1. Childhood and Neurodevelopmental Disorders
Chapter 11
Childhood and Neurodevelopmental Disorders
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

2. Introduction
75% of adults diagnosed with psychiatric disorders first diagnosed between ages 11 and 18 years
Disruption to normal pattern of childhood development
Difficulty diagnosing younger people
Lack of services and premature termination of treatment
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

3. Etiology Biological factors Psychological factors
Genetic
Neurobiological
Psychological factors
Temperament
Resilience
Environmental factors
Cultural
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

4. Case Study
A child with many “risk factors” for the development of mental illness develops normally. You hear the term resilience used. What are some characteristics this child has?
The resilient child has the following characteristics:
(1) adaptability to changes in the environment
(2) ability to form nurturing relationships with other adults when the parent is not available
(3) ability to distance self from emotional chaos
(4) good social intelligence
(5) good problem-solving skills
(6) ability to perceive a long-term future
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

5. Case Study (Cont.)
What are some familial risk factors that appear to be related to a child’s experiencing a psychiatric disorder?
Familial risk factors that correlate with psychiatric disorders in children include:
(1) severe marital discord
(2) low socioeconomic status
(3) large families and overcrowding
(4) parental criminality
(5) maternal psychiatric disorders
(6) foster-care placement
Other factors for mental health problems include:
Witnessing violence
Children who have experienced abuse
Bullying
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

6. Assessing Development and Functioning
Assessment data
Data collection
Mental status examination
Developmental assessment
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

7. General Interventions for Children and Adolescents
Family therapy
Group therapy
Behavioral therapy
Cognitive behavioral therapy
Disruptive behavior management
Time-out
Quiet room
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

8. General Interventions (Cont.)
Play therapy
Bibliotherapy
Therapeutic drawing
Music therapy
Psychopharmacology
Team work and safety
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

9. Communication Disorders
Speech disorders
Language disorders
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

10. Learning Disorders Dyslexia (reading) Dyscalculia (math)
Dysgraphia (written expression)
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

11. Motor Disorders Stereotypic movement disorder Tourette’s disorder
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

12. Intellectual Development Disorder
Deficits in
Intellectual functioning
Social functioning
Managing age-appropriate activities of daily living, functioning at school or work, and performing self-care
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

13. Autism Spectrum Disorder
Neurobiological disability
Developmental disability
Appears during first 3 years of life
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

14. Autism Spectrum Disorder: Application of the Nursing Process
Assessment
Diagnosis
Outcomes Identification
Implementation
Psychosocial interventions
Psychobiological interventions
Evaluation
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

15. Case Study (Cont.)
If a child is diagnosed with autism, what type of treatment will be recommended?
Treatment plans:
(1) Behavior management, with a reward system that teaches parents to provide structure and rewards,
consistency in rules and expectations at home in order to shape and modify behavior and foster the development of socially appropriate skills
(2) Child may receive physical, occupational, and speech therapy as part of the plan of care
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

16. Attention Deficit Hyperactivity Disorder
Inappropriate degree of
Inattention
Impulsiveness
Hyperactivity
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

17. Attention Deficit Hyperactivity Disorder (Cont.)
Assessment
Level of physical activity, attention span, talkativeness
Social skills
Comorbidity
Diagnosis
Outcomes Identification
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

18. Attention Deficit Hyperactivity Disorder (Cont.)
Implementation
Psychosocial interventions
Psychobiological interventions
Psychopharmacology
Evaluation
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

19. Question 1
Which statement demonstrates that a parent understands the diagnosis of attention deficit hyperactivity disorder?
“My child will never be able to graduate or go to college but may be able to learn a vocational skill.”
“My child’s performance will improve in a structured setting that provides rewards for appropriate behavior.”
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

20. Question 1 (Cont.)
“Nothing is wrong with my child. The school hasn’t provided qualified teachers and classroom settings.”
“My child is just going through a stage. This problem will go away with time.”
Answer: B
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

21. Audience Response Questions
Which child would be most difficult to diagnose for a neurodevelopmental disorder?
3 year old
5 year old
8 year old
12 year old
ANS: A
Younger children are more difficult to diagnose than older children because of their limited language skills and cognitive and emotional development.
REF: 181
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

22. Audience Response Questions
A 4-year-old frequently lashes out in anger at adults and other children. This child’s style of behavior is an aspect of
neurobiology.
temperament.
resilience.
culture.
ANS: B
Temperament is the style of behavior a child habitually uses to cope with the demands and expectations of the environment.
REF: 183
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.