AUTISM VS.

AD/HD

Pervasive Developmental Disorder: Autistic Disorder

- Characterized by impairment in social and communication skills and the display of stereotypical behaviors. - Autistic disorder is marked by severe deficits in language, perceptual and motor development, defective reality testing; and an inability to function in social settings.

 Autism often is not diagnosed until the age of 2-3, but early signs during infancy detects it like: >failure to cuddle >failure to make eye contact >failure to exhibit facial responsiveness >unable to play cooperatively >may not reach to be picked up

COMMON SYMPTOMS INCLUDE: failure to develop social relations abnormal responses to sensory stimuli inappropriate or decreased emotional expressions specific, limited intellectual problem solving abilities Repetitive use of language (echolalia) impaired ability to initiate or sustain a conversation

Appearance: Clean, flat, act as deaf Behavior: Ritualistic, insensitive to pain, no fear to death, uncuddly, point s to anything, temper tantrums, solitary play, LABILE mood Communication: Echolalia; giggling laugh NX: Impaired verbal communication; impaired social interaction; risk for injury (directed to self) Nursing Priority: Safety Activity: Non-competitive, monotonous Attitude therapy: Active friendliness

Autism

Attention-deficit hyperactivity disorder >>> is a persistent pattern of inattention and/or hyperactivity-impulsiveness reveled before age of 7 Estimated to occur in about 3-7% of children in Requires 2 settings: home and school

ADHD

Appearance: Dirty child Behavior: Clumsy, hyperactive, impatient Communication: talkative, bursts out Structure Setting limits Schedule

ADHD
Important to distinguish ADHD from normal, active behavior, behavioral signs of psychosocial stressors, inadequate parenting, or other psychiatric disorders such as bipolar disorder Can persist into adulthood Often diagnosed when child starts school

At school age, symptoms of ADHD begin to interfere significantly with behavior and performance: Fidgets constantly Makes excessive noise Normal environmental noises are distracting Cannot listen to directions or complete tasks Blurts out answers before questions are completed Hurried, careless mistakes in schoolwork Loses or forgets homework assignments Fails to follow directions Peers may ostracize

ADHD

Combination of pharmacotherapy with behavioral, psychosocial, and educational interventions

(CARD)

Treatment

Stimulants: pemoline (Cylert) amphetamine compound (Adderall), methylphenidate (Ritalin), an dextroamphetamine (Dexedrine), and Common side effects: insomnia, loss of appetite, and weight loss or failure to gain weight

T O U G H

Strategies for Home and School

-Therapeutic play techniques -Offering consistent praise -Using time-out -Giving verbal reprimands -Helping with parenting strategies

P -Providing consistent rewards and consequences for behavior I -Issuing daily report cards for behavior G -Give point systems for positive and negative behavior

AD/HD
Etiology Decrease glucose; early malnutrition; prenatal trauma; hereditary; social Dirty, low self-esteem, Clumsy, hyperactive, inattentive

Appearance Behavior

Communication NX

Excessive talking, burst out in class Impaired social interaction; risk for injury (directed to others) safety

Nursing Priority

Nutrition

Treatment
Milieu Activity

AD/HD Increase in calories, finger foods Ritalin, Dexedrine, Cylert (CA-R-D) Non-stimulating
Quiet, non-competitive

Attitude therapy Kind firmness

Mental Retardation

Mental Retardation

Mental retardation
Subnormal general intellectual functioning which originates during the developmental period and is associated with impairment of either learning and social adjustment or maturation or both.

Genetic: chromosomal and inherited conditions Acquired syndromes: perinatal trauma Developmental: prenatal exposure to toxins and infections Only 2/3 of all individuals with MR, the probable cause is identified Ex. Down syndrome (trisomy 21) caused by chromosomal abnormality abnormal accumulation of chemicals interferes with brain development and may lead to MR Fetus exposed to alcohol, drugs, radiation, oxygen deprivation, syphilis, poor maternal nutrition

Causes:

Physical Appearance
almond-shaped head downward slanted eyes mouthbreathers and prone to respiratory infections imitate others tongue is flabby with deep groves and fissures small head acute leukemia is more prevalent in them short fat hands with usually one palmar line (simian crease); friendly age of death- 30s or earlier thick lips temper tantrums yellow complexion

Classification of mental retardation according to IQ

CATEGORY IQ

Borderline
mild moderate

68-85
52-67 36-51

severe
profound

20-35
Under 20

Mild (Educable/Moron)
85% of all persons with mental retardation social and vocational skills for minimum self-support up to sixth grade level social communication skills minimal retardation in sensorimotor areas

10% of all persons with mental retardation May profit from vocational training Can function in sheltered workshops as unskilled or semiskilled persons up to 2nd grade level Can talk or learn to communicate poor social awareness fair motor development may learn to travel alone in familiar places

Moderate (Trainable/Imbecile)

3% to 4% of all persons with MR Poor motor development speech is minimal generally unable to profit from training in self-help; little or no communication skills Can talk or learn to communicate elemental health habits, self maintenance under complete supervision;

Severe(Imbecile)

Profound (Idiot)
1% to 2 % of all persons with MR Gross retardation; minimal capacity for sensorimotor areas needs nursing care (0-5) Some motor and speech development; may achieve very limited self-care

Nursing Care
Help parents accept diagnosis of mental retardation Consider the developmental/functional age, not the chronological age

Teach parents/caregivers that they should:

Protect the child from danger Make the child as independent as his condition will permit Teach the child to refrain from holding their mouths open as this gives them a dull appearance Select attractive, well-fitting clothing, hairstyle and good hygiene practices Eliminate the childs undesirable social traits, e.g. touching their noses and ears, scratching Refrain from scolding because it blocks learning Recognize that temper tantrum as a childs attempt to meet some underlying emotional needs

Teach parents/caregivers that they should:

When teaching the child: Demonstrate Use pictures for these are valuable teaching aids Start teaching simple things, gradually progressing to complex learning experiences Teach only one thing at a time Repetition and patience are necessary virtues

Nursing Care