MH | Neurodevelopment Disorders

1. Attention-Deficit/Hyperactivity Disorder (ADHD) Diagnosis: A persistent pattern of inattention, hyperactivity, and impulsivity impacting academic and social life. It affects 9% of school-aged children, and symptoms persist into adulthood for 60% of cases. Females often present with less noticeable inattentive behaviors and are diagnosed later. Expected Findings: Short attention span, high distractibility, labile moods, inability to sit still, excessive talking, and impulsive actions without perceiving harm. Priority Interventions:Safety First: Stop unsafe behavior immediately and provide close supervision.Milieu Management: Provide a quiet environment free from distractions for task completion.Communication: Gain full attention (eye contact) before speaking. Give instructions slowly, use concrete language, and break complex tasks into small steps.Family Education: Emphasize a structured daily routine. Teach parents to balance correcting behavior with praising the child's strengths. Must-Know Medications:Stimulants (Methylphenidate, Amphetamines): NCLEX Alert: Monitor for insomnia, appetite suppression, and weight loss/growth delays. Give tablets after meals and ensure the last dose is in the early afternoon.SNRIs (Atomoxetine): Second-line treatment. Monitor for liver damage and decreased appetite.Antihypertensives (Clonidine, Guanfacine): Monitor for hypotension, dizziness, and syncope.2. Autism Spectrum Disorder (ASD) Diagnosis: A continuum characterized by severe impairment of reciprocal social interaction, communication deviance, and restricted stereotypical behaviors. It is four times more prevalent in males and usually identified by 18 months to 3 years of age. Expected Findings: Avoidance of eye contact, lack of pretend play, delayed speech, obsessive interests, and distress over minor routine changes. Look for stereotyped motor behaviors (e.g., hand flapping, body twisting, head banging). Priority Interventions:Safety: Protect the child from self-injury during tantrums or head banging; short-term inpatient care may be needed for crises.Milieu Management: Provide a safe, consistent environment, minimizing noise and lighting. Use accommodations like ear plugs for sensory integration.Therapies: Applied behavior analysis (ABA) is used in natural settings to encourage desired behaviors. Must-Know Medications: No meds exist for ASD itself. Antipsychotics treat aggressiveness/tantrums, while SSRIs mitigate repetitive behaviors.3. Other High-Yield ConditionsIntellectual Developmental Disorder: Below-average intellectual functioning (IQ <70) with impaired communication and self-care.Tourette’s Disorder: Multiple motor tics and vocal tics (e.g., echolalia) lasting over a year. Treated with atypical antipsychotics.Enuresis: Repeated voiding of urine. NCLEX Alert: Treated with imipramine (an antidepressant causing urinary retention) or desmopressin.