Ch 16: Pediatrics And Adolescents Flashcards
What percent of public school aged children (55M) present with disabling conditions that require special ed services under IDEA?
13% or 6.5M
IDEA
Individuals with disabilities education act
Federal education mandate requiring public schools to provide a free appropriate public education through the use of special ed supports and services to children with eligible disabilities
Section 504 of Rehabilitation Act of 1973
Classroom accommodations
Federal law designed to protect the rights of individuals with disabilities in programs and activities that receive fed financial assistance from the US Dept of Education
What is the leading cause of death and acquired disability in children and adolescents in the US?
TBI
What are the two age groups most at risk for TBI?
Children ages 0-4 and adolescents ages 15-19
Incidence of approximately 738 per 100,000 children ages 0-15
How many ER visits for TBI are for children ages 0-14?
500,000
Of the age group 0-4, what are most ER visits for?
Falls
**However, young children are relatively susceptible to abusive head trauma (AHT) or shaken baby syndrome (SBS)
What are the 3 leading causes of head injury in teens 15-19?
- Being struck by or against something (concussion)
- Falls
- MVA
What are the factors that affect pediatric brain injury outcomes?
- Age at the time of the injury
- Developmental state of the brain at time of injury
- Nature and extent of the injury
What is the prognosis for acquiring new skills after brain injury based on age?
Worse the younger the child is at the time of injury
Why is the prognosis for new skill acquisition worse the younger the child is?
Injury interferes with the establishment of an adequate platform or foundation upon which to build new learning processes and more complex skills
Why might it take longer for the effects of brain injury to be seen in younger children?
Their brains are still developing and less is expected of them at younger ages.
*this phenomenon may be misinterpreted later in their learning careers, causing them to be mislabeled as other types of learning disabilities, behavior, or emotional problems.
Brain maturation: birth to 5y/o
Most brain maturation occurs during this time
Injury during this time may be the most devastating time for injury to occur
Brain maturation: 3-5 y/o
Period of rapid overall brain growth
All regions of the brain (ie: EF, visuospatial somatic, and visuoauditory functions) show signs of synchronous development.
Maturation of Sensory motor regions peak at age 6
Brain maturation: 8-10 y/o
Motor system maturation and accelerated frontal executive system development
Begin to perform formal operations and perceive new meaning in familiar objects
Brain maturation: 14-15 y/o
Able to review formal operations, recognize flaws, and create new ones
Brain maturation: 17-19 y/o
Extensive maturation of prefrontal cortex (ie: executive functions)
What percent of head trauma related deaths in infants/children less than 2 y/o are a result of abuse?
50-80%
57% under the age of 1
Risk factors associated with SBS/AHT
- Male vs female
- Infants with excessive crying from birth to 4 months of age
- Toddlers presenting with temper tantrums Or toilet training problems
Caregivers:
- males vs female (56% father, 16% bf, 15% mother, 5% babysitter, 9% other)
- younger age, unrealistic parenting expectations, mental health issues, domestic violence, and substance abuse
Which gender is at greater risk for SBS?
Males
What are the underlying developmental aspects that make infants more vulnerable to severe TBI?
Underdeveloped brain
Large head
Weak neck muscles
What are the three key identifiers for shaken baby syndrome/abusive head trauma?
Bleeding of the brain (subdural hemorrhage)
Brain swelling (cerebral edema)
Bleeding in eyes (retinal hemorrhage)
What percent of SBS victims present with retinal bleeding?
85%
What percent of SBS survivors have a long term disability?
ie: learning disability, seizures, behavior problems, blindness,deafness, CP
70-85%
**Only 15% have no disability
What percent of SBS survivors will not be able to live independently?
40%
What percent of children die from SBS?
15-30%
What percent of teenagers and adults didn’t realize that shaking a baby could be dangerous?
25-50%
Individual health care plan
guideline to assist with managing a child’s medical concerns and to handle emergency situations via a designated action plan
