WCU NSG 311 Exam 4
What factors influence personality and mental growth potential in a child - ✔️✔️-
genetic makeup
- cultural background
- family environment
- socioeconomic status
- access to community resources and support
Intellectual Health Disorders - ✔️✔️- commonly defined based on two factors:
intellectual functioning significantly below average (an IQ of 70 to 75 or lower with onset
during the developmental period) and concurrent deficits in adaptive functioning in
conceptual, social, and practical domains
Common Causes of Intellectual Disability - ✔️✔️- Chromosomal abnormalities such as
Down syndrome and fragile X syndrome
- Infection in utero (rubella or cytomegalic inclusion disease)
- Anoxia at birth from such causes as umbilical cord compression
- Fetal alcohol spectrum disorder
- Inherited metabolic disorders such as phenylketonuria or Tay-Sachs disease
- Head trauma, lead poisoning, or hypothyroidism
- Brain malformations such as anencephaly
- Very low birth weight
- Infections such as measles encephalitis
- Autism spectrum disorder
Factors to include in assessing mental health: Observational - ✔️✔️- General
Appearance
- Motor behaviors
- Speech and language
- Affect
- Thought process
- Ability to relate to the evaluator
- Behaviors displayed during the interview
Factors to include in assessing mental health: Interview Data - ✔️✔️- Interpersonal
relationships
- Self-concept and image
- Conscience or moral reasoning
,Common Symptoms in the Child with Autism Spectrum Disorder - ✔️✔️- Failure to
develop social relations
- Stereotyped behaviors such as hand gestures
- Extreme resistance to change in routine
- Abnormal responses to sensory stimuli
- Decreased sensitivity to pain
- Inappropriate or decreased emotional expressions
- Specific, limited intellectual problem-solving abilities
- Stereotyped or repetitive use of language
- Impaired ability to initiate or sustain a conversation
Autism Spectrum Disorder (ASD) - ✔️✔️- three main areas marked with difficulties:
social deficits, communication issues, restricted behaviors
- Children with ASD often lack responsiveness to people around them, display gross
impairment in communication skills, and produce bizarre responses to various aspects
of environment within the FIRST 36 MONTHS
- More common in males
- About 50% also diagnosed with intellectual disability
ADHD: assessment - ✔️✔️- History: pregnancy, birth, ability to meet developmental
milestones, ***A TYPICAL DAY***
- Ask about activities: excessive and disorganized; repetitive; driven or compulsive
- Variability: behavior has a good and bad moment (rather than days)
- High level of impulsiveness
- "All-or-none" reaction to stimuli
- Difficulty with sequencing or relating thing to one another in time or space
- Difficulty using conjunctions or prepositions correctly; difficulty learning to read words
of more than one syllable
- No intelligence deficit
Attention Deficit Hyperactivity Disorder (ADHD) - ✔️✔️- Many parents recognize
excessive motor activity when the child is a toddler, although symptoms are difficult to
distinguish from normative behavior until the age of 4 years
- Preschool-aged child often presents with hyperactivity and impulsivity but as the child
gets older, inattention may become the predominant manifestation
- Slightly more common in males
- Generally do not have deficit in intelligence
ADHD Criteria for diagnosis - ✔️✔️- thorough initial history
- physical examination
- completion of evidence-based rating scales by individual who is familiar with the child
(parent, teacher, etc)
- Family history (more common in first-degree relatives)
Separation anxiety in the older child: assessment - ✔️✔️- When separated, nausea,
vomiting or crying
,- Familial history
- Temperament may be contributing factor
- unresolved internal conflicts, insecurity in the home environment, parent-induced
anxious attachment are common
Separation anxiety - ✔️✔️- considered a disorder when an older child shows excessive
anxiety about separation or the possibility of separation from parents (difficulty falling
asleep at night or insist on sleeping with their parents or just outside their parents'
bedroom door)
- experience acute distress and perhaps frequent nightmares about separation and,
when separated, show somatic symptoms of nausea, vomiting, or crying to such a
degree that it prevents them from visiting at friends' houses, enjoying a camp
experience, or actively participating in school
Anxiety disorders - ✔️✔️- Children and teens with anxiety disorders experience severe
and persistent distress that interferes with their daily lives
- Anxiety disorders are associated with other major classes of disorders, including
bipolar and related disorders, depressive disorders, disruptive disorders, eating
disorders, and substance use disorders
- It is important for children and teens with anxiety disorders to receive treatment, as
emerging evidence shows that anxiety disorders may be part of a developmental
progression in which anxiety is expressed early in life, followed by depression in
adulthood
- Occur slightly more frequently in girls than in boys
Risk factors for anxiety disorders - ✔️✔️- family history
- negative experiences
- temperament
- new social or work demands
- health conditions that may draw attention (such a physical disability)
posttraumatic stress disorder (PTSD) - ✔️✔️- Survived traumatic experience
(maltreatment, domestic violence, natural disaster, harrowing accident, near-fatal
illness)
- Experience recurring recollections or dreams of the event
- Possibly have guilt that they survived
- Absence of effective support can contribute to and even exacerbate symptoms
Diagnostic criteria for PTSD - ✔️✔️- Symptoms that occur 1 month following initial
event
- Child continue to have recurring recollections or dreams of the event or demonstrate
intense psychological symptoms if reminder of event occurs
Eating Disorders - ✔️✔️-characterized by persistent disturbance of eating or eating-
related behavior that results in altered consumption or absorption and significantly
impairs physical health or psychosocial functioning
, Pica assessment - ✔️✔️- Often presents as pica-induced complications (not diagnosed
until complication occurs)
- Highly-associated with iron-deficiency anemia (correcting anemia corrects pica in most
cases)
Pica - ✔️✔️- persistent eating of nonfood substances such as dirt, clay, paint chips,
crayons, yarn, or paper
- Dangerous disorder because of the possibility of unintentional poisoning
- Complications: constipation, GI malabsorption, fecal impaction, intestinal obstruction
- Seen primarily between ages 2 to 6
- High prevalence in children with intellectual disability
Rumination disorder of infancy assessment - ✔️✔️- report of constantly "spitting up" or
vomiting
- breath smells sour
- signs of failure to thrive
Rumination disorder of infancy - ✔️✔️- Act of repeated regurgitation and then
reswallowing of previously ingested food
- rare, affects infants between ages of 3 and 12 months
- most often in children with intellectual disability
- Associated with GERD
- Associated with lack of stimulation in the environment
- Distracting by holding, rocking, and talking to infant tends to decrease rumination
Food refusal or aversion assessment - ✔️✔️- significant failure to gain weight or weight
loss, without medical reason or lack of food
- may present as sleepy, upset, or too stressed to feed
- May be associated with emotional difficulties in older children
food refusal or aversion - ✔️✔️- failure to eat adequately because of lack of interest in
food, sensory characteristics of food, or related aversive consequences
- typically begins in infancy and is usually seen in children younger than 6 years of age
- aversion typically used as a method of control for the child
Anorexia nervosa assessment - ✔️✔️- Perceive food as revolting and nauseating,
refusal to eat or vomit food immediately after eating, possible use of laxative or diuretic
or extensively exercising
- Weight loss, acidosis, dependent edema, hypotension, hypothermia, bradycardia,
formation of lanugo, pale, lethargic, amenorrhea
- severely disordered body image
- Body weight less than 85% of expected weight
What factors influence personality and mental growth potential in a child - ✔️✔️-
genetic makeup
- cultural background
- family environment
- socioeconomic status
- access to community resources and support
Intellectual Health Disorders - ✔️✔️- commonly defined based on two factors:
intellectual functioning significantly below average (an IQ of 70 to 75 or lower with onset
during the developmental period) and concurrent deficits in adaptive functioning in
conceptual, social, and practical domains
Common Causes of Intellectual Disability - ✔️✔️- Chromosomal abnormalities such as
Down syndrome and fragile X syndrome
- Infection in utero (rubella or cytomegalic inclusion disease)
- Anoxia at birth from such causes as umbilical cord compression
- Fetal alcohol spectrum disorder
- Inherited metabolic disorders such as phenylketonuria or Tay-Sachs disease
- Head trauma, lead poisoning, or hypothyroidism
- Brain malformations such as anencephaly
- Very low birth weight
- Infections such as measles encephalitis
- Autism spectrum disorder
Factors to include in assessing mental health: Observational - ✔️✔️- General
Appearance
- Motor behaviors
- Speech and language
- Affect
- Thought process
- Ability to relate to the evaluator
- Behaviors displayed during the interview
Factors to include in assessing mental health: Interview Data - ✔️✔️- Interpersonal
relationships
- Self-concept and image
- Conscience or moral reasoning
,Common Symptoms in the Child with Autism Spectrum Disorder - ✔️✔️- Failure to
develop social relations
- Stereotyped behaviors such as hand gestures
- Extreme resistance to change in routine
- Abnormal responses to sensory stimuli
- Decreased sensitivity to pain
- Inappropriate or decreased emotional expressions
- Specific, limited intellectual problem-solving abilities
- Stereotyped or repetitive use of language
- Impaired ability to initiate or sustain a conversation
Autism Spectrum Disorder (ASD) - ✔️✔️- three main areas marked with difficulties:
social deficits, communication issues, restricted behaviors
- Children with ASD often lack responsiveness to people around them, display gross
impairment in communication skills, and produce bizarre responses to various aspects
of environment within the FIRST 36 MONTHS
- More common in males
- About 50% also diagnosed with intellectual disability
ADHD: assessment - ✔️✔️- History: pregnancy, birth, ability to meet developmental
milestones, ***A TYPICAL DAY***
- Ask about activities: excessive and disorganized; repetitive; driven or compulsive
- Variability: behavior has a good and bad moment (rather than days)
- High level of impulsiveness
- "All-or-none" reaction to stimuli
- Difficulty with sequencing or relating thing to one another in time or space
- Difficulty using conjunctions or prepositions correctly; difficulty learning to read words
of more than one syllable
- No intelligence deficit
Attention Deficit Hyperactivity Disorder (ADHD) - ✔️✔️- Many parents recognize
excessive motor activity when the child is a toddler, although symptoms are difficult to
distinguish from normative behavior until the age of 4 years
- Preschool-aged child often presents with hyperactivity and impulsivity but as the child
gets older, inattention may become the predominant manifestation
- Slightly more common in males
- Generally do not have deficit in intelligence
ADHD Criteria for diagnosis - ✔️✔️- thorough initial history
- physical examination
- completion of evidence-based rating scales by individual who is familiar with the child
(parent, teacher, etc)
- Family history (more common in first-degree relatives)
Separation anxiety in the older child: assessment - ✔️✔️- When separated, nausea,
vomiting or crying
,- Familial history
- Temperament may be contributing factor
- unresolved internal conflicts, insecurity in the home environment, parent-induced
anxious attachment are common
Separation anxiety - ✔️✔️- considered a disorder when an older child shows excessive
anxiety about separation or the possibility of separation from parents (difficulty falling
asleep at night or insist on sleeping with their parents or just outside their parents'
bedroom door)
- experience acute distress and perhaps frequent nightmares about separation and,
when separated, show somatic symptoms of nausea, vomiting, or crying to such a
degree that it prevents them from visiting at friends' houses, enjoying a camp
experience, or actively participating in school
Anxiety disorders - ✔️✔️- Children and teens with anxiety disorders experience severe
and persistent distress that interferes with their daily lives
- Anxiety disorders are associated with other major classes of disorders, including
bipolar and related disorders, depressive disorders, disruptive disorders, eating
disorders, and substance use disorders
- It is important for children and teens with anxiety disorders to receive treatment, as
emerging evidence shows that anxiety disorders may be part of a developmental
progression in which anxiety is expressed early in life, followed by depression in
adulthood
- Occur slightly more frequently in girls than in boys
Risk factors for anxiety disorders - ✔️✔️- family history
- negative experiences
- temperament
- new social or work demands
- health conditions that may draw attention (such a physical disability)
posttraumatic stress disorder (PTSD) - ✔️✔️- Survived traumatic experience
(maltreatment, domestic violence, natural disaster, harrowing accident, near-fatal
illness)
- Experience recurring recollections or dreams of the event
- Possibly have guilt that they survived
- Absence of effective support can contribute to and even exacerbate symptoms
Diagnostic criteria for PTSD - ✔️✔️- Symptoms that occur 1 month following initial
event
- Child continue to have recurring recollections or dreams of the event or demonstrate
intense psychological symptoms if reminder of event occurs
Eating Disorders - ✔️✔️-characterized by persistent disturbance of eating or eating-
related behavior that results in altered consumption or absorption and significantly
impairs physical health or psychosocial functioning
, Pica assessment - ✔️✔️- Often presents as pica-induced complications (not diagnosed
until complication occurs)
- Highly-associated with iron-deficiency anemia (correcting anemia corrects pica in most
cases)
Pica - ✔️✔️- persistent eating of nonfood substances such as dirt, clay, paint chips,
crayons, yarn, or paper
- Dangerous disorder because of the possibility of unintentional poisoning
- Complications: constipation, GI malabsorption, fecal impaction, intestinal obstruction
- Seen primarily between ages 2 to 6
- High prevalence in children with intellectual disability
Rumination disorder of infancy assessment - ✔️✔️- report of constantly "spitting up" or
vomiting
- breath smells sour
- signs of failure to thrive
Rumination disorder of infancy - ✔️✔️- Act of repeated regurgitation and then
reswallowing of previously ingested food
- rare, affects infants between ages of 3 and 12 months
- most often in children with intellectual disability
- Associated with GERD
- Associated with lack of stimulation in the environment
- Distracting by holding, rocking, and talking to infant tends to decrease rumination
Food refusal or aversion assessment - ✔️✔️- significant failure to gain weight or weight
loss, without medical reason or lack of food
- may present as sleepy, upset, or too stressed to feed
- May be associated with emotional difficulties in older children
food refusal or aversion - ✔️✔️- failure to eat adequately because of lack of interest in
food, sensory characteristics of food, or related aversive consequences
- typically begins in infancy and is usually seen in children younger than 6 years of age
- aversion typically used as a method of control for the child
Anorexia nervosa assessment - ✔️✔️- Perceive food as revolting and nauseating,
refusal to eat or vomit food immediately after eating, possible use of laxative or diuretic
or extensively exercising
- Weight loss, acidosis, dependent edema, hypotension, hypothermia, bradycardia,
formation of lanugo, pale, lethargic, amenorrhea
- severely disordered body image
- Body weight less than 85% of expected weight
