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Mental Retardation and Downs Syndrome

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The most common chromosomal abnormality of a generalized syndrome. Trisomy 21 (95 ... Hydrocephalus. Nutrition. Environmental factors. Psychiatric disorders. 5 ... – PowerPoint PPT presentation

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Title: Mental Retardation and Downs Syndrome


1
Mental Retardation and Downs Syndrome
  • Peggy Pannell RN, MSN

2
Objectives
  • Define MR and Downs Syndrome
  • Signs and Symptoms
  • Lab and Diagnostic studies
  • Treatment modalities
  • Plan of care
  • Emotional needs of client and family

3
Definition (Objective 1)
  • Mental Retardation
  • Also known as Cognitive impairment. Any type of
    mental difficulty or deficiency.
  • Downs Syndrome
  • The most common chromosomal abnormality of a
    generalized syndrome.
  • Trisomy 21 (95)
  • Translocation of 15 and 21 or 22 (3-4)
  • Mosaicism (1-2)

4
Causes of MR
  • Genetic
  • Downs Syndrome
  • Other syndromes (fragile X, etc)
  • Biochemical
  • Alcohol, Drugs, exposures
  • Infectious
  • Rubella, syphilis, kernicterus
  • Unknown
  • Trauma, physical agent
  • Hydrocephalus
  • Nutrition
  • Environmental factors
  • Psychiatric disorders

5
Signs and Symptoms of MR Objective 2
  • Developmental Delay
  • Speech
  • Mobility
  • Early signs
  • Non-responsiveness to contact
  • Poor eye contact during feeding
  • Diminished spontaneous activity
  • Decreased alertness to voice or movement
  • Irritability
  • Slow feeding
  • less than a normal child of that age

6
SS of Downs Syndrome (clinical manifestations)
obj 2
  • Head
  • Face
  • Eyes
  • Nose
  • Ears
  • Mouth
  • Teeth
  • Chest
  • Neck
  • Abdomen
  • Genitalia
  • Hands
  • Feet
  • Musculoskeletal
  • Skin
  • Other

7
Diagnostic Studies Objective 3
  • Chromosome Analysis
  • To determine Downs and other syndromes
  • Standardized test
  • Vineland Social Maturity Scale
  • AAMR Adaptive Behavior Scale
  • Classification
  • Educable Mentally Retarded (EMR)
  • Trainable Mentally Retarded (TMR)

8
Causes and Diagnostic Evaluation
  • Causes
  • Nonfamilial Trisomy 21 (95)
  • Translocation of chrom 15, 21, 22 (3-4)
  • Mosaicism (normal and abnormal chrom (1-2)
  • Diagnosis
  • Clinical Manifestation
  • Chromosome Analysis

9
How MR is measured
  • IQ (Intelligence Quotient)
  • 70-75 or below
  • Adaptive Skills
  • 2 out of 10 possible
  • Age of diagnosis
  • 18 or younger

10
Intelligence Quotient
  • Mild 50-55 to 70-75
  • Moderate 35-40 to 50-55
  • Severe 20-25 to 35-40
  • Profound below 20-25

11
Adaptive Skills
  • Communication
  • Self Care
  • Home Living
  • Social Skills
  • Leisure
  • Will have difficulty in at least 2 areas
  • Health and Safety
  • Self Direction
  • Functional Academics
  • Community Use
  • Work

12
Treatment Modalities
  • Prevention
  • Educate Child/Family
  • Early Intervention
  • Self Care Skills
  • Optimum Development
  • Play/Exercise
  • Downs Syndrome
  • Communication
  • Discipline
  • Socialization
  • Sexuality
  • Future Care
  • Hospitalization

13
Treatment Modalities DS
  • Corrective surgery for anomalies
  • Cosmetic surgery for physical stigmata
  • Regular evaluation of sight and hearing
  • Periodic testing of thyroid
  • Evaluate for atlantoaxial instability (for
    sports)

14
Emotional Needs
  • During
  • Initial Diagnosis
  • At birth or later
  • Hospitalization/medical care
  • Developmental years
  • Planning Future Care
  • For complex care
  • Respite care
  • Permanent care giver

15
Plan of Care
  • Diagnosis
  • Altered Growth and Development Related to
    impaired cognitive functioning.
  • Goal
  • Child will exhibit evidence of appropriate growth
    and development behaviors for age and abilities.
  • Page 1260

16
Plan
  • Involve child and family in early intervention
  • MS has early intervention
  • McDougal Center, Region III Rehabilitation
  • Assess development at regular intervals
  • Varies
  • Help family set realistic goals
  • Not going to be a rocket scientist
  • Emphasize childs normal needs
  • Love, praise, acceptance, discipline, interaction
  • Counsel child and parents on issues
  • Sexuality, birth control, marriage, job
  • Page 1260

17
Plan of Care
  • Diagnosis
  • Altered family processes related to having a
    child with mental retardation
  • Goal
  • Family members demonstrate acceptance of child
  • Page 1260

18
Plan
  • Inform family of infant problems ASAP
  • Provide time to absorb and adjust
  • Provide written materials
  • Demonstrate your acceptance of child
  • Explore families reaction to child
  • Arrange for and participate in family conferences
  • Assess resources and coping abilities
  • Page 1260
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