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 Definition of Developmental Disability, Intellectual Disability, and Autism Spectrum Disorder

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 Definition of Developmental Disability, Intellectual Disability, and Autism Spectrum Disorder

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Autism Spectrum Disorder (ASD): Intellectual disability refers to a group of individuals limited through mental capacity and difficulty adapting their behaviors to meet different scenarios, such as managing money and schedules, or social interactions. This will develop before the age of 18, and can result from physical disabilities such as autism, and cerebral palsy. As well as, non-physical disabilities such as lack of stimulation and adult receptivity.

Developmental disability is long term, and affects cognitive ability, and physical functioning of the person diagnosed. This diagnosis appears before a person turns 22 years of age. Developmental disability is composed of intellectual disability, and physical disabilities, but does necessarily have to be both.

(U.S. Department of Health and Human Services)

Autism is a neurodevelopmental disorder not based on atomic or specific generic markers, yet instead is based on both behavioral and developmental characteristics. This Disorder has some specific diagnostic criteria found in the DSM-5, which include deficits in social communication, interactions and understanding relationships.  As well as, specific and reoccurring behaviors or activities that become ritualized and inflexible to change. Furthermore, ASD is broken up into severity levels: level 1, level 2, and level 3.

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Most researchers believe the cause for ASD is the way Neurological structure and development occurs. Although, a few people believe there are environmental factors.

Neurological structure and development: Approximately half of children who have autism have abnormal EEG, which leads to an underlying structural problem with their brains. Also, individuals with ASD have smaller and fewer Purkinje cells in the cerebellum, and less compacted densely packed in the limbic system, compared to people who aren’t diagnosed with ASD. Lastly, the frontal cortex of a person who has ASD tends to be smaller and more detached, unlike typically developing brains.

Environmental factors: Most researchers have found no link to pesticides or immunizations, although there are numerous anecdotes of parents using bio-treatments that cure their child’s Autism diagnosis.

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The biggest system affect is ones through social interactions.  Someone growing up may find a harder time making friends like others who aren’t diagnosed with Autism. Although, people who are diagnoses with ASD also tend to have repetitive, structured, and ritual behaviors. This may affect people who they work with, as well as family members.  They may not be o work on time, or not able to see family members.

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Secondary conditions associated with ASD, including epilepsy, sleeping disorders, hyperactivity, anxiety and depression.  Although, the most prominent secondary conditions are sensory processing dysfunction, cognitive impairments and self-injuries.

Sensory processing dysfunction include over-responsivity, which is caused by the brain being unable to stop sensory information effectively. On the other hand, a person diagnosed with ASD can also experience sensory under-responsivity, which occurs when less sensory information is communicated to the brain; and because of the children with ASD tend to jump, spin, and move more than other children not diagnosed with ASD.

Cognitive impairment is affected with Individuals diagnosed with ASD by how they think more visually, rather than linguistically. This referring to their cognition being very literal. People who have Autism tend to no be able carry on situation from on environment to another.

Self-injuries are the last major secondary condition associated with people with ASD. This happens when someone’s behavior is self-inflicted and causes physical harm. This can include biting, scratching, hitting, etc. towards themselves.

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Effective treatments for individuals with ASD, which include an early and very structured intervention. Some of the treatments are antecedent package, behavioral package, and self-management interventions.

Antecedent package: This usually focuses on a need to increase or decrease a specific behavior.

Behavioral package: This type of intervention should teach an alternative behavior or skill when trying to reduce a problem behavior.

Self-management: This involves encouraging independence by helping the individual regulate their own behaviors.

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- Infections or trauma (before or after birth)
- Toxic materials (such as alcohol, cocaine, and other drugs)
- Chromosomal abnormalities (such as down syndrome)
- Environmental or nutritional factors.
- Metabolic factors (such as high bilirubin levels in babies)

(U.S. National Library of Medicine- MedlinePlus)

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Effective Recreational Therapy interventions for Intellectual Disability

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Effective Recreational Therapy interventions for Intellectual Disability

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Effective Recreational Therapy interventions for individuals with intellectual disability have the purpose to provide a better quality of life.  These type pf treatments include, but not limited to, community integration, functional skills and education opportunities, and leisure interventions.

Community integration: Inclusion support staff are essential when assisting people with intellectual disabilities for leisure and social skills. Both adults and children who are diagnosed benefit from community-based interventions, which can reduce anxiety and build confidence and sociability.

Functional skills and education: This focuses on improving social skills and decreasing maladaptive behavior. Informing people diagnosed with intellectual disabilities how to shape their current behavior to adapt more efficiently in different situations.

Leisure interventions:  Some examples include engagement in exercises, playing games and doing crafts, and social interactions with others.  The purpose is to reduce stress and increase quality of life.

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Congenital visual impairments are any condition present at birth that affect the eyes or vision.
(AFB- American Foundation for the Blind)

Whereas acquired visual impairments are when there is damage to the brain, or physical and neurological conditions that affect a person vision later in their life.

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Hearing lost is caused by noise, age, heredity, medications, disease and illnesses.
Although, 25% of babies born with hearing loss is unknown, and another 25% is due to the mother. Either from infections during pregnancy, complications after birth, and head trauma. The last 50% of newborns develop hearing impairments because of genetics. Majority of the genetics these babies are born with diagnosis them as either having down or usher syndrome.

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1.  Conductive hearing loss: hearing loss caused by something that stops sound from getting through the outer or middle ear.

2. Sensorineural hearing loss: this type of hearing loss occurs when there is a problem in the inner ear or how the hearing nerves are working.

3.  Mixed hearing loss: Hearing loss that includes both Conductive and Sensorineural hearing loss

4. Auditory Neuropathy Spectrum Disorder: This occurs when sound enters the ear normally, but damage to the inner ear or hearing nerves doesn't allow sound to organize in a way that the brain can understand.

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1. Mild Hearing Loss: This type of hearing loss is when a person with a may hear some speech sounds.  Although hard sounds are much easier for this person than soft sounds.

2. Moderate Hearing Loss: a person may hear almost no speech when another person is talking at a normal tone and volume.

3. Severe Hearing Loss: A person with this diagnosis will hear no speech when another person is talking at a normal level, and only some loud sounds.

4. Profound Hearing Loss: This degree of hearing loss is when a person will not hear any speech and only hear loud sounds.

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Visual acuity is a measure of your eye's ability to distinguish shapes and the details of objects at a given distance.
(US National Library of Medicine and National Institute of Health)

20/20 is considered "normal" visual acuity. Although there are also people who have been tested as a 20/40 visual acuity. This means that a "normal" range of vision could see something at 20 feet, the the person who scored 20/40 would see something 20 feet away, while the "normal" vision can see the object 40 feet away.

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There are many ocular and cortical causes of why someone has or develops visual impairments. Ocular visual impairments are caused by disease or conditions related to the eye. Whereas, cortical  visual impairments are caused by injury or a structure difference in the brain.

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Recreational Therapy Interventions for hearing loss and visual impairments

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Recreational Therapy Interventions for hearing loss and visual impairments

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there are many Aspects that TR interventions aim for when working with clients who are diagnosed with hearing loss or visual impairments.
For people diagnosed with hearing loss, interventions focus on communication, social skills and relationships, and the use of assistive technology. Communication skills may be working on a person vocabulary for communicating emotions. Social skills may focus on learning and correctly interpreting facial and non-verbal gestures. Lastly, assistive technology will help a patient, such as hearing aids or a voice to text application in a movie.
On the other hand, people who are diagnosed with visual impairments will have TR interventions including problem solving on orientation and mobility, self-care, and communication.  Someone who is visually impaired will need to have effective orientation and mobility skills to help them be safe, and independent. This may be when a Rec. Therapist assists an individual by providing effective descriptive information about various environments. Self-care interventions would be a TR helping someone with visual impairments effectively eat their foot on a plate by using a "clock method".  Lastly, communication skills are important for someone who is visually impaired because they connect heavily to social skills.  Being able to effectively use social skills encourage engagement with others.  The client is then able to recognize and utilize socially normative behavior, like hand shaking, making eye contact and interpreting gestures.

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Voice record

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Basic information regarding Duchenne's Muscular Dystrophy (DMD)

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Basic information regarding Duchenne's Muscular Dystrophy (DMD)

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DMD usually affects males in the ages of 5- 24 years old, and are caused by mutations in a gene. This is a condition that, over time, decreases the mobility and increases weakness in the body making everyday tasks much more difficult. The parts of the body that show weakness first in an individual are the upper legs and upper arms. Although, Heart, lungs, throat, stomach, intestines, and spine are also parts of the body that can be affected by DMD.

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Basic information regarding Cerebral Palsy

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Basic information regarding Cerebral Palsy

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There are many categories of Cerebral Palsy (CP)

- Spastic CP: Include muscle stiffness and tightness. As well as, permanently contracted.

- Athetoid or dyskinetic CP: Includes slow, uncontrollable movements commonly in the face and limbs or appendages of the body. Likewise, low muscle tone and frequently having difficult with coordination of the muscles needed for speech.

- Ataxic CP: Balance and depth is affected most. Likewise, a person diagnosed with this condition has poor coordination and unsteady, wide-based gait.

- Mixed: When someone is diagnosed with a mixed classification of CP, they are diagnosed with a combination of any of the types above. They may have a combination of high and low tone or stiffness and involuntary movements.

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General symptoms:
- Ataxia
- Poor muscle control
- Spasticity or tight muscles
- Atypical gait
- Drooling
- Swallowing and eating difficulties
- Difficulty with fine motor tasks
- Toe walking
- Atypical  muscle tone (too high or too low)
- Involuntary movements or tremors

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The cause of 70% to 80% of people diagnosed with CP occurs prenatally:
- Caused by genetic conditions
- Infection
- Maternal bleeding or seizures
- Abnormal brain development
- Lack of oxygen
- Stroke
- Intrauterine growth restrictions
- Abnormalities with the placenta

Causes that occur during birth:
- Breech position
- infections
- lack of oxygen
- stroke
- multiple births
- jaundice
- low birth weight (higher chance)

Causes that occur within five years of life:
- Head injury
- Viral or bacterial infections   affecting the Central Nervous System
- Seizures
- Motor vehicle accidents
- child abuse

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Commonly occurring with CP include:

- Intellectual disability:  Most common secondary disability paired with CP.

- Epilepsy or seizures

- Both intellectual disability and seizure disorder

- Behavioral problems:  These include attention-deficit/hypertension disorder, dependency, Oppositional defiance disorder, and general hypertension.

- Learning disabilities:

- Sensory  impairments: These include vision impairments, and hearing impairments. Likewise, people diagnosed with CP may also develop strabismus

- Feeding difficulties and malnutrition: This includes complications such as choking and long feeding time, which may lead to needing a gastric tube. Likewise, children may have problems sucking and swallowing.

- Lung problems: Pulmonary infection many be experienced by someone diagnosed with CP

- Chronic pain: Pain, which is usually in back, foot, ankle, knee and shoulders. As well as, headaches may occur.

- Autism

Lastly, some individuals diagnosed with CP can have secondary complications that are related to neurological damage or physical limitations.

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Recreational therapy interventions for Cerebral Palsy

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Recreational therapy interventions for Cerebral Palsy

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- Exercise, stretching, and fitness is important to promote activity and fitness in individuals with CP.  That allows the patient to maintain muscle strength and endurance.

- Aquatic therapy benefits individuals by improving their physical functions, respiratory functions and range of motion.

- Hippotherapy is an intervention strategy with the use of horses instructed by health professionals. Some benefits include improvement of head, neck, trunk control, posture, gross motor skills, muscle symmetry, self-esteem, endurance and mobility. Likewise, relaxation is promoted while using hippotherapy.

- Therapeutic horseback riding is conducted by non-health professionals, with training and knowledge-based perceptive. The purpose of this therapy is to improve the rider's ability to receive and process body-wide sensory information from the smooth, rhythmical movements made by the horse.

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Classifications based on physical areas affected by CP:

- dyplegia: only legs are impacted

- hemiplegia: only half of the body is impacted, usually one side of the body in both extremities.

- quadriplegia: Both upper and lower extremities are impacted, may also include facial and trunk muscles.

General symptoms (terms)
- Ataxia: Poor muscle coordination

- congenital: Disease or physical abnormality present at birth

- dysarthria: Speech that is characterized as slurred, slow and difficult to understand

- spasticity: State of increased tone of muscle. (legs may feel tight and rigid)

- contractures: a permanent shortening of muscle, tendon, or scar tissue, that produces deformity or distortion

- osteopenia: Mild thinning of the bone mass.

(MedicineNet)

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Basic information regarding Spinal Cord Injury (SCI)

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Basic information regarding Spinal Cord Injury (SCI)

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A Spinal Cord Injury can vary in levels of injury. The Manual Muscle exam uses the following criteria
- Normal: 100% functionality. Complete range of motion against gravity with full resistance from examiner.

- Good: 75% functionality. Complete range of motion against gravity with come resistance.

- Fair: 50% functionality. Complete range of motion against gravity.

- Poor: 25% functionality. Complete range of motion with gravity eliminated by examiner.

- Trace: 10% functionality. Evidence of contractility.

- Zero: 0% functionality. No evidence of contractility.

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There are two types of SCI: tetraplegia (C1-C8) and paralegia (T1-S5). There is complete vs incomplete of both of these types.

There are many classifications for Spinal Cord Injury

- C1-C3: Characteristics include limited neck flexion, extension. Likewise, the individual must use s ventilator for breathing. Possibility for own breath in C3.  Dependent for activities of daily living. Can verbalize and direct care, but needs assistance with bowel and bladder care.

- C4: increased control of neck flexion, extension, rotation, scapula elevation, and inspiration. May need ventilator, but most are weaned from machines and to their own breath.  Can be verbally direct, and do most activities of daily living (ADL's), but needs assistance with bowel and bladder care.

- C5: A person diagnosed with this condition will have elbow flexion and supination. As well as, increased shoulder control, which includes shoulder flexion abduction, and extension. This individual is able to breath on their own, and verbally direct care for bathing, dressing and uneven transfers. Although, needs management with bowel and bladder.

- C6: This condition is characterized as increased strength, and control of upper extremities. As well as, radial wrist extension. This patient would have increased independence with ADL's. In addition, this individual needs adaptive equipment with bowel and bladder care. Lastly, increased participation in upper extremities with gross motor movement.

- C7- C8:  The key muscle actions include radial and ulnar wrist extension, elbow extension, partial finger extension, and thumb abduction. There is a partial finger flex with C8.  In addition, this individual is very independent with ADL's with adaptive equipment. This includes, feeding, grooming, bathing, and upper body dressing. Lastly, this individual is able to drive with hand controls, and increased participation in a variety of active recreation  activities.

- T1-T7: The key muscle actions include upper extremity muscle function intact, and some trunk control and stability. This individual is has modified ADL's, as well as bowel and bladder management. This individual uses a mobility chair. As well as, greater participation in all recreation activities with or without adaptive equipment.

- T8 - L1: This individual's key muscle actions include improved trunk flexion, extension, and rotation. This individual has modified ADL's, help with bowel and bladder management. This diagnosis also includes power and efficiency in propelling wheelchair.

- L2- S5: This individual has partial to full control of lower extremities as hips flexors, knee extenders, ankle dorsiflexors and plantar flexors return with each level of SCI. In addition, this individual has increased potential for standing, and with leg and ankle bracing.

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The American Spinal Injury Association developed a scale called the ASIA Impairment Scale. It includes A,B,C,D, and E.

- A: Refers to no motor or sensory functioning below the injury level.
- B: Has sensory but no motor function below injury level.
- C: Has motor function below injury level and 0-2 muscle grade.
- D: has motor functioning below injury level and 3 or more muscle grade.
- E: previous motor and/or sensory deficit, but now exhibits no deficits.

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- Autonomic dysreflexia

- Pressure ulcer

- Respiratory complications: such as pneumonia.

- spasticity or spastic hypertonia: the interruption of messages to the reflex center of the brain, which may result in overcompensation of the spinal cord reflex system and lead to spasticity.

- temperature regulations: Caused by the brains inability to send normal temperature sensations to the brain.

- Heterotopic assification: the growth of a new bone in soft tissue area.

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- tetraplegia: Paralysis caused by illness or injury that result in the partial or total loss of use of all four limbs and torso.

- paraplegia: Partial or complete paralysis of the lower half of the body with  involvement of both legs that is usually due to injury or disease of the spinal cord

- complete spinal cord injury: injury that results in complete and total loss of function below the point of injury

- incomplete spinal cord injury: some feeling or movement is still evident below the point of injury

- autonomic dysreflexia: condition when your involuntary nervous system overreacts to an external stimuli, or a faulty response  to a stimuli. This is a life threatening rise in blood pressure.

- pressure ulcer: injuries to the skin and underlying tissue that are caused by prolonged pressure on the skin.

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pressure ulcer: injuries to the skin and underlying tissue that are caused by prolonged pressure on the skin.

incontinence:  Any accidental or involuntary loss of urine from the bladders

delirium: acute brain dysfunction

dementia: Condition characterized by loss of memory functioning, and deterioration of adapting functions.

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Alzheimer's Disease is characterized by an inability to carry out everyday tasks or perform activities of daily living.

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The onset of Alzheimer's Disease is usually in a person’s later life. The most common time is when a person reaches 85 years old or older. Although, there is early onset Alzheimer's Disease, which is when a person is diagnosed at the age of 65 years of age or after; but this type is more uncommon.

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1.     This happens to a person when plaques form in the brain. These plaques damage and destroy the brain cells.  This leads to progressive deterioration of higher cognitive functioning, specifically areas that involve as memory, problem solving, and thinking.

2.     Research suggests the effect of increased presents of Alzheimer's Disease.

3.     The APOE e4 lipoprotein of the genetic sequence is associated with a higher risk of developing Alzheimer's Disease

4.     Evidence for a genetic component from genetic testing and family history.

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1.     Complex attention: This includes being easily distracted by external events in the environment that obstructed the ability to function efficiently.

2.     Executive functioning: This refers to increased efforts for completing a multistage task, resuming a task, or making decisions and organizing

3.     Learning and memory: Individual has trouble with recalling information or keeping track of lists.

4.     Language: In the individual there is noticeable word finding difficulty and general terms are substituted for specific terms. They may not be able to name a family or friend that they know.

5.     Perceptual-motor ability: This individual can get lost easily. For mild cases this is with newer places, but with more serious cases and have problems doing spatial tasks.

6.     Social cognition: Individuals with mild cases would have changes in personality, behavior, and attitudes. As well as, less likely to be able to understand and read facial expressions of others.

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Lewy Body Neurocognitive Disorders (NCD)

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Lewy Body Neurocognitive Disorders (NCD)

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This condition develops as a gradual progression. It is likely to be fluctuating cognition with pronounced variations, and recurrent visual hallucinations.  As well as cognitive decline, rapid eye movement, sleeping disorders, and severe neuroleptic sensitivity.

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Lewy Body Neurocognitive Disorders (NCD) related diagnoses

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Lewy Body Neurocognitive Disorders (NCD) related diagnoses

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1. Parkinson's disease

2. Sleeping Disorders

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Recreational therapy approaches for individuals with Neurocognitive Disorders (NCD)

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Recreational therapy approaches for individuals with Neurocognitive Disorders (NCD)

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Recreational therapy approaches for an individual with NCD must promote well-being. The individual will benefit most from selecting an activity themselves. This will also help the client find a sense of personal expression. In addition, if a client's program is more personalized to them, it will encourage more active physical or social involvements.
When looking at TR approaches, you have to consider the individual. Those who have extroverted personalities would benefit more from social and creative experiences. Whereas, individuals who have introverted personalities would benefit more from cooking, reading, or gardening activities.

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How Neurocognitive Disorders (NCD) affect the family

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How Neurocognitive Disorders (NCD) affect the family

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When an individual is diagnosed with NCD, many factors can play a role in their relationships with their family.  The individual may forget their family member's birthdays, gathering, and even names. This can cause stress and sadness among the family.
likewise, mood disorders can often occur with phase two of NCD. The individuals personality and mood are different that they used to be. This can affect their family by, perhaps the individual with NCD may show more aggression than before or less outgoing attitude that they used to. Both of these changes can cause the individuals family to become more distant.
lastly, an individual diagnosed with NCD may lose the ability to preform activities of daily living by themselves. This may cause stress on the family if they need to help the individual, or if they worry about the individual.

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PTSD is when an Individual develops characteristic symptoms after exposure to one or more traumatic events.

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Possible causes of Post Traumatic Stress Disorder (PTSD)

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Possible causes of Post Traumatic Stress Disorder (PTSD)

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There are many different events that can cause PTSD. This diagnosis varies greatly among different individuals. The individual may have experienced, witnessed, or was involved in the traumatic event.
Some examples include:
- Rape
- Abuse (emotional, physical, sexual)
- natural disaster
- being in a war zone
- exposure to terrorist attack.

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An individual diagnosed with PTSD may have a different mood that they did previous to their experience. Also, their ability to cope effectively with current stressful events; although many people without PTSD wouldn't become stressed in these situations.

In addition, a person's social functioning could be affected after have been diagnosed with PTSD. PTSD affects the individual by making them feel lonely and detached from others.

lastly, a person diagnosed with PTSD may have cognitive difficulties such as poor concentration, and focus. PTSD can affect brain structures such as the limbic system.

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- agoraphobia
- obsessive-compulsive disorder
- social phobias
- specific phobias
- major depressive disorder
- major anxiety disorder
- somatization disorders
- substance related disorders

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Five categories of symptoms for Schizophrenia

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Five categories of symptoms for Schizophrenia

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Delusions: These are beliefs that a patient will not change, even though they are contracted by evidence in the current situation. There are a few types of delusions. these include:
- Persecution: belief that someone or something intends to harm them
- Referential: client believes that a certain gesture or cue are directed at them.
- Grandiose: inaccurately believes that she/he has exceptional abilities.
- Erotomanic: incorrect beliefs that someone is in love with them
- Nihilistic: refer to a client believing in impending destruction.
- Somatic: inaccurate beliefs about health.

Hallucinations: To a client, this symptom is a vivid perception of something that is occurring in real life, even though nothing in the environment is causing these perceptions and no other person can see them.

Disordered thinking and speech: These two symptoms directly relate to each other. An indication of your thought process is shown through speech. To be considered disordered speech, the speech must be enough substantially impair communication. speech is unorganized, and consistently and randomly switching between topics. Likewise, memory deficits, delayed recall, difficultly accessing vocabulary, difficulty or inability to plan, impairments when organizing information, and lastly, having problems solving one or more tasks.

Motor Behavior: this is diagnosed when the behavior interferes with activities of daily life or other goal-oriented behaviors. Catatonia is included in this symptom. This is when behaviors include resistance to instruction, rigid or bizarre postures, and lack of response.

Negative Symptoms: These symptoms are called negative symptoms because they are diagnosed when a patient seems to be missing something.
These could be:
- diminished emotional expression/ flattened affect
- few or lack of emphatic facial expressions
-  lack of intonation in speech
- lack of eye contact
- few physical movement while communicating

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Schizophrenia can affect many areas of functioning in a individual. these include: cognitive, emotional, and social functioning.

cognitive functioning: delusional and disordered speech and thinking classify under cognitive functioning. Likewise, auditory or visual hallucinations also affect cognitive functioning. Lastly, a person with Schizophrenia will often experience impairments in receiving, processing, and initiating conversation.

Emotional functioning: Negative symptoms involve blunted or flattened affect. Also, a person diagnosed with Schizophrenia may have the inability to experience pleasure.

social functioning: Negative symptoms affect the person's ability to empathize with others. This affects the basis for social interactions, and also affects social communications.

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hallucination: an experience involving an apparent perception of something that isn't present in the real world.

delusion: A belief or impression that is firmly maintained despite being contradicted by evidence

psychosis: A condition where thoughts and emotions are so impaired that contact is lost with external reality.

anhedonia: inability to experience pleasure

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This is a pervasive disorder; and when triggers by situational factors act upon the individual, they respond much more severe that expected with such triggers.

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Major Depressive Disorder (MDD) symptoms

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Major Depressive Disorder (MDD) symptoms

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An individual would be diagnosed in they showed the following symptoms that significantly impair functioning for at least two weeks:

- Depressed mood most of the day, nearly every day

- Diminished interest or pleasure in most or all of the activities nearly every day

- Significant unintentional increase or decrease in weight or appetite

- Lack of sleep or excessively sleeping every day

- Psycho motor changes noticed by others, this is agitation or sluggishness almost every day

- Fatigue or loss of energy almost every day

- Feeling of guilt or worthlessness almost every day

- Diminished cognitive abilities nearly every day

- Reoccurring thoughts of death

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A person who is diagnosed with MDD can be affected in significant diminished quality-of-life, loss of work productivity, and cognitive and emotional impairments.

Symptoms of MDD have the potential to negatively impact all different kinds of relationships. As well as alter one’s perception of existing social support. In addition MDD can also disrupt daily activities through symptoms of amotivation, lethargy, and low self-efficacy.

lastly basic self-care is neglected and weight gain or weight loss may be a result.

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MDD frequently occurs with many physical and mental health conditions. These may include chronic pain, illness, disability, and cardiovascular disorders all due to chronic MDD.  As well as, other secondary conditions that occurs frequently with MDD which are anxiety, substance abuse, eating disorders, dementia, and personal disorders.

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It is characterized by excessive and uncontrollable worrying about every day things for more days than not, for a period of at least six months.

The anxiety may manifest and physical symptoms which often include muscle tension, sweating, nausea, gastrointestinal problems, jumpiness, fidgeting, trembling, and ability to relax, being easily startled, trouble sleeping and feeling on edge. The sources of worry can vary from patient to patient, but often include issues of financials, jobs, responsibilities, and relationships in the person’s life.

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GAD affects mental functions of a patient which include mood, cognition, and social functioning. Cognition refers to trouble concentrating, difficulty learning new information and behaviors, misperception of events and situations, poor short-term memory, and difficulty with abstract thinking.

In addition, GAD also affects various systems within the body that influence a patient’s emotional state; and anxiety can affect the patient is motor functioning. This may be shakiness, restlessness, headaches, and the gastrointestinal system.

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ADHD is a neurodevelopment disorder that interferes with social and academic/ occupational functioning or development.

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There is no clearly identified cause, but there are potential factors. ADHD is a neurological basis with heredity having a strong influence in most cases. There is also environmental exposure which leads to high lead concentration in the blood, brain injury, prenatal exposure to tobacco and alcohol, low birth weight or difficulties during pregnancy are potential risk factors.
There are also psychological factors, which include past traumatic events, temperament, and societal demands of behaving a certain way.

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The patient has a decreased cognitive processing ability related to insufficient attention span, and impulsivity.

Also, there are impairments to the Central nervous system, which may cause activity limitation, participation restrictions, difficulty engaging in schoolwork, leisure, and interpersonal relationships.
Lastly, emotional health may also be affected with patients who are diagnosed with ADHD. These individuals have increased cases of depression and anxiety. As well as increased interpersonal problems that may be a direct result of an organic problem, or an indirect result of societal’s negative reactions towards the clients impaired social skills.

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Emotional Impairments:
Emotional difficulties include anger, aggression, frustration, reduce empathy, decreased arousal to stimulation, and emotion dysregulation, which can be affected with a person diagnosed with ADHD. In addition, clients diagnosed with ADHD have a difficulty monitoring and suppressing emotional reactions. As well as, they tend to show more extreme emotional reactions compared to their peers. This can make it seem that patients with ADHD are impulsive and creates a poor self-esteem, depression, poor self perception, a distorted self image, and anxiety for the patient.

Social Impairments:
Patients with ADHD have difficulty using observation to learn social skills, and because of this many individuals have impaired social skills. Also, the lack of number and quality of peer social interactions affects their social development. There are a few reasons why patients with ADHD have difficulty learning positive social skills:

1. ADHD affects their ability to understand knowledge of what a positive social skill is.

2. People in the patient’s life fail to provide extra practice and feedback that is needed to effectively learn social skills as a child.

3. Lack of self control interferes with performing a social skill behavior.

4. Difficulty with transitions can make a positive interaction in a social situation more challenging.

5. Patients have already learned other inappropriate behaviors that are now ingrained.

6. Misunderstanding of other social cues can affect social impairments.

Physical Activity Deficits:
A patient diagnosed with ADHD can have perceptual motor deficits and general coordination deficits. This can make it more difficult to participate in sports and other high-level physical activities. These can also increase the risk of injuries, hospital admissions, and emergency room visits.

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Recreational therapy interventions for ADHD

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Recreational therapy interventions for ADHD

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Behavioral parent training:
This usually consists of an 8 to 12 week formal training program for the parents of children who are diagnosed as ADHD. The parents learn through discussion, coaching, and role-play how to alter, influence, and change their children’s behavior through behavior modification.

Behavioral classroom management:
Findings indicate that prudent negative consequences are superior to contingent praise alone. Likewise, brief time out works better than long ones and consequences are more effective than rewards. Providing these techniques with consistency is key.

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ODD is described as an externalizing disorder. This disorders is characterized by outward-directed behaviors, like aggressiveness, noncompliance, over activity, and impulsivity; a defiant, disobedient, and hostile behavior.

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ODD may be a combination of inherited and environmental factors. These include:

1. child’s natural disposition

2. limitations or developmental delays in the child’s ability to process their thoughts and feelings

3.  An imbalance of specific brain chemicals, like a decrease in serotonin

4. lack of supervision from authority figure

5. Inconsistent and harsh discipline

6. Abuse or neglect of a child

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Recreational therapy interventions for ODD

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Recreational therapy interventions for ODD

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Functional skill Development:
This can include changing the patients distorted thinking patterns, which can be referred to decreasing delinquent and antisocial behavior. This intervention also includes improvement of communication, which is important to facilitate the basic social skills and interpersonal relationship activities.

Education, Training, and Counseling:
This intervention includes basic social skills that refers to when a patient learns how to initiate and develop healthy relationships with other people. As well as interpersonal relationship activities, which means recreation and leisure activities that are developed for interpersonal interactions and relationships. Lastly, the patient can improve their anger management through opportunities to vent feelings of anger with relaxation techniques, journaling, structured recreational sports, and other activities.

Community Integration: Community integration refers to recreation and leisure activities that are engaging in a non-competitive form. These are expressive and cooperative recreational program, such as arts, crafts, and cultural festivals offered by the community. This gives the client an opportunity to express themselves, to explore others differences, and tolerate others in a social setting.

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anorexia nervosa: Refusal to maintain body weight at or above a minimally normal weight for height, body type, age, and activity level.

bulimia nervosa: episodes of eating large quantities of food in short periods of time, commonly in secret, without feeling hunger or fullness, and loss of control. After these episodes, some form of purging or compensatory behavior to make up for the excessive calories taken in.

binge-eating disorder: Frequent episodes of eating large quantities of food in short periods of time in secret. When this happens, the individual disregards the feelings of hunger or fullness. There is no purging after these episodes.

Pica: The continuous eating of nonfood or nonutritive substances that is developmentally inappropriate and is not supported by any particular cultural or social practice.

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Eating disorders are influences by both genetics and environmental factors.
Genetics: Eating disorders tend to run in families.

Biological issues: Serotonin may influence eating behaviors. Restricting food intake, bingeing, and purging has been shown to alter brain structures and will continue those behaviors.

Psychological or interpersonal issues:  Eating disorders may develop as a search for control, coping with stress or trauma, personality factors, family issues, low self-esteem, feelings of inadequacy.

social/societal issues: Today's culture often promotes and reinforces a desire for thinness. Peer pressure, and opinions of peers have influenced this.  The unrealistic idea of thinness can cause the development of eating disorder.

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Social issues: Eating disorders impact family units. Individuals are often withdrawn and socially isolated.

Cognitive issues: Individuals may show denial of illness, severe body images issue, perfectionism, and challenges with the need for control.

Emotional issues: These may include anxiety, depression, decreased self-esteem and self worth.

Physical issues: These individuals may experience dehydration, low blood pressure, osteoporosis, stomach and digestive complications.

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Severe medical issues: including cardiac arrhythmia, cardiac arrest, brain damage, osteoporosis, infertility, and death.
Pregnancy risks:  risk of premature labor, low- birth weights, cardiac irregularities, stillbirth or fetal death.
Medical conditions: bone loss, difficulties with body temp regulations, loss of menstrual period, low heart rate, low blood pressure, anxiety, depression, social isolation, and perfectionism.

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Some causes of substance related disorders

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Some causes of substance related disorders

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Familial, social, or cultural factors: Problems of substance-abuse abuse and more likely to occur when a person‘s family social or cultural network tolerates and approve these type of behaviors. This generally shifts from family environment to friends during adolescence and early adulthood.

Personality factors: Individuals experiencing depression, high stress levels, challenges in self regulated behaviors, and poor coping skills are more likely to develop substance abuse problems.

Cognitive factors: substance produces a positive fact that reinforces the continued cycle or increased usage of substance abuse.

Genetic factors: and individual with a parent who has developed substance abuse disorder is that a greater risk for developing it themselves, even if social factors are controlled.

Biological factors: Dopamine and serotonin affect the reward pathway of the brain; substance abuse can artificially influence the functioning of these two neurotransmitters to the extent where it becomes difficult for the reward system of the brain to stimulate these naturally.

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Systems affected by substance related disorders

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Systems affected by substance related disorders

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Mental health concerns for an individual will include anxiety, depression, loss of motivation, anger camera your ability, and agitation.

Personal health includes injuries, illnesses, hyperactivity of the atomic nervous system, and physical damage to the body.

Cognitive health may be affected by displaying confusion, learning problems, and memory loss

health problems may include poor impulse control, poor judgment, poor sleep quality and insomnia.

Lifestyle issues could result in financial instability, unemployment, homelessness, traffic accidents, food in security, poor nutritional intake and conflict with the law.

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Secondary problems of substance related disorders

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Secondary problems of substance related disorders

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Concurrent disorders or dual diagnosis: Research shows that substance abuse commonly occurs with mental illness. This correlation does not improve over time. The individual may experience higher rates of unemployment, relationship difficulties, social anxiety, poverty, homelessness, social marginalization, and conflict with the law.

Disorders associated with substance abuse:

Anxiety disorders, attention deficit hyperactivity disorder, mood disorders, experience delusions and hallucinations, and personality disorders.

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what happens in the brain when a CVA (stroke) occurs

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what happens in the brain when a CVA (stroke) occurs

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When a bloodless saw that carries oxygen and nutrients to the brain ruptures or is blocked by a clot. After this happens, some parts of the brain to not receive the oxygen they require. Due to this lack of oxygen the brain cells, and part of this brain will die. This causes neurological impairments.

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The acronym, F.A.S.T., if to help individuals remember the sudden signs and symptoms of a stroke.

F stands for face drooping. This is when one side of the persons face is numb or droops.

A stands for our weekends. This is when one arm is numb or week and. A person cannot raise both arms without having one of them drift.

S stands for speech. The person is experiencing slurred speech or unable to speak.

T stands for time to call 911. If any of the signs are showing, you must get this person to a hospital.

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When the brain has a stroke on one side or the other, different aspects about the individual are affected.

Left CVA: right hemiplegia, language deficits, slow and caution behavior styles.

Right CVA: left hemiplegia, visual deficits, quick and impulsive behavior style

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Vascular system is the foundations for the causes of  a stroke.

1.  A blood clot develops in the brain and blocks blood flow. This is called a thrombosis.

2. A blood clot originated it’s somewhere in the vascular system and travel to the brain. Then becomes lodged and blocks blood. This is called embolism.

3.  A blood vessel or rupture, which causes bleeding in the brain. This is called a hemorrhage and is causes by weakened blood vessels and increased blood pressure

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A stroke can affect an individual’s motor, sensory, cognitive, language, and visual functioning.

Motor impairments may include hemiplegia, motor planning, muscle power, muscle tone, reflexes, balance, gait, apraxia, and coordination.

Sensory impairments refer to decreased sensory awareness, numbness, tingling, astereognosis, agraphia, and processing problems

Cognitive impairments are when an individual shows decreases in consciousness functions, calculation abilities, attention, concentration, problem-solving, organizing, perception, orientation, planning, and time management

Language impairments may include aspects such as dysphasia in comprehension, reading, and writing, and a decrease in expression and reception of language

Visual impairments refers to a double vision, depth perception problems, and field cuts.

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Some secondary problems associated with stroke

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Some secondary problems associated with stroke

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Inactivity may result from a lack of mobility, poor coping mechanism, loss of function, and barriers to recreation and leisure choice.

In addition, individuals who are experiencing post stroke symptoms may include a decrease in independence and participation, lost mobility, loss of ability to perform activities of daily living, and increased number of and severity of falls

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A Trumatic brain injury is a form of acquired brain injury that occurs from a direct trauma to the brain. It may be caused by a blow or joints to the head, or a penetrating injury, such as a gunshot wound that causes damage to the brain.

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They are classified as a mild, moderate, severe depending on the extent of damage to the brain.

Mild brain injuries occur when an impact or forceful motion of the head result in a brief alteration of mental status, such as confusion or disorientation, loss of memory for events immediately before and after the injury, or brief loss of consciousness.

Moderate brain injuries include loss of consciousness, along with persistent confusion and functional impairments in one or more of the cognitive, physical, emotional, or behavioral domains, with a GCS score of 8-12.

Severe Traumatic brain injury is when a prolonged unconscious state or coma with a GCS score less than eight

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The primary system affected is the structure of the brain.

There are physical changes which include impairments such as weakness, muscle tone, coordination problems, full or partial paralysis, balance difficulties, and fatigue.

There are cognitive changes that include impairments in arousal and attention, memory, problem-solving, organizing planning, time management, judgment, and abstract reasoning.

Emotional and behavioral changes include difficulty with social skills, such as an ability to emphasize with others or poor pragmatics, disinhibited behavior, and other emotional-behavioral issues.

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Some secondary problems associated with TBI

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Some secondary problems associated with TBI

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Secondary problems of traumatic brain injury include several that cause further damage to the brain structure.

Anoxic injury: an injury that results from an absence of oxygen to the brain.

hypoxic injury:  an injury that results from a decrease of oxygen to the brain.

Cranial nerve dysfunction: injury to one of the cranial nerves because impairments and taste, Smell, visual, auditory, or vestibular function.

Edema:swelling an excess fluid in the brain.

Hematomas: a collection or pooling of blood that can increase pressure in the brain.

hydrocephalus: vestibular enlargement that occurs when cerebral spinal fluid accumulates in the brain. This results in dilation of the cerebral ventricles and increases an internal pressure.

Seizures: post to medic seizures, recurrent seizures, and epilepsy are known to be complications of a Traumatic brain injury