Child With an Intellectual or Developmental Disability | Chapter 54 – Maternal-Child Nursing (6th)

This chapter offers an in-depth exploration of the nursing care required for children with intellectual and developmental disabilities, emphasizing the nurse’s role as an advocate, educator, and clinical coordinator. It begins by establishing a foundational understanding of genetic influences, distinguishing between an individual's genotype and their observable phenotype, and explains how mutations can lead to various cognitive or physical impairments. The text highlights the importance of using terms like mental age and functional age rather than relying solely on intelligence quotient scores to assess a child's understanding and coping abilities. Nursing care is framed within the context of public policy, such as the Americans with Disabilities Act and the Individuals with Disabilities Education Act, which mandate personalized support like Individualized Education Plans to help children succeed in school. The discussion covers major genetic conditions, including Down Syndrome (Trisomy 21), noting its characteristic physical markers and the high risk for comorbid conditions like cardiac defects and atlantoaxial instability. It further examines Fragile X Syndrome as a common inherited cause of cognitive impairment and Rett Syndrome, a condition primarily affecting females that involves a regression in motor and social skills. Environmental impacts are addressed through Fetal Alcohol Spectrum Disorder, which requires specific nutritional and behavioral interventions, and Failure to Thrive, which is explored as a complex interplay of physical and psychosocial factors. A significant portion of the chapter is dedicated to Autism Spectrum Disorder, detailing the essential nursing focus on maintaining strict routines, managing sensory sensitivities, and implementing safety protocols to prevent wandering or self-injury. Throughout, the chapter underscores that successful management involves a multidisciplinary approach focused on early intervention, family support during the grieving process, and the promotion of maximal independence for the child across their lifespan.


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