Psychiatric Nursing
Autism
Attention Deficit
Hyperactive Disorder
Mental Retardation

General Objectives:
• At the end of the presentation the

viewers will be able to understand about autism, mental retardation and
ADHD.

Specific Objectives:
At end of presentation the viewers will be able to:
• Define what is autism, ADHD and MR.
• Differentiate the mental disorders.
• To know the principles of the disorders. What is autism?
• Autism is a complex developmental

disorder that appears in the first
3yrs. of life (through it may be diagnosed later). It affects the brain’s normal development of social and communication skills.

Alternative Names:
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Autistic disorder
Infantile autism
Autistic-like/ autistic- like tendencies
Pervasive developmental delay
Autism spectrum

Causes: “unknown”
Some combination of the following areas maybe affected in varying degrees. 9. Impairment in communication
-echolalia
-confusion of personal pronouns
-verbal perseveration
-abnormal of prosody
-no meaningful speech in severe cases
2. Impairment in social interaction
- deficient non-verbal forms of social interaction
- withdrawn
-inability to appreciate other emotion

3. Sensory impairment
- hyperactive
- mouthing of object
- heightened or decrease sensitivity
- self-stimulating behaviors (rocks, body, flaps hands, jumps, etc.)
- self-injurious behaviors (head banging, pinches, hits self)
- resistance to change
4. Behavioral problems
- tantrums
- manipulative behavior

Basic principle and management technique:
• Be consistent
• Be firm; use clear rules
• Use appropriate rewards
• Choose priorities
• Use appropriate cues to assist understanding and learning

Signs and symptoms
• Resists normal teaching method
• Inappropriate laughing and giggling
• Echolalia
• Acts as if deaf
• No fear of real dangers
• Apparent insensitivity to pain
• Crying, tantrums, extreme distress for discernible reason
• Spins object
• Not cuddly
• Sustained odd play

• Difficulty mixing with other children
• Resist change in routine
• No eye contact
• Stand-offish manner
• Uneven gross and fine motor skills-

may not to kick ball but can stack blocks • Inappropriate attachment to objects
• Indicate needs by gesture
• Marked physical over activity or extreme passivity

What causes ADHD?
• Exact cause is unknown
• There are implication of:
a. genetics/heredity
b. complication in pregnancy
• exposure to toxins
• Episodes of oxygen deprivation of the fetus
• mothers who smoke during

Problems of inattention
• They appear not to listen when spoken to
• Easily distracted
• Prone to make careless mistakes &

disorganized with school work
• Do not follow direction
• Do not obey
• Find it difficult & unpleasant to finish their school works
• Losing their school books & assignments
• Have trouble sustaining attention in the classroom • Often forgetful in daily activities

Problems in hyperactivity
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Fidgeting, squirming around when seated
Get up frequently
May talk excessively
Has difficulty playing quietly

Problems in impulsivity
• Often blurts out answers before questions have been completed
• Has difficulty awaiting turn
• Often blurts or intrudes on others (butts into conversation/games) – Furthermore, children with ADHD can present a challenge that puts significant stress on the family, skills training for parents and siblings.

Mental retardation
• An individual is considered to have

mental retardation based on the following 3 criteria: intellectual functioning level (IQ) is below 70-75; significant limitations exist in two or more adaptive skill areas, and the condition is present from childhood
(defined as age 18 or less) (AAMR),
1992)

What are the adaptive skills essential for daily functioning?
Adaptive skill areas are those daily living skills needed to live, work and play in