Intellectual Disabilities
What do we use the phrase "cognitive impairment" in place of?
What age must you be to get diagnosed with a cognitive impairment?
It is a general term used instead of "mental retardation" that encompasses any type of mental difficulty/deficiency
Must be 2 years old to get diagnosed
Most common chromosome abnormality...
Down syndrome
True or False: Autism can be cured with intense therapy and discipline from parents
FALSE !
Autism can be improved in certain areas (such as language skills), but there is NO cure
What is Attention Deficit Hyperactivity Disorder?
(Hint: think about the name/what each letter of ADHD stands for)
developmentally inappropriate degrees of inattention, over activity, and impulsivity
What are some areas of functional impairments a child with an intellectual disability might struggle in?
- Communication
- Home living
- Community use
- Leisure
- Health and safety
- Self care
- Social skills
- Academics
- Work
- Self direction (this can be a parental issue because they are not getting disciplined at home)
Difference between Mild vs Severe intellectual disability
Bonus: what must be put in place for severe disability?
Mild: self esteem issues, social isolation, loneliness, depression
Severe: self injury, fecal smearing, temper tantrums, tearing personal items, disrobing
- safety precautions must be put in place for severe !
What is a severe disorder related to environmental alterations?
- Bonus: describe it the best you can :)
Fetal Alcohol Syndrome (FAS)
- malformations in face and skull, CNS deficits, intellectual/developmental disabilities, persistent symmetric growth retardation
- early intervention! special attention must be given to parents (involving the care of the infant)
Who usually picks up on Autism?
Who does NOT pick up on Autism?
Teachers are usually the 1st to pick up on Autism
Parent's do NOT pick up on it because their child's behaviors have become normal to them
- (parents usually express guilt and shame)
True or False: early diagnosis is important for ADHD
TRUE
What are some helpful ways to deal with a child with Autism?
(Hint: think about the tv show clip Mrs. Cagel showed us in class)
Consistency and being firm with the child
ex: setting consistent boundaries and establishing discipline
List the causes of intellectual disability
- Genetic
- Alterations occurring during pregnancy (such as FAS or taking drugs)
- Neonatal alterations (hypoxia at birth resulting in neurological damage)
- Acquired childhood conditions or diseases (ex: bit by a mosquito with malaria)
- Environmental problems
- Some have unknown causes (Autism)
Which disorders have a known genetic cause?
What is the main difference between the two?
Fragile X and Rett Syndrome
- Fragile X usually affects BOYS
- Rett syndrome usually affects GIRLS
What is the name of "high functioning Autism"?
Bonus: name symptoms of this syndrome
Asperger Syndrome
- Symptoms: severe social and emotional disabilities/withdrawal, rigidity regarding schedules, motor clumsiness, organizational skill problems
- Despite social and emotional withdrawal, those with Aspergers are VERY intelligent :)
Children up to ___ years old are identified as having ADD
16 years old
How can you differentiate Fragile X Syndrome and Autism?
Physical looks and genetic testing (Autism cannot be determined from genetic testing)
Why might a child with an intellectual disability throw a temper tantrum, tear up personal items, or disrobe themselves?
The child has trouble communicating so this is how they express themselves
True or False: Rett Syndrome is more severe than Fragile X
TRUE
Rett Syndrome IS MORE SEVERE than Fragile X !!!!
What symptoms of Autism will an infant present with?
- Infant does not want to be touched/cuddled
- Will not make eye contact
What interventions are used for ADHD?
Behavioral therapy and medications (stimulants)
- square head w/ upward slant of eyes
- flat nasal bridge
- protruding tongue
- hypotonia (decreased muscle tone)
What is the nursing care for intellectual disabilities?
PROMOTE CHILDS OPTIMAL DEVELOPMENT
- EARLY INTERVENTION: educate pt and family about following milestones (early treatment decreases chance of falling behind on milestones)
- ESTABLISH DISCIPLINE !
- Increase time spent in a regular school setting
Clinical manifestations of Fragile X syndrome
- large head circumference
- prognathism (long face w/ a prominent jaw)
- large protruding ears
- large testes if they have already started puberty
What age are symptoms of Autism usually noticeable?
How early in age can a child start presenting with symptoms?
Can a child be diagnosed at this age?
Symptoms are noticeable by 3 years old
Can start presenting as early as 1 year of age
Diagnosis is often delayed until 2-3 years of age
Name some assessment findings of ADHD
- fidgets or squirms in seat
- easily distracted
- difficulty following directions
- poor attention span
- shifts from 1 uncompleted activity to another
- talks excessively
- interrupts
- engages in physically dangerous activities without considering possible consequences
- sleep disturbances
- difficulty in social relationships
1) What age do symptoms of Rett syndrome emerge?
2) What type of gait disturbances do we see in Rett syndrome?
3) Impairments of Rett syndrome can affect abilities to...
1) Symptoms emerge between 6-18 months
2) Repetitive hand movements such as clapping, flapping, and clasping hands
3) Can affect ability to breathe, talk, walk, and eat
More info:
- infant initially shows normal development from birth to 6 months
- social and intellectual development stops
- seizures, stereotypical hand and gait disturbances