1. Chapter 40 Developmental Disabilities All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

2. Disability   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 or death.   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. 2 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

3. Developmental Disability   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 (supporting oneself financially)   Developmentally disabled children become adults.   A DD affects the family throughout life. 3 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

4. OBRA and ADA   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. 4 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

5. 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 5 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

6. The Arc   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. 6 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

7. Down Syndrome   DS is the most common genetic cause of mild to moderate intellectual disability (mental retardation).   It is caused by an error in cell division (an extra 21st chromosome is present).   It occurs at fertilization.   The child with DS has certain features caused by the extra chromosome.   Many children with DS have other health problems as well. 7 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

8. Down Syndrome (Cont’d)   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 8 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

9. Fragile X Syndrome   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, social and emotional, behavior problems, speech and language problems, and sensitivity to sensory input.   FXS has no cure. 9 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

10. Cerebral Palsy   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 10 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

11. Cerebral Palsy (Cont’d)   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. 11 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

12. 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 girls.   The disorder can range from mild to severe. 12 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

13. Autism (Cont’d)   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. 13 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

14. Spina Bifida   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. 14 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

15. Types of Spina Bifida   Types of spina bifida include:   Spina bifida occulta Vertebrae are closed Spinal cord and nerves are normal   Spina bifida cystica Meningocele Myelomeningocele (meningomyelocele) 15 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

16. Hydrocephalus   With hydrocephalus, cerebrospinal fluid collects in and around the brain.   The head enlarges.   Pressure inside the head increases.   Intellectual disabilities (mental retardation) and neurologic 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. 16 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

17. 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. 17 All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.