Chapter 34: Caring for the Special Needs Child Flashcards
Children with special health-care needs
They are defined as those who have or are at risk for a chronic physical, developmental, behavioral, or emotional conditions beyond needs generally required for children. Children who have a terminal illness or otherwise dying also require additional care.
Stages of development that may be affected
Infants may fail to develop a sense of trust or attachment due to the multiple caregivers for Parental detachment.
Toddler may experience difficulty developing autonomy because of dependency on others
Preschool may not develop a sense of initiative because of limited opportunities for socialization. Magical thinking may make them feel guilty
School-age child may fail to develop a sense of industry because of decreased opportunity.
Adolescents may fail to have a sense of personal identity because of their lack of skills and abilities and the feeling of being different
Vulnerable child syndrome
Clinical state in which the parents reactions to serious illness or event in the child’s past continue to have long-term psychologically harmful effects on the child and parents for many years. Risk factors include preterm birth, congenital anomaly comment Jandus, handicapping condition, an accident or illness that the child is not expected to recover from, Crying or feeding problems in the first five years of life. Parent has difficulty separating from the child, the child senses anxiety and develops symptoms that reinforce the parent fears. Parents may fear disciplining the child as they do not want to upset child. Parents seek healthcare for their child very frequently sometimes for unwarranted concerns
The premature infant
They often display the following medical or developmental problems: chronic lung disease, cardiac changes such as right ventricular hypertrophy and pulmonary artery hypertension, growth retardation, poor feeding, anemia, nutrient deficiencies, apnea, GERD, bradycardia, SIDS, Rickets, hydrocephalus, inguinal or umbilical hernias, retinopathy, decreased visual acuity, hearing deficits, delayed dentition, gross motor, fine motor, and language delay, sensory integration issues
Long-term they are higher risk of developing cognitive disabilities, difficulties with socialization, vulnerable child syndrome, cerebral palsy, attention deficit disorder.
Give immunizations according to chronological age. They should receive the flu vaccine after six months. RSV prophylaxis is critical for premature infants.
Use the corrected age for growth and development until the child is three years old. All their formula or breast milk is often fortified with additional calcium & phosphorus.
Always referrer if they failed to meet a developmental delay so they can be evaluated.
Failure to thrive
Inadequate growth in infants and children. The child fails to demonstrate appropriate weight gain over a prolonged period of time. This most often seen in premature infants. Adequate nutrition is critical for brain growth in the first two years of life. Developmental disability may contribute to failure to thrive because of sensory or motor delays.
Organic causes include inability to suck or swallow, malabsorption, diarrhea, vomiting, alterations in metabolism and caloric nutrient needs associated with chronic illnesses. Kids with cardiac metabolic disease, chronic lung disease, cleft palate, or GERD are at risk.
Inorganic causes include neglect, abuse, behavioral problems, lack of maternal interaction, poor feeding technique, lack of parental knowledge, parental mental illness. Children live in poverty are at risk.
During screening, children may have a history of developmental delays or have loss of aquired milestones. Performing detailed diet history and obtain a three day food diary. Assess parent child interaction. Observe feeding.
May require hospitalizations and enteral tube feeding.
Education of the special needs
Government-funded care for special education for children up to three years of age. From age 3 to 21 services are provided within the public school systems. Each child is entitled to an individualized educational program/IEP.
The least restrictive environment is preferred. They should participate in classes containing age-appropriate typical peers whenever possible.
Transition from adolescence to adult
By age 14 ensure that the IEP reflect post high school plans. By age 17 explore healthcare financing for young adults. Initiate guardianship procedures if appropriate. Notify the team that all rights transferred to him or her at the age of majority. Determine if the child is available for SSI. If attending college contact the college campuses student disability program. Age 21 ensure that they have registered with the division of developmental disabilities for adult services.
Prior to moving to adult care make sure they understand the treatment rationale, symptoms of a worsening condition, and the danger signs. Teach them when to seek help. Provide a detailed written plan to the care Coordinator.
