exam 2 peds barriers (minus the LD stuff bc its all in that one sheet)

what is the definition of intellectual disability?

impairments of general mental abilities that impact adaptive functioning in 3 domains; conceptual, social, and practical

when do intellectual disabilities begin?

they begin during development and are chronic, often co-occurring with other mental health conditions

what are the skills/behaviors within the conceptual domain

language, reading, writing, math, reasoning, knowledge, and memory

what are the skills/behaviors within the social domain

empathy, social judgement, interpersonal communication skills, the ability to make and retain friendships and similar capacities.

what are the skills/behaviors within the practical domain

self-management, self-care, job responsibilities, recreation, and organizing school and work tasks.

what does the DSM-V say about IQ scores in relation to intellectual disabilities?

IQ score or about 70 or below or two standard deviations or more below population indicates an intellectual disability

what is the etiology/prevalence of prader willi syndrome?

abnormality on the 15th chromosome occurring equally in males and females. caused by genetics

what are main features of prader willi?

• slow metabolism due to thyroid dysfunction causing a constant hunger that is never satiated

• hypogonadism= incomplete sex organ development

• growth hormone insufficiency

• behavioral issues and temper tantrums regardless of age

• high pain threshold

• skin picking

• mild intellectual disability impacting understanding, functional independence, learning and problem solving.

what are the precautions associated with Prader willi syndrome?

needing to be supervised at all times around food and caution around uncooked foods in fridge, constant attention to food management and skin integrity, safety due to ID, and temperature changes

what is the etiology/prevalence in cru di chat?

rare genetic disorder when the 5th chromosome is either missing or translocated to another chromosome, impacting females more often than males. caused by spontaneous genetic disorders

what are the main features associated with cru di chat syndrome?

• structural difference in the larynx causing cat like cry and high pitched tone to voice

• intellectual disability in majority of cases being moderate-severe

• heart defects

• Having low tone and orthopedic issues

• delayed motor and communication skills

• short attention span, ADHD, restlessness and behavior issues

what are some precautions associated with cru di chat syndrome?

at risk for self-injury, safety awareness is decreased, rare but endurance concerns if there is heart condition

what is the relevance/etiology of fragile x?

lengthening of a gene on the X chromosome, switching off protein production that is involved in brain development. Boys are impacted more commonly than girls.

what are the main features of fragile x

• cleft palate, club foot, hernias

• hypotonia

• seizures

• eye, ear and sinus disorders and infections

• connective tissue issues like scoliosis and hyperflexible joints.

what are the precautions of fragile x?

• be careful with overstimulation due to sensory defensiveness

• safety concerns due to ID and ASD features

• aggression may occur

what are the behavioral/emotional concerns for someone with fragile X?

• anxiety and shyness

• ADHD

• ASD behaviors

• difficulty with eye contact

• motor planning and sensory concerns

what are the motor skill concerns for someone with fragile X?

hypotonia and motor incoordination with both fine and gross motor tasks

what are the communication concerns for someone with fragile X?

speech and language problems are common with boys with fragile x like stuttering, inability to understanding social cues like tone of voice

what are the cognitive concerns for someone with fragile X?

majority of males demonstrate significant ID, females have more mild ID impacting ability to think, learn and reason

what are the emotional regulation concerns for someone with fragile X?

children may be anxious, aggressive or hyperactive in different situations and may throw temper tantrums. this combined with sensitive sensory need make emotional regulation difficult

what is the etiology/prevalance of angelman syndrome

deletion of a chromosome causes AS, occurs equally in males and females. caused by mostly random but sometimes it is inherited

what are the main features of angelman

• ataxia- balance and motor coordination concerns

• low tone

• tremors and hyperactive reflexes

• ID that is typically severe

• happy demeanor and frequently laughing, but have speech issues

• sensory processing needs, may be hyperactive and exhibit hand flapping when fascinated with specific stimulations

what are the body functions/structures for AS?

microcephaly, protruding tongue, prognathia (protruding mandible more forwards than usual), strabismus.

what are precautions associated with AS?

falls because of the ataxia, safety concerns with ID, sleep disorders, seizures are common and concerning, wandering

who was the first professional to come up with a definition for ASD?

Kanner- before him ASD was misclassified as an ID or schizophrenia but he noticed the key sensory concerns with ASD like fear of noises, movement seeking behaviors, flickering lights and watching spinning wheels

what did the scientist Asperger do for ASD research?

discovered that ASD is a spectrum disorder with restricted patterns of behavior, interests and activities with no specific delay in language or cognitive skills

what is sensory defensiveness?

overload of a certain sensory stimulus leading to an outward negative emotional response

what is the prevalence and co-morbidities of ASD?

1/54 kids are diagnosed with autism, boys are 4 times more likely to be diagnosed. 31% of kids with ASD have an ID as well.

what is the etiology of ASD?

there is no clear etiology, we are looking at environmental and genetic contributions to find a cause but early diagnosis is key to find out a plan of support

what does current practice say about diagnosing ASD

• conducting a parent interview

• MCHAT done twice and can even be done by parents

• ASQ- set of questions that explore different facets of child development

how do we assess children with ASD?

with standardized assessments, clinical observations and functional participation to improve engagement in occupations

what are the major 5 diagnostic criteria for autism under the DSM-V

1. persistent deficits in social communication and interaction

2. restricted and repetitive patterns of behavior or interests

3. symptoms must be present in early developmental period

4. symptoms cause clinically significant impairment in social, occupational or important areas of current function

5. These disturbances are not better explained by the diagnosis of ID

what is the etiology and prevalence of ADHD?

genetics are the biggest role in ADHD, with boys being twice as likley to have ADHD than girls

why is ADHD a brain-based neurodevelopmental disorder?

because ADHD causes children to have structural (thinner cortical areas in right frontal and parietal lobes), chemical (lower amounts of dopamine receptors), and connectiveness (reduced amount of default networks) differences in their brains

what are some characteristics of subtype 1predominantly attentive presentation ADHD?

• does not follow through on instructions and fails to finish schoolwork

• fails to give close attention to details or makes careless mistakes in schoolwork

• has trouble holding and maintaining attention during gear shifts

• does not seem to listen when spoken to directly

• easily distracted and forgetful in activities

what are some characteristics of kids with subtype 2: hyperactive impulsive presentation of ADHD

• movers and shakers, fidgets or taps often

• runs around or climbs at inappropriate times

• leaves seat often

• unable to take part in activities quietly

• talks excessively and blurts out answers before a question has been completed

• has trouble waiting their turn

• interrupts and intrudes

• time blindness

what are the most common co-morbidities for those who have ADHD?

ODD (40%), depression (15%), learning disabilities (50%), sleep issues (40-50%), sensory processing disorders (40%0 and anxiety (30%)

what are most common treatments for those with ADHD?

medications (could be either stimulant medications, nonstimulants or both) and multimodal treatments with strengths based approach

what is the PIC-me assessment

helps children in setting goals from themselves, and focuses on effort, emotion, working memory, activation, focus, and action

what is the cog-fun intervention?

promotes acquisition of executive strategies and self-efficacy in occupational performance through a play-based approach

what is a learning disability?

a disorder in one or more of the basic processes involved in understanding or in using language, either spoken or written. This kind of disorder can cause imperfect ability to listen, think, speak, read, write, spell, or do math

what are non-verbal LDs?

LDs where individuals have unique learning and behavioral profiles that may have strengths in verbal expression, vocabulary, reading, comprehension, auditory memory, and attention to detail with barriers are in math, problem solving, visual-spatial tasks, motor coordination, reading body language and social cues