44. Developmental Delay and Disability Flashcards
Why is disability increasing globally?
What are some barriers that may affect children with disabilites and their families?
Define the following: impairment, disability, handicap.
Partly due to population ageing and increases in chronic health conditions, less access to health care services for people with disabilites.
Inadequate legislation, policies and services, negative attitudes, lack of accessible environments. Lack of timely, appropriate intervention, support and protection at an early stage. Poor access to culturally appropriate clinical and diagnostic services.
Impairment: loss/abnormality of psychological, physiological or anatomical structure or function e.g. paralysis of legs.
Disability: restriction/lack of ability to perform an activity in the manner or within the range considered normal e.g inability to walk.
Handicap: impact of the impairment/disability on the person’s pursuit/acheivement of the goals which are desired or expected by society e.g. unable to work in a job that requires mobility.
These terms tend not to be used - drive to provide a unified and standard language to describe health(related) states.
What are the 2 parts to the ICF classification of health and health-related domains (relating to disability)?
Why might a child present?
What are some developmental trajectories, and their interpretations?
Part 1: Functioning and Disability: (a) impairements of body functions/structures, (b) activities and participation. Part 2: Contextual Factors: (c) environmental factors, (d) personal factors. But this terminology is not used in the UK.
Screening programmes, routine reviews, parental concerns, concerns of others. Problems often complex and multiple.
Normal (linear), plateau (e.g. autism), delay (increases but a lot slower than normal), progressive disorder, episodic (e.g. metabolic disorders).
Why are children suspected of disability assessed?
What are some implications for a family of having a child with a disability?
What comes next after noticing facial features of Downs sydrome at birth?
Need to know what is normal to identify a child who is ‘slow’ or has abnormal signs, not always precise diagnosis or cure, assess to identify need and enable support.
Grief (loss of normal child, normal parenting role, anticipated independent adult), stigma, financial, fear, use of the terms slow/delayed may suggest that children will catch up, understanding/use of term disability, affects all family, lots to learn.
Telling parents, confirming diagnosis, establishing whether other medical problems, supporting parents, providing information, referring on for follow up. Tell both parents with a senior staff in privacy, warm + caring + honest manner, written info and follow up arranged.
What stages of grief might the parents feel?
What diagnostic tests are carried out?
When the parents are ‘re-assessed’ at 2 months, what do you need to think about? What 3 types of early support should be considered?
Shock, disbelief, revulsion, rejection, over-protection, grief, loss, anger (at God, health professionals, child), guilt, embarassment, stigma, fear (unknown, financial), seek multiple opinions, chronic sorrow and depression, ACCEPTANCE.
Chromosome analysis, microarray, cardiac assessment, hearing and vision test, speech and language assessment.
What do parents understand and main concerns, information provision, assessment of child’s needs, multi-disciplinary and multi-agency input, early support: Portage (home visiting educational service for pre-school kids with additonal support needs and their families), early support programme (central government mechanism for improving quality, consistency and coordination of family-focussed services for young disables children and their familes e.g. short breaks, holiday play schemes, care at home, aids), key worker (oversee and manage delivery of services from all agencies - single point of contact).
