Ch 16: Pediatrics And Adolescents

Question 1

What percent of public school aged children (55M) present with disabling conditions that require special ed services under IDEA?

Answer 1

13% or 6.5M

Question 2

IDEA

Answer 2

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

Question 3

Section 504 of Rehabilitation Act of 1973

Answer 3

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

Question 4

What is the leading cause of death and acquired disability in children and adolescents in the US?

Answer 4

TBI

Question 5

What are the two age groups most at risk for TBI?

Answer 5

Children ages 0-4 and adolescents ages 15-19

Incidence of approximately 738 per 100,000 children ages 0-15

Question 6

How many ER visits for TBI are for children ages 0-14?

Answer 6

500,000

Question 7

Of the age group 0-4, what are most ER visits for?

Answer 7

Falls

**However, young children are relatively susceptible to abusive head trauma (AHT) or shaken baby syndrome (SBS)

Question 8

What are the 3 leading causes of head injury in teens 15-19?

Answer 8

1. Being struck by or against something (concussion)
2. Falls
3. MVA

Question 9

What are the factors for pediatric brain injury outcomes?

Answer 9

1. Age at the time of the injury
2. Developmental state of the brain at time of injury
3. Nature and extent of the injury

Question 10

Why is the prognosis for functional recovery of a previously learned skill, better the younger the child is?

Answer 10

Neuroplasticity

Question 11

Why is the prognosis for new skill acquisition worse the younger the child is?

Answer 11

Injury interferes with the establishment of an adequate platform or foundation upon which to build new learning processes and more complex skills

Question 12

Why might it take longer for the effects of brain injury to be seen in younger children?

Answer 12

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.

Question 13

Brain maturation: birth to 5y/o

Answer 13

Most brain maturation occurs during this time

Injury during this time may be the most devastating time for injury to occur

Question 14

Brain maturation: 3-5 y/o

Answer 14

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

Question 15

Brain maturation: 8-10 y/o

Answer 15

Motor system maturation and accelerated frontal executive system development

Begin to perform formal operations and perceive new meaning in familiar objects

Question 16

Brain maturation: 14-15 y/o

Answer 16

Able to review formal operations, recognize flaws, and create new ones

Question 17

Brain maturation: 17-19 y/o

Answer 17

Extensive maturation of prefrontal cortex (ie: executive functions)

Question 18

What percent of head trauma related deaths in infants/children less than 2 y/o are a result of abuse?

Answer 18

50-80%

57% under the age of 1

Question 19

Risk factors associated with SBS/AHT

Answer 19

• 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

Question 20

Which gender is at greater risk for SBS?

Answer 20

Males

Question 21

What are the underlying developmental aspects that make infants more vulnerable to severe TBI?

Answer 21

Underdeveloped brain

Large head

Weak neck muscles

Question 22

What are the three key identifiers for SBS?

Answer 22

Bleeding of the brain (SDH)

Brain swelling (cerebral edema)

Bleeding in eyes (retinal hemorrhage)

Question 23

What percent of SBS victims present with retinal bleeding?

Answer 23

85%

Question 24

What percent of SBS survivors have a long term disability?

ie: learning disability, seizures, behavior problems, blindness,deafness, CP

Answer 24

70-85%

**Only 15% have no disability

Question 25

What percent of SBS survivors will not be able to live independently?

Answer 25

40%

Question 26

What percent of children die from SBS?

Answer 26

15-30%

Question 27

What percent of teenagers and adults didn’t realize that shaking a baby could be dangerous?

Answer 27

25-50%