Study Guide: Intellectual Disability Essay

Study Guide: Intellectual Disability Essay

 

Intellectual Disability

My study guide for intellectual disability begins with the general DSM-5 definition and signs and symptoms as classified by the DSM-5 criteria. I have also used mnemonics and color-coding to ensure visual aiding. This study guide is meant to provide a rough overview of the topics to be studied before the examination. The study guide follows the information arrangement by the DSM-5 but another input has been derived from scholarly book chapters and organizational websites for up-to-date current trends.

Study Guide
Intellectual Disability Definition   Deficiency in the domains of mental capabilities and functioning

(American Psychiatric Association, 2013)

Signs and symptoms according to the DSM-5

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(Symptoms in Criteria A, B, and C must be met)

Intellectual function deficits

(Criterion A) (American Psychiatric Association, 2013)

Problem-solving, reasoning, judgment, abstract thinking, learning deficits, lower standardized intellectual tests
Adaptive functioning deficits

(Criterion B) (American Psychiatric Association, 2013)

Social participation, communication, living independently, poor adaptation to change in physical settings
Criterion C (American Psychiatric Association, 2013) Onset during the development period
Differential diagnoses M2AS2C3

M

M

A

S

S

C

C

C

 

Major neurocognitive disorder Alzheimer’s disease, downs syndrome
Mild neurocognitive disorder Alzheimer’s disease, downs syndrome
Autism spectrum disorder Social, communication, and behavior deficits
Specific learning disorder No deficits in intellectual and adaptive behaviors
Communication disorder No deficits in intellectual and adaptive behaviors
Child abuse Can cause developmental delays
Speech disorder Aphasia
Cerebral palsy Poor vision, improper muscle coordination, and reduced hearing
Incidence and prevalence 1 percent of the general population

6 per 1000 cases are severe  (American Psychiatric Association, 2013)

In 2014 – 3.4% in the US (CDC, 2019)

In 2016 – 3.57% in the US (CDC, 2019)

Risks and Prognosticators ¾     Genetics – CNS malformations, inborn errors of metabolism,

¾     Acquired – meningitis, seizure disorders, neonatal encephalopathy

¾     Teratogens – alcohol, toxins, drugs in utero

¾     Hypoxic-ischemic injury

¾     Placental diseases

¾     Traumatic brain injury

¾     Toxic metabolism syndromes

¾     Chronic social deprivation

Development and course ¾     Starts in the development period

¾     Age at onset is determined by severity and comorbidities

¾     Severe types can be diagnosed by age 2 (American Psychiatric Association, 2013)

¾     Severity can be mild, moderate, and severe depending on presentation and assessment

¾     The course is nonprogressive, sometimes with fluctuating periods

¾     Intellectual deficits precede adaptive function deficits

¾     Language and motor skills are seen first (Schaepper et al., 2021)

¾     The concept is loss of previously acquired skills during development or lack of acquisition of these skills at all in the development period

Cultural & Gender considerations ¾     Need to understand the ethnic, cultural, and linguistic background of the patient

¾     All races and cultures are afflicted

¾     Family history is essential as well as the genogram

¾     Male more than females – 1.6/1 (American Psychiatric Association, 2013)

¾     X-linked genetic disease responsible for the variations in gender

Pharmacotherapy ¾     No pharmacotherapy approved by the food and drug administration (FDA) (Schaepper et al., 2021)

¾     Medications may be used to treat particular disease presentations of comorbidities such as ADHD – methylphenidate, clonidine, atomoxetine

¾     Risperidone has been used for aggressive behavior

¾     Aripiprazole for aggression

Non-pharmacotherapy ¾     Special education to the patients

¾     Parental psychoeducation

¾     Family therapy and support

¾     Vocational training and support

¾     Housing, residential, and social support

¾     Childhood to adulthood transition support services (Schaepper et al., 2021)

Diagnostics ¾     Clinical judgment is the first step to suspicion

¾     Mental state examination

¾     Full IQ score tests, nowadays not mandatory (American Psychiatric Association, 2013)

¾     The IQ tests should be:

o   Psychometrically valid

o   Psychometrically sound

o   Culturally appropriate

¾     Adaptive Behavior Assessment System for adaptive function assessment (Lee et al., 2021)

¾     Other tests:

o   Karyotyping

o   Urine analysis

o   Neuroimaging

o   Enzyme deficiency blood tests

Comorbidities Most common

¾     Bipolar disorder

¾     Autism spectrum disorders

¾     Stereotypic movement disorder

¾     Major neurocognitive disorder

¾     Anxiety disorders

¾     Depression disorders

(American Psychiatric Association, 2013)

More common

¾     Epilepsy

¾     Mental disorders

¾     Cerebral palsy

¾     Motor disorders

¾     Impulse control disorder

¾     Attention deficit disorders

(Schaepper et al., 2021)

Legal and ethical considerations ¾     Individuals have the rights to access appropriate knowledge – justice

¾     Parents to teach their afflicted children the necessary laws for the land – legal

¾     Need to fair and just access to community resources and services – ethical justice

¾     Promote independence and responsibility in the patients – respect autonomy

¾     Susceptibility to physical and sexual abuse  (Tomsa et al., 2021)

Pertinent patient education considerations  ¾     Functional skills

¾     Behavioral skills

¾     Vocational skills

¾     Communication skills

¾     Including the family in patient education beyond the classroom

¾     Creation of the least restrictive environment for education

¾     Seeking assistance

¾     Social skills

¾      Rule out other causes of learning disabilities

¾     Screen for visual and hearing problems

(Lee et al., 2021)

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References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5 (R)) (5th ed.). American Psychiatric Association Publishing.

CDC. (2019, June 6). Products – data briefs – number 291 – November 2017. Cdc.Gov. https://www.cdc.gov/nchs/products/databriefs/db291.htm

Lee, K., Cascella, M., & Marwaha, R. (2021). Intellectual Disability. StatPearls Publishing.

Schaepper, M. A., Hauser, M., & Kagadkar, F. (2021, August). What is intellectual disability? The Psychiatry of Intellectual Disability; CRC Press.

 

Week 8: Neurodevelopmental Disorders
I can’t believe I am sitting here talking to this lady. Mom thinks I am nuts just because I will not do what she asks. She doesn\’t care about me. She only cares about my little brother and that man that keeps coming around. I don’t care about her. That is why I throw things and won’t do what she asks. I don’t care about anyone. Those kids at school who used to be my friends don’t know anything. I am so much smarter than they are.
—Jacob, age 11

There are many mental disorders that occur early in the life course. The DSM-5 describes neurodevelopmental disorders such as intellectual disability and delay, autism spectrum disorder, language and speech disorders, ADHD and specific learning disorder (e.g., dyslexia, difficulty mastering mathematical reasoning). Diagnosis of these various conditions can rarely be made in a single office visit and often requires a comprehensive approach involving multiple stakeholders, including the child, his or her parents, teachers, other significant figures in the child\’s life, and medical and mental health professionals, such as psychologists who can conduct comprehensive neuropsychological testing.
The PMHNP must coordinate and integrate several sources of information to arrive at an accurate diagnosis of these disorders. Early and accurate diagnosis is essential to developing an effective treatment plan, which will have the potential to minimize the impact of these disorders on the child’s developmental trajectory. When one considers appropriate diagnosis from this perspective, the importance of diagnostic accuracy becomes quite apparent.

This week, you begin exploring disorders that occur early in the life course and use this knowledge to create a study guide for a neurodevelopmental disorder.

Learning Objectives
Students will:

Analyze signs and symptoms of neurodevelopmental disorders
Analyze the pathophysiology of neurodevelopmental disorders
Analyze diagnosis and treatment methods for neurodevelopmental disorders
Summarize legal, ethical, and patient education factors related to neurodevelopmental disorders
Learning Resources
Required Readings (click to expand/reduce)

Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.

Chapter 12, “Developmental Milestones”
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.

Chapter 51, “Autism Spectrum Disorder”
Chapter 55, “ADHD and Hyperkinetic Disorder”
Utah State University. (n.d.). Creating study guides. https://www.usu.edu/academic-support/test/creating_study_guides

Walden University. (2020). Success strategies: Self-paced interactive tutorials. https://academicguides.waldenu.edu/academic-skills-center/skills/tutorials/success-strategies

Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual. Springer.

Chapter 13, “Child/Adolescent Neurodevelopmental Disorders”
Required Media (click to expand/reduce)

Dillon, K. (2019, March 23). DSM-5 neurodevelopmental disorders. [Video]. YouTube. https://www.youtube.com/watch?v=Ydr9s_UwACo

The National Center for Learning Disabilities. (2013, February 20). What is ADHD? [Video]. YouTube. https://youtu.be/0Wz7LdLFJVM

Osmosis. (2017, October 17). Autism – causes, symptoms, diagnosis, treatment, pathology [Video]. YouTube. https://youtu.be/x2hWVgZ8J4A

Medication Review
Irritability in autism Attention-deficit/hyperactivity disorder
aripiprazole
risperidone
amphetamine IR, XR, and ER
dextroamphetamine
atomoxetine

clonidine hydrocholoride ER
Dexmethylphenidate IR and XR
guanfacine hydrocholride ER
lisdexamfetamine
methylphenidate
methylphenidate hydrocholoride IR and ER, transdermal

Assignment: Study Guide Forum
Abnormal brain development or damage at an early age can lead to neurodevelopmental disorders. Within this group of disorders, some are resolvable with appropriate and timely interventions, either pharmacological or nonpharmacological, while other disorders are chronic and need to be managed throughout the lifespan.

For this Assignment, you will develop a study guide for an assigned disorder and share it with your colleagues. In sum, these study guides will be a powerful tool in preparing for your certification exam.

Photo Credit: Getty Images/iStockphoto

To Prepare
Your Instructor will assign you to a specific neurodevelopmental disorder from the DSM-5.
Research your assigned disorder using the Walden Library. Then, develop an organizational scheme for the important information about the disorder.
The Assignment
Create a study guide for your assigned disorder. Your study guide should be in the form of an outline with references, and you should incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards. Be creative! It should not be in the format of an APA paper. Your guide should be informed by the DSM-5 but also supported by at least three other scholarly resources.

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Areas of importance you should address, but are not limited to, are:

Signs and symptoms according to the DSM-5
Differential diagnoses
Incidence
Development and course
Prognosis
Considerations related to culture, gender, age
Pharmacological treatments, including any side effects
Nonpharmacological treatments
Diagnostics and labs
Comorbidities
Legal and ethical considerations
Pertinent patient education considerations
By Day 7 of Week 8
Submit your Assignment to the forum as an attachment. Although no responses are required, collegial discussion is welcome. You are encouraged to utilize your peers’ submitted guides on their assigned neurodevelopmental disorders for study.

Submission and Grading Information
Grading Criteria
To access your rubric:

Week 8 Assignment Rubric

Post by Day 7 of Week 8
To Participate in this Assignment:

Week 8 Assignment

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