A nurse is caring for a school-age child.
Nurses’ Notes
First visit:
A child is brought to the clinic accompanied by guardians. The guardians have received feedback from the child’s teacher that the child has become disinterested in schoolwork and has difficulty paying attention during class. The child often loses their school supplies.
The guardians report that the child demonstrates these behaviors at home as well. The child refuses to participate in household chores, keeps their room untidy, does not clean up when told to, and is generally careless and disinterested. On assessing, the child is found to be talkative, restless, and easily distracted.
2 weeks later.
The child’s guardians report that the child seems to be doing better at school. The child is improving at paying attention during class and completing assignments on time.
For each assessment finding, specify if the finding is consistent with attention deficit hyperactivity disorder (ADHD) or intellectual disability (ID). Each finding may support more than 1 disease process.
A.
Intellectual impairment
B.
Losing necessary things
C.
Impaired language skills
D.
Hyperreactivity to sensory input
E.
Interrupting others
The correct answer and Explanation is :
Based on the assessment findings, here’s an analysis of each finding in relation to Attention Deficit Hyperactivity Disorder (ADHD) and Intellectual Disability (ID):
A. Intellectual impairment
This finding is more indicative of Intellectual Disability (ID). Children with ID often exhibit lower cognitive functioning and may struggle with problem-solving and adaptive skills. While some children with ADHD can have learning difficulties, their cognitive abilities are typically within the normal range.
B. Losing necessary things
This behavior is consistent with ADHD. Children with ADHD often experience difficulties with organization and memory, leading to losing items like school supplies. While children with ID might also lose things due to cognitive challenges, this specific finding aligns more closely with ADHD symptoms.
C. Impaired language skills
Impaired language skills can suggest both ADHD and ID, but the context matters. Children with ID may have significant language delays or impairments. In ADHD, language issues might stem from impulsivity and inattention rather than developmental delay. Therefore, this finding could support either diagnosis depending on further assessment.
D. Hyperreactivity to sensory input
Hyperreactivity is primarily associated with ADHD, where children may be overly sensitive to sensory stimuli, leading to distractibility and restlessness. This finding is less characteristic of ID, which usually does not include hyperreactivity as a symptom.
E. Interrupting others
Interrupting others is a common behavior in ADHD, linked to impulsivity and difficulty with self-regulation. While children with ID can also struggle with social interactions, the impulsivity inherent in ADHD makes this behavior more characteristic of that disorder.
In summary, the assessment findings suggest that the child’s behaviors are more consistent with ADHD, particularly with losing necessary things, hyperreactivity to sensory input, and interrupting others. Intellectual Disability may also be considered, especially regarding intellectual impairment and potential language issues, but the evidence strongly leans toward ADHD given the overall presentation and improvement noted in school.