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54 Cards in this Set
- Front
- Back
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Mental Retardation is traditionally based on what?
what is it based on now? |
-traditionally based on IQ scores
- now based on IQ and adaptive functioning |
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What is the formula for IQ?
within how many standard deviations of the IQ bell curve is considered normal IQ? |
IQ = ability/ average ability for age x 100
- within 1 standard deviation = normal |
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What are the 3 criteria's for mental retardation according to DSM IV?
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1) IQ of 70 or below
2) concurrent deficits in present adaptive functioning (work, leasure, health, safety etc.) 3) onset BEFORE age 18 |
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If a patient in his mid 40's has a brain injury resulting in an IQ of 30, is he mentally retarded?
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Nope. according to DSM IV, onset has to be before the age of 18
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What are the 5 categories of mental retardation? include IQ
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- mild MR- IQ 50-55 to 70
- Moderate MR- IQ 35-40 to 50-55 - Severe MR- IQ 20-25 to 35-40 - Profound MR- IQ below 20-25 - MR severity unspecified: IQ untestable |
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What % of the population is mentally retarded?
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2.5%
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How many people worldwide receive services for mental retardation?
(doubt this will be on the exam) Is there any gender favorite? |
-1.5 million
- more prevalent in boys |
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Just know
Mild MR is usually linked to lower socioeconomic status + lack of stimulation Severe MR: biological causes such as fragile X, down syndrome, fetal alcohol |
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Down syndrome is an anomaly of which chromosome?
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21st
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What are the 3 types of down syndrome? % of each?
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trisomy 21 (95%)
translocation of 21 (4%) moasicism (1%) |
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Out of 1000 live births, how many have down syndrome?
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.92
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what is the greatest risk factor for down syndrome?
statistics? another risk factor? |
maternal age
20 yr old; 1 in 20,000 45 yr old; 1 in 20 also translocation not related to parents age, test parents if they're carriers |
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What are the 2 prenatal tests for down syndrome?
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1) alpha fetoprotein test- at 16 weeks
2)aminocentesis for + AFP or women > 35 yr old |
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What are the physical features of down syndrome at birth?
with maturation? |
hypotonia, flat facial profile, upward slanting palpebral fissures (eyes), small ears, small nose, low nasal bridge, single palmer crease
(yes. i know. go ahead, look at your palm) with maturation-> short height, mental retardation |
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what are some complications associated with down syndrome?
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congenital heart disease
atlantoaxial instablity ****** increased risk of immune disorder and leukemia hearing loss seizures alzheimers eye abnormalities (strabismus, nystagmus) |
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what complications with down syndrome should you as an OT look out for?
SAFETY = 2 QUESTIONS ON EXAM. KNOW IT. |
atlantoaxial instability!
be very protective w/ their neck |
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Describe the movement of an individual with down syndrome
(term for it) |
hypotonia- slow movement
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Describe gross motor skills, social aspect, speech, cognitive impairment in individuals w/ down syndrome.
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- delayed gross motor skills
- similar to other children in social - delayed speech, does speak full sentences - cognitive impairment minimal, but gap widens as they age |
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When is an appropriate age for early intervention for individuals with down syndrome?
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first year of life
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Is having down syndrome individuals in the same class as others common?
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yes
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What is the statistics regarding life expectancy of individuals w/ down syndrome?
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>50% live past 50
13.5% alive at 68 |
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What is one of the most common inherited genetic cause of intellectual disability?
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Fragile X syndrome (aka FXS)
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what % of children receiving special ed, has fragile X syndrome?
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1.1%
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What % of children with Mental Retardation receiving services has fragile X syndrome?
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5.5%
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highly doubt this will be on the exam.
Fragile X syndrome: nucleotide bases Cytosine-guanine-guanine repeated excessively of 40 (40 = typical development) intermediate allele 41-58 repeat premature allele 59-200 repeat full mutation >200 repeat |
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Fragile X syndrome causes a decrease in what?
what is it involved in? is this more severe for males or females |
protein FMR1
involved in neurological development and function more severe for males (XY) because males only have 1 X to produce FMR1 |
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Describe Fragile X genetic transmission
(aka. expression/non expression because of carrier (which parent)) |
- influenced by which parent is the carrier
- father carrier to daughter- chances of expression decreased - mother carrier to children- increased risk of expression per generation |
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Describe Males in full mutation of fragile X syndrome
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- macroorchidism
- enlarged head - protruding ears - high arched palate - hypotonic - poor coordination - growth spurt in childhood, short as adults - delayed motor skills - impaired cognition - language delays - steroetypic movements (e.g.hand flapping) |
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Does premutation fragile x syndrome have any effects on males?
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- yes increased incidence of learning disabilities, visual-spatial processing, cognitive difficulties
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Describe fragile X for females
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-70% are in premutation, no clinical signs
- in full mutation, less severe than males - narrow face, 50% have mild MR - shy, poor eye contact, steroetypic movement, poor visual- spatial skills, poor executive functioning (judgment) - language delays |
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Does fragile X have an affect on life expectancy?
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nope
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What is phenylketonuria (PKU)?
prevalence? What results if untreated? |
- inborn error of metabolism
- error of amino acid metabolism- deficiency in enzyme Phenylaline hydroxlase - prevalence 1 in 10,000 live births - untreated: MR, microcephaly, abnormal gait, seizures |
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What are the 3 types of inborn errors of metabolism?
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1) silent - may lead to developmental disability (PKU)
2) acute toxicity- life threathening ( urea cycle disorders) 3) progressive neurological defects (Krabbes disease) |
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How do we identify PKU?
treatments? concerns for females? |
- blood test to newborns
- restrict diet throughout childhood (females need to return to diet when bearing child to decrease risk of MR, cleft lip, palate, heart disease) |
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what are some clinical signs of the teratogenic syndrome: fetal alcohol syndrome?
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- growth retardation both pre and post natal
- microcephaly - wide space between eyes - short eye slits - short nose - 20-50% with congenital heart defect - vision problems such as strabismus and nystagmus - hypotonia, delayed motor skills - increased risk of otitis media due to middle ear infections |
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what are some psychological test for mental retardation?
doubt she'll ask but you never know |
bayley scales of infant development (1-42 months)
Kaufman Assessment battery for children (12 years) Stanford-Binet intelligence scale- 4th edition (2yrs to adult) Wechsler Preschool and primary scale of intelligence- (3-7 yrs) Wechsler intelligence scale for children-3rd edition (6-17 yrs) |
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What are some tests for adaptive functioning in mental retardation?
doubt she'll ask but you never know |
Vineland adaptive behavioral scale
woodcock-johnson scales of independent behavior |
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Will IQ scores change w/ treatment?
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generally will not
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What behavioral therapy is available for Mental Retardation?
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positive behavioral support
- assesses antecedents that trigger certain behaviors, provides structure, rewards, punishment, must be consistent at home and school |
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What is a type of neurosurgical treatment for cerebral palsy?
how does it work? results in? |
Selected dorsal Rhizotomy
laminectomy performed in lumber area (LE), spastic rootlets are severed (about 1/3) - causes decrease in spasticity, AND strength |
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Role of therapist after an Individual with CP undergoes selective dorsal rhizotomy?
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- promote movement
- promote normal life - educate parents, teachers - promote energy efficient movements (educated guess works too.) |
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Define epilepsy
Define seizure |
epilepsy: chronic neurological condition of recurrent seizures occurring w/ or w/o other brain abnormalities
seizure: abnormal hypersynchronous electrical surcharge of neurons on surface of brain |
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Are isolated seizures referred to as epilepsy?
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nope
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Are seizures often chronic?
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nope
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what is Ictal?
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refers to events during a seizure
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what is postictal?
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refers to events after a seizure
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what are the 4 main types of seizures?
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partial seizure
generalized seizure mixed seizure status epilepticus |
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what are the 2 types of partial seizures?
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1) simple partial seizures
2) complex partial seizures |
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what are the 4 types of generalized seizures?
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1) absence seizures
2) tonic-clonic seizures 3) myoclonic seizures 4) atonic seizures |
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What are partial seizures?
how do we differentiate between complex and simple partial seizures? sensory partial seizures begin with? |
seizures that arise from one area of the brain
- simple seizures limit to one area - complex seizures spread to other areas sensory partial seizures begin with auras (a change in sensation) also know postictal motor paralysis can last for hours, may have sensation changes as well such as taste, touch, smell |
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Describe primarily generalized seizures.
what are the 4 types? |
- no focus of onset
- both brain involved - large area of cortex 4 types 1) absence seizures 2) tonic-clonic seizures 3) myoclonic seizures 4) atonic seizures |
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Describe absence seizures (a type of primarily generalized seizure)
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- paucity of movement
- black stare, lapse in consciousness - does not remember seizure |
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Describe Tonic-Clonic seizures (a type of primarily generalized seizure)
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- most common type of generalized seizures
- most dramatic - tonic phase- trunk stiffen w/ apnea, tongue biting, last 1 minute - clonic phase- relaxation and jerking of limbs, (may affect bladder sphincter causing incontinence), last several minutes -postictal: sleep/lethargy |
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what is the most common type of generalized seizures?
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tonic-clonic seizures
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