NEURODEVELOPMENTAL AND DISRUPTIVE BEHAVIOR DISORDERS

What is resiliency

developed through successful transition through a previous crisis, often with guidance and support.

Factors that lead to disruption in behavior

genetic, biochemical, environmental

What is the Denver II Developmental screening

Designed for infants and children up to 6 years old

Child-adolescent mental status assessment

General appearance, activity level (hyper or hypo, tics, autoerotic and self-comforting movements), coordination or motor function, speech, affect, manner of relating (eye contact, ability to separate from caregiver, behavior during interview), intellectual functions, thought process and content (orientation), characteristics of child’s play

What is intellectual disability disorder (IDD), RFs, and causes

mild-profound

RFs: maternal age, exposure to substances or poor fetal tone

Causes: Rubella, Tay-Sachs disease, fragile X syndrome in pregnancy problems

Communication disorders

Language, speech sound disorder, childhood-onset fluency disorder (stuttering), social communication disorder

Autism spectrum disorders (ASD), and criteria

Severity 1-3

Two or more of the following:

Stereotyped or repetitive movement, excessive adherence to routine or rituals, fixated interests, hypo-hyper active

Treatment of ASD, goal

goal is to reduce behavioral symptoms

Meds: Haldol, risperidone, Abilify, SSRIs or beta blockers

early treatment, individualized, CBT

What is ADHD in terms of children? S/S?

s/s: problems with concentration and focus, failure to listen and follow, forgetfulness, lack of follow-through

Diagnosis of ADHD?

Vanderbilt assessment scale: a psychological assessment tool for parents of children aged 6 to 12 designed to measure the severity of attention deficit hyperactivity disorder (ADHD) symptoms.

Connor scale for ADHD assessment

What does NOT cause ADHD

sugar, food addittives, colorings, or preservatives

Interventions for ADHD

Behavioral modification therapy

Pharm: stimulants (methylphenidate, amphetamines), nonstimulants (Strattera SNRI, Tenex, Clonidine)

Big side affect of stimulants

loss of appetite, weight loss, insomnia

Core nursing interventions ADHD

simple instructions, safety, structured daily routine, role performance

What are different motor disorders and s/s?

Developmental coordination disorder: clumsiness, slowness, difficulty with handwriting or riding a bike

Tourette’s disorder: Simple, motor, or complex tics

Treatment for developmental coordination disorder?

adaptive physical education and sensory integration to foster normal growth and development

Treatment for Tourette’s disorder?

atypical antipsychotics – risperidone or aripiprazole

Comprehensive behavioral intervention for tics - habit reversal

DSM-5

PT and OT

What is disruptive mood dysregulation disorder?

Must be diagnosed in childhood - temper tantrums

Onset: before age 10

Symptoms: sadness, crying, lack of energy, change in appetite or sleep patterns, and negative or suicidal thoughts

Severe: recurrent outbursts, persistent irritability

Assessment, diagnosis, and implementation for depressive disorders

SAD PERSONS scale or HEADSSS to assess suicide risk

Treatment:

Individual and group therapy

Behavior modification

Family support and protection

Medications: antidepressants, stimulants and/or mood stabilizers

What is separation anxiety disorder?

Most common type of anxiety disorder in children

Can lead to headaches, n/v, sleep disturbances

treatment for anxiety disorders

SSRI, beta blockers, antihistamines

What is reactive attachment disorder?

Cause: inconsistent care or frequent change in caregiver, foster care

Symptoms: Limited positive affect, irritability, sadness, fearfulness, and minimal social responsiveness

Treatment for elimination disorders

Bladder training, schedule, dietary changes

imapramine, desmopressin, oxybutynin, stimulants, SSRI

What is oppositional defiant disorder (ODD)

Loses temper frequently; easily annoyed Angry mood Argues with authority figures Deliberately annoys others Blames others for mistakes or misbehavior Vindictive Defiant and headstrong behaviors Almost all children show symptoms found in ODD. however, the behaviors need to occur “more persistently and frequently.”

What is conduct disorder

precursor for antisocial disorder

more severe than ODD

What is intermittent explosive disorder?

Episode of impulsive aggressive behavior

Treatment - lithium, fluoexetine, mood stabilizers, SSRIs

CBT

avoid alcohol and substances