Neurodevelopment disorder in children 2

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  1. Oppositional defiant disorder
    • characterized by a persistent patterns of angry mood and defiant behavior
    • occurs more frequently that is usually observed in individuals of comparable age and developmental level
    • Interferes with social, educational, or vocational activites
    • - difficulty w/peers-interpersonal relationships not satisfying
    • - school performance poor refuse to participant, resist external demands/change
    • go to to develop CD
    • annoying
    • personality disorder: passive aggressive
    • maybe see them in couseling
  2. ODD etiology
    • biological: not full esta
    • - maybe biochemical, genetic
    • - temperament influence
    • Parental issues:
    • - inconsistent caregivers (not around)
    • - absence
    • - harsh, inconsistent, neglectful parenting
    • - power and control issues for parents, power struggles established with children
    • - impulse disorder parent: defiant with other, child identifies with it
    • - permissive
    • outcome for children: assume responsibility about their thoughts and actions
    • -
  3. ODD passive aggressive behavior
    • loss temper
    • argues with parents
    • dilberatley annoys people
    • blames others for his or hers mistake or misbehaviors
    • dont see self as opposition: other unreasonable demands on them
    • stubborn, proscrinate
    • careless
    • running away
    • school avoidance & underachievement
    • temper tantums
    • impaired interpersonal relationships
  4. ODD when it happens
    • before puberty more boys than girls but after puberty is equalizes it
    • significant % go on to CD
    • behavior similar to CD
    • expection: no violation of rights of others, ODD: passive aggressive; CD: aggressive
    • significant impairment in social, academic, occupational functioning
  5. ODD
    Defensive Coping
    • r/t slow/poor ego development, unsatisfactory parent/child relationship, low self esteem
    • AEB: blaming other for problems, defiant, disobedient, fighting
    • they don't know how to cope well
    • Outcomes:
    • - ST: verbalized personal responsiblity for difficulties experienced in interpersonal relationship
    • - LT: accept responsiblity for our behaviors and interact w/others without becoming defensive
    • Intervention:
    • - help patient identify their feelings and what provokes behavior
    • - provide immediate and non threaten feedback for passive aggressive behaviors
    • - help identify situations that provoke defensiveness; role play approriate responses
    • - positive immediate feedback for acceptable behaviors- repitition
    • remember lack confidence self esteem
  6. ODD:
    Noncompliance w/therapy (activites)
    • r/t negative temperant, underlying hostility
    • AEB: denial of problems, passive agressive behavior
    • Outcomes:
    • - ST: will participant and cooperate during activities
    • - LT: complete assigned task willing, independently with minium assistance
    • Intervention:
    • - set structure plan of activities, minimal expectation, increa with time
    • - system of awards with compliance and consequences with non compliance
    • - acceptance of person different from behavior
  7. ODD:
    Impaired social interaction
    • r/t negative temperant, manipulation of others
    • AEB: poor interpersonal relationships with peers, family, blaming others
    • Outcomes:
    • - ST: interact in a age approriate manner with primary care giver
    • - LT interact with peers using approriate behaviors
    • interventions:
    • - developed trusting relationship- accept person not behavior
    • - explains passive aggressive behaviors, how others perceive it, identify positive behaviors, role play adaptive behaviors, positive for accepted behaviors
    • - provide peer group situation- do well in groups- peer groups trying to get them to take a look at what is going on. learn new coping skills
  8. Conduct Disorder
    • repetitive violation of others
    • major age approriate and societal norms of violating other
    • Aggression to people and animals
    • - bullies threatens intimidates frighten
    • - initiates fights
    • - use of weapons
    • - physical cruelity to people and animals
    • - stealing
    • - setting fires
  9. CD symptoms
    • Destruction of property- delibrate
    • deceifulness of theft- breaking into cars, lying conning people, victim, foggery
    • serious violations of rulesĀ  like stays out all night before the age of 13, run away, trauncy from school before 13
  10. CD other symptoms
    • high risk behaviors- high accident rate, drink drug and drive
    • Little empathy/concern for others
    • low self esteem- low frustation tolerance,
    • co morbidity: mood anxiety, PTSD, SA AD/HD (common), learning problems
    • main issue is safety- others and self
  11. CD etiology
    • Genetic: unclear
    • - temperant difficult (mood and behavorial tendencies affect actions and reactions)
    • biochemical: unclear
    • - some evidence of increase testorone
    • Pyschosocial:
    • - peer relationships
    • - often actively dislike, rejected
    • - cognitive deficient learning disorder
    • environmental/family influences (prediposes to dx)
    • - parental rejection or neglect
    • - frequent changes in parental figures
    • - large family sizes
    • - absent father
    • - parents with issues
    • - marital conflicts or divorce
    • - inadequate communication patterns
  12. CD:
    risk for others directed violence
    • r/t temperament, negative parental role models, dysfunctional family dynamics
    • Outcomes:
    • - will discuss feelings of anger ST what is going on with them
    • - LT will not harm others or property
    • Interventions:
    • - observed behaviors (frequently) identify behaviors that indicate rise in agitation
    • - redirect violent behavior with physical outlet (least restrictive measure)
    • - encourage expression of anger, as as role model, indicate show of strength if necessary
    • - tranqualizing meds restraints if needed
  13. CD other NANDA
    • impaired social interactions
    • defensive coping
    • ODD
  14. Separation Anxiety disorder
    • all children experience anxiety 8-14 is normal
    • disorder: fear r/t separation from who the child is close to (child over 6yrs, longer than four weeks, developmentally inapproriate)
    • Behaviors (anxiety/fear)
    • - tantums, crying, screaming, clinging
    • - not devel approriate
    • somatic compliants:
    • GI sleep
    • interferes with social, academic occupational functioning
    • first do couseling, cognitive, start to experience things at a small level
  15. SA etiology
    • genetic component: temperament- anxiety proness or vulnerabilty, phobias depressed mood
    • Environmental: effected by stressful events
    • family influence:
    • - overattached mother
    • - separation conflict between mom and child
    • - transfer of fear from adult to child
    • - parents instill this anxiety
    • - mom usually has issues herself LOL
  16. SA:
    Anxiety: severe
    • r/t fhx, temperament, overattachment of parent,
    • AEB: clinging, missing school, dif sleeping, crying, wont leave mother
    • outcomes:
    • ST: with discuss fears of separation w/trusting individual
    • LT: anxiety no higher than moderate when in formly known panic circumstances
    • Interventions:
    • - esta atmosphere of calm, trust, genuine positive regard
    • - assure pt of safety and security
    • - explore fears of separating from parents, also do this with parents vice versa
    • - help parent and child initiate realistic goals- do baby steps of separation
    • - give positive reinforcement encourage parents to do the same
  17. SA
    Ineffective coping
    • r/t unresolved separation conflicts and inadequate coping skills
    • AEB: numerous somatic compliants
    • outcomes:
    • ST: verbalize correlation to somatic symtoms and fears of separations
    • LT: demo use of adaptive coping stragtegies (than physical symptoms) in response to stressful situations
    • Interventions;
    • - encourage discussion of situation that makes them stressed out
    • - help perfectionist to recognize self expectation maybe unrealistic; make connections of unmet expectations
    • - encourage parents and child to identify other coping things to use when highly anxious..role play
  18. Tourettes disorder
    • tics: motor or verbal
    • alot of kids outgrow
    • early - 2-7
    • usually in boys
    • severe it may continue
    • if child is engaged in activities the symptoms decre
    • both nature and nurture
  19. tourettes vocal tics
    • corprolalia: obscenities verbal
    • palilalia: repeating ones on words and phrases
    • echolia: repeating others words

    • excerbated by stress
    • 2/3 of people have relative who has it
    • meds: haldol antipsychotic and pimozide (orap)
    • combo with meds and counseling they do good
  20. tourettes:
    risk for self directed or others directed violence
    • r/t low tolerance for frustration
    • severe cases
    • outcomes:
    • - ST: seek staff/support if thougts of harming self/others
    • - LT: not harm self/others
    • Interventions:
    • - observe behaviors-signs of increasing agitation
    • - monitor for self destruction impulses 1:1 PRN
    • - hand covering other restriants cause of self mutlilating
    • redirect violant behaviors with physical outlets
  21. tourettes:
    Low self esteem
    • r/t embrassed associated
    • AEB: tic behaviors
    • outcomes;
    • ST: verbalize positive aspect about self
    • LT: exhibit increa of feeling of self worth
    • Intervention:
    • - unconditional acceptance and positive regard
    • - sets limits on manipulating behavior and have consequences
    • - help understand use manipulation to increa own self esteem. identify other actions to accomplish this goal
    • - provide tic time and discuss feeling with staff
    • - ensure one on one staff not focusing on behavior
Card Set:
Neurodevelopment disorder in children 2
2015-03-08 19:31:48

dun language
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