Block 5- Week 4: Childhood disability Flashcards
Define Childhood disabilty
Depends which model is used:
- Medical
- Social
- Interactional/ Integrated
- Disability results from interactions of an individuals impairments & conditions with the context of which they live (physical, social & attitudinal barriers)
How can we measure disability?
- ICD10/DSM: Some impairments & Conditions
- Medical Model
-
Concept of Limiting Long Standing Illness/ Disability (UK Census & Equality Act)
- Social Model
- International Classification of Functioning: Children & Youth (ICF-CY)
What is the UK Equality Act (2010) definition of disabilty?
Aperson is disabled if they have a physical or mental impairment or condition that has a substantial & long term effect on their ability to carry out normal day-to-day activities
How many children have a disabilty in the UK?
8%
Why is the prevelance arising in relation to autism & ADHD?
- ADHD: Associated w/ recognition & diagnostic
- Autism: Increased awareness, new administrative classifications & diagnostic processes
What is the cause of childhood disabilty?
Most impairments & conditions result from social & genetic factors coming together in complex ways, often across generations
What are the risk factors assoicated w/ childhood disabilty?
- Pregnancyoutcomes(BW/Prem)
- Age
- Sex
- Ethnicity
- SE disadvantage
- Parental behaviours
- Communicablediseases
- Unintentional injuries
Which & why are Pregnancy outcomes a risk Factor?
Low BW –> Cerebral Palsy
Prem Babies:
- Extreme prem (22-26wks) greater risk of poor health outcomes & neurodevelopment disability
- EPICure 1 & 2 Studies- more are suriviving disabilty free
What are the Sex risk factors?
Which sex is disabilty higher? Then why does it level out?
Prevalence higher in boys in early years
By late teens girls similar to boys
Associated w/ genetic differences, under identification in girls due to diagnostic characteristics
What are the Ethinic Risk Factors?
What needs to be controlled? When this has been which groups were found to be at risk?
Who is there a lower identification rate amongst?
What are the exceptions?
Limited evidence for association
Need to control for SE status
- Studies controlling ^ have found increased risk for disability among children of mixed ethnicity & African/Caribbean origin only
7-15yrs identification rates lower in BME
- Higher rates of less severe intellectual disability among Gypsy/ Roma & Traveller children of Irish heritage
- More severe forms of interlectual disability in Pakistani/ Bangladeshi
Why is SE disadvantage a risk factor?
Prevalence increases down SE ladder
Children in low SES households more exposed to social & environmental risk factors in prenatal & early childhood
What are the risk factors assoicated w/ parental behaviour?
Why do parents often behave this why?
- Parental smoking, particularly maternal, associated w/ low BW, preterm birth & autism
- Alcohol consumption associated w/ Growth (before&afterbirth), Educational Outcomes & FAS
- Unsupportive &Understimulating linked w/ Intellectual disability & Conduct disorders
Poor parental behaviours associated w/ poor personal & household resources
What other risk factors for childhood disabilty?
- Communicable Diseases
- MMR
- Unintentional Injury:
- Increases with age
- Poorer households at greatest risk
- Intentional injury
What are the primary prevention stratergies?
Why are they sometimes contentious?
Can be associated w/ devaluing the lives of those children who live with disabilty
- Reduce SE disadvantage
- Improve material environment
- Reduce exposure to environmental hazards
- Reduced exposure to parental & other sources of environmental tobacco
- Safe Alcohol consumption in pregnancy
- Adequate dietary intake of key nutrients including folic acid, vitamins & minerals
- Immunisation
What are the secondary Preventions?
- Screening programmes:
- Antental, Newborn, Hearing, Childhood vision
- Development Assessment- Healthy Child programme
- Contact with other services (non health)
