Which of the following behaviors observed by the nurse will be important to disclose to the teacher of a child with a stereotypic movement disorder?
1. An episode of self-mutilation
2. Depression that results from feelings of inadequacy
3. Tendency to be hypoactive
4. Flexibility and ability to contribute to learning
1
Rationale: Some children with a spectrum disorder have many associated behavioral problems such as hyperactivity, aggressiveness, self-injurious behaviors such as head banging, and temper tantrums. This is important and relevant to discuss with the child's teacher who is a member of the treatment team. Problems with socialization and communication difficulties are also common, evidenced by deficits in spontaneous, imaginative play. Stereotypic movement disorder involves repetitive nonfunctional motor behavior (i.e., hand waving, self-biting, body rocking, or head banging) that interferes with normal activity or risks self-inflicted bodily injury. The behavior lasts 4 weeks or longer. These behaviors are seemingly driven and protective measures are usually needed so that medical treatment will not be necessary. These children will have difficulty adapting to change, so they will have great difficulty, if able at all, to be flexible or contribute to their learning. The child's tendency would be toward hyperactivity rather than hypoactivity.
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