Autism Spectrum Disorder, ADHD, ODD, and ICD

Week 3: Autism Spectrum Disorder, ADHD, ODD, and ICD

“I can’t believe I am sitting here talking to this lady. Mom thinks I am nuts just because I will not do what she asks. She does not care about me. She only cares about my little brother and that man that keeps coming around. I don’t care anything about her. That is why I throw things and won’t do what she asks. I don’t care about anyone. Those kids at school who used to be my friends don’t know anything. I am so much smarter than they are.
Jacob, age 11”

There are many mental disorders that occur early in the life course. The DSM-5 describes neurodevelopmental disorders such as autism spectrum disorder and ADHD and disruptive, impulse-control, and conduct disorders, such as oppositional defiant disorder and conduct disorder. These disorders are examined together with a particular emphasis on comparing and contrasting presenting features. Diagnosis of these various conditions can rarely be made in a single office setting and often require a comprehensive approach involving multiple stakeholders, including the child, as well as his or her parents, teachers, and other significant figures in the child’s life and mental health professionals, such as psychologists who can conduct comprehensive neuropsychological testing.
The PMHNP must coordinate and integrate several sources of information to arrive at an accurate diagnosis of these disorders. Early and accurate diagnosis is essential to developing an effective treatment plan, which will have the potential to minimize the impact of these disorders on the child’s developmental trajectory. When one considers appropriate diagnosis from this perspective, the importance of diagnostic accuracy becomes quite apparent.
This week, you begin exploring disorders that occur early in the life course by working with your group to develop a Parent Guide. You also examine a case to determine a differential diagnosis and treatment plan that incorporates both psychotherapy and psychopharmacology.

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Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

  • Chapter 3, “Contributions of the Sociocultural Sciences” (pp. 131–150)
  • Chapter 31, “Child Psychiatry” (pp. 1152–1181, 1244–1253)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

  • “Neurodevelopmental Disorders”
    • “Intellectual Disabilities”
    • “Communication Disorders”
  • “Disruptive, Impulse-Control, and Conduct Disorders”

Note: You will access this book from the Walden Library databases.

Volkmar, F., Siegel, M., Woodbury-Smith, M., King, B., McCracken, J., & State, M. (2014). Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry53(2), 237–257. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00819-8/pdf

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.
 
Note: All Stahl resources can be accessed through the Walden Library using the link. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.
 
To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Review the following medications:

Irritability in autism Attention-deficit/hyperactivity disorder
aripiprazole
risperidone
armodafinil
amphetamine (d)
amphetamine (d,l)
atomoxetine
bupropion
chlorpromazine (hyperactivity)
clonidine
guanfacine
haloperidol (hyperactivity)
lisdexamfetamine
methylphenidate (d)
methylphenidate (d,l)
modafinil
reboxetine

Note: Many of these medications are FDA approved for adults only. Some are FDA approved for disorders in children and adolescents. Many are used “off label” for the disorders examined in this week. As you read the Stahl drug monographs, focus your attention on FDA approvals for children/adolescents (including “ages” for which the medication is approved, if applicable) and further note which drugs are “off label.”

Required Media

Laureate Education (Producer). (2017b). A young girl with difficulties in school [Multimedia file]. Baltimore, MD: Author.

Optional Resources

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.

  • Chapter 51, “Autism Spectrum Disorder” (pp. 665–682)

Note: You and your group will use the wiki function to develop three Parent Guides (one in Week 3, one in Week 7, and one in Week 10). A wiki is a site that allows collaborative editing by all users. Each group will have its own place to communicate and collaborate on the assignments. Once your group has completed each assignment, one member should transfer the information to its final format and submit it through the group submission link in the Discussion. Do not delete the assignment from the wiki format, as your Instructor will review this area to determine each member’s participation.

Collaboration is essential to accurate diagnosis of the conditions under consideration in this week. For this week’s Discussion, you practice collaboration by working in a group on developing a “Parent Guide,” which will serve as a teaching tool for parents with children who have been diagnosed with a specific mental health disorder.
It is recommended that you make your project as attractive as possible and consider using the finished product as teaching tools for families that you will work with in your own practices.

Learning Objectives

Students will:
  • Analyze signs and symptoms of neurodevelopmental disorders
  • Analyze the pathophysiology of neurodevelopmental disorders
  • Analyze diagnosis and treatment methods for neurodevelopmental disorders
  • Evaluate Parent Guides

To Prepare for this Discussion:

  • Your Instructor will assign you to a group and a disorder by Day 1 of Week 2.
  • Review the resources concerning your assigned disorder.
  • Review the Blackboard Help website concerning wikis.
  • Use your group’s Discussion Board to design and develop the Parent Guide before posting to the group wiki. For further guidance, refer to the Accessing Group Discussions instructions below.

Using evidence-based research, design and develop a Parent Guide for your assigned disorder including:

  • Signs and symptoms
  • Pathophysiology
  • How the disorder is diagnosed
  • Treatment options

Provide a minimum of three academic references.

By Day 5

One designated group member should post the completed Parent Guide to the Discussion.

By Day 7

Respond to at least two other groups’ wikis by providing at least two contributions for improving or including in their Parent Guide and at least two things that you like about their guide.

Submission and Grading Information

Accessing Group Discussions and Wikis

To access your group’s discussion, click on the Parent Guide Groups link. Once you have clicked on the link, select your assigned team (e.g., Team A, Team B, Team C, etc.) to access your team’s home page. Select Group Discussion Board under the Group Tools menu to work on your participate in your group’s discussion.
To access your group’s wiki, click on the Parent Guide Groups link. Once you have clicked on the link, select your assigned team (e.g., Team A, Team B, Team C, etc.) to access your team’s home page.

Creating a Wiki Page

Create the first wiki topic page by entering the group’s wiki area and selecting Create Wiki Page. Use the group’s assigned disorder as the name of your wiki. Then add your Parent Guide in the Content text box. You can use the editor functions to format the text and include files, images, web links, multimedia, and mashups. Select Submit when you have completed the wiki page.

Grading Criteria

To access your rubric:
Week 3 Parent Guide Discussion Rubric

To access your group discussion / wiki:
Parent Guide Groups

Post to Discussion by Day 5 and Respond by Day 7

To participate in this Discussion:
Parent Guide Groups – Week 3


Assignment 1: Practicum: Decision Tree

For this Assignment, you examine the client case study in this week’s Learning Resources. Consider how you might assess and treat pediatric clients presenting with symptoms noted in the case.

Note: This Assignment is the first of three assignments that are based on interactive client case studies. For these assignments, you will be required to make decisions about how to assess and treat clients. Each of your decisions will have a consequence. Some consequences will be insignificant, and others may be life altering. You are not expected to make the “right” decision every time; in fact, some scenarios may not have a “right” decision. You are, however, expected to learn from each decision you make and demonstrate the ability to weigh risks versus benefits to prescribe appropriate treatments for clients.

Learning Objectives

Students will:
  • Evaluate clients for treatment of mental health disorders
  • Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders

The Assignment:
Examine Case 1. You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.
At each Decision Point, stop to complete the following:

  • Decision #1: Differential Diagnosis
    • Which Decision did you select?
    • Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?
  • Decision #2: Treatment Plan for Psychotherapy
    • Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?
  • Decision #3: Treatment Plan for Psychopharmacology
    • Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
  • Also include how ethical considerations might impact your treatment plan and communication with clients and their families.

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

By Day 7 of Week 4

Submit your Assignment.


Assignment 2: Board Vitals

This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.
These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability.
You can access Board Vitals through the link sent to you in email or by following the link below:
https://www.boardvitals.com/
By Day 7
Complete the Board Vitals questions.


Making Connections

This week, you began exploring disorders that occur early in the life course by working with your group to develop a Parent Guide. You also examined a case to determine a differential diagnosis and treatment plan, which incorporates both psychotherapy and psychopharmacology.
Next week, you examine several cases of child abuse and neglect and recommend strategies for assessing for abuse. You analyze influences of media and social media on mental health and evaluate the need for mandatory reporting of abuse. You also submit your Practicum Journal and Assignments.

Autism Spectrum Disorder, ADHD, ODD, and ICD

Use the Internet to research aspects of biology.
Select an article from a magazine or newspaper that has something in it that pertains to biology. This will serve as the “target article” for this assignment. For instance, you can select an article about medicine, invasive species, nature, conservation, genetic technology, ecology, or any other topic that is related to biology. One purpose of this assignment is to help you become aware of how biology is related to your everyday life.
Write a one to three (1-3) page paper in which you:

  1. Summarize the article in one (1) or more paragraphs, using your own words. Be sure to identify the article using an in-text citation in the body of the paper, as well as a reference in the reference section.
  2. Explain how the article relates to this course. Identify which biological concepts from the course and / or text are relevant to the topic covered in the article. Citing the course text, discuss the ways in which this course does (or doesn’t) provide background information to help you understand the article and the larger issues surrounding it.
  3. Explain why the article caught your attention. Relate the article to your life and to issues that are important to you. Discuss how or if the scientific knowledge about the topic covered in the article affects you directly or indirectly.
  4. Discuss your opinion on how research on this topic should be funded. State whether you think taxpayer monies should support research on this topic or whether such research in this area should be funded by the private sector. Rate the importance of research on this topic, relative to other areas of research.

Strategic management of health care organizations (7th ed). Hoboken, NJ: Wiley]]>

Etta – Where is the line between too much and too little regulation? 

 I will attach the Unit V discussion that caused my professor to ask this question. 

Cultural Sensitivity: Risk Factors Essay Assignment
What are risk factors and how do they impact the cultures you serve as a nurse?
In a 1-2 page Word document, explain about risk factors for a different culture. (Hispanic Culture) You may conduct independent online research to provide information for your response. Please cite any outside research sources.

  1. What is the definition of risk factors?
  2. Select a different culture than your own (Hispanic Culture) and describe two risk factors.
  3. What one nursing strategy can you implement to effectively care for this culture, based upon the risk factors that you identified?
  4. Identify one health promotion intervention that might reduce the risk factor.

Cultural Sensitivity: Risk Factors Essay Assignment

Introduction:

It is essential that nurses understand the issues related to healthcare financing, including local, state, and national healthcare policies and initiatives that affect healthcare delivery. As a patient advocate, the professional nurse is in a position to work with patients and families to access available resources to meet their healthcare needs.

Requirements:

Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. Use the Turnitin Originality Report available in Taskstream as a guide for this measure of originality.

COMPARE THE U.S. HEALTHCARE SYSTEM WITH THE HEALTHCARE SYSTEM OF GREAT BRITAIN, JAPAN, GERMANY, OR SWITZERLAND.You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
 
A.  Compare the U.S. healthcare system with the healthcare system of Great Britain, Japan, Germany, or Switzerland, by doing the following:
1.  Identify one country from the following list whose healthcare system you will compare to the U.S. healthcare system: Great Britain, Japan, Germany, or Switzerland.
2.  Compare access between the two healthcare systems for children, people who are unemployed, and people who are retired.
a.  Discuss coverage for medications in the two healthcare systems.
b.  Determine the requirements to get a referral to see a specialist in the two healthcare systems.
c.  Discuss coverage for preexisting conditions in the two healthcare systems.
3.  Explain two financial implications for patients with regard to the healthcare delivery differences between the two countries (i.e.; how are the patients financially impacted).
 
B.  Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
 
C.  Demonstrate professional communication in the content and presentation of your submission.

Cancer

7/10/18, 1(33 AMResearching Cancer Scoring Guide
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Researching Cancer Scoring Guide
CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Describe cancer in biological terms at the levels of the cell.
Does not identify cancer in biological terms.
Identifies cancer in biological terms, but does not describe it at the level of the cell.
Describes cancer in biological terms at the levels of the cell.
Discusses cancer in biological terms at the levels of the cell, and explains how all cancer follows a similar path at the cellular level.
Describe the steps in the progress of a specific type of cancer.
Does not list the steps in the progress of a specific type of cancer.
Lists the steps in the progress of a specific type of cancer, but does not describe the steps in adequate detail.
Describes the steps in the progress of a specific type of cancer.
Discusses the steps in the progress of a specific type of cancer in clear and concise detail, and discusses the impact each step has in the life of a cancer patient.
Explain how cancer disrupts homeostasis.
Does not identify how cancer disrupts homeostasis.
Identifies but does not explain how cancer disrupts homeostasis.
Explains how cancer disrupts homeostasis.
Discusses how cancer disrupts homeostasis, and relates it to the mechanisms at the level of the cells involved.
Identify a high- quality and appropriate scientific information source on a biological topic.
Does not list an information source on a biological topic.
Lists an information source, but it may not be a high-quality or appropriate source, or may not have scientific credibility on a biological topic.
Identifies a high-quality and appropriate scientific information source on a biological topic.
Analyzes a high-quality and appropriate scientific information source on a biological topic, and supports the analysis with additional sources.
Discuss the therapies available for treatment of a specific type of cancer.
Does not identify therapies available for treatment of cancer.
Identifies therapies available for treatment of cancer, but does not discuss the specific type of cancer chosen.
Discusses the therapies available for treatment of a specific type of cancer.
Compares the therapies available for treatment of a specific type of cancer and discusses impacts of the treatments on quality of life and expected clinical outcomes.
Discuss the lifestyle choices that might aid in prevention or treatment of a specific type of cancer.
Does not list lifestyle choices that might aid in the treatment or prevention of a specific type of cancer.
Lists lifestyle choices that might aid in the treatment or prevention of a specific type of cancer.
Discusses lifestyle choices that might aid in the treatment or prevention of a specific type of cancer.
Discusses lifestyle choices that might aid in the treatment or prevention of a specific type of cancer, and provides an example of how these choices could be implemented.
Write coherently to support a central idea in appropriate format with correct grammar, usage, and mechanics, including correct APA format
Does not write coherently to support a central idea.
Writes to support a central idea but the format is inconsistent and there are errors in grammar, usage, and mechanics.
Writes coherently to support a central idea in appropriate format with correct grammar, usage, and mechanics, including correct APA format and citations.
Writes coherently to support a central idea in appropriate format with correct grammar, usage, and mechanics, including correct APA format and citations, and using concise, clear, and thorough
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and citations. language.
For this discussion board, please find an example of efforts to reduce climate change in your own life.  Note that it can be something that might serve a dual purpose, or even be one not necessarily designed to reduce climate change impacts, but is still doing so indirectly. I give you broad range on how to do this, but examples might be:

  • Appliances that are designed to be energy saving
  • Solar panels in your neighborhood
  • Local legislation aimed at reducing carbon-based sources of power

For the discussion board please:

  1. Write a short (100 word) post about the effort you have found.
  2. Include a relevant photo of your effort; this can be either a photo you find online or one you take yourself.

MALE PATIENT IS ADMITTED TO THE ICU WITH TERMINAL LIVER CANCER.

Scenario: A 96-year-old male patient is admitted to the ICU with terminal liver cancer. He is confused and disoriented very skinny and appears underfed and is covered with bruises which are common in patients with liver disorders. His daughter who is a naturopathic physician insists that she can cure her father by administering unknown substances some of which smell like feces and look like tar down his NG tube. He is clearly in pain after she does this. She insists that these are life-saving interventions on her part but the nursing and physician staff caring for the patient are very upset and concerned that she is hastening his death. They have come to you for help.1) Write a paper (1 250-1 500 words) that describes how to use the method of ethical decision making reviewed in the module to help resolve this ethical dilemma. Address the following to generate your conclusions about how you would proceed:a) What are the dimensions of the ethical dilemma?b) What are the issues?c) Apply the four core ethical principles and the process of ethical decision making.2) Prepare this assignment according to the APA guidelines. This assignment uses a grading rubric..THE RUBRIC1 Unsatisfactory 0.00%2 Less Than Satisfactory 74.00%3 Satisfactory 79.00%4 Good 87.00%5 Excellent 100.00%70.0 %Content40.0 %Demonstrates the use of the method of ethical decision making along with critical thinking and analysis to develop a plan to address the ethical issues in the scenario.Does not demonstrate an understanding of the model of ethical decision making. Does not demonstrate critical thinking and analysis to develop an effective plan to address the ethical issues.Demonstrates only minimal understanding of the model of ethical decision making. Demonstrates only minimal abilities for critical thinking and analysis to develop an effective plan to address the ethical issues.Demonstrates knowledge of the method of ethical decision making accurately but has some slight misunderstanding of the implications to the scenario. Provides a basic idea of critical thinking and analysis. Does not include examples or descriptions.Describes clearly most of the main concepts regarding the method of ethical decision making (in your own words). Understands the implications of the scenario and exhibits critical thinking and analysis with a few examples.Describes clearly all of the main concepts regarding the method of ethical decision making (in your own words). Clearly describes a complete analysis of the development of a plan to address the ethical issues. Strong evidence of critical thinking and analysis in the plan’s development.30.0 %Integrates information from outside resources into the body of paper.Does not use references examples or explanations.Provides some supporting examples but minimal explanations and no published references.Supports main points with examples and explanations but fails to include published references to support claims and ideas.Supports main points with references explanations and examples. Analysis and description is direct competent and appropriate of the criteria.Supports main points with references examples and full explanations of how they apply. Thoughtfully analyzes evaluates and describes major points of the criteria.20.0 %Organization and Effectiveness7.0 %Assignment Development and PurposePaper lacks any discernible overall purpose or organizing claim.Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear.Thesis and/or main claim are apparent and appropriate to purpose.Thesis and/or main claim are clear and forecast the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose.Thesis and/or main claim are comprehensive. The essence of the paper is contained within the thesis. Thesis statement makes the purpose of the paper clear.8.0 %Argument Logic and ConstructionStatement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically but not thoroughly supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.5.0 %Mechanics of Writing (includes spelling punctuation grammar language use)Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) sentence structure and/or word choice are present.Some mechanical errors or typos are present but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.Prose is largely free of mechanical errors although a few may be present. A variety of sentence structures and effective figures of speech are used.Writer is clearly in command of standard written academic English.10.0 %Format5.0 %Paper Format (Use of appropriate style for the major and assignment)Template is not used appropriately or documentation format is rarely followed correctly.Appropriate template is used but some elements are missing or mistaken. A lack of control with formatting is apparent.Appropriate template is used. Formatting is correct although some minor errors may be present.Appropriate template is fully used. There are virtually no errors in formatting style.All format elements are correct.5.0 %Research Citations (In-text citations for paraphrasing and direct quotes and reference page listing and formatting as appropriate to assignment and style)No reference page is included. No citations are used.Reference page is present. Citations are inconsistently used.Reference page is included and lists sources used in the paper. Sources are appropriately documented although some errors may be presentReference page is present and fully inclusive of all cited sources. Documentation is appropriate and citation style is usually correct.In-text citations and a reference page are complete and correct. The documentation of cited sources is free of error.

Cite and discuss at least one outside reference source to support your statement]]>