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Asperger’s DisorderThis disorder is recognized later than autistic disorder. There are no significant delays in cognitive & language development or in self-help skills, but severe & sustained impairment in social interactions, development of restricted,repetitive patterns of behavior in interest & activities, & delayed motor milestones do occur. Social interaction problems are more noticeable when child enters school, as are problems w/empathy & modulating social relationships.Rhett’s DisorderThis is seen only in females, w/onset before age 4 years. Characteristics include persistent loss of manual skills, development of stereotyped hand movements (hand wringing), problems w/coordination & gait, severe psychomotor retardation, severe problems w/expressive & receptive language, & loss of interest in social interactions.Application of Nursing ProcessAssessmentAssessment Guidelines: Pervasive Developmental DisordersAssess for developmental spurts, lags, uneven development, & loss of previously acquired abilities.1.Assess quality of relationship between child & caregiver for evidence of bonding, anxiety, tension, fit between temperaments.2.Be aware that children w/behavioral & development problems are at risk for abuse.DxDelayed growth & development, Impaired social interactions, Impaired verbal communication are often useful.Outcomes IdentificationNursing Outcomes Classification (NOC)identifies a # of outcomes that are appropriate for a child w/PDD. See Table 28-3.ImplementationInterventions center around helping child reach his or her full potential by fostering developmental competence & coping skills (e.g., increasing interest in reciprocal interactions, fostering social skill development, facilitating expression of appropriate emotional responses, fostering development of reciprocal communication, fostering cognitive skills, fostering development of self-control, etc.).ADHD & Disruptive Behavior DisordersAttention Deficit Hyperactivity DisorderAffected children show inappropriate inattention, impulsiveness, & hyperactivity. ADHD may be associated w/oppositional defiant or conduct disorder or Tourette’s disorder.Presenting sx of ADHD include:1. Inattention
2. Hyperactivity3. ImpulsivityOppositional Defiant DisorderA recurrent pattern of negativistic, disobedient, hostile, defiant behavior toward authority figures, without serious violations of basic rights of others. Such a child may exhibit following characteristics: loses temper, argues w/adults, actively defies, refuses to comply, deliberately annoys people, blames others for mistakes, is easily annoyed by others,is angry or resentful, spiteful, or vindictive.Conduct DisorderThis is characterized by a persistent pattern of behavior in which rights of others & age-appropriate societal norms areviolated. Rates for males range from 6% to 16% & for females 2% to 9%. Predisposing factors are ADHD, parental rejection, inconsistent parenting w/harsh discipline, early institutional living, absence of father, alcoholic father, & similar causes. Childhood-onset conduct disorder occurs prior to age 10 & is marked by physical aggression. youth