Three components:
Sub-average intellectual functioning Deficits in adaptive behavior Onset before 18 years of age Recently IQ was increased from 70 to 75 and adaptive behaviors were more clearly defined
Adaptive Limitations
Communication Self-care Home living Social skills Leisure Health and safety Self-direction Functional academics Community use Work
Terms
EDUCABLE MENTALLY RETARDED: corresponds to the mildly retarded group TRAINABLE MENTALLY RETARDED: corresponds to children with moderate levels of mental retardation
Classifications Of Mental Retardation
Mild Moderate Severe Profound
Causes Of Mental Retardation
Infection and intoxication Trauma or physical agent Metabolism or nutrition Gross postnatal brain disease Unknown prenatal influence Chromosome abnormalities
Causes Of Mental Retardation (Cont’d.)
Other conditions originating in the perinatal period Psychiatric disorders with onset during child’s developmental period Environmental influences
General Aspects Of Care
Educate the child and family Promote optimum development Promote independent self-help skills Help families adjust to future care Care for the child during hospitalization Assist in measures to prevent retardation
Definition Of Down Syndrome
An autosomal trisomic syndrome Trisomy is a genetic abnormality in which an extra chromosome is presentClinical syndromes are based upon which of the 23 types of chromosomes is abnormalCondition in which there are three, rather than two, copies of one chromosome in same cell
Etiology Of Down Syndrome
Cause is unknown Three chromosomal abnormalities can cause Down Syndrome:Trisomy of chromosome 21 Translocation of chromosome 21 Mosaicism
Trisomy 21
Accounts for 92 to 95% of incidence Sporadic Related to chronological age of parents: greater risk in older women Incidence However, majority of infants with DS are born to women under age 35 Fathers >55 years of age can contribute to this chromosomal abnormality
Translocation
Of Chromosome 21
Occurs in 3 to 6% of affected infants Usually hereditary and is not r/t parental age Translocation: transfer of all or part of a chromosome to a different chromosome following chromosome breakage Incidence Genetic counseling
Mosaicism
Occurs in 2 to 3% of affected infants Cells contain both normal and abnormal chromosome components Have fewer physical problems and higher intellectual ability than other Downs kids Degree of impairment is related to the percentage of cells with the abnormalities
Associated Problems
With
Down Syndrome
*Congenital heart defects Congenital structural defects:Chronic rhinitis Lower respiratory infections Chronic conjunctivitis Visual and hearing defects Chronic dental problemsTE fistula, duodenal atresia, Hirschsprung disease, hip subluxation
Assessment Of Child
With
Down Syndrome
Observable physical characteristics Intellectual and social characteristics Sexual development
Intellectual And Social Characteristics
By age 3 to 4, intellectual ability can be predicted Rate of growth and development is steady, but slower Speech development is generally slower than ability to acquire other skills Most are capable of being trained to some degree
Assessment Of
Sexual Development
Underdeveloped genitalia Breast tissue of women may develop moderately; menstruation can occur as normal Adolescents generally demonstrate no overt sexuality Males thought to be infertile Many instances of females bearing offspring
Nursing Care Of Child
With
Down Syndrome
Diagnosis Provision of physical care:Prevent infection Correction of physical problems Promotion of optimal developmentNutrition Skin care
Mental Retardation
And
Down Syndrome
Any questions? Thank you for your attention THE END!