Paper I have written Complex Care for people with Intellectual...

Paper I have written

Complex Care for people with Intellectual Disabilities

 

 

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Complex Care for Patients with Intellectual Disabilities

Intellectual disability or intellectual development disorder can be diagnosed when individuals have both sub-average logical effectiveness and deficits or impairments in their adaptive functioning and accomplishing everyday activities (Bowling et al., 2017). Furthermore, the intellectual disability is categorized based on the extent of impairment and the care support needed, including moderate, severe, mild, and profound. Besides, reports indicate that approximately two percent of the total world inhabitants are approximated to have an intellectual disability, with around eighty percent in the mild range (Bowling et al., 2017). Therefore, this paper will define the intellectual disability patient population, their intervention measures and describe intervention comparison. Finally, the paper will explain the outcomes of intervention measures.

Patient Population

Intellectual disability is common to children of lower SES and minority groups, reflecting identification and referral biasness. The reports indicate that more males are diagnosed with the condition than females. Bowling et al. (2017) state that speech and language impairments are the most common difficulties children experience. In addition, the experience deficit including impulse anxiety and impulse control problems, ADHD-related symptoms, self-injury behavior, and other physical and developmental disabilities.

These disabilities can be associated with the etiological variation in genetic issues and neurobiological influences. In addition, the condition is mainly linked to familial, cultural causes, including economic deprivation, inadequate family care, and family history.

Description of Intervention of Interest.

The intervention of interest involves various therapy sessions, such as physical therapy and speech therapy (Kuluski et al., 2017). However, to conduct an appropriate therapy, the first step is to conduct a diagnostic test.

Diagnostic Test

The diagnostic test of intellectual disability is conducted through an exam and standardized testing by a qualified medical practitioner. Nambot et al. (2018) indicate that standardized testing is the common primary diagnosis for the condition. A specific full score IQ test score could also be used for diagnosis. For instance, in IQ test score, the score of between 69 and 74 indicate a substantial limitation in intellectual functioning. However, the context of the child's difficulty in general mental abilities is considered for the interpretation of the IQ score. In addition, overall the full-scale IQ score because of the varying scores of subtests may not accurately reflect intellectual functioning.

In addition, while conducting the intellectual disability diagnosis, conceptual, social, and practical areas are considered. For conceptual, Nambot et al. (2018) outline that it includes memory, knowledge, writing, reasoning, language, reading, and math. Bowling et al. (2017) state that adaptive social functioning includes social judgment, empathy, the ability to follow the rules, and making and keeping the friendship (Nambot et al., 2018). On the practical side, it includes job responsibilities, individual care, reaction, and shaping school and work tasks. The standardized measures with interviews with family members, teachers, and caregivers assess adaptive functioning.

Most people are in the mild category. There are also moderate and severe categories. Their symptoms begin in childhood or adolescence. At the age of two years, language or motor skills delays may be experienced (Nambot et al., 2018). At the same time, the mild category is mainly encountered during the school age.

Moreover, the diagnosis of the intellectual condition starts with a complete physical condition. Therefore, a thorough review is conducted to determine the medical or physical causes of the identified child's symptoms. This comprehensive assessment includes; educational history, interviews with primary caregivers and teachers, family history, social history, social and child's observable social behavior in the natural environment, adaptive functioning testing, complete medical exam, and probable genetic and neurological test (Nambot et al., 2018). Through these adaptive and intellective functioning tests, the primary diagnosis criteria are achieved.

There are commonly used adaptive functioning tests. For instance, Woodcock-Johnson Scales of Independent Behavior measure children's independent behavior. In addition, social skills are measured by the Vineland Adaptive Behavior Scale (VABS) from individuals' birth to nineteen years. In this VABS diagnostic test, questions are directed to the patient's primary caregiver and individuals close to the child. Besides, in this method, the child is not asked questions. In addition, everyday living, motor, socializing, and communication skills are part of this section's test (Nambot et al., 2018). Finally, the Diagnostic Adaptive Behavior Scale (AAIDD, 2013) measures the adaptive behavioral skills, which measures the adaptive categories of skills. The skills measured include social, conceptual, and practical life skills. The test helps identify and evaluate the intensity and type of support required to take full advantage of independent functioning and quality of life.

Intervention of interest

The intervention of interest includes therapy, which is the standard care for the treatment of intellectual disability. For instance, research suggests that Cognitive Behavioral Therapy (CBT) has a positive and emerging evidence base in treating individuals with intellectual disabilities. Furthermore, the reports show that individuals with these intellectual disabilities have the required skills to undergo CBT. CBT is a talking therapy that aims at modifying harmful behavior linked with psychological distress. Therefore, it is evident that the therapy is effective for treating people diagnosed with intellectual disabilities. In addition, it involves a collaboration between the therapist and the client to understand how people feel, think, or behave.

Besides, the existing literature on cognitive behavior therapy for adults, children, and adolescents indicates, comorbid mental health disorders are likely to affect children with intellectual disabilities. Therefore, research indicates individuals with mild to moderate intellectual disability can engage in cognitive-based interventions (Siegel et al., 2020). In addition, the therapy can help improve the feeling of anger and despair among the participants. Furthermore, case studies have reported that CBT may be a feasible and effective approach for treating intellectual difficulties such as mood disorders, anxiety, and depression.

Moreover, there is Animal-Assisted therapy, which involves using animals to enhance the physical, emotional, and social well-being of humans. The therapy consists of including animals in goal-directed treatment sessions. Social, mental, emotional, and physical goals are the main objectives of Animal-Assisted therapy (Siegel et al., 2020). It involves animals accompanying their owners to the clinics or the health providers. The therapy has proven to be helpful to both adults and children. The individuals are provided with a purely non-judgmental space to work out their problems in the presence of a therapy animal. The intellectual disabilities that have proven effective with animal-assisted therapy include attention deficit hyperactivity disorder (ADAH), autism, anxiety, and depression (Siegel et al., 2020). Children with the above intellectual disorder can be treated by undergoing animal-assisted therapy. Children with this disorder are assigned service animals to help them with daily living activities like learning to identify the signs of an impending anxiety attack and remembering to take their medicine. In addition, the therapy releases endorphins that produce calming effects to the patients, which help improve the overall psychological state of the patients.

In addition, there are other therapies, such as occupational therapy. The therapy includes purposeful and meaningful activities such as self-care activities, i.e., dressing, feeding, dressing, and bathing. It also involves employment, leisure, and domestic activities (Reid et al., 2018). Several researchers have found evidence linking occupational therapy to the effective and safe way of treating intellectual disability. In addition, another therapy is speech therapy, which improves communication skills, vocabulary, and skill articulation. Speech therapy helps treat intellectually disabled individuals with a learning disorder to develop effective communication skills in class and their families (Reid et al., 2018). Finally, other therapies such as talk therapy and physical therapy also play an important role in treating intellectual disorders. For example, other literature has proven that quality of life is enhanced by physical therapy by maximizing mobility and self-locomotion and improving sensory integration.

Description of comparison intervention.

Another intervention measure for the treatment of intellectual disability is using a placebo. Although there is no legitimate medication prescribed for the root cause of intellectual disability, placebo has been applied for attempted treatment (Yuan et al., 2018). Furthermore, research shows that according to the literature conducted on placebo application in the treatment of intellectual stability, the results indicated that the entire spectrum of disorders that cause intellectual disabilities does not have a single medication.

However, some nootropic medications, also known as smart drugs, have been applied to treat disorders such as learning disorder, which causes intellectual disability (Siegel et al., 2020). Although these drugs have been used, there is no concrete evidence suggesting that drugs such as nootropics can treat learning disorders.

Furthermore, there have been attempts to apply secretin to treat children with autism disorder. Bowling et al. (2017) indicate that secretin placebo is not effective in treating intellectual disability. In addition, research was conducted on the different treatments and other clinical populations of children with an intellectual disability through intravenous injections of a placebo (Siegel et al., 2020). The results indicated that the current evidence on the biological placebo effect is minimal. The research concluded that single secretin is not an effective treatment for the perceived development disorder.

Although there has been ethical concern raised regarding placebo use in clinical research and treatment of intellectual disability (Yuan et al., 2018). However, a recent study recommends placebo controls are defensible and necessary on ethical grounds to control or treat intellectual disability if certain conditions are met (Bowling et al., 2017). Finally, although placebo has been used in biological practice to design preventions and control intellectual disability, medical ethics have dismissed the application of placebo in practice because there has little or no effect.

Description of Outcome

According to the diagnostic test, intellectual disability is a disease that can be managed in children by treating several disorders that result in the disability. Therefore, the two intervention methods have been widely used by physicians to treat and control the disability (Yuan et al., 2018). However, according to the reports and research, therapy has been the best-proven method to treat intellectual disability.

Several researchers have discovered the effectiveness and the efficiency of the therapy in the treatment of intellectual disability. In contrast, the researchers have dismissed the claim of applying a placebo in the treatment. Although physicians to treat autism disorders have used medicines such as secretin, they have proved to be much ineffective. Furthermore, the placebo has proven to have minimal effect in treating this disease (Yuan et al., 2018). Therefore, the best and most effective way to treat intellectual disability is through physical therapy, speech therapy, and cognitive and behavioral therapy.

Studies and evidence from the literature have suggested that therapy helps early children develop and develop learning and daily activities such as feeding and eating (Reid et al., 2018). These activities help them control the disorders, which result in intellectual disability. Therefore, according to the review of evidence from the kinds of literature, therapy is the best way to care for patients with intellectual disabilities because they have proven to be effective and safe for children to improve their lives (Reid et al., 2018). On the other hand, medical ethics indicate that placebo is not an effective way to treat intellectual disabilities.

Conclusion

Intellectual disability has been common in children. However, early diagnosis of this disability may result in the children's best solution and treatment method. Although other treatment methods, such as the use of a placebo, therapy has proven to be the best treatment method for the condition. Therapies such as cognitive behavioral therapy may be a feasible and effective approach for treating intellectual difficulties such as mood disorders, anxiety, and depression. Besides, the first growing number of children with intellectual disabilities is worrying and needs to be addressed sooner.

            

 

 

 

 

 

 

 

 

 

 

 

References

Bowling, K. M., Thompson, M. L., Amaral, M. D., Finnila, C. R., Hiatt, S. M., Engel, K. L., ... & Cooper, G. M. (2017). Genomic diagnosis for children with intellectual disability and/or developmental delay. Genome medicine, 9(1), 1-11. DOI: 10.1186/s13073-017-0433-1

Kuluski, K., Ho, J. W., Hans, P. K., & Nelson, M. L. (2017). Community care for people with complex care needs: bridging the gap between health and social care. International journal of integrated care, 17(4). DOI: 10.5334/ijic.2944

Nambot, S., Thevenon, J., Kuentz, P., Duffourd, Y., Tisserant, E., Bruel, A. L., ... & Thauvin-Robinet, C. (2018). Clinical whole-exome sequencing for diagnosing rare disorders with congenital anomalies and intellectual disability: substantial interest of prospective annual reanalysis. Genetics in Medicine, 20(6), 645-654. DOI: 10.1038/gim.2017.162

Reid, S. M., Meehan, E. M., Arnup, S. J., & Reddihough, D. S. (2018). Intellectual disability in cerebral palsy: a population‐based retrospective study. Developmental Medicine & Child Neurology, 60(7), 687-694. DOI: 10.1111/dmcn.13773

Siegel, M., McGuire, K., Veenstra-VanderWeele, J., Stratigos, K., King, B., Bellonci, C., ... & Walter, H. J. (2020). Practice parameter for assessing and treating psychiatric disorders in children and adolescents with intellectual disability (intellectual developmental disorder). Journal of the American Academy of Child & Adolescent Psychiatry, 59(4), 468-496. DOI: 10.1016/j.jaac.2019.11.018 

Yuan, J., Song, J., Zhu, D., Sun, E., Xia, L., Zhang, X., ... & Zhu, C. (2018). Lithium treatment is safe in children with intellectual disabilities. Frontiers in molecular neuroscience, 11, 425. DOI: 10.3389/fnmol.2018.00425

 

Rubric for the Paper

This paper is a "mini" EBP project. It requires the student to select a topic of interest. The student will define the patient population of interest as it relates to the topic. The student will then compare two (2) interventions for its treatment (one intervention may be a placebo - as long as it is an ethically acceptable treatment for the selected condition). The outcomes of the two interventions will be compared and contrasted based upon the evidence found in the literature. A recommendation will be made for the treatment supported as the best intervention based upon the findings in the literature. A minimum of five (5) research articles must be used in this paper.

 

Grading Criteria for Complex Care Topic Paper:

 

APA format with appropriate headings

10 points

Grammar & Spelling with complete introduction, body and summary

10 points

Description of Patient Population (P)

-         If possible, limit population to a certain age group or special sub-group

15 points

Description of Intervention of interest (I)

-         May include exposure, treatment, patient perception, diagnostic test, prognostic factor or others

 

15 points

Description of Comparison intervention (C)

-         The comparison is often the usual standard of care, but it may also be a control group or placebo

15 points

Description of Outcome (O)

-         End result

15 points

Use of appropriate, current (less than 5 years old) research and references with a minimum of five (5) research articles

15 points

Submission to Blackboard Assignment Folder by due date July 5^th  , 2021

5 points

 

Total points for paper                                                            100 points

 

 

Class textbooks

 

Urden, L., Stacy, K., & Lough, M., (2020). Priorities in critical care. (8^th ed.). St. Louis, MO: Elsevier. 

    ISBN:978-0-323-53199-3

Ignatavicius, D., & Workman, L., (2018). Medical-surgical nursing: Concepts for interprofessional

    collaborative care. (9^th ed.). St Louis MO: Elsevier.

Please help me with fixing any errors and additional information needed based on the rubric. APA format is key. The references I put in bold need attention because I am not sure if that is how the first reference with many authors is supposed to be. APA 7 edition is the recommended type for writing the paper in. Any grammar errors that need to be fixed please help as well..

Thank you for your help.