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43 Cards in this Set
- Front
- Back
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define developmental disabilities |
-group of severe chronic conditions manifested during the development period, cause is typically unknown -these conditions are attributable to an impairment in physical, cognitive, speech or loaguage, psychological or self care issues |
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percentage of us kids with developmental disabilities? |
17% of kids <18yo have some form of developmental or behaviorial disability
approx 2% have a serious one |
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define early intervention |
-coordinated, community based. multidisciplinary, services for children with delays or at risk for delays -IDEA part C birth to 3, part b 3-5 (early childhood special ed) |
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who must states provide servics for |
children experiencing developmental delays children with established mental and physical risk conditions
services may be prorvided to indiv at risk of exper a dev delay |
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what are the 5 domains states must est a def of disability for |
motor communication cognitive daily living socio-emotional
note: def vary by state |
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why would pediatricians not refer for EI? |
-believe est diag is important associa w/ dec referral for speech delay and those parents who express concern for non-TD |
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benefits of Ei |
-gives best chance of reaching full potential -provides support and edu for fam -helps monitor for 2* problems |
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Early intervention is a federally mandated program. T/F |
true |
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ages covered by EI |
-birth to 36 mo -develop delays |
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components of IDEA part C for EI |
-indiv family service plan (IFSP) -child find system, public awareness -service provided in families natural or the least restrictive environment |
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eligibility criteria for EI in maine |
-est condition (prematurity) -delay in one or more of hte areas of development - child has questionable quality of developmental skills (clinical judgement) -PHYSICIAN DIAGNOSIS NOT NEEDED |
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what is included in "est condition"? |
-medical diag -child abuse/neglect -in utero exposures -reg disorders -high led levels |
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who refers for early intervention |
physicians, parents, parent educator, child protective servuces |
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what is the agency for the EI hotline? |
national earluy childhood technical assistance center |
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what occurs at initial EI visit? |
-intake -developmental evaluation -eligibility if determined -if eligible develop IFSP -receipt of services (services must start) within 45 days of signing consent |
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what is in an IFSP? |
-present level of development -family resources, priorities and concerns -ways to enhance child's development -outcome expectations -specific services to be provided -date to start and stop/re-eval -name of service coordinator |
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how is an EI coordinator choosed? |
-professionally choosed based on child's > area of need - persons: PT, OT social worker, educator, SLP, psychologist and nurse |
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define cerebral palsy |
a non-progressive neurological condition that changes over the life span b/c the impact of the condition on the person changes with age -may occur in utero or shortly after birth -produces motor and possibly sensory deficits noticable in infancy -impaired control and coordination of voluntary muscles -characterized by MOVEMENT DYSFUCTION |
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where are deficits seen in CP? |
- one or more limbs and freq the trunk -cog delays 50-75% -speech delay 25% -auditory impairment 25% (involving auditory processing) -seizure disorders 25-35% -vision problems 40-50% |
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secondary problems associated with CP |
social and family issues; sleep and eating problems; pain - in a sm child refer to parents; difficulties with self care |
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cp can be classified by |
-body area affected (extent of palsy) -according to movement abnormality -severity (being replaced by GMFCS) |
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CP classified by movement abnormaility |
-spastic (dipelgia 41.5%; hemipelgia 36.4%; quadrapelgia 7.3%) -ataxic 5% (cerebellar lesion) -athetoid -hypotonic -typically there is a mixture of movement abnormailites |
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hypotonic CP |
smallest group; lesion is often not identified; dec resting tone; dec ability to generate vol muscle force |
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atheloid (dykinesis) CP |
characterized by fluctuating tone, seen in tongue; due to damage of BG; cognition is typically spared |
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Level 1 GMFCS 6-12yo |
walks w/out restrictions, limitations in more advanced gross motor skill; diag can be missed due to mildness of impairment |
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Level 2 GMFCS 6-12yo |
walks w/out assistive device; limitations walking outdoors and in community |
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Level 3 GMFCS 6-12yo |
walks with assisstive mobility device; limitations walking outdoors and in the community. |
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Level 4 GMFCS 6-12yo |
self mobility limitations; children are transported or use power mobility out of doors; typically do not walk more than they would need to to get into Jazzy |
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Level 5 GMFCS 6-12yo |
self mobility is severly limited even with use of technology; child must be picked up and placed in chair, may or may not be able to use joystick |
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children can move btwn levels, so level only is pertinent at time of the review |
a reverse walker can help a child move from a level three to 2, helps with extensor muscle development |
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types of neuropathic lesions identified with CP |
neuropathy dies to subepnedymal hemmorage (IVH) -encephalopathy caused by anocia or hypoxia (HIE) -PVL |
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CP causes |
-half cases are in full term infants -coagulation disorders -intrauterine exposure to infectionor inflamation (neonatal encephalopathy) STORCH -preterm birth, up to 33% CP (half dipelgia, quarter hemipelgia, 5% quad) -intercrainal hemmorhage in pre-term babies |
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CP incidence |
2.5/1000 1950s 1.5/1000 1955-1970 2.5/1000 1970 2/1000 currently, maybe due to our awesomeness at saving premies dec birth weight (?) strongly linked to CP |
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1* prevention for CP |
-improve prenatal health of at risk mothers -maternal edu (folic acid) -pre-natal obstetric care for mom -inc safety and inc use of c-section over risky delivery procedures (forceps for breach presentation) |
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refer to pediatrician or neurologist w/ info from what tests? |
AIMS TIMP pretchel's GMA (most accurate) |
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cautions w/ CP diagnosis |
-seeming resolves in many low birth weight infants (only 55% of cases diag at age 2 were deemed to have CP at age 5) -diag when child does not reach motor milestones and exhibits abnormal movement patterns such as assymetry -should be diagnosed in all but the mildest cases by 6mo |
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onset and integration for suck swallow |
o 28wk gest i 2-5 mo |
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onset and integration for rooting |
o 28 wk gest i 3 mo
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onset and integration for flexor withdrawl |
28 wk gest i= 1-2 mo
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onset and integration for moro |
o = 28wk i = 4-6 mo |
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onset and integration for positive support |
o = 35 wk gest i = 1-2 mo
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onset and integration for ATNR |
o = birth i = 4-6 mo
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onset and integration for palmar grasp |
o = birth i = 9mo |
