• NU674-7B
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• Unit 7 Assignment – Developmental Disorders Case Study
Case Study
You are working in a community health center as an NP. Although you see children for mental health you will also see children for some basic “bridge” care until primary care providers have openings. If the medical issue is complex then the clinic coordinator will escalate the referral for quicker appointment scheduling.
Presentation: Makala, who is 7, has come to the clinic with a suspected ear infection and as a referral for her daughter’s behaviors. Makala’s mother says that her daughter has been rocking rhythmically and clutching her ear at the same time. There has been some moisture on her pillow in the morning and Makala is reluctant to let her mother investigate what is wrong.
Makala is attempting to rock while she is seated on her mother’s knee and uses the same repetitive vocalization “Don’t wanna go to the shops” over and over again.
She has a history of speech delay but can now complete many full sentences. She has also had some behavior and attention issues in school. She disrupts the teacher often and then gets up from her seat during focus time to go to play centers. She is not easily redirected and becomes argumentative.
She feels hot to touch and will not let healthcare practitioners approach her with any equipment. Her vocalization becomes louder and more insistent when you attempt the examination.
Recognizing possible autism as well as some ADHD diagnosis criteria, discuss the next steps in the answers to the questions.
Instructions
Write a 2-3 page paper answering the following questions. Be sure to include a minimum of 2 scholarly articles to support your discussion.
1. Discuss autism and ADHD diagnostic criteria.
2. How should you approach examining Makala as a child, and strive to gain her trust?
3. You suspect that autism may be a possibility. What should you do to ensure that your suspicions are correct and how should you go about referring Makala to the local autism team?
4. Makala is showing signs and symptoms that may overlap between autism and ADHD. How do you differentiate autism from ADHD based on diagnostic criteria?
Rubric
NU674 Unit 7 Assignment – Developmental Disorders Case Study Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeContent 20 pts
Distinguished
All parts of the assignment are included and addressed, displaying thorough understanding and connection to the topic through supported opinions and ideas. 15 pts
Competent
All parts of the assignment are included and addressed, displaying comprehensive understanding and connection to the topic through supported opinions and ideas. 10 pts
Emerging
Components of the assignment are missing or uses clear and accurate expression but lacks connection to the topic. The assignment components need more substantive content. 5 pts
Novice
Components of the assignment display unclear connection to the topic and/or offers minimal expression of ideas and opinions. 0 pts
Level 0
Does not meet this section
20 pts
This criterion is linked to a Learning OutcomeAnalysis 10 pts
Distinguished
Assignment displays analysis that is thorough and aligns to the topic. Required elements show evidence of knowledge and understanding with breadth and depth supported by several examples. 8 pts
Competent
Assignment displays analysis that is justified and aligns to the topic. Required elements show evidence of comprehensive knowledge and understanding supported by few examples. 5 pts
Emerging
Assignment displays analysis that is basic without depth or breadth. Required elements show evidence of basic knowledge and understanding supported by limited examples. 2 pts
Novice
Assignment displays minimal analysis of the topic and/or is not supported by resources and/or examples. 0 pts
Level 0
Does not meet this section
10 pts
This criterion is linked to a Learning OutcomeOrganization 10 pts
Distinguished
The organization is logical, with clear identification of each required element. The assignment design/layout is purposeful with exemplary transitions between elements. 8 pts
Competent
The organization is logical with identification of each required element present. The assignment’s design/layout offers transitions between elements. 5 pts
Emerging
The organization is disjointed. The assignment’s design/layout does not offer clear or appropriate transitions between elements and/or elements may be missing. 2 pts
Novice
The organization affects the audience’s ability to view the elements or elements are missing that affect the overall purpose of the assignment. 0 pts
Level 0
Does not meet this section
10 pts
This criterion is linked to a Learning OutcomeResources 10 pts
Distinguished
Uses five or greater resources that extend learning, are relevant (within the last five years), and relate to the topic. 8 pts
Competent
Uses three to four resources that are relevant (within the last five years) and comprehensive to support the ideas and opinions submitted. 5 pts
Emerging
Uses one to two resources that are relevant (within the last five years) and comprehensive to support the ideas and opinions submitted. 2 pts
Novice
Uses resources that are not relevant (within the last five years) or not related to the topic. 0 pts
Level 0
Does not meet this section
10 pts
This criterion is linked to a Learning OutcomeAPA 10 pts
Distinguished
All sources are properly formatted following APA guidelines for in-text citations, references, headers, and title and reference pages. 8 pts
Competent
Attempted in-text citations, references, headers, and title and reference page following APA formatting with 1-2 errors. 5 pts
Emerging
Attempted in-text citations, references, headers, and title and reference page following APA formatting with 3-5 errors. 2 pts
Novice
In-text citations and/or references are missing or there are greater than 5 errors in APA formatting. 0 pts
Level 0
Does not meet this section
10 pts
Total Points: 60
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Discuss autism and ADHD diagnostic criteria.
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social communication and interaction, as well as restricted and repetitive behaviors and interests. The DSM-5 lists several criteria for the diagnosis of ASD, including difficulties with social-emotional reciprocity, problems with nonverbal communicative behaviors, difficulties in developing and maintaining relationships, and repetitive patterns of behavior, interests, or activities.
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsiveness. According to the DSM-5, a diagnosis of ADHD requires six or more symptoms of inattention and/or six or more symptoms of hyperactivity/impulsiveness, with onset prior to age 12 and impairment in at least two settings (such as home, school, or work).
How should you approach examining Makala as a child, and strive to gain her trust?
It is important to approach Makala in a manner that is sensitive to her needs and takes into account her emotional state. This may involve using a calming and reassuring tone, making eye contact, and allowing her to feel in control of the examination process. It is also important to explain the examination process in simple language and answer any questions she may have. This may help to reduce her anxiety and increase her comfort level. Additionally, it is important to respect her boundaries, such as if she does not want to be touched or approached with equipment. Using play therapy techniques, such as toys or games, may also be helpful in establishing rapport and gaining her trust.
You suspect that autism may be a possibility. What should you do to ensure that your suspicions are correct and how should you go about referring Makala to the local autism team?
If you suspect that Makala may have autism, it is important to conduct a comprehensive Assessment, including developmental, behavioral, and medical assessments. This may involve obtaining a detailed developmental history, observing Makala in various settings, and conducting standardized assessments such as the Autism Diagnostic Observation Schedule (ADOS) or the Autism Diagnostic Interview-Revised (ADI-R).
If the results of the assessment indicate that autism is a possibility, the next step would be to refer Makala to the local autism team for a comprehensive Assessment and diagnosis. This team may consist of a pediatrician, psychologist, speech therapist, and occupational therapist, who will work together to determine an accurate diagnosis and develop an individualized treatment plan.
Makala is showing signs and symptoms that may overlap between autism and ADHD. How do you differentiate autism from ADHD based on diagnostic criteria?
Both autism and ADHD can present with symptoms of inattention, hyperactivity, and impulsiveness. However, there are key differences in the diagnostic criteria that can help differentiate the two disorders. For example, individuals with autism typically have difficulties with social communication and interaction, while those with ADHD primarily have symptoms of inattention, hyperactivity, and impulsiveness. Additionally, individuals with autism may engage in repetitive behaviors and have restrictive interests, while those with ADHD do not typically exhibit these symptoms.
It is important to conduct a comprehensive Assessment and use standardized assessments, such as the ADOS or ADI-R, to accurately diagnose autism. In some cases, a co-occurring diagnosis of ADHD may also be made. The best way to differentiate between autism and ADHD is to conduct a thorough Assessment by a multidisciplinary team of professionals, who can take into account the individual’s developmental history, behavior, and symptoms.
