rst 230 exam 3

legally blind

his/her vision in the better eye, even with glasses or contact lenses, is no better than 20/200 or if his/her visual field has a maximum diameter of 20 degrees.

visually impaired/partially sighted

serious loss of vision or surgical procedures or with conventional eye glasses

Levels of visual impairment

acuity= describes the amount of detail an individual sees compared to what a person with normal vision sees

visual field=includes the entire area that can be seen at one time with the fixed eye.

ocular dominance and miles test

the tendency to prefer visual input from one eye to another

miles test=look straight ahead, triangle in arms, look in the triangle close right eye, still see letter or moved. Close right and still=right eye dominant, same for left eye dominant

tunnel vision

you can see straight ahead but cant see to the side

peripheral vision

you can see the periphery(sides) but cant see straight ahead

cataracs

common- lens becomes milky or cloudy and this cloudiness distorts rays of light and prevents light from being focused on the retina

primary cause of blindness among older adults.

causes- lack of oxygen--- disturbance in the nutrition of the lens or external forces(electrical shock, wounds, x-rays

glaucoma

caused by the increased pressure within eyeball

liquid builds up and increases pressure within the eye

such increased pressure can damage the optic nerve.

Symptoms- loss of peripheral vision, sensitivity to light and glare, problems with night vision, blurred vision

diabetic retinopathy

one of the most common causes of vision impairness and blindness. diabetes causes changed in blood vessels in the retina that causes hemorrhaging.

symptoms= spots floating in visual field, vision loss, blurred vision, poor night vision.

major causes of visual impairments

aging, congenital, disease, accidents

sighted guide technique

-A blind person's right hand will grip your left elbow
-Keep your arm close to your body
-Blind person will travel half step behind you
-Keep the person aware of conditions or changes in surroundings, mention curbs stairs etc
-when guiding a person who is blind to seat, simply place her hand on the back of the chair and let her seat herself

hearing impairments

general term used to describe all types of hearing loss, ranging from very mild to profound deafness

deafness

state occurring when a person is unable to understand speech through the ear alone, either with or without a hearing aid

hard of hearing

people who have mild to moderate hearing loss resulting in decreased perception of conversational speech, but sufficient hearing to permit understanding under optimal circumstances

pre-lingual hearing loss

before language-hearing loss that occurs before speech develops

which means that a child is born deaf or with certain hearing loss or acquires hearing loss before he or she learns to speak- difficult to learn how to speak

post-lingual hearing loss

after language- hearing loss that happens after the child or after the adult learns to speak

Rh incompatibility

A complication of pregnancy in which a mother who is Rh negative carries an Rh-positive fetus

under certain conditions, antibodies in the mother's blood can attack the fetus's red blood cells. blood of baby mixes with mom so antibodies begin to form- if during child birth fine but then next pregnancy could be bad

conductive hearing loss

outer or middle ear

most common cause is obstruction in the ear canal (stuck in ear canal-wax) 2. puncture of ear drum 3. otosclerosis=calcification and softening of 3 little bones in middle ear

sensorineural hearing loss

"nerve deafness"

inner ear=cochlea

causes- aging, congenital (viral infection of the mother), exposure to high levels of noise, Rh incompatibility, high fevers in childhood

central hearing loss

hearing portions of brain-pathways of brain is damaged

causes- accident(hit yourself in heard in temporal lobes)

communication with people with hearing impairments

-get their attention
-speak clearly and distinctly at a normal rate and volume
-be expressive
-prevent distractions
-position yourself

-lip reading
-sign language
-technical assistance
-hearing aids= behind ear, in ear(moderate to severe), in canal(mild to moderate), completely in canal "invisible" (mild to moderate)

Working with a sign language interpreter

-Always look at and speak directly to the person with a hearing impairment
-Always speak in the first person, do not say "tell him " or "ask her"
-Do not ask the interpreter to interpret select portions of what you said
-Make sure the person with a hearing impairment can clearly see both the interpreter and the speaker
-Hand all materials to the person with a hearing impairment, not to the interpreter
-Speak normally, rely on the interpreter to let you know if there is a need to slow down or pause
-When giving visual handouts, allow time to review the printed materials either before or after the explanation

Autism

a complex developmental disability that involves a number of specific communication , social, and behavioral impairments.

White couples with higher social class are more likely to have children with it

Causes= we don't know

common impairments associated with autism

-social skills off
-sports not normal way
-vocabulary decreases- limited
-lack of social play
-lack of eye contact
-initiating and staying in conversation

-some have tantrums
-special talents-math, drawing
-need routines
-run
-rocking, flapping hands

intellectual disability/ mental retardation

-prior to 1992, it was diagnosed based on IQ only: mild (50/55-70), moderate( 35/40-50/55), severe (20/25-35/40), profound(below 20/25).

New diagnose- based on IQ, adaptive skills (impairment in at lest 2-can live independently, basic transportation, and can you put sentences together ), time of onset(prior to 18).

levels=mild mostly, moderate, severe

2.5% of population

based on IQ only= 3-5/1000 births

causes of intellectual disability/ mental retardation

Causes:
Non-organic= Are not caused by external factors, No known medical cause of intellectual impairment

Organic= Known medical, external cause. most common in western world is Alcohol during pregnancy(fetal alcohol syndrome- 0.2-2 cases per 1000. comparable to or higher than other disabilities), Brain injury,Lack of oxygen during birth,Premature birth, Smoking

fetal alcohol syndrome

physical and cognitive abnormalities in children caused by a pregnant woman's heavy drinking.

cognitive and functional disabilities= poor memory, attention deficits, impulsive behavior, poor cause-effect reasoning

secondary disabilities= mental health problems and drug addiction

FAS runs in families-mom does it, then child does it, on and on

Diagnose=

1. growth deficiency- prenatal or postnatal height or weight or both at or below the 10th percentile
2. FAS facial features- all three features must be present( smooth philtrum, thin vermillion, shorten eye width)
3. Central nervous system damage- head circumference at or below 10th percentile, brain abnormalities observable through imaging, neurologic problems(motor problems, seizures), low functional test performance

wide nasal bridge, narrowly set eyes, thin upper lip, plitrum= flat, # of creases on palm is only 1-simian crease

down syndrome

facial appearance is different, ex. flatter, shorter, eyes are almond shaped, high obesity rates-heart problems

mental retardation and aging

Alzheimer's disease, dementia, age faster

considerations for people with intellectual disability

A. Special considerations
-Significant and lower strength
-High obesity rates
-More time needed to learn skills
-Slower performance
-Unable to handle multiple instructions

B. Suggestions on how to deal with people with MR in rec. settings:
(a) Focus on abilities
(b) Make it understandable
(c) Ensure dignity
(d) Facilitate decision-making
(e) Provide feedback
(f) Look to experts for support
(g) Structure the environment
(h) Set clear behavioral expectations
(i) Ensure safety

Atlantoaxial instability

a type of misalignment of the upper spinal column that is often found in people with Down syndrome

greater than normal mobility of the two upper cervical vertebra

• neck can be broken very easily

epilepsy

-A chronic medical condition caused by temporary changes in the electrical functioning of the brain (caused by a chemical imbalance)
-Symptoms: cause seizures which affects awareness, movement, or sensation

major causes of epileptic disorders

-6 out of 10 cases we really dont know, born with it, diagnosed as children, runs in family
-40%= stroke, brain damage, meningitis

generalized seizures and types

= two hemispheres of the brain

grand mal- seizure with complete loss of consciousness: typical
petit mal- "brief period of fixation", "absence" -stares into space and does not respond to external stimuli

partial seizure and type

partial-one hemisphere of brain

Jacksonian=shaking in one part of the limb then spread to the entire side of the body

treatment during grand mal seizure

-Ease person to floor
-Turn person on side to help breath
-Clear area around person of anything hard or sharp to prevent injury
-Put something flat like a folded jacket under head
-Remove eyeglasses
-Loosen ties around neck that might restrict breathing
-Call 911

DO NOT
Hold person down to try to stop his or her movements
Put anything in a person's mouth to injure teeth and the jaw.

Call 911 if:
-Person has never had a seizure
-Person has difficulty breathing or walking after seizure
-Lasts longer than 5 minutes
-If one follows after the first

stroke

Damage to the brain from interruption of its blood supply

cerebrovascular incident or TBI that originates inside of the brain where a portion of the brain is deprived of blood.

.#3 cause of death in the US

80% are preventable

ischemic cascade

progress of stroke: portion of the brain that receives less than 20% of the normal blood flow

transient ischemic attacks

-Brief episodes of circulatory deficiency to the cerebrum

-Tiny strokes where brain does not get enough oxygen through blood

-Like a stroke but goes away after a few seconds to a few minutes

-Mini strokes before big one comes (30 minutes or 8 months - doesn't matter how long)

uncontrollable stroke risk factors

1. Age- 60%, 2/3 happen to people 65 yrs or older

2. personal history of stroke-had one your more likely to get another. 42% for men will have another within 5 years. 24-24% of women will have another

3. personal history of diabetes

4. family history of stroke

5. race- african americans highest, then whites, than latinos

controllable stroke risk factors

1. Blood pressure(systolic-heart beats, diastolic-between heartbeats

2. obesity
   3.alcohol
   4.smoking

3. diet-high cholesterol

ischemic stroke

causes by blockage of any artery (80%) age-older adults

cerebral thrombosis

Ischemic:
-Accounts for 50% of all strokes
-Blood clot forms in an artery-stays and prevents blood to brain
-Usually seen in older people
-High cholesterol

cerebral embolism

ischemic:
blood clot travels to the brain, build up of fatty plaque

hemorrhagic stroke

causes by bleeding in brain (20%)- any age

cerebral hemorrhage

Hemorrhagic stroke:

-A blood vessel in the brain bursts and bleed (aneurysm)
-When an artery bleeds, the brain does not receive oxygen and nutrients
-Pressure builds up in surrounding tissues, and causes irritation and swelling

symptoms of stroke

1.weakness, numbness, paralysis of face, arm, or leg on one side of the body. right-left weak, left=right weak

2. sudden or sharp dizziness
3. trouble walking or loss of balance
4. dimness or loss of vision in one eye
5. loss of ability to speak or understand speech
6. severe headache without a known cause

effects of stroke

-Hemiplegia: weakness or paralysis-one side or both

-Memory loss-Speech/Language Problems-short term=both sides

-Reflexes: crying or laughter, inappropriate responses (laughing during sad times vice versa)

-Hemianopsia: half of your visual field dissapears

-Aphasia=
--Receptive Aphasia: not receiving info- can respond
--Expressive aphasia: not expressing info (no speaking) can understand but cant respond

Treatment and dealing with stroke patients

Immediately call 911, every minute counts, need medication to stop it within 6 hours.

never drive

42% wait 24 hours after to go to hospital- 13 hours is average

anxiety disorders

most common-28.8% of people

impulse control disorders

24.8% of people-gambling

mood disorders

20.8% of people

Neurosis (mental illness)

manic-depressive disorder, schizophrenia(delusions)

neurosis (mental illness)

Mild depression, mild anxiety, phobias, obsessional behavior (less sever)

mental illness vs. mental retardation/intellectual disability

mental illness= not a developmental disability and does not directly impact intellectual capacity- any age, does not lower potential, medication to treat

mental Retardation- developmental disability that affects the development of a persons intellectual potential-diagnosed before 28, no treatment, affects potential

depression

-major depressive episodes are characterized by at least 5 of 9 symptoms displayed within a 2 week period, with at least one of the symptoms being either depressed mood or loss of interest in pressure

Symptoms:
-sleep disturbance
-Appetite disturbance
-Lack of energy
-excessive feelings of guilt or worthlessness
-indescivenss
-Slower than normal
-recurring thoughts of death or suicide
-Social isolation

postpartum depression-hormonal changes thoughts in heads

bipolar disorder

(manic depression)
mental illness characterized by mood swings from periods of extreme euphoria to severe depression, extreme changes in energy levels and behavior

manic phase- The high phase, being on cloud nine, filled with ideas, social, spending a lot of money, overconfidence, fast and loud speaking, aggression, irritability, invincible

depression phase- 5 out of 9 criteria

schizophrenia

a psychological disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotional expression

psychotic illness in which people experience hallucinations, abnormal emotions, impaired thinking, and behavioral changes

-genetically determines mostly or drugs
later teens or early adults
uncommon after 30 yrs old

positive symptoms-in addition to something

thought disorders- diminished ability to think clearly, disorganized thinking that manifests itself in disorganized speech

delusions-belief in something that is not there. paranoid- beings conspire against, broadcast-others can hear thoughts in head

hallucinations- heard, seen, felt things not there

negative symtoms-lack something

social withdrawal, lost of energy, lack of empathy

generalized anxiety disorder

-excessive, unrealistic worry that lasts 6 months or more and physical symptoms
-symptoms-dizziness, stomach upsets, concentrating issues, sleeping issues
-treatments=sspis- increase seratonin

-Amygdala
-Fight or flight stress all the time, not being able to calm yourself down

panic disorder

Severe attacks of panic and physical symptoms

Heart attack symptoms:
-Trembling
-Sweating
-Fear of dying
-Heart rate goes up
-butterflys
-choking sensation
-faintness
-blushing
-avoidance

social anxiety disorder

Extreme anxiety about being judged by others or behaving in a way that may cause embarrassment or ridicule + physical symptoms

Symptoms:
Sweaty
Avoidance features - lack of eye contact
Increased heart rate
Red face - blushing

phobias

intense fear reaction to a specific object or situation -cant control

separation anxiety disorder

the inappropriate and excessive display of fear and distress when faced with situations of separation from the home or from a specific attachment figure

-7% adults suffer but usually kids

symptoms:
-cant sleep without adult or go to school
-crying
-excuses
-clingy
-fear of being alone
-tantrums

reactive attachment disorder

characterized by serious problems in emotional attachments to others. results from failure to form normal attachments to primary caregivers in early childhood

diagnose among children who did not receive appropriate childcare from 6 months-3 years old-foster, left in crib, abuse

symptoms- crying without console. colicky, eating problems, sleep issues

older age- anger and relationship issues

obsessive-compulsive disorder

Persistent, recurring thoughts (obsessions) that may lead to performing a routine

body dysmorphic disorder

a person cannot stop thinking about a minor or imagined flaw in his/her appearance. It causes significant distress and impacts a person's ability to function in daily life.

-refuses to leave house, be in social situations, no pictures, takes selfies, cosmetic surgeries, makeup

PTSD (Post Traumatic Stress Disorder)

follows an exposure to a traumatic event

Causes:
CombatCar accidents
Sexual assault
Child abuse
Spousal abuse

Symptoms:
Flinching
Avoid place where it happened
Nightmares / flashbacks
alcohol/substance abuse

eating disorders

Life threatening illness in which people have a preoccupation with food and an irrational fear of becoming fat

anorexia

refusal to maintain a minimum body weight

intense fear of becoming fat: see fat but there is none

bulimia

Binge eating- eating in a discrete period of time more than most people would normally eat and a lack of control over eating during the episode
Compensatory behaviors - they make themselves throw up,over exercising, laxative

pica

-Eating non food substances
-Lint out of their dryers, paper, dirt

-doesnt count if pregnant

orthorexia

Preoccupation with healthy food

Healthy foods take over your life - avoid social situations where unhealthy food is there, do not go to restaurants that have unhealthy food

ADHD

attention deficit hyperactivity disorder.

3 to 7% school aged children-most grow out of it

hyperactivity-cant sit still, cant be quiet, on-the-go, talks excessively.

impulsivity- interrupt,

diagnose symptoms show before 7 and in more than 1 setting.

causes-genetic, mothers substance abuse

inattention symtoms.

1. fails to give close attention to details or makes careless decisions
2. difficulty sustaining attention in tasks or play activities
3. often does not seem to listen when spoken to
4. does not follow through on instructions
5. difficulty organizing tasks and activities
6. avoids dislikes or is reluctant to engage in tasks that require sustained mental effort
7. loses things necessarily for tasks or activities
8. easily distracted by external stimuli
9. forgetful in daily activites

Intermittent Explosive Disorder

Extreme expressions of anger, often to the point of uncontrollable rage, that are disproportionate to the situation at hand

-overreact
-they feel like they don't have control over what they are doing but after they apologize
-brain disorder

Prevalence-between 4-6% of population-common among men

symptoms- sweating, stuttering, twitching, tightness in chest, palpitations, blushing

Diagnostic criteria: -A1 - high frequency, low intensityHappens a few times a week, but low intensity. It is bearable, they are not physically harmful

-A2 - low frequency, high intensityIt is physical

-Can have both at the same time - goes off a few times a year physically, and also weekly but not physically

oppositional defiant disorder

An ongoing pattern or anger-guided disobedience, hostility, and defiant behavior toward authority.

-diagnosed among children younger than 8-70% of kids will move out and have a life-30% will get conduct disorder(90% have opppsitial in childhood).

continuity:
oppositional----conduct----antisocial

prevalence- 2 to 16% of children show signs

diagnose- 4 or more of 8 signs for 6 months
1.loses tempter (tantrums)
2.argues with adults

3. actively defies or refused to comply with adult rules
4. deliberately annoys people
5. blames others for there mistakes or behaviors
6. touchy or easily annoyed by others
7. angry or resentful
8. spiteful or vindictive

conduct disorder

-Aggressive or non-aggressive behaviors against people, animals or property that may be characterized as destructive, threatening, physically cruel, deceitful, disobedient or dishonest
---Between kids ages 9-18
--Have childhood onset or teenage onset

prevalence: 1 and 10% of teens show signs
onsets:
1) childhood=serious, common
2) teenage= less common, less serious

diagnose: 3 or more
1)Aggression to people and animals-Bullies, mugging of others, intimidating animals
2)Destruction of property-Deliberately destroys others' property
3)Deceitfulness or theft-lies, robbery
4)Serious violation of rules

Causes:

1. Biological- lower IQ, differences in brain, responsible for judgement, impulse control- reduced levels of serotonin and cortisol, genetics
2. environmental- family+peer influence

strict, dont show attention

antisocial personality disorder

-A pervasive pattern of disregard for, or violation of social norms and the rights of others. There may be a history of crime, legal problems, impulsive and aggressive behavior. Does not mean social withdrawal-do not confused with A -social personality

prevalence: 0.2 to 3.3% of adult population has it
100%genetically determined

diagnose: 3 criteria
1) Evidence of conduct disorder prior to age of 15
2) has to be at least 18 years of age
3) Display 3 or more of following behaviors
1) Unlawful behaviors-break law
2)Deception-repeated lying, use of alias
3)Impulsivity or failure to plan ahead
4)Irritability and aggressiveness 5)Reckless disregard for safety of self and others
6)Irresponsibility as indicated by repeated behavior to sustain consistent work behavior or honor financial obligations

Causes:
1)biological- genetically determined-frontal lobe deficits
2) environmental-antisocial peers, parents

psychopathy

A personality disorder characterized partly by antisocial behavior, a diminished capacity for remorse/lack of guilt, lack of empathy, and poor behavioral controls

know they hurt people but dont care

ex. ted bundy- killed 30 men by pretending to have a disability , hitler, hannibal lecter, berne nodal

brain-show pictures of crying and psychopaths dont show anything in frontal lobe

Factor 1 of Psychopathy

"selfish, callous, and remorseless use of others"
-you can rarely tell. they are doctors, lawyers, professors

• glibness/superficial charm
  -pathological lying
  -cunning/manipulation
  -lack of remorse or guilt
  -lack of empathy
  -grandiosity
  -shallow effect/callousness
  -failure to accept responsibility
  -high achievement
  -smart and will smile on face, the will swindle you out of anything
  -cheat, lie, play you with a smile
  -ted bundy

Factor 2 of Psychopathy

"chronically unstable, antisocial, and socially defiant lifestyle"

-violent behavior,
-juvenile delinquency,
-need for stimulation/proneness to boredom,
-parasitic lifestyle,
-impulsivity,
-lack of long term goals, -
-irresponsibility,
-poor behavioral controls,
-early behavioral problems
-lack of empathy

narcissistic personality disorder

pervasive pattern of grandiosity (in-fantasy or behavior), need for admiration, and lack of empathy

Elliot rodgers- kills girls at santa barbara

prevalence= 6.2% of population has it, 75%= men

Diagnose:
1) grandiose sense of self important
2)preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
3) he/she believes special, unique, and can only be understood by or should be associated with other special or high status people
4) requires excessive admiration
5) sense of entitlement, unreasonable, expectation of especially favorable treatment or automatic compliance with his/her expectations
6) uses others and takes advantage of others to achieve needs
7)lacks empathy
8)envious of others
9)arrogant behaviors or attitudes

borderline personality disorder

a pervasive pattern of instability in interpersonal relationships, self-image, and affect with marked impulsive features such as frantic efforts to avoid real or imagined abandonment.

-affects primarily women=75%

prevalence= 5.9% of population

Diagnose:
1)fear of abandonment
2) unstable interpersonal relationships
3) unstable self image
4) impulsivity-drinking, drugs
5) control, manipulate people(dump me and ill kms)
6) anger=constantly with tantrums
7) mood changes

historonic personality disorder

a pervasive pattern of excessive emotion and attention seeking

prevalence-1.8% of population-mostly women

-have to be center of attention, change thoughts to please people, revealing clothes, !!! emojis, believe everyone is best friend until there not

insomnia

sleep disorder in which there is inability to fall asleep or to stay asleep as long as desired. IT causes distress in social, occupational, or other important areas of functioning

-30% of adults

-primary=poor sleep hygiene, food, caffeine, exercise, temperature, noise, sleep medication, withdrawal
-secondary=another medical or psychiratic condition, depression, anxiety

Narcolepsy

a neurological disorder caused by the brains inability to normally regulate sleep-wake cycles. It is causes by disturbed structure of sleep

Symptoms- excessive daytime sleepiness (ETS), muscle weakness ( cataplexy), sleep paralysis, hallucinations

about 20000

breathing related disorders

Sleep disruption, leading to excessive sleepiness that is due to a sleep-related breathing condition