CHILDHOOD COGNITIVE DISORDERS

ADHD

MENTAL RETARDATION

IQ (INTELLIGENCE QUOTIENT)
IQ = MENTAL AGE CHRONOLOGICAL AGE x 100

MENTAL AGE
refers to the typical intelligence level found for people at a given chronological age. Example: A 16 y/o performs at the level of a 14 y/o IQ = 14/16 x 100 = 88 (Below Average)

IQ SCORES > 130 120-129 110-119 90-109 80-89 70-79 50-69 35-49 20-34 < 20

PERCENTILE RANGE

CLASSIFICATION Very

> 98 91-97 74-89 25-73 9-23 2-8 Below 2nd Below 1st Below 1st Below 1st

High Average Average Below Average Borderline Mild MR Moderate MR Severe MR Profound MR

MENTAL RETARDATION
means subaverage intellectual functioning.

DEGREES OF MR
CLASSIFICATION MILD (Moron) MODERATE (Imbecile) SEVERE (Idiot) IQ LEVEL 55-69 40-54 25-39 MANAGEMENT EDUCABLE Can enroll SPED (special education school) TRAINABLE - Vocational school for ADL CLOSE SUPERVISION - highly structured environment; needs assistance in ADL COSTUDIAL CARE -totally dependent -treat the child like an infant - needs assistance in ADL

PROFOUND

Less than 25

MENTAL RETARDATION
Description: In MR, the child manifests subaverage intellectual functioning along with deficits in adaptive skills Example is DOWN SYNDROME

DOWN SYNDROME
- is a congenital condition that results in moderate to severe retardation and has been linked to an extra group of chromosome Chromosome 21 - onset at birth

Clinical manifestations of Down Syndrome:

- brachycephaly (head) - epicanthal folds - flat nasal bridge - low set ears - protruding tongue - Simean crease on palms

AUTISM

AUTISM
Description: AUTISM is a severe mental disorder beginning in infancy or toddlerhood. It is characterized by impairment in reciprocal social interaction and in verbal and nonverbal communication. - The cause is unknown and the prognosis may be poor. - Diagnosis is established based on symptoms and through the use of specialized autism assessment tools. - Also called as Infantile Autism. - The disorder is apparent before the child is 3 years old.

Clinical manifestations:
Trapped in their own world/Aloof Unusual language Indifference to others Rigid and ritualistic Security blanket Dislikes changes in routines/ADL Headbanging, hitting, biting, temper tantrums Unusual fascination with inanimate objects such as fans & aircons

Diagnosis: at 2-3 years old Management:

Nutrition-provide small frequent feeding, assist in eating with wellbalanced diet

Safety: paddings on walls and floors

-Helmet

Nursing Interventions - Monitor behavior 1:1 - Consistent environment to avoid confusion -Gradually introduce new activities - Love and belongingness - involve families in activities - Family therapy

Medications - Haloperidol (Haldol)commonly used to decrease tantrums/stereotypical behaviors -CNS stimulants -Naloxone -Tofranil

ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)

ADHD
Description: - A developmental disorder characterized by developmentally inappropriate degrees of inattention, overactivity and impulsivity. - One of the most common reasons of referral for children to mental health services. More common in males. - Impulsive, violators/law-breakers - Hyperactive, poor/short attention span, usually dirty

 Diagnosis: not later than 7 y/o Nutrition: give finger foods - To prevent aspiration: avoid foods with seeds or with skin Give foods high in CALORIES,PROTEIN & CARBOHYDRATES Nursing Diagnosis: Risk for injury (other) remove sharps/metalics,/glasswares, Avoid contact sports Sleep Deprivation give warm milk and bath, avoid nap in the pm. Consistent limit- setting Provide Love and Belongingness