontinence or soiling, is the repeated
passing of stool (usually involuntarily) into clothing.
Typically it happens when impacted stool collects in the colon and rectum:
The colon becomes too full and liquid stool leaks around the retained stool,
staining underwear.
Children aged 4 years and older, common in males
Primary if the child was never fully toilet trained and secondary if the
problem began after effective training.
Children with encopresis often have the following symptoms:
Not being able to hold their stool until they get to a toilet.
Passing stool in their clothes.
Hiding bowel movements (poop) or keeping them a secret.
Hiding soiled clothes.
Not having regular bowel movements.
Feeling bloated or experiencing pain in their abdomen or stomach.
Loss of appetite.
Treatment is unique to each child diagnosed
with encopresis and could include:
Removal of any stool ball.
Taking stool softeners, laxatives or enemas to
ensure regular, soft stools.
Scheduled toilet sitting.
Eating a diet high in fiber (fruits, whole grains,
vegetables).
Drinking plenty of water.