Child and Adolescent Disorder (1) (1)
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Transcript of Child and Adolescent Disorder (1) (1)
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Child and adolescent disorders
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Mental retardation
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Mental retardation
Mental retardation involves below-averageintellectual functioning (IQ below 70),accompanied by significant limitations in
adaptive functioning areas, such ascommunication skills, self-care, home living,social or interpersonal skills, use ofcommunity resources, self-direction, academic
skills, work, leisure, health, and safety.
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Degrees of retardation
Mild (IQ 50 to ---70)
Moderate (IQ 35 to ---50)
Severe (IQ 20 to ---35) Profound (IQ below 20)
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Signs & Symptoms
D decreased Cognitive & intellectual
functioning
D deficits in psychomotor skills D difficulties in performing self-care
activities
D degrees of neurologic impairment
D depressed or labile mood
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Treatment
1. BEHAVIOR MANGEMENT
2. ENVIRONMENTAL SUPERVISON
3. MONITORING OF CHILDS DEVELOPMENTALNEEDS & PROBLEMS
4. PROGRAMS THATMAXIMIZE SKILLS
5. FAMILY THERAPY
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Nursing Intervention
1. Determine a plan of care
2. Monitor childs developmental levels
3. Teach about natural & normal feelings of
emotions
4. Safety needs
5. Prevent self-injury
6. Behavior modification
7. KEY COMMUNICATION : brief, simple & consistent
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Autistic Disorder
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Autistic Disorder
Best known of these disorders
More prevalent in boys
Present by age 3
Child has little eye contact, few facial expressions,does not communicate verbally or with gestures,doesnt relate to peers or parents, lacks spontaneousenjoyment; apparent absence of mood and affect;
cannot engage in play or make-believe with toys
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Autistic Disorder
Hand-flapping, body-twisting, head-banging
Autism may improve, sometimes substantially,
as language and communication skills arelearned.
Traits persist into adulthood. Few attain
complete independence, marry, or have
children.
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Autistic Disorder
Most autistic children are mainstreamed in
school.
Medications may be used to target specific
behaviors but do not treat the autism.
Goals are to reduce behavioral symptoms and
promote learning, development, and language
skills.
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Treatment
1. Early intervention, special education &family support.
2. Drugs, Methylphenidate to reduceinattentiveness, impulsivity & overactivity.
3. Family counselling
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Nursing Intervention
1. Choose words carefully when speaking.
2. Provide emotional support to parents
3. Promote communication : close, face-to-
face contact with the child
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Retts Disorder
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Aspergers Disorder
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Aspergers Disorder
Same impaired social interaction and
restricted stereotyped movements as in
autism, but no language or cognitive delays;
rare
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Attention Deficit Hyperactivity
Disorder (ADHD)
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Attention Deficit Hyperactivity
Disorder (ADHD)
Marked by developmentally inappropriate
inattention, impulsiveness, and in some cases,
HYPERACTIVITY.
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Signs & Symptoms INATTENTION
Fails to close attention details
Has trouble sustaining attention in tasks
Not to listen when spoken directly
Fails to follow instructions
Trouble in organizing tasks
Reluctant to engage in tasks
HYPERACTIVITY-IMPULSIVITY
Fidgets with his hands or feet or squirms in his seat
Run abouts
Trouble in playing & engagaing in leisure activities
On the go
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Treatment
P Psychotherapy to reduce ADHDsymptoms
E Education
P Pharmacology, RITALIN
S - strengths
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Nursing Interventions
1. Trusting & accepting relationship
2. Verbalize emotions
3. Assess risk of injury
4. Safe & calm environment
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Conduct Disorder
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Conduct Disorder
Persistent antisocial behavior of children andadolescents that significantly impairs ability tofunction in social, academic, or occupational areas
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Signs & Symptoms
C Cheats D destroys property
O Obnoxious I - intimidates
N Nasty in speech & S Steals
& behavior
D Drug & alcohol use O onset of antisocial PD
U unpredictable behavior R - rages
C cruel to people D disrespectful
or animals
T truant E esteem low
D destroys property R reckless or risky
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Treatment
1. Psychotherapy
2. Drugs that can treat neurologic difficulties
3. Educational Strategies
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Nursing Intervention
1. Work to establish a trusting relationship
with the child.
2. Behavioral guidelines 3. Talk about making acceptable choices
4. Effective problem-solving skills
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Oppositional Defiant Disorder
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Oppositional Defiant Disorder
Enduring pattern of uncooperative, defiant,
and hostile behavior toward authority figures
that does not involve major antisocial
violations
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Signs & Symptoms
1. Loses TEMPER
2. often argues with adults
3. Often defies or refuses to comply with adults
requests 4. Annoys people deliberately
5. blames others for mistakes
6. Touchy or easily annoyed by others
7. Angry & resentful
8. Spiteful & vindictive
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Treatment & Nursing Intervention
FAMILY THERAPY
Convey acceptance
Discuss childs limits & consequences
Help address negative feelings
Stop plotting accept responsibility of own
behavior Role-playing problem solving skills
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Tourettes Disorder
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Tourettes Disorder
Multiple motor tics and one or more vocal
tics; vocal tics can be name-calling or
profanity; can persist into adulthood
Person is embarrassed and self-conscious, and
has significant impairment in academic, social,
occupational areas.
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Signs & Symptoms
Tics
eye blinking
Facial grimacing
Neck, head jerking
Neck stretching
Foot stamping
Body twisting & bending
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Treatment
1. Psychotherapy
2. Pharmacotherapy
Low dose anti-psychotics, PIMOZIDE, RESPERIDONE,
HALOPERIDOL
SSRIs, fluoxetine
Anti-HPN, clonidine
NURSING INTERVENTION: Develop childs TRUST; provide
quiet activities; Stay positive about himself
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Chronic Motor or Tic Disorder
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Chronic Motor or Tic Disorder
Has only vocal tic or only motor tics, not both,
as with Tourettes.
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Self-Awareness Issues
Recognize own beliefs about parenting and
how they differ from others.
Focus on patients strengths, not justproblems.
Try to have positive impact on child, even
when disability is severe.
Support parents
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Thank you!