PSYCHIATRIC NURSING

NEURODEVELOPMENTAL
disorders
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Meet Our Team

CARA AISHA JESSERY

ABEJO COROBONG RAMOS

ANGEL CHRISTIAN JAMES

BILBAO GAMOLO TIMBAL
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Table of Contents

Introduction
DIAGNOSIS
ETIOLOGY
CARDINAL SYMPTOMS
MEDICAL MANAGEMENT
NURSING MANAGEMENT
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Introduction
PSYCHIATRIC DISORDERS ARE NOT DIAGNOSED AS EASILY IN
CHILDREN AS THEY ARE IN ADULTS. CHILDREN USUALLY LACK THE
ABSTRACT COGNITIVE ABILITIES AND VERBAL SKILLS TO DESCRIBE
WHAT IS HAPPENING.

INTELLECTUAL DISABILITY IS THE CORRECT DIAGNOSTIC TERM FOR

WHAT WAS ONCE CALLED MENTAL RETARDATION, A TERM OFTEN
USED IN A DISPARAGING MANNER TO BULLY OR RIDICULE
INDIVIDUALS WITH IMPAIRED COGNITIVE ABILITIES

USUALLY DIAGNOSED IN INFANCY OR CHILDHOOD AND SOMETIMES

ADOLESCENCE; MANY OF THESE DISORDERS PERSIST INTO
ADULTHOOD.
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AUTISM SPECTRUM DISORDER (ASD)

characterized by pervasive and usually
severe impairment of reciprocal social
interaction skills, communication deviance,
and restricted stereotypical behavioral
patterns.

Formerly called autistic disorder or just

autism.

MOSTLY BOYS

18 MONHS AND NO LATER THAN 3 YEARS OF AGE.

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TIC DISORDER
a sudden, rapid, recurrent, nonrhythmic, stereotyped motor
movement or vocalization.

STRESS EXACERBATES TICS COMMON SIMPLE MOTOR

TICS COMPLEX MOTOR TICS
DIMINISH DURING SLEEP AND WHEN

THE PERSON IS ENGAGED IN AN BLINKING, JERKING THE NECK, FACIAL GESTURES, JUMPING, OR
ABSORBING ACTIVITY. SHRUGGING THE SHOULDERS, TOUCHING OR SMELLING AN
GRIMACING, AND COUGHING. OBJECT

COMMON SIMPLE VOCAL

TICS TOURETTE DISORDER

COMPLEX VOCAL TICS

CLEARING THE THROAT,

MULTIPLE MOTOR TICS AND ONE
GRUNTING, SNIFFING, SNORTING, REPEATING WORDS OR PHRASES OR MORE VOCAL TICS, WHICH
AND BARKING. OUT OF CONTEXT OCCUR MANY TIMES A DAY FOR
MORE THAN 1 YEAR.
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CHRONIC
MOTOR OR TIC
DISORDER
DIFFERS FROM TOURETTE
DISORDER IN THAT EITHER THE
MOTOR OR THE VOCAL TIC IS
SEEN, BUT NOT BOTH.
TRANSIENT TIC DISORDER MAY
INVOLVE SINGLE OR MULTIPLE
VOCAL OR MOTOR TICS, BUT THE
OCCURRENCES LAST NO LONGER
THAN 12 MONTHS.
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LEARNING
DISORDERS
WHEN A CHILD’S ACHIEVEMENT IN
READING, MATHEMATICS, OR
WRITTEN EXPRESSION IS BELOW
THAT EXPECTED FOR AGE,
FORMAL EDUCATION, AND
INTELLIGENCE
READING AND WRITTEN
EXPRESSION DISORDERS ARE
USUALLY IDENTIFIED IN THE
FIRST GRADE; MATH DISORDER
MAY GO UNDETECTED UNTIL THE
CHILD REACHES FIFTH GRADE
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MOTOR SKILLS DISORDERS
THE ESSENTIAL FEATURE OF DEVELOPMENTAL
COORDINATION DISORDER IS IMPAIRED
COORDINATION SEVERE ENOUGH TO INTERFERE
WITH ACADEMIC ACHIEVEMENT OR ACTIVITIES
OF DAILY LIVING. THIS DIAGNOSIS IS NOT MADE
IF THE PROBLEM WITH MOTOR COORDINATION
IS PART OF A GENERAL MEDICAL CONDITION,
SUCH AS CEREBRAL PALSY OR MUSCULAR
DYSTROPHY.
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STEREOTYPIC MOVEMENT
DISORDER
IS CHARACTERIZED BY RHYTHMIC,
REPETITIVE BEHAVIORS, SUCH AS
HAND WAVING, ROCKING, HEAD
BANGING, AND BITING, THAT APPEARS
TO HAVE NO PURPOSE. SELF-
INFLICTED INJURIES ARE COMMON,
AND THE PAIN IS NOT A DETERRENT
TO THE BEHAVIOR
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COMMUNICATION DISORDER
A communication disorder involves
deficits in language, speech, and
communication

Stuttering is a disturbance of
fluency and patterning of speech
with sound and syllable repetitions.

Communication disorders may be mild

to severe. Difficulties that persist
into adulthood are related most
closely to the severity of the
disorder.
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ELIMINATION DISORDERS
ENCOPRESIS IS THE REPEATED
PASSAGE OF FECES INTO
INAPPROPRIATE PLACES SUCH AS
CLOTHING OR THE FLOOR BY A CHILD
WHO IS AT LEAST 4 YEARS OF AGE
EITHER CHRONOLOGICALLY OR
DEVELOPMENTALLY.
ENURESIS IS THE REPEATED VOIDING ENCOPRESIS CAN PERSIST
OF URINE DURING THE DAY OR AT WITH INTERMITTENT
NIGHT INTO CLOTHING OR BED BY A EXACERBATIONS FOR YEARS;
CHILD AT LEAST 5 YEARS OF AGE IT IS RARELY CHRONIC.
EITHER CHRONOLOGICALLY OR SLUGGISH COGNITIVE TEMPO
DEVELOPMENTALLY. (SCT) IS A SYNDROME THAT IS
NOT A DSM-5 DIAGNOSIS.

IMPAIRMENT ASSOCIATED WITH ENURESIS CAN BE TREATED

ELIMINATION DISORDERS DEPENDS ON
THE LIMITATIONS ON THE CHILD’S
SOCIAL ACTIVITIES, EFFECTS ON SELF-
ESTEEM, DEGREE OF SOCIAL
OSTRACISM BY PEERS, AND ANGER,
PUNISHMENT, AND REJECTION ON THE
PART OF PARENTS OR CAREGIVERS.
EFFECTIVELY WITH IMIPRAMINE
(TOFRANIL), AN ANTIDEPRESSANT
WITH A SIDE EFFECT OF URINARY
RETENTION. BOTH ELIMINATION
DISORDERS RESPOND TO
BEHAVIORAL APPROACHES
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ATTENTION-DEFICIT/HYPERACTIVITY DISORDER

Attention-deficit/hyperactivity
disorder (ADHD) is characterized by
inattentiveness, overactivity, and
impulsiveness.

ADHD is a common disorder, especially

in boys, and probably accounts for
more child mental health referrals
than any other single disorder.

A key feature of ADHD is the

consistency of the child’s behavior—
every day, in almost all situations,
and with almost all caregivers, the
child demonstrates the problematic
behaviors.
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ETIOLOGY
THERE MAY BE CORTICAL-AROUSAL, INFORMATION-PROCESSING,
OR MATURATIONAL ABNORMALITIES IN THE BRAIN. COMBINED
FACTORS, SUCH AS ENVIRONMENTAL TOXINS, PRENATAL
INFLUENCES, HEREDITY, AND DAMAGE TO BRAIN STRUCTURE AND
FUNCTIONS, ARE LIKELY RESPONSIBLE. PRENATAL EXPOSURE TO
ALCOHOL, TOBACCO, AND LEAD AND SEVERE MALNUTRITION IN
EARLY CHILDHOOD INCREASE THE LIKEHOOD OF ADHD.
BRAIN IMAGES OF PEOPLE WITH ADHD SUGGEST DECREASED
METABOLISM IN THE FRONTAL LOBES, WHICH ARE ESSENTIAL
FOR ATTENTION, IMPULSE CONTROL, ORGANIZATION, AND
SUSTAINED GOAL-DIRECTED ACTIVITY. STUDIES HAVE ALSO
SHOWN DECREASED BLOOD PERFUSION OF THE FRONTAL CORTEX
IN CHILDREN WITH ADHD AND FRONTAL CORTICAL ATROPHY IN
YOUNG ADULTS WITH A HISTORY OF CHILDHOOD ADHD.
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Cardinal Sypmtons
HISTORY GENERAL APPEARANCE MOOD AND AFFECT THOUGHT PROCESS AND
AND MOTOR CONTENT

ROLES AND RELATIONSHIP PHYSIOLOGICAL AND

JUDGEMENT AND INSIGHT SELF-CONCEPT SELF-CARE
CONSIDERATIONS
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general appearance
History
THE CHILD WAS FUSSY AND HAD
PROBLEMS AS AN INFANT, OR THEY
MAY NOT HAVE NOTICED THE
HYPERACTIVE BEHAVIOR UNTIL THE
CHILD WAS A TODDLER OR ENTERED
DAY CARE OR SCHOOL.
THE CHILD PROBABLY HAS
DIFFICULTIES IN ALL MAJOR LIFE
AREAS SUCH AS SCHOOL OR PLAY,
AND HE OR SHE LIKELY DISPLAYS
OVERACTIVE OR EVEN DAN- GEROUS
BEHAVIOR AT HOME.
OFTEN, PARENTS SAY THE CHILD IS
"OUT OF CONTROL," AND THEY FEEL
UNABLE TO DEAL WITH THE
BEHAVIOR.
PARENTS MAY REPORT MANY
LARGELY UNSUC- CESSFUL
ATTEMPTS TO DISCIPLINE THE CHILD
OR CHANGE THE BEHAVIOR.
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and motor
THE CHILD CANNOT SIT STILL IN A
CHAIR AND SQUIRMS AND WIGGLES
WHILE TRYING TO DO SO.
HE OR SHE MAY DART AROUND THE
ROOM WITH LITTLE OR NO APPARENT
PURPOSE.
SPEECH IS UNIMPAIRED, BUT THE
CHILD CANNOT CARRY ON A
CONVERSA- TION, HE OR SHE
INTERRUPTS, BLURTS OUT ANSWERS
BEFORE THE QUESTION IS FINISHED,
AND FAILS TO PAY ATTENTION TO
WHAT HAS BEEN SAID.
CONVERSATION TOPICS MAY JUMP
ABRUPTLY. THE CHILD MAY APPEAR
IMMATURE OR LAG BEHIND IN DEVEL-
OPMENTAL MILESTONES.
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mood and
affect
MOOD MAY BE LABILE, EVEN TO THE
POINT OF VERBAL OUT- BURSTS OR
TEMPER TANTRUMS.
ANXIETY, FRUSTRATION, AND
AGITATION ARE COMMON.
THE CHILD APPEARS TO BE DRIVEN TO
KEEP MOVING OR TALKING AND
APPEARS TO HAVE LITTLE CONTROL
OVER MOVEMENT OR SPEECH.
ATTEMPTS TO FOCUS THE CHILD'S
ATTENTION OR REDIRECT THE CHILD
TO A TOPIC MAY EVOKE RESISTANCE
AND ANGER.
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thought
process and
content
THERE ARE GENERALLY NO
IMPAIRMENTS IN THIS AREA, THOUGH
ASSESSMENT CAN BE DIFFICULT
DEPENDING ON THE CHILD'S ACTIVITY
LEVEL AND AGE OR DEVELOPMENTAL
STAGE. SENSORIUM AND
INTELLECTUAL PROCESSES
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judgement
and insight
CHILDREN WITH ADHD USUALLY
EXHIBIT POOR JUDGMENT AND OFTEN
DO NOT THINK BEFORE ACTING.
THEY MAY FAIL TO PERCEIVE HARM
OR DANGER AND ENGAGE IN
IMPULSIVE ACTS, SUCH AS RUNNING
INTO THE STREET OR JUMPING OFF
HIGH OBJECTS.
ALTHOUGH ASSESSING JUDGMENT AND
INSIGHT IN YOUNG CHILDREN IS
DIFFICULT, CHILDREN WITH ADHD
DISPLAY MORE LACK OF JUDGMENT
COMPARED WITH OTHERS OF THE
SAME AGE.
MOST YOUNG CHILDREN WITH ADHD
ARE TOTALLY UNAWARE THAT THEIR
BEHAVIOR IS DIFFERENT FROM THAT
OF OTHERS AND CANNOT PERCEIVE
HOW IT HARMS OTHERS.
OLDER CHILDREN MIGHT REPORT, "NO
ONE AT SCHOOL LIKES ME," BUT THEY
CANNOT RELATE THE LACK OF
FRIENDS TO THEIR OWN BEHAVIOR.
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SElf-concept
THIS MAY BE DIFFICULT TO ASSESS IN
A VERY YOUNG CHILD, BUT
GENERALLY, THE SELF-ESTEEM OF
CHILDREN WITH ADHD IS LOW.
BECAUSE THEY ARE NOT SUCCESSFUL
AT SCHOOL, MAY NOT HAVE MANY
FRIENDS, AND HAVE TROUBLE
GETTING ALONG AT HOME, THEY
GENERALLY FEEL OUT OF PLACE AND
BAD ABOUT THEMSELVES.
THE NEGATIVE REACTIONS THEIR
BEHAVIOR EVOKES FROM OTHERS
OFTEN CAUSE THEM TO SEE
THEMSELVES AS BAD OR STUPID.

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roles and physiological and self-

relationship care considerations
THE CHILD IS USUALLY UNSUCCESSFUL
ACADEMICALLY AND SOCIALLY AT SCHOOL.
HE OR SHE IS FREQUENTLY DISRUPTIVE AND
INTRUSIVE AT HOME, WHICH CAUSES FRICTION
WITH SIBLINGS AND PARENTS. CHILDREN WITH ADHD MAY BE THIN IF
UNTIL THE CHILD IS DIAGNOSED AND TREATED, THEY DO NOT TAKE TIME TO EAT
PARENTS OFTEN BELIEVE THAT THE CHILD IS PROPERLY OR CANNOT SIT THROUGH
WILLFUL, STUBBORN, AND PURPOSEFULLY MEALS.
MISBEHAVING. GENERALLY, MEASURES TO TROUBLE SETTLING DOWN AND
DISCIPLINE HAVE LIMITED SUCCESS; IN SOME DIFFICULTY SLEEPING ARE
CASES, THE CHILD BECOMES PHYSICALLY OUT OF PROBLEMS AS WELL.
CONTROL, EVEN HITTING PARENTS OR IF THE CHILD ENGAGES IN RECKLESS
DESTROYING FAMILY POSSESSIONS. OR RISKTAKING BEHAVIORS, THERE
PARENTS FIND THEMSELVES CHRONICALLY MAY ALSO BE A HISTORY OF
EXHAUSTED MENTALLY AND PHYSICALLY. PHYSICAL INJURIES.
TEACHERS OFTEN FEEL THE SAME FRUSTRATION
AS PARENTS, AND DAY CARE PROVIDERS OR
BABYSITTERS MAY REFUSE TO CARE FOR THE
CHILD WITH ADHD, WHICH ADDS TO THE CHILD'S
REJECTION.
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MEDICAL MANAGEMENT
sugar-controlled diets and megavitamin
therapy. goals of treatment involve
managing symptoms, reducing hyperactivity
and impulsivity, and increasing the child’s
attention so that he or she can grow and
develop normally.
The most common medications are
methylphenidate (Ritalin) and an amphetamine
compound (Adderall). Methylphenidate is
effective in 70% to 80% of children with ADHD

Dextroamphetamine (Dexedrine) and pemoline

(Cylert)

ATOMOXETINE (STRATTERA) IS THE ONLY

NONSTIMULANT DRUG SPECIFICALLY DEVELOPED AND
TESTED BY THE U.S. FOOD AND DRUG
ADMINISTRATION FOR THE TREATMENT OF ADHD.
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DRUGS USED TO TREAT ADHD

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NURSING MANAGEMENT

Nursing management for neurodevelopmental

disorders involves a comprehensive approach
that encompasses assessment, planning,
implementation, and evaluation of care for
individuals with these conditions.Here are
some key points to keep in mind when caring
for patients with neurodevelopmental
disorders:
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assessment planning

NURSES SHOULD CONDUCT A ONCE A COMPREHENSIVE

THOROUGH ASSESSMENT OF THE ASSESSMENT IS COMPLETED,
PATIENT'S DEVELOPMENTAL NURSES SHOULD COLLABORATE
HISTORY, CURRENT SYMPTOMS, WITH THE HEALTHCARE TEAM AND
AND ANY COMORBIDITIES. THIS THE PATIENT'S FAMILY TO
INCLUDES A DETAILED PHYSICAL DEVELOP A CARE PLAN THAT IS
EXAMINATION, NEUROLOGIC TAILORED TO THE PATIENT'S
EVALUATION, AND SPECIFIC NEEDS. THIS CARE PLAN
PSYCHOLOGICAL TESTING IF SHOULD ADDRESS THE PATIENT'S
NECESSARY. ASSESSMENT ALSO PHYSICAL, EMOTIONAL, AND
INCLUDES EVALUATION OF THE DEVELOPMENTAL NEEDS, AS WELL
PATIENT'S COGNITIVE, AS ANY COMORBIDITIES.
EMOTIONAL, AND SOCIAL
FUNCTIONING.
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implementation
NURSING INTERVENTIONS FOR
PATIENTS WITH
NEURODEVELOPMENTAL
DISORDERS MAY INCLUDE
MEDICATION MANAGEMENT,
BEHAVIORAL THERAPIES, AND
EDUCATIONAL INTERVENTIONS. IT
IS IMPORTANT FOR NURSES TO
WORK CLOSELY WITH OTHER
HEALTHCARE PROVIDERS, SUCH AS
OCCUPATIONAL THERAPISTS,
PHYSICAL THERAPISTS, AND
SPEECH THERAPISTS, TO PROVIDE
A MULTIDISCIPLINARY APPROACH
TO CARE.
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Evaluation
NURSES SHOULD MONITOR THE
PATIENT'S PROGRESS AND ADJUST
THE CARE PLAN AS NECESSARY.
THEY SHOULD ALSO PROVIDE
ONGOING EDUCATION AND
SUPPORT TO THE PATIENT AND
THEIR FAMILY, AS WELL AS
COORDINATE REFERRALS TO
COMMUNITY RESOURCES AS
NEEDED.
thank you