Sierra and Dan married when Wendy was 5 1/2, and, in general, this has been a good thing for the family. With more money from month to month, some of the stressors have been removed, and life is much different for Sierra and Wendy in that regard. However, at age seven, Wendy continues to demonstrate behavior that is hard for Dan and Sierra to understand: she is often distant and then seems, out of nowhere, to throw a tantrum for reasons that are hard to identify in spite of the medication she is on.
Sierra had taken Wendy to a child psychiatrist when Wendy was 4, almost out of desperation. The psychiatrist prescribed medication for Wendy, and Sierra began giving her Risperdal. This seemed to calm Wendy most of the time, and Sierra did not give it much thought. Some relief was all she was looking for at the time, and she trusted the psychiatrist. It wasn't until Wendy started having her episodes again that the psychiatrist increased the dosage of the medication, a process that took place 3 times. By age 5, Wendy was taking what seemed to be a significant amount of the drug. Sierra started to notice that Wendy developed tremors in her hands, and Sierra worried that there was more wrong with Wendy than she thought. She continued to give Wendy her medication at the urging of her psychiatrist who also ordered some additional tests.
Now at age 7, Wendy has a hard time feeding herself because her tremors are so intense. Sierra is beside herself with fear and worry. What could be causing such terrible symptoms in her little girl? She and Dan did not know what to do or where to turn.
* Describe developmental milestones for a typically-developing 7 year old. Based on what you know about Wendy this week and in the last post, how atypical is her development?
* Is the drug Risperdal approved for use in children? How is it that a child psychiatrist is able to use this drug? What diagnosis would support the use of this particular medication?
* What are the known effects of the drug Risperdal including those that are not the primary/desired effects?
1. Describe developmental milestones for a typically-developing 7 year old. Based on what you know about Wendy this week and in the last post, how atypical is her development?
ReplyDeleteA typical seven year old should physically have better hand-eye coordination. Most children this age can bike, swim, and play other sports depending on how often they practice. They should also be able to do somersaults at this age. On the cognitive level, seven year old have a vocabulary of thousands of words. They begin to understand that letters represent the sounds that form words. Seven year olds use more complex strategies to solve problems and start to reason more to make a decision. They gain an understanding of the difference between right and wrong. At this age, children have a longer attention span and are very curious about the world around them as one can tell with their copious amounts of questions. Typically, seven year olds can tell time, understand how to use rulers to measure things, have a strong number sense, understand how to estimate, and can do addition and subtraction problems. Socially and emotionally most seven year olds enjoy having friends and understand how to treat others with respect. They like to play games with rules and understand how to wait their turn in a game. At this age, they can follow less detailed directions and tend to be more independent from their parents. Many seven year olds can shower on their own, prepare their own breakfast, pack their backpack, and help out around the house (chores). They also tend to complain more and also avoid or withdraw from adults around this age and enjoy hanging out with their friends. Seven year olds should be able to be separated from their parents without additional stress or problems. Usually children at this age want to be perfect and may be more self-critical as they develop more self-awareness. They tend to worry more and begin to feel guilt and shame.
Although the post this week did not really describe Wendy’s physical development or cognitive development, it did convey some information about her social and emotional development. According to the post, Wendy is typically distant, possibly a sign of independence or it could also indicate her need of social isolation, which is unusual in a seven year old. Wendy also throws tantrums, which is unusual for a child at this age as they should be able to control their emotions by now. However, Wendy may be under a lot of stress and her tantrums could be a way to release her tension. In addition, Wendy’s tremors are very atypical for a seven year old. At this age, children can shower on their own, make their own lunch, and can definitely eat without assistance. But Wendy is having difficulties eating independently because of her tremors, which clearly is not typical of a seven year old. Wendy should see a professional to look at her tremors to make sure they do not weaken crucial motor skills or affect other future developmental milestones.
References:
Destefanis, J. & Firchow, N. (n.d.). Developmental milestones: Your 7-year-old-child. Great
Schools. Retrieved from http://www.greatschools.org/special-education/
health/731-developmental-milestones-your-7-year-old-child.gs
Henry, S. (n.d.). Developmental milestone: Separation and independence. Baby Center.
Retrieved on http://www.babycenter.com/302_7-years-old_3657631.bc
PBS Parents. (2012). Child development tracker. PBS Parents. Retrieved from
http://www.pbs.org/parents/childdevelopmenttracker/seven/index.html
2. Is the drug Risperdal approved for use in children? How is it that a child psychiatrist is able to use this drug? What diagnosis would support the use of this particular medication?
ReplyDeleteThe FDA has approved the use of Risperdal to treat schizophrenia and bipolar disorder in children ages thirteen to seventeen. This drug has also been approved to treat irritability in children with autism for ages five to sixteen. The drug is normally prescribed for the use in adults with schizophrenia. Child psychiatrists can use this drug because the FDA asked Risperdal’s company to study the effect of Risperdal in kids and teens and found that the drug was safe to use. Both schizophrenia and bipolar disorder support the use of Risperdal as researchers have found that patients typically experienced fewer symptoms, such as fewer hallucinations in schizophrenia and lower levels of hyperactivity in bipolar disorder. Today, child psychiatrists are also prescribing the drug as a psychiatric drug to treat children with symptoms of ADHD, behavioral problems, and children with Aspergers and autism disorders.
References:
Paddock, C. (2007). FDA approves antipsychotic Risperdal for adolescents and children. Retrieved from http://www.medicalnewstoday.com/articles/80443.php
Risperdal for Aspergers Syndrome. Lawrence Weathers, PhD. Psychologist. Retrieved
from http://www.adhdhelp.org/Risperdal.htm
http://www.adhdhelp.org/Risperdal.htm
3. What are the known effects of the drug Risperdal including those that are not the primary/desired effects?
ReplyDeleteBy changing specific natural brain substances, Risperdal is an antipsychotic drug used to treat schizophrenia, mania, and bi polar disorder in both adults and children age 10 and up. Risperdal may be prescribed to children with autism ages 5-16 to help manage some behavior problems.
Risperdal has many side effects that may potentially cause many issues, both major and minor. Common side effects while taking this medication are somnolence, increased appetite, fatigue, rhinitis, upper respiratory tract infection, vomiting, coughing, urinary incontinence, increased saliva, constipation, fever, muscle stiffness, abdominal pain, nausea, dizziness, dry mouth, rash, and indigestion.
Other, more serious side effects can be life changing and possibly fatal. The first is Neuroleptic Malignant Syndrome, a life-threatening neurological disorder developed in response to anti-psychotic drugs. Although NMS commonly develops in the first few weeks it may occur at any time while taking the medication. A second dangerous risk to taking Risperdal is called Tardive Dyskinesia, or involuntary, repetitive and purposeless body movements. This may be a permanent side effect even after discontinuing the medication. Risperdal may also raise prolactin and blood sugar levels. The raise in these levels can lead to risk hyperprolactinemia and diabetes, especially in families with a history of these conditions. Individuals with seizure disorders or have experienced a past seizure may want to use this drug cautiously, as there is an increased risk for seizures.
References:
Janssen Pharmaceuticals, Inc. (2010). Risperdal: FAQs about Schizophrenia.
Risperdal.com. Retrieved from http://www.risperdal.com/
National Institute of Neurological Disorders and Stroke. (2007). NINDS:
Neuroleptic Malignant Syndrome information page. National Institutes of Health.
Retrieved from
http://www.ninds.nih.gov/disorders/neuroleptic_syndrome/neuroleptic_syndrome.htm
National Institute of Neurological Disorders and Stroke. (2007). NINDS:
Tardive Dyskinesia information page. National Institutes of Health.
Retrieved from http://www.ninds.nih.gov/disorders/tardive/tardive.htm
U.S. National Library of Medicine. (2011). Risperidone. PubMed Health. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000944/
DECISION POINT ::: Do Dan and Sierra continue to give Wendy Risperdal?
ReplyDeleteWendy has been showing very serious side affects for the past two years. As her dosage has been increased, so have the tremors. Dan and Sierra should stop giving Wendy the Risperdal. It would be very irresponsible to continue a young child, who has already developed serious and likely permanent symptoms, on a powerful drug, especially with such an elevated dosage. They should look into other options available, and possibly a new psychiatrist for a fresh opinion.