1. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 45 Developmental Disabilities

2. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  A disability is any lost, absent, or impaired physical or mental function.  A birth defect is an abnormality present at birth that can involve a body structure or function. Some infants have birth defects that result in disabilities.  Childhood illness and injuries can result in disabilities.  A disability occurring before 22 years of age is called a developmental disability (DD).  A DD can be a physical or mental impairment or both.  It is severe and permanent. Slide 2

3. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  With DDs, function is limited in three or more life skills:  Self-care  Understanding and expressing language  Learning  Mobility  Self-direction  Capacity for independent living  Economic self-sufficiency  Developmentally disabled children become adults.  A DD affects the family throughout life. Slide 3

4. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  Some nursing centers admit developmentally disabled adults.  OBRA requires that centers provide age- appropriate activities for them.  Staff must have special training to meet their care needs. Slide 4

5. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc. Intellectual Disabilities (Mental Retardation)  An intellectual disability involves severe limits in intellectual function and adaptive behavior.  Intellectual function relates to learning, thinking, reasoning, and solving problems.  Adaptive behaviors are ones needed to function in everyday life.  The Arc of the United States describes intellectual disability as:  An IQ score of about 70 or below  A significant limit in at least one adaptive behavior  The condition being present before 18 years of age Slide 5

6. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  According to The Arc, alcohol is the leading preventable cause of intellectual disabilities.  Brain development is impaired.  Intellectual disabilities range from mild to severe.  The Arc believes that:  Persons with intellectual disabilities must be able to enjoy and maintain a good quality of life.  Children should live in a family and live and play with children without disabilities.  As adults they should control their lives to the greatest extent possible.  The Arc recognizes the sexuality of persons with intellectual disabilities and related developmental disabilities. Slide 6

7. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc. Down Syndrome (DS)  DS is the most common genetic cause of mild to moderate intellectual disabilities (mental retardation).  It is caused by an error in cell division (an extra 21st chromosome is present).  It occurs at fertilization.  The DS child has certain features caused by the extra chromosome.  Many children with DS have other health problems. Slide 7

8. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  Dementia may appear in adults with DS.  Persons with DS:  Need speech, language, physical, and occupational therapies  Need health and sex education  Need a healthy diet and regular exercise Slide 8

9. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc. Fragile X Syndrome (FXS)  FXS is the most common form of inherited intellectual disabilities.  With FXS there is a change in the gene that makes a protein needed for brain development.  Signs and symptoms vary.  Girls often have milder symptoms than boys.  Common disabilities include learning disabilities and behavior problems, speech and language problems, and sensitivity to sensory input.  FSX has no cure. Slide 9

10. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc. Cerebral Palsy (CP)  CP is a term applied to a group of disorders involving muscle weakness or poor muscle control.  The defect is in the motor region of the brain.  Causes include:  Lack of oxygen to the brain (the usual cause)  Brain defects from faulty brain development  There is no cure.  These types are the most common:  Spastic cerebral palsy  Athetoid cerebral palsy Slide 10

11. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  Certain terms describe the body parts involved:  Hemiplegia  Diplegia  Quadriplegia  The person with CP can have other health problems.  Care needs depend on the degree of brain damage.  The goal is for the person to be as independent as possible. Slide 11

12. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc. Autism  Autism begins in early childhood.  It is a brain disorder with no cure.  The child has:  Problems with social skills  Verbal and nonverbal communication problems  Repetitive behaviors and routines and narrow interests  Autism is more common in boys than in girls.  The disorder can range from mild to severe. Slide 12

13. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  The cause of autism is unknown.  Many therapies are used. With therapy, the person can learn to change or control behaviors.  The person needs to develop social and work skills.  Persons with autism may have other disorders. Slide 13

14. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc. Spina Bifida (SB)  Spina bifida is a defect of the spinal column.  The defect occurs during the first month of pregnancy.  Hydrocephalus often occurs with spina bifida.  In spina bifida, vertebrae do not form properly.  Spina bifida can occur anywhere in the spine.  The lower back is the most common site. Slide 14

15. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  Types of spina bifida include:  Spina bifida occulta Vertebrae are closed Vertebrae are closed Spinal cord and nerves are normal Spinal cord and nerves are normal  Spina bifida cystica Meningocele Meningocele Myelomeningocele (meningomyelocele) Myelomeningocele (meningomyelocele) Slide 15

16. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc. Hydrocephalus  With hydrocephalus, cerebrospinal fluid collects in and around the brain.  The head enlarges.  Pressure inside the head increases.  Intellectual disabilities (mental retardation) and neurological damage occur without treatment.  A shunt is placed in the brain to allow cerebrospinal fluid to drain from the brain.  The shunt must remain open (patent).  The person can have many problems. Slide 16

17. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc. Quality of Life  Persons with DD have the right to live, learn, work, and enjoy life.  The Americans With Disabilities Act of 1990 (ADA) and the Developmental Disabilities Assistance and Bill of Rights Act of 2000 further protect their rights.  Some persons with DD need nursing center care. They are further protected by OBRA.  Independence to the extent possible is the goal for these persons. Slide 17