Neurodevelopmental Disorders

What is important for children with mental illness?

Early intervention

Autism Spectrum Disorder

Neurodevelopmental delays with or without intellectual disability. May have age-appropiate language and intelligence

Autism and Asperger Syndrome

No longer considered separate disorders. Now considered an autism spectrum disorder (ASD) differentiated by language or intellectual impairment. Many overlapping symptoms, which can be difficult to differentiate 

Autism Spectrum Disorder Characteristics

Severe and sustained impairment in social interaction, restricted, repetitive patterns of behavior, interests, or activities, social deficits, stereotypic behaviors, such as rocking and hand flapping, and highly restricted areas of interest

What are some nursing considerations for patients with ASD?

Physical safety is a priority, treatment outcomes need to be individualized, and these patients may need predictability and stability in routine

What medications are used to treat ASD?

Antipsychotics are used to manage symptoms, but there is no cure for the social and language deficits of ASD

Motor Tics

Quick, jerky movements of the eyes, face, neck, and shoulders

Phonic Tics

Repetitive throat clearing , grunting, or other noises or complex sounds such as words, parts of words, or possible obscenities

Tourette Disorders

Multiple motor and phonic tics. Usual onset is around 7 years old, with motor tics showing before phonic tics. The disorder waxes and wanes, and there may be more tics in high stress situations

Oppositional Defiant Disorder

Persistent pattern of disobedience, argumentativeness, angry outbursts, low tolerance for frustration, and tendency to blame others for misfortunes

Conduct Disorder

Characterized by more serious violations of social norms, including aggressive behavior, destruction of property, and cruelty to animals

Attention-Deficit Hyperactivity Disorder

Persistent pattern of inattention, hyperactivity, easily distracted, and impulsiveness. Most commonly diagnosed disorder in school-aged children. Usually diagnosed in childhood and persists into adulthood

How do stimulant medications work?

Low doses help to calm the nerve signals in the brain, which decrease impulsivity and improve executive function (help to stay on task). Involves neurotransmission of dopamine or norepinephrine.

What is something to consider when patients are on stimulants for ADHD?

The stimulants will peak, and the dose should be given so it peaks at the right time

How do non-stimulant medications work?

Blocks reuptake of norepinephrine. Moderates release of norepinephrine in various areas of the brain. Thought to work better for hyperactivity, impulsivity, and tics than on cognitive impairment. Thes medications take longer to kick in.

What are some nursing interventions for patients with ADHD?

Behavioral programs (rewards for positive behavior) and cognitive behavioral techniques

Cognitive Behavioral Techniques

Clear limits with clear consequences, predictable environment with decreased stimuli (one assignment at a time), calm environment with few stimuli (homework in a quiet place), eye contact before giving directions, and asking to repeat what was heard