NCM 105 – DISORDERS COMMONLY ASSOCIATED WITH INFANCY, CHILDHOOD, OR ADOLESCENCE

1. Which is a description of the etiology of autism from a genetic perspective?

A. Parents who have one child diagnosed with autism are at higher risk for having other children with the disorder.
B. Amygdala abnormality in the anterior portion of the temporal lobe is associated with the diagnosis of autism.
C. Decreased levels of serotonin have been found in individuals diagnosed with autism.
D. Congenital rubella is implicated in the predisposition to autistic disorders.
Research has revealed strong evidence that genetic factors may play a significant role in the etiology of autism
spectrum disorder. Studies show that parents who have one child with this disorder are at an increased risk for having
more than one child with the disorder. Also, monozygotic and dizygotic twin studies have provided evidence of
genetic involvement.

2. Which is a predisposing factor in the diagnosis of autism?

A. Having a sibling diagnosed with mental retardation.
B. Congenital rubella.
C. Dysfunctional family systems.
D. Inadequate ego development.
Congenital rubella syndrome (CRS) consists of a group of abnormalities that develop in children as a result of maternal
infection with rubella virus. CRS may lead to new physical symptoms during adolescence or adulthood, referred to as
“late manifestations”. Psychiatric disorders are often seen among CRS patients, with an incidence of 4.12–7.3% for
autism.
Children diagnosed with congenital rubella, postnatal neurological infections, phenylketonuria, or fragile X syndrome are
predisposed to being diagnosed with autism.

3. Which factors does Mahler attribute to the etiology of attention-deficit/hyperactivity disorder?

A. Genetic factors.
B. Psychodynamic factors.
C. Neurochemical factors.
D. Family dynamic factors.
Mahler's theory suggests that a child with ADHD has psychodynamic problems. Mahler describes these children as
fixed in the symbiotic phase of development. They have not differentiated self from mother. Ego development is
retarded, and impulsive behavior, dictated by the id, is manifested

4. The theory of family dynamics has been implicated as contributing to the etiology of conduct disorders. Which of the
following are factors related to this theory? Select all that apply.
A. Frequent shifting of parental figures.
B. Birth temperament.
C. Father absenteeism.
D. Large family size.
E. Fixation in the separation individuation phase of development.
According to the theory of family dynamics, frequent shifting of parental figures has been implicated as a contributing
factor in the predisposition to conduct disorder. An example of frequent shifting of parental figures may include, but
is not limited to, divorce, death, and inconsistent foster care. And the absence of a father, or the presence of a father
diagnosed with alcohol use disorder, has been implicated as a contributing factor to the diagnosis of conduct disorder.
And lastly large family size has been implicated as a contributing factor in the predisposition to conduct disorder. The
quality of family relationships needs to be assessed for evidence of overcrowding, poverty, neglect, and abuse to
determine this risk factor.

5. Which is associated with the etiology of Tourette’s disorder from a biochemical perspective?
A. An inheritable component, as suggested by monozygotic and dizygotic twin studies.
B. Abnormal levels of several neurotransmitters.
C. Prenatal complications, including low birth weight.
D. Enlargement of the caudate nucleus of the brain.
Abnormalities in levels of dopamine, serotonin, dynorphin, gamma-aminobutyric acid, acetylcholine, and
norepinephrine have been associated with Tourette’s disorder. This etiology is from a biochemical perspective.
6. Which developmental characteristic would be expected of an individual with an IQ level of 40?
A. Independent living with assistance during times of stress.
B. Academic skill to 6th grade level.
C. Little, if any, speech development.
D. Academic skill to 2nd grade level.
An IQ level of 40 is within the range of moderate mental retardation (IQ level 35 to 49). Academic skill to 2nd grade level
would be a developmental characteristic expected of an individual in this IQ range

7. A client has been diagnosed with an IQ level of 60. Which client social/communication capability would the nurse
expect to observe?
A. The client has almost no speech development and no socialization skills.
B. The client may experience some limitation in speech and social convention.
C. The client may have minimal verbal skills, with acting-out behavior.
D. The client is capable of developing social and communication skills
A client with mild mental retardation (IQ level 50 to 70) would be capable of devel- oping social and
communication skills. The client would function well in a struc- tured, sheltered setting

8. The nurse on an in-patient pediatric psychiatric unit is admitting a client diagnosed with an autistic disorder. Which
would the nurse expect to assess?
A. A strong connection with siblings.
B. An active imagination.
C. Abnormalities in physical appearance.
D. Absence of language.
One of the first characteristics that the nurse would note is the client’s abnormal language patterning or total absence
of language. These children cannot use or understand abstract language, and they may make unintelligible sounds or
say the same word repeatedly.

9. Which is a criterion for the diagnosis of attention-deficit/hyperactivity disorder?

A. Inattention.
B. Recurrent and persistent thoughts.
C. Physical aggression.
D. Anxiety and panic attacks.
Essential diagnostic criteria for ADHD includes inattention, along with hyperactivity and impulsivity. Children with
this disorder are highly distractible and have extremely limited attention spans.

10. When admitting a child diagnosed with a conduct disorder, which symptom would the nurse expect to assess?
A. Excessive distress about separation from home and family.
B. Repeated complaints of physical symptoms such as headaches and stomachaches.
C. History of cruelty toward people and animals.
D. Confabulation when confronted with wrongdoing.
A history of physical cruelty toward people and animals is commonly associated with conduct disorder. These
children may bury animals alive and set fires intending to cause harm and damage.

11. The nursing instructor is preparing to teach nursing students about oppositional defiant disorder (ODD). Which fact
should be included in the lesson plan?
A. Prevalence of ODD is higher in girls than in boys.
B. The diagnosis of ODD occurs before the age of 3.
C. The diagnosis of ODD occurs no later than early adolescence.
D. The diagnosis of ODD is not a developmental antecedent to conduct disorder.
The symptoms of ODD usually appear no later than early adolescence. A child diagnosed with ODD presents with a
pattern of negativity, disobedience, and hostile behavior toward authority figures. This pattern of behavior occurs
 more frequently than is typically observed in individuals of comparable age and developmental level

12. Which of the following signs and symptoms supports a diagnosis of depression in an adolescent? Select all that apply.
A. Poor self-esteem.
B. Insomnia and anorexia.
C. Sexually acting out and inappropriate anger.
D. Increased serotonin levels.
E. Exaggerated psychosomatic complaints.
A symptom of depression in adolescence is poor self-esteem. Puberty and maturity are gradual processes and vary
among individuals. Adolescents may experience a lack of self-esteem when their expectations of maturity are not met
or when they compare themselves unfavorably with peers. Eating and sleeping disturbances are common signs and
symptoms of depression in adolescents. Acting out sexually and expressing inappropriate anger are symptoms of
depression in adolescence. The fluctuating hormone levels that accompany puberty contribute to these behaviors. A
manifestation of behavioral change that lasts for several weeks is the best indicator of a mood disorder in an
adolescent. And Exaggerated psychosomatic complaints are symptoms of depression in adolescence. Between the
ages of 11 and 16, normal rapid changes to the body occur, and psychosomatic complaints are common. These
complaints must be differentiated from the exaggerated psychosomatic complaints that occur in adolescent depression

13. A child diagnosed with mild to moderate mental retardation is admitted to the medical/ surgical floor for an
appendectomy. The nurse observes that the child is having difficulty making desires known. Which nursing diagnosis
reflects this client’s problem?
A. Ineffective coping R/T developmental delay.
B. Anxiety R/T hospitalization and absence of familiar surroundings.
C. Impaired verbal communication R/T developmental alteration.
D. Impaired adjustment R/T recent admission to hospital.
Impaired verbal communication R/T developmental alteration is the appropriate nursing diagnosis for a child diagnosed
with mild to moderate IDD who is having difficulties making needs and desires understood to staff members. Clients
diagnosed with mild to moderate IDD often have deficits in communication.

14. A child diagnosed with severe mental retardation displays failure to thrive related to neglect and abuse. Which nursing
diagnosis would best reflect this situation?
A. Altered role performance R/T failure to complete kindergarten.
B. Risk for injury: self-directed R/T poor self-esteem.
C. Altered growth and development R/T inadequate environmental stimulation.
D. Anxiety R/T ineffective coping skills.
The nursing diagnosis of altered growth and development related to inadequate environmental stimulation would best
address this child's problem of failure to thrive. Failure to thrive frequently results from neglect and abuse.

15. A child diagnosed with an autistic disorder makes no eye contact; is unresponsive to staff members; and continuously
twists, spins, and head bangs. Which nursing diagnosis would take priority?
A. Personal identity disorder R/T poor ego differentiation.
B. Impaired verbal communication R/T withdrawal into self.
C. Risk for injury R/T head banging.
D. Impaired social interaction R/T delay in accomplishing developmental tasks.
The priority nursing responsibility is to ensure the safety needs of the patient.

16. A foster child diagnosed with oppositional defiant disorder is spiteful, vindictive, and argumentative, and has a history
of aggression toward others. Which nursing diagnosis would take priority?
A. Impaired social interaction R/T refusal to adhere to conventional social behavior.
B. Defensive coping R/T unsatisfactory child-parent relationship.
C. Risk for violence: directed at others R/T poor impulse control.
D. Noncompliance R/T a negativistic attitude.
Risk for violence: directed at others is defined as behaviors in which an individual demonstrates that he or she can be
physically, emotionally, or sexually harmful to others. Children diagnosed with ODD have a pattern of negativistic,
spiteful, and vindictive behaviors. The foster child described in the question also has a history of aggressive
behaviors. Because maintaining safety is a critical responsibility of the nurse, risk for violence: directed at others
 would be the priority nursing diagnosis.

17. A child diagnosed with severe mental retardation becomes aggressive with staff members when faced with the
inability to complete simple tasks. Which nursing diagnosis would reflect this client’s problem?
A. Ineffective coping R/T inability to deal with frustration.
B. Anxiety R/T feelings of powerlessness and threat to self-esteem.
C. Social isolation R/T unconventional social behavior.
D. Risk for injury R/T altered physical mobility.
The child wasn’t able to cope frustration that’s why the child becomes aggressive and can’t complete simple task.

18. A child admitted to an in-patient psychiatric unit is diagnosed with separation anxiety disorder. This child is
continually refusing to go to bed at the designated time. Which nursing diagnosis best documents this child’s problem?
A. Noncompliance with rules R/T low self-esteem.
B. Ineffective coping R/T hospitalization and absence of major attachment 7gure.
C. Powerlessness R/T confusion and disorientation.
D. Risk for injury R/T sleep deprivation.
Ineffective coping is defined as the inability to form a valid appraisal of the stressors, ineffective choices of practiced
responses, or inability to use available resources. A child diagnosed with separation anxiety often refuses to go to
school or bed because of fears of separation from home or from individuals to whom the child is attached. The child
in the question is refusing to go to bed as a way to cope with fear and anxiety. The nursing diagnosis of ineffective
coping would be an appropriate documentation of this client's problem.

19. Which short-term outcome would take priority for a client who is diagnosed with moderate mental retardation, and
who resorts to self-mutilation during times of peer and staff conflict?
A. The client will form peer relationships by end of shift.
B. The client will demonstrate adaptive coping skills in response to conflicts.
C. The client will take direction without becoming defensive by discharge.
D. The client will experience no physical harm during this shift.
A child diagnosed with moderate IDD who resorts to self-mutilation during times of peer and staff conflict must be
protected from self-harm. A realistic, measurable outcome would be that the client would experience no physical
harm during this shift.

20. A client diagnosed with moderate mental retardation suddenly refuses to participate in supervised hygiene care. Which
short-term outcome would be appropriate for this individual?
A. The client will comply with supervised hygiene by day 3.
B. The client will be able to complete hygiene without supervision by day 3.
C. The client will be able to maintain anxiety at a manageable level by day 2.
D. The client will accept assistance with hygiene by day 2.
With appropriately implemented interventions that direct the client back to previously supervised hygiene
performance, the short-term outcome of client adherence and participation by day 2 can be a reasonable expectation.
To achieve this outcome, interventions might include exploring reasons for nonadherence; maintaining consistency of
staff members; or providing the client with familiar objects, such as an old versus new toothbrush.

21. Which short-term outcome would be considered a priority for a hospitalized child diagnosed with a chronic autistic
disorder who bites self when care is attempted?
A. The child will initiate social interactions with one caregiver by discharge.
B. The child will demonstrate trust in one caregiver by day 3.
C. The child will not inflict harm on self during the next 24-hour period.
D. The child will establish a means of communicating needs by discharge.
A child diagnosed with autism spectrum disorder who bites self when care is attempted is at risk for injury R/T
selfmutilation. Self-injurious behaviors, such as head banging and hand and arm biting, are used as a means to relieve
tension. Considering that the nurse's primary responsibility is client safety, expecting the child to refrain from
inflicting self-harm during a 24-hour period is the short-term outcome that should take priority.

22. A child diagnosed with a conduct disorder is disruptive and noncompliant with rules in the milieu. Which outcome,
related to this client’s problem, should the nurse expect the client to achieve?
 A. The child will maintain anxiety at a reasonable level by day 2.
B. The child will interact with others in a socially appropriate manner by day 2.
C. The child will accept direction without becoming defensive by discharge.
D. The child will contract not to harm self during this shift.
Accepting direction without becoming defensive by discharge is a specific, measurable, positive, realistic, client-
centered outcome for this child. The disruption and nonadherence to rules on the milieu is this child's defensive
coping mechanism. Helping the child to see the correlation between this defensiveness and the child's low self-esteem,
anger, and frustration would assist in meeting this outcome.

23. Which charting entry would document an appropriate nursing intervention for a client diagnosed with profound mental
retardation?
A. “Rewarded client with lollipop after independent completion of self-care.”
B. “Encouraged client to tie own shoelaces.”
C. “Kept client in line of sight continually during shift.”
D. “Taught the client to sing the alphabet ‘ABC’ song.”
A client diagnosed with profound IDD requires constant care and supervision. Keeping this client in line of sight
continuously during the shift is an appropriate intervention for a child with an IQ level ,20.

24. A child diagnosed with autistic disorder has a nursing diagnosis of impaired social interaction R/T shyness and
withdrawal into self. Which of the following nursing interventions would be most appropriate to address this problem?
Select all that apply.
A. Prevent physical aggression by recognizing signs of agitation.
B. Allow the client to behave spontaneously, and shelter the client from peers.
C. Remain with the client during initial interaction with others on the unit.
D. Establish a procedure for behavior modification with rewards to the client for appropriate behaviors.
E. Explain to other clients the meaning behind some of the client’s nonverbal gestures and signals.
The nurse assumes the role of advocate and social mediator when the nurse remains with the client during initial
interactions with others on the unit. The presence of a trusted individual provides a feeling of security and supports
the client while appropriate socialization skills are learned. Positive reinforcements can contribute to desired changes
in socialization behaviors. These privileges are individually determined as staff members learn the client's likes and
dislikes. By explaining to peers the meaning behind some of the client's nonverbal gestures, signals, and
communication attempts, the nurse facilitates social interactions. With this understanding, others in the client's social
setting would be more receptive to social interaction.

25. A child diagnosed with an autistic disorder withdraws into self and, when spoken to, makes inappropriate nonverbal
expressions. The nursing diagnosis impaired verbal communication is documented. Which intervention would address this
problem?
A. Assist the child to recognize separateness during self-care activities.
B. Use a face-to-face and eye-to-eye approach when communicating.
C. Provide the child with a familiar toy or blanket to increase feelings of security.
D. Offer self to the child during times of increasing anxiety.
A child diagnosed with autism spectrum disorder has impairment in communication affecting verbal and nonverbal
skills. Nonverbal communication, such as facial expression, eye contact, or gestures, is often absent or socially
inappropriate. Eye-to-eye and face-to-face contact expresses genuine interest in, and respect for, the individual and
role-models correct nonverbal expressions.

26. A child diagnosed with oppositional defiant disorder begins yelling at staff members when asked to leave group
therapy because of inappropriate language. Which nursing intervention would be appropriate?
A. Administer PRN medication to decrease acting-out behaviors.
B. Accompany the child to a quiet area to decrease external stimuli.
C. Institute seclusion following agency protocol.
D. Allow the child to stay in group therapy to monitor the situation further.
Accompanying the child to a quiet area to decrease external stimuli is the most beneficial action for this child. This
action would aid in decreasing anger and hostility expressed by the child's outburst and inappropriate language. Later,
the nurse may sit with the child and develop a system of rewards for adherence with therapy and consequences for
nonadherence. This can be accomplished by starting with minimal expectations and increasing these expectations as
 the child begins to manifest evidence of control and adherence.

27. A child newly admitted to an in-patient psychiatric unit with a diagnosis of major depressive disorder has a nursing
diagnosis of high risk for suicide R/T depressed mood. Which nursing intervention would be most appropriate at this
time?
A. Encourage the child to participate in group therapy activities daily.
B. Engage in one-on-one interactions to assist in building a trusting relationship.
C. Monitor the child continuously while no longer than an arm’s length away.
D. Maintain open lines of communication for expression of feelings.
Monitoring the child continuously while no longer than an arm's length away would be an appropriate nursing
intervention. This observation would allow the nurse to note self-harm behaviors and intervene immediately if
necessary.

28. A client diagnosed with oppositional defiant disorder has an outcome of learning new coping skills through behavior
modification. Which client statement indicates that behavioral modification has occurred?
A. “I didn’t hit Johnny. Can I have my Tootsie Roll?”
B. “I want to wear a helmet like Jane wears.”
C. “Can I watch television after supper?”
D. “I want a puppy right now.”
The question implies that the client defensively copes with frustration by lashing out and hitting people. New coping
skills have been achieved through behavior modification when the client states, "I didn't hit Johnny. Can I have my
Tootsie Roll?" The intervention used to achieve this outcome is a reward system that recognizes and appreciates
appropriate behavior, modifying behavior that was previously unacceptable.

29. A client diagnosed with Tourette’s disorder has a nursing diagnosis of social isolation. Which charting entry
documents a successful outcome related to this client’s problem?
A. “Compliant with instructions to use bathroom before bedtime.”
B. “Made potholder at activity therapy session.”
C. “Able to distinguish right hand from left hand.”
D. “Able to focus on TV cartoons for 30 minutes.”
During activity therapy, clients interact with peers and staff. This participation in a social activity reflects a successful
outcome for the nursing diagnosis of social isolation.

30. A child diagnosed with an autistic disorder has a nursing diagnosis of impaired social interaction. The child is
currently making eye contact and allowing physical touch. Which of the following statements addresses the evaluation of
this child’s behavior?
A. The nurse is unable to evaluate this child’s ability to interact socially based on the observed behaviors.
B. The child is experiencing improved social interaction as evidenced by making eye contact and allowing physical
touch.
C. The nurse is unable to evaluate this child’s ability to interact socially because the child has not experienced these
behaviors for an extended period.
D. The child’s making eye contact and allowing physical touch are indications of improved personal identity, not
improved social interaction.
Making eye contact and allowing physical touch, this child is experiencing improved social interaction, making this
an accurate evaluative statement.
31. A 6-year-old diagnosed with ADHD is throwing pencils at the other children. The initial response by the nurse would
be:
A. “You might hurt others if you continue.”
B. “This is why you get into trouble.”
C. “Stop this right now.”
D. “Your doctor will have to be called.”
Stopping the bad doing of the child will help changing the behavior.

32. The nurse working in the emergency department usually assesses adult patients, but tonight she is responsible for
assessing the suicide potential of a 13-year-old adolescent. Which topic must be explored in this assessment of an
adolescent that is different from such an assessment in an adult?
A. The presence of distorted perceptions about suicide and death
B. The presence of ideas about hurting self seriously or causing death
C. Circumstances at the time suicidal thoughts are experienced
D. Identification of feelings such as depression, anger, guilt, and rejection
Most adolescent patient now a days once their has problem one of their thought of solving a problem is to do suicide.
As a nurse the nursing responsibilities are Exploring and guiding the patient to have a clear thought of doing suicide.

33. A 15-year-old boy is diagnosed with conduct disorder. He has not been attending school and states that his parents
told him it was OK to stay home. The best response by the nurse would be:
A. “Your parents are not aware of your class schedule.”
B. “Skipping classes is against the rules.”
C. “A family meeting must be arranged.”
D. “I will refer you to the principal’s office.”
Allowing what the child’s want is not appropriate for helping his condition, skipping classes is against the rules is
good answer in the situation.

34. Which topic would be least relevant as a focus during the assessment of a 12-year-old with suspected ADHD?
A. Effect of impulsive behavior on the child’s life at home and school
B. The child’s level of physical activity and attention span
C. The child’s ability to pay attention and perform in school
D. The child’s progress with toilet training and self-care habits
The child’s progresss with toilet training and self care habits is less relevant to a 12 year- old , toilet training most
started at 24-36 months.

35. Nurses working with children and adolescents should be focused on:
A. avoidance of their own childhood issues.
B. sharing aspects of their own childhood with patients’ families.
C. development of insight into their own childhood issues.
D. teaching staff that childhood concerns can be lifelong.
Development of insight into their own childhood issues in order them to become independent and realized of what
they are doing.
ANSWER THE FOLLOWING CASES:

1. Thomas, a 4-year-old boy, has been diagnosed with an autism spectrum disorder.
A. Describe the kinds of behavioral data you would find on assessment in terms of (1) communication, (2) social
interactions, and (3) behaviors and activities.

(1) can’t form sentences, repeats words or phrases over and over, doesn’t answer questions appropriately or follow
directions, doesn’t understand counting or time, reverses pronouns (for example, says “you” instead of “I”), rarely
or never uses gestures or body language like waving or pointing, talks in a flat or sing-song voice, doesn’t
understand jokes, sarcasm, or teasing.

(2) doesn’t respond to their name, avoids eye contact, prefers playing alone than playing with others, doesn’t share
well with others or take turns, doesn’t participate in pretend play, isn’t interested in interacting or socializing with
others, doesn’t like or actively avoids physical contact, isn’t interested or doesn’t know how to make friends,
doesn’t make facial expressions or makes inappropriate expressions, cannot be easily soothed or comforted, has
difficulty expressing or talking about their feelings, has difficulty understanding other people’s feelings.
(3) performs repetitive motions (flaps hands, rocks back and forth, spins), lines up toys or other objects in an
organized fashion, gets upset or frustrated by small changes in daily routine, plays with toys the same way every
time, likes certain parts of objects (often wheels or spinning parts), has obsessive interests, has to follow certain
routines.

B. Name at least six realistic outcomes for Thomas.

Inclusion – People with autism  should be welcomed to participate  actively in their schools, workplaces  and
communities
Communication – People with autism  should be able to express themselves  and interact with others in a
meaningful  way
Health and Well-being – People with autism should feel and be well physically and have access to the services
they need to stay health
Safety – People with autism should feel secure and be able to get help from their communities, law enforcement
and others as needed
Academic Success – People with autism should have the opportunity to participate in school to their fullest
capability and learn in an environment and manner that enables them to succeed
Social Connection

C. Which treatment modalities do you think would be the most effective for a child with autism spectrum disorder
(ASD)? Defend your answer.

Treatment of children with autism are to reduce behavioral symptoms (e.g., stereotyped motor behaviors) and to
promote learning and development, particularly the acquisition of language skills. Comprehensive and
individualized treatment, including special education and language therapy, is associated with more favorable
outcomes
Behavior and communication therapies. Many programs address the range of social, language
and behavioral difficulties associated with autism spectrum disorder. Some programs focus on
 reducing problem behaviors and teaching new skills. Other programs focus on teaching children
how to act in social situations or communicate better with others. Applied behavior analysis
(ABA) can help children learn new skills and generalize these skills to multiple situations through
a reward-based motivation system.

D. What kinds of support should the family receive?

 Autism Speaks. This nationally recognized organization provides a great deal of information parents of recently
diagnosed children would find useful. This information includes reviews of apps, resources for children with
autism, and a unique 100-Day Kit that provides a step-by-step guide and schedule as to what to do in the 100 days
following the diagnosis of autism.  
 Online Asperger Syndrome Information and Support center. The website has a database of support groups
searchable by where you live. Support groups include treatment and therapy groups for children with Asperger
syndrome, as well as support groups for parents. 
 GRASP. The Global and Regional Asperger Syndrome Partnership was created to improve the lives of adults and
teens on the autism spectrum through community outreach, online support, education, and advocacy. Membership
is free.
 Wrong Planet. This is an internet community offering support to individuals, parents, and professionals with
Asperger syndrome, ADHD, and other neurological conditions. Resources include a discussion forum, a library of
articles, blogs, and a chat room.
 ASPEN. The Asperger Syndrome Education Network is a New Jersey-based resource offering support for
families, as well as a listing of other online support groups.
 Asperger Syndrome and High Functioning Autism Association. This group reaches people in New York City
and throughout Long Island, N.Y., with local activities and events and online support.

2. Nancy is a 7-year-old girl who has been diagnosed with ADHD.

A. This child is in second grade. What clinical behaviors might she be exhibiting at home and in the classroom?
Give behavioral examples for her (1) inattention, (2) hyperactivity, and (3) impulsivity.
1. Inattention

 Failing to pay close attention to details;

 Making frequent and careless mistakes during schoolwork or other activities;
 Trouble keeping attention focused during play or tasks;
 Appearing not to listen when being spoken to;
 Failing to follow instructions;
 Difficulty completing tasks;
 Avoiding tasks that require a high amount of mental effort and organization, such as school projects;
 Frequently losing items needed to complete activities, such as school supplies;
 Excessive distractibility;
 Forgetfulness;
 Procrastination, inability to begin an activity; and,
 Associated problems such as low self-esteem, depression, or anxiety.

2. Hyperactivity

 Diminished need for sleep;

 Fidgeting with hands or feet, or squirming in their seat;
 Leaving their seat often, even when asked not to do so;
 Running or climbing at inappropriate times;
 Difficulty with quiet play;
 Frequent feelings of restlessness; and,
 Excessive speech.

3. Impulsively

 Social immaturity;
 Frequent arguments with caregivers and peers;
 Disregard for socially-accepted behavioral expectations;
 Requiring more supervision than average;
 Inconsistently meeting responsibilities or completing chores;
 Continually striving to be the center of attention;
 Answering a question before the speaker has finished;
 Failing to await one's turn;
 Interrupting the activities of others at inappropriate times; and,
 Poor peer relationships.

B. Identify at least four intervention strategies that you might suggest to be used to help her.

1. Provide Positive Attention

2. Give Effective Instructions
3. Establish a Reward System
4. Use Time-Out When Necessary

C. What type of medications might help her?

There are two basic categories of ADHD medication:

1. Stimulant drugs; and,
2. Non-stimulant drugs (primarily anti-depressant drugs).

Stimulants are the most commonly prescribed medication for ADHD (Cherney, 2014). Stimulants affect dopamine levels.
Stimulants block dopamine reabsorption (reuptake) so dopamine remains active longer. These medications may also block
some of the metabolic enzymes that function to weaken dopamine's effect. Stimulant medication makes up for this
insufficiency. Once the insufficiency is corrected, attention and impulse control improve.

3. Jeffrey is an 8-year-old boy who has been diagnosed with conduct disorder.
A. Explain to one of Jeffrey’s classmates his probable behaviors in terms of (1) aggression toward others, (2)
destruction of property, (3) deceitfulness, and (4) violation of rules.
1. Aggressive to others

 breaking rules at home and school

 bullying
 vandalism
 getting into fights
 stealing
 breaking & entering
 lying or being deceitful
  manipulating others

2. Destruction of property
 deliberately engages in fire-setting with the intention of doing serious damage;
 deliberately destroys others' property (other than by fire).

3. Deceitfulness
 breaks into someone else's house, building, or car;
 lies to obtain goods, favors, or to avoid obligations;
 steals objects of non-trivial value without confronting the victim.
4. Violation of rules
 stays out late at night against parental prohibition before age 13;
 runs away once for a lengthy period of time or twice overnight;
 is truant from school before age 13.

B. What are the outcomes for this child? What is the overall prognosis for children with this disorder?
Outcome criteria include short- and long-term goals. Timelines are individually determined. The following
criteria may be used for measurement of outcomes in the care of the client with conduct disorder:
The client:
1. Has not harmed self or others.
2. Interacts with others in a socially appropriate manner.
3. Accepts direction without becoming defensive.
4. Demonstrates evidence of increased self-esteem by discontinuing exploitative and demanding behaviors
toward others.

C. What are at least seven ways you could support Jeffrey’s parents?
Do what feels right

What you do has to be right for your child, yourself and the family. If you do something you don't believe in or that you
don't feel is right, it probably won't work. Children notice when you don't mean what you're saying.

Don't give up

Once you've decided to do something, continue to do it. Solutions take time to work. Get support from your partner, a
friend, another parent or your health visitor. It's good to have someone to talk to about what you're doing.

Be consistent
Children need consistency. If you react to your child's behaviour in one way one day and a different way the next, it's
confusing for them. It's also important that everyone close to your child deals with their behaviour in the same way.

Try not to overreact

This can be difficult. When your child does something annoying time after time, your anger and frustration can build up.
It's impossible not to show your irritation sometimes, but try to stay calm. Move on to other things you can both enjoy or
feel good about as soon as possible. Find other ways to cope with your frustration, like talking to other parents.

Talk to your child

Children don't have to be able to talk to understand. It can help if they understand why you want them to do something.
For example, explain why you want them to hold your hand while crossing the road. Once your child can talk, encourage
them to explain why they're angry or upset. This will help them feel less frustrated.

Be positive about the good things

When a child's behaviour is difficult, the things they do well can be overlooked. Tell your child when you're pleased about
something they've done. You can let your child know when you're pleased by giving them attention, a hug or a smile.

Offer rewards

You can help your child by rewarding them for behaving well. For example, praise them or give them their favourite food
for tea" Don't give your child a reward before they've done what they were asked to do. That's a bribe, not a reward.

Avoid smacking

Smacking may stop a child doing what they're doing at that moment, but it doesn't have a lasting positive effect.

D. Use the computer to find locations within your community that might be the best place to refer Jeffrey’s parents
for support and guidance.
- Silliman University states in their website that they have been receiving students/children with different kind of
disorders including conduct disorder. They were able to manage these children using specific therapies one of the
therapies is Emotion-Focused therapy (EFT) they use this to interact with their students effectively.