Developmentally Appropriate Practices Flashcards
Identify some of the infections that can cause intellectual disabilities in babies and young children.
Congenital cytomegalovirus (CMV) is passed to fetuses from mothers, who may be asymptomatic. About 90% of newborns are also asymptomatic; 5% to 10% of these have later problems. Of the 10% born with symptoms, 90% will have later neurological abnormalities, including intellectual disabilities. Congenital rubella, or German measles, is also passed to fetuses from unvaccinated and exposed mothers, causing neurological damage including blindness or other eye disorders, deafness, heart defects, and intellectual disabilities. Congenital toxoplasmosis is passed to fetuses by infected mothers, who can be asymptomatic, with a parasite from raw or undercooked meat that causes intellectual disabilities, vision or hearing loss, and other conditions. Encephalitis is brain inflammation caused by infection, most often viral. Meningitis is inflammation of the meninges, or membranes, covering the brain and is caused by viral or bacterial infection; the bacterial form is more serious. Both encephalitis and meningitis can cause intellectual disabilities. Maternal human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) can be passed to fetuses, destroying immunity to infections, which can cause intellectual disabilities. Maternal listeriosis, a bacterial infection from contaminated food, animals, soil, or water, can cause meningitis and intellectual disabilities in surviving fetuses and infants.
Identify some environmental, nutritional, and metabolic influences that can cause intellectual disabilities in babies and young children.
Environmental deprivation syndrome results when developing children are deprived of necessary environmental elements-physical, including adequate nourishment (malnutrition); climate or temperature control (extremes of heat or cold); hygiene, like changing and bathing; and so on. It also includes lack of adequate cognitive stimulation, which can stunt a child’s intellectual development, and neglect in general. Malnutrition results from starvation; vitamin, mineral, or nutrient deficiency; deficiencies in digesting or absorbing foods; and some other medical conditions. Environmental radiation, depending on dosage and time of exposure, can cause intellectual disabilities. Congenital hypothyroidism (underactive thyroid) can cause intellectual disabilities, as can hypoglycemia (low blood sugar) from inadequately controlled diabetes or occurring independently and infant hyperbilirubinemia. Bilirubin, a waste product of old red blood cells, is found in bile made by the liver and is normally removed by the liver; excessive bilirubin buildup in babies can cause intellectual disabilities. Reye syndrome, caused by aspirin given children with flu or chicken pox, or following these viruses or other upper respiratory infections, or from unknown causes, produces sudden liver and brain damage and can result in intellectual disabilities.
Describe some genetic abnormalities and syndromes affecting the nervous system that cause intellectual disabilities in babies and young children.
Rett syndrome is a nervous system disorder causing developmental regression, particularly severe in expressive language and hand function. It is associated with a defective protein gene on an X chromosome. Having two X chromosomes, females with the defect on one of them can survive; with only one X chromosome, males are either miscarried, !,tillborn, or die early in infancy. Rett syndrome produces many symptoms, including intellectual disabilities. Tay-Sachs disease, an autosomal recessive disorder, is a nervous system disease caused by a defective gene on chromosome 15 resulting in a missing protein for breaking down gangliosides, chemicals in nerve tissues that build up in cells, particularly brain neurons, causing damage. Tay-Sachs is more prevalent in Ashkenazi Jews. The adult form is rare; the infantile form is commonest, with nerve damage starting in utero. Many symptoms, including intellectual disabilities, appear at 3 to 6 months and death occurs by 4 to S years. Tuberous sclerosis, caused by genetic mutations, produces tumors damaging the kidneys, heart, skin, brain, and central nervous system. Symptoms include intellectual disabilities, seizures, and developmental delays.
Describe some of the general characteristics of infants and young children with intellectual disabilities.
Newborns with intellectual disabilities, especially of greater severity, may not demonstrate normal reflexes, such as rooting and sucking reflexes, necessary for nursing. They may not show other temporary infant reflexes such as the Moro, Babinski, swimming, stepping, or labyrinthine reflexes, or they may demonstrate weaker versions of some of these. In some babies, these reflexes will exist but persist past the age when they normally disappear. Babies with intellectual disabilities are likely to display developmental milestones at later-than-typical ages. The ages when they do display milestones vary according to the severity of the disability and by individual. Young children with intellectual disabilities are likely to walk, self-feed, and speak later than normally developing children. Those who learn to read and write do so at later ages. Children with mild intellectual disabilities may lack curiosity and have quiet demeanors; those with profound intellectual disabilities are likely to remain infantile in abilities and behaviors throughout life. Intellectually disabled children will score below normal on standardized IQ tests and adaptive behavior rating scales.
Describe some genetic or inherited metabolic disorders that cause intellectual disabilities in babies and young children.
Adrenoleukodystrophy is an X-linked genetic trait. Some female carriers have mild forms, but it affects more males more seriously. It impairs metabolism of very long-chain fatty acids, which build up in the nervous system (as well as adrenal glands and male testes). The childhood cerebral form, manifesting at ages 4 to 8, causes seizures, visual and hearing impairments, receptive aphasia, dysgraphia, dysphagia, intellectual disabilities, and other effects. Galactosemia is an inability to process galactose, a simple sugar in lactose, or milk sugar. By-product buildup damages the liver, kidneys, eyes, and brain. Hunter syndrome, Hurler syndrome, and Sanfilippo syndrome each cause the lack of different enzymes; all cause an inability to process mucopolysaccharides or glycosaminoglycans (long sugar-molecule chains). Hurler and Sanfilippo (but not Hunter) syndromes are autosomal recessive traits, meaning both parents must pass on the defect. All cause progressive intellectual disabilities. Lesch-Nyhan syndrome, affecting males, is a metabolic deficiency in processing purines. It causes hemiplegia, varying degrees of intellectual disabilities, and self-injurious behaviors. Phenylketonuria (PKU), an autosomal recessive trait, causes lack of the enzyme to process dietary phenylalanine, resulting in intellectual disabilities.
Identify some prescription drugs, substances of abuse, social drugs, and diseases in pregnant mothers that can cause intellectual disabilities in developing fetuses and newborn infants.
Warfarin, a prescription anticoagulant drug to thin the blood and prevent excessive clotting, can cause microcephaly (undersized head) and intellectual disabilities in an infant when the mother has taken it during pregnancy. The prescription antiseizure drug Trimethadione can cause developmental delays in babies when it has been taken by pregnant mothers. Maternal abuse of solvent chemicals during pregnancy can also cause microcephaly and intellectual disabilities. Maternal crack cocaine abuse during pregnancy can cause severe and profound intellectual disabilities and many other developmental defects in fetuses, which become evident when they are newborns. Maternal alcohol abuse can cause fetal alcohol syndrome, which often includes intellectual disabilities, among many other symptoms. Maternal rubella (German measles) virus can cause intellectual disabilities as well as visual and hearing impairments and heart defects. Maternal herpes simplex virus can cause microcephaly, intellectual disabilities, and microophthalmia (small or no eyes). The varicella (chicken pox) virus in pregnant mothers can also cause intellectual disabilities as well as muscle atrophy in babies.
Identify some variables having the potential to cause learning disabilities (LDs) in young children.
LDs are basically neurological disorders. Though they are more specific to particular areas of learning than global disorders like intellectual disabilities, scientific research has found correlations between LDs and many of the same factors that cause intellectual disabilities, including prenatal influences like excessive alcohol or other drug consumption, diseases, and so on. Once babies are born, glandular disorders, brain injuries, exposure to secondhand smoke or other toxins, infections of the central nervous system, physical trauma, or malnutrition can cause neurological damage resulting in LDs. Hypoxia and anoxia (oxygen loss) before, during, or after birth is a cause, as are radiation and chemotherapy. These same influences often cause behavioral disorders as well as LDs. Another factor is genetic: Both LDs and behavior disorders have been observed to run in families. While research has not yet identified specific genetic factors, heritability does appear to be a component in influencing learning and behavioral disorders.
Identify several types of neurological damage that have been found in children with learning disabilities (LDs) and attention deficit hyperactivity (ADHD) disorder.
Various neurological research studies have revealed that children diagnosed with LDs and ADHD have at least one of several kinds of structural damage to their brains. Scientists have found smaller numbers of cells in certain important regions of the brains of some children with learning and behavioral disorders. Some of these children are found to have brain cells of smaller than normal size. In some cases, dysplasia is discovered; that is, some brain cells migrate into the wrong area of the brain. In some children with learning and behavioral disorders, blood flow is found to be lower than normal to certain regions in the brain. Also, the brain cells of some children with learning and behavioral disabilities show lower levels of glucose metabolism; glucose (blood sugar) is the brain’s main source of fuel, so inadequate utilization of glucose can affect the brain’s ability to perform some functions related to cognitive processing, as in LDs, and to attention and impulse control, as in ADHD.
Name and describe the attachment styles identified in toddlers by Mary Ainsworth. Explain how certain attachment styles can be indicative or predictive of emotional disturbance.
Mary Ainsworth worked with John Bowlby, discovering the first empirical evidence supporting his attachment theory. From her Strange Situation experiments, she identified secure, insecure and avoidant, insecure and resistant, and insecure and disorganized attachment styles. Securely attached children show normal separation anxiety when mother leaves and happiness when she returns, avoid strangers when alone but are friendly with mother present, and use mother as a safe base for environmental exploring. Insecure and resistant children show exaggerated separation anxiety, ambivalence and resistance to mother upon reuniting, fear strangers, cry more, and explore less than secure or avoidant babies. Insecure and avoidant children show no separation anxiety or stranger anxiety and little interest on reunions with mother and are comforted equally by mother or strangers. Insecure and disorganized types seem dazed and confused, respond inconsistently, and may mix resistant and ambivalent and avoidant behaviors. Secure styles are associated with sensitive, responsive caregiving and children’s positive self-images and other images, resistant and ambivalent styles with inconsistent caregiving, and avoidant with unresponsive caregivers. Avoidant, resistant, and disorganized styles, associated with negative self-images and low self-esteem, are most predictive of emotional disturbances.
Identify some emotional disturbances in young children classified as anxiety disorders and some of their symptoms.
Anxiety disorders include generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), posttraumatic stress disorder
(PTSD), panic disorder, social phobia, and specific phobias. All share a common characteristic of overwhelming, irrational, and unrealistic fears. GAD involves excessive worrying about anything or everything and free-floating anxiety. Anxiety may be about real issues but is nonetheless exaggerated and spreads, overtaking the child’s life. OCD involves obsessive and preoccupied thoughts and compulsive or irresistible actions, including often bizarre rituals. Germ phobia, constant hand washing, repeatedly checking whether tasks are done or undone, and collecting things excessively are common. PTSD follows traumatic experiences/ events. Children have frequent, extreme nightmares, crying, flashbacks wherein they vividly perceive or believe they are experiencing the traumatic event again, insomnia, depression, anxiety, and social withdrawal. Symptoms of panic disorder are panic attacks involving extreme fear and physical symptoms like a racing heart, cold hands and feet, pallor, hyperventilation, and feeling unable to move. Children with social phobia develop fear and avoidance of day care, preschool, or other social settings. Specific phobias are associated with specific objects, animals, or persons and are often triggered by traumatic experiences involving these.
Identify some different types of learning disabilities (LDs ), and describe some of their respective characteristics.
Dyslexia, the most common LD, means deficiency or inability in reading. It primarily affects reading but can also interfere with writing and speaking. Characteristics include reversing letters and words, for example, confusing b and din reading and writing; reading won as now, confusing similar speech sounds like /p/ and /b/, and perceiving spaces between words in the wrong places when reading. Dyscalculia is difficulty doing mathematical calculations; it can also affect using money and telling time. Dysgraphia means difficulties specifically with writing, including omitting words in writing sentences or leaving sentences unfinished, difficulty putting one’s thoughts into writing, and poor handwriting. Central auditory processing disorder causes difficulty perceiving small differences in words despite normal hearing acuity; for example, couch and chair may be perceived as cow and hair. Background noise and information overloads exacerbate the effects. Visual processing disorders affect visual perception despite normal visual acuity, causing difficulty finding information in printed text or from maps, charts, pictures, graphs, and so on; synthesizing information from various sources into one place; and remembering directions to locations.
Identify some factors that can contribute to emotional disturbances in young children.
Researchers have investigated emotional disturbances but have not yet established known causes for any. Some disturbances, for example the major mental illness schizophrenia, seem to run in families and hence include a genetic component; childhood schizophrenia exists as a specific diagnosis. Factors contributing to emotional disturbances can be biological or environmental but more often are likely a combination of both. Dysfunctional family dynamics can often contribute to child emotional disorders. Physical and psychological stressors on children can also contribute to the development of emotional problems. Some people have attributed emotional disturbances to diet, and scientists have also researched this but have not discovered proof of cause and effect. Bipolar disorder is often successfully treated with the chemical lithium, which affects sodium flow through nerve cells, so chemical imbalance may be implicated as an etiology. Pediatric bipolar disorder, which has different symptoms than adult bipolar disorder, correlates highly with histories of bipolar and other mood disorders or alcoholism in both parents.
Describe some of the symptoms of pediatric bipolar disorder.
Bipolar, formerly called manic-depressive disorder, has similar depressive symptoms in children as adults. However, children’s mood swings often occur much faster, and children show more symptoms of anger and irritability than other adult manic symptoms. Bipolar children’s most common symptoms include frequent mood swings; extreme irritability; protracted (up to several hours) tantrums or rages; separation anxiety; oppositional behavior; hyperactivity, impulsivity, and distractibility; restlessness and fidgetiness; silly, giddy, or goofy behavior; aggression; racing thoughts; grandiose beliefs or behaviors; risk-taking; depressed moods; lethargy; low self-esteem; social anxiety; hypersensitivity to environmental or emotional triggers; carbohydrate (sugar or starch) cravings; and trouble getting up in the morning. Other common symptoms include bed-wetting (especially in boys), night terrors, pressured or fast speech, obsessive or compulsive behaviors, motor and vocal tics, excessive daydreaming, poor short-term memory, poor organization, learning disabilities, morbid fascinations, hypersexuality, bossiness and manipulative behavior, lying, property destruction, paranoia, hallucinations, delusions, and suicidal ideations. Less common symptoms include migraines, bingeing, self-injurious behaviors, and animal cruelty.
Identify some of the contributing factors to and characteristics of the emotional disturbance known as conduct disorder in children.
Factors contributing to conduct disorders in children include genetic predispositions, neurological damage, child abuse, and other traumatic experiences. Children with conduct disorders display characteristic emotional and behavioral patterns. These include aggression: They bully or intimidate others, often start physical fights, will use dangerous objects as weapons, exhibit physical cruelty to animals or humans, and assault and steal from others. Deliberate property destruction is another characteristic-breaking things or setting fires. Young children are limited in some of these activities by their smaller size, lesser strength, and lack of access; however, they show the same types of behaviors against smaller, younger, weaker, or more vulnerable children and animals, along with oppositional and defiant behaviors against adults. Also, while truancy is impossible or unlikely in preschoolers, and running away from home is less likely, young children with conduct disorders are likely to demonstrate some forms of seriously violating rules, another symptom of this disorder.
Discuss some symptoms of childhood-onset schizophrenia and how they differ from other symptoms.
The incidence of childhood-onset schizophrenia is rare, but it does exist. One example of differential diagnosis involves distinguishing qualitatively between true auditory hallucinations and young children’s “hearing voices” otherwise: In the latter case, a child hears his or her own or a familiar adult’s voice in his or her head and does not seem upset by it, while in the former, a child may hear other voices, seemingly in his or her ears, and is frightened and confused by them. Tantrums, defiance, aggression, and other acting-out, externalized behaviors are less frequent in childhood-onset schizophrenia than internalized developmental differences, for example, isolation, shyness, awkwardness, fickleness, strange facial expressions, mistrust, paranoia, anxiety, and depression. Children demonstrate nonpsychotic symptoms earlier than psychotic ones. However, it is difficult to use prepsychotic symptoms as predictors due to variance among developmental peculiarities. While psychiatrists find the course of childhood-onset schizophrenia somewhat more variable than in adults, child symptoms resemble adult symptoms. Childhood-onset schizophrenia is typically chronic and severe, responds less to medication, and has a more guarded prognosis than adolescent- or adult-onset schizophrenia.
Describe some of the developmental characteristics of infants and young children with visual impairments (VI).
Historically, it was thought that VI children developed more slowly than normal; however, it is now known that ages for reaching developmental milestones are equally variable in VI babies as in others and that they acquire milestones within equal age ranges. One developmental difference is in sequence: VI children tend to utter their first words or subject-verb 2-word sentences earlier than other children. Some VI children also demonstrate higher levels of language development at younger-than-typical ages. For example, they may sing songs from memory or recall events from the past at earlier ages than other children. This is a logical development in children who must rely more on input to their hearing and other senses than to their vision when the latter is impaired. Totally blind babies reach for objects later, hence explore the environment later; hand use, eye-hand coordination, and gross and fine motor skills are delayed. Blind infants’ posture control develops normally (rolling, sitting, all-fours, and standing), but mobility (raising on arms, pulling up, and walking) are delayed.
Describe some factors related to diagnosing the emotional disturbances in children classified as psychotic disorders.
Psychosis is a general psychiatric category referring to thought disturbances or disorders. The most common symptoms are delusions that is, believing things that are not true, and hallucinations, that is, seeing, hearing, feeling, tasting, or smelling things that are not there. While early childhood psychosis is rarer than at later ages, psychiatrists confirm it does occur. Moreover, prognosis is poorer for psychosis with onset in early childhood than in adolescence or adulthood. Causes can be from known metabolic or brain disorders or unknown. Younger children are more vulnerable to environmental stressors. Also, in young children, thoughts distorted by fantasy can be from normal cognitive immaturity, due to lack of experience and a larger range of normal functioning, or pathology; where they lie on this continuum must be determined by clinicians. Believing one is a superhero who can fly can be vivid imagination or delusional; having imaginary friends can be pretend play or hallucinatory. Other developmental disorders can also cloud differential diagnosis.
Identify some of the causes of visual impairments (VI) in babies and young children.
Syndrome-related and other malformations like cleft iris or lens dislocation causing VI can have prenatal origins. Cataracts clouding the eye’s lens can be congenital, traumatic, or due to maternal rubella. Eyes can be normal, but impairment in the brain’s visual cortex can cause VI. Infantile glaucoma, like adult glaucoma, causes intraocular fluid buildup pressure and VI. Conjunctivitis and other infections cause VI. Strabismus and nystagmus are ocular-muscle conditions, respectively causing eye misalignments and involuntary eye movements. Trauma damaging the eyeball(s) is another VI cause. The optic nerve can suffer from atrophy (dysfunction) or hypoplasia, that is, developmental regression, usually prenatally due to neurological trauma; acuity cannot be corrected. Refractive errors like nearsightedness, farsightedness, and astigmatism are correctable. Retinoblastoma, or behind-the-eye tumors, can cause blindness and fatality; surgical or chemotherapeutic treatment is usually required before age 2. Premature infants can have retinopathy of prematurity or retrolental fibroplasia. Cryotherapeutic treatment seems to stop disease progression. Its effects range from none to severe VI
(approximately 25% of children) to complete blindness.
Discuss some of the impacts of blindness upon the cognitive development of infants and young children.
Blind children have more difficulty determining and confirming characteristics of things, hence defining concepts and organizing them into more abstract levels; their problem-solving is active but harder, and they construct different realities than sighted children. Blind babies typically acquire object permanence (the understanding that unseen objects still exist) a year later than normal; they learn to reach for objects only by hearing. Understanding cause-and-effect relationships is difficult without visual evidence. Blind babies and toddlers take longer to understand and object’s constancy regardless of their orientation in space, affecting their ability to orient toys and their own hands. Blind children can identify object size differences and similarities, but classifying object differences and similarities in other attributes requires longer times and more exposures to various similar objects. Blind children’s development of the abilities to conserve object properties like material or substance, weight, amount and volume, length, and liquid volume is later than normal.
Describe some ways that blindness in babies and young children affects their emotional and social development, including self-concept, relationships, and self-help skills.
Blind babies and children are more dependent than others on adults, affecting development. With control of their inner realities but not of their outer environments, blind children may withdraw, seeking and responding less to social interaction. They may not readily develop concepts of the external world or self-concepts as beings separate from the world and the understanding that they can be both agents and recipients of actions relative to the environment. Mother-infant smiling initiates recognition, attachment, and communication in sighted babies; blind infants smile on hearing mother’s voice at 2 months. Only tactile stimuli like tickling and nuzzling evoke regular smiling in blind babies. Missing facial expressions and other visual cues, blind children have more complicated social interactions. They often do not understand the basics of playing with others and seem emotionally ambivalent or uninterested and uncommunicative. Peers may reject or avoid them; adults often overprotect them. Self-help skills like chewing, scooping, self-feeding, teeth brushing, grooming, and toilet training are delayed in blind children.
Identify some factors that can contribute to speech and language impairments in young children.
Some speech and language disorders in children have unknown causes. Others have known causes such as hearing loss: Speech and language are normally acquired primarily through the auditory sense, so children with impaired hearing have delayed and impaired development of speech and language. Brain injuries, neurological disorders, viral diseases, and some medications can also cause problems with developing language or speech. Children with intellectual disabilities are more likely to have delayed language development, and their speech is also more likely to develop more slowly and to be distorted. Cerebral palsy causes neuromuscular weakness and incoordination of speech. When severe, it can cause inability to produce recognizable speech sounds; some children without speech can still vocalize, and some cannot. A cleft palate or lip and other physical impairments affect speech. Inadequate speech-language modeling at home inhibits speech-language development. Vocal abuse in children (screaming, coughing, throat clearing, or excessive talking) can cause vocal nodules or polyps, causing voice disorders. Stuttering can be related to maturation, anxiety or stress, auditory feedback defects, or unknown causes.
Identify the prevalence and some etiologies of hearing impairments in babies and young children.
Half or more (50% to 60%) of infant hearing losses have genetic origins-Down and other genetically based syndromes or the existence of parental hearing loss. About 25% or more of infant hearing losses are caused by maternal infections during pregnancy, such as cytomegalovirus (CMV), postnatal complications like blood transfusions or infection with meningitis, or traumatic head injuries. Included in this 25% or more are babies having nongenetic neurological disorders or conditions that affect their hearing. Malformations of the ears, head, or face can cause hearing loss in babies. Babies spending 5 days or longer in neonatal intensive care units (NICUs) or having complications while in the NICU are also more likely to suffer hearing loss. Around 25% of babies are diagnosed with hearing loss whose etiology is unknown.
Describe some of the signs of hearing impairments in babies and young children.
If an infant does not display a startle response at loud noises, this is a potential sign of hearing loss. This can also indicate other developmental disabilities, but because hearing loss is the most prevalent disability among newborns, hearing screening is a priority. Between birth and 3 or 4 months old, babies should turn toward the source of a sound; if they do not, it could indicate hearing loss. A child who does not utter first words like “mama” or “dada” by age 1 could have hearing impairment. When babies or young children do not turn their heads when their names are called, adults may mistake this for inattention or ignoring; however, children turning upon seeing adults, but not upon hearing their names, can indicate hearing loss. Babies and children who seem to hear certain sounds but not others may have partial hearing losses. Delayed speech-language development or unclear speech, not following directions, saying “Huh?” often, and wanting higher TV or music volumes can indicate hearing loss in children.
Describe some of the characteristics of speech and language impairments in young children.
In speech, most phonological disorders are articulatory; that is, children fail to pronounce specific speech sounds or phonemes correctly beyond the normal developmental age for achieving accuracy. Stuttering, disfluency, and rate and rhythm disorders cause children to repeat phonemes, especially initial word sounds; to repeat words; to prolong vowels or consonants; or to block, that is, straining so hard to produce a sound that, pressure builds, but no sound issues. Their speech rates may also speed and slow irregularly. Children with voice disorders can have voices that sound hoarse, raspy, overly nasal, higher- or lower-pitched than normal, overly weak or strident, and whispery or harsh. Hoarseness is common with vocal nodules and polyps. Cleft palate commonly causes hypernasality. In language, one of the most common impairments is delayed language development due to environmental deprivation, intellectual disabilities, neurological damage or defects, hearing loss, visual impairment, and so on. Children with neurological damage or disorders may exhibit aphasias, language disorders characterized by receptive difficulty with understanding spoken or written language, or expressive difficulty constructing spoken or written language.
Identify some examples of physical and health impairments in babies and young children that cause disabling conditions.
In the special education field of early childhood education, other health impairment is a term referring to health and physical conditions that rob a child of strength, vitality, or alertness or that cause excessive alertness to environmental stimuli, all having the end result of impeding the child’s ability to attend or respond to the educational environment. Health problems can be acute, that is short-term or temporary but serious, or chronic, that is, long-term, persistent, or recurrent. Some examples of such health and physical impairments include: cerebral palsy, spina bifida, amputations or missing limbs, muscular dystrophy, cystic fibrosis, asthma, rheumatic fever, sickle-cell anemia, nephritis or kidney disease, leukemia, Tourette syndrome, hemophilia, diabetes, heart disease, AIDS, and lead poisoning. All these conditions and others can interfere with a child’s development and ability to attend and learn. In addition to seizure disorders, which often cause neurological damage, seizure-controlling medications also frequently cause drowsiness, interfering with attention and cognition. Attention deficit and attention deficit hyperactivity disorders (ADD and ADHD) limit attention span, focus, and concentration and thus are sometimes classified as health impairments requiring special education services.
Describe some of the characteristics of babies and children with physical and health impairments.
The characteristics of children having various physical or health impairments can range from having no limitations to severe limitations in their activities. Children with cerebral palsy, for example, usually have deficiencies in gross and fine motor development and deficits in speech-language development. Physical and health conditions causing severe debilitation in some children not only seriously limit their daily activities but also cause multiple primary disabilities and impair their intellectual functioning. Other children with physical or health impairments function at average, above-average, or gifted intellectual and academic levels. An important consideration when working with babies and young children having physical or health impairments is handling and positioning them physically. Correctly picking up, holding, carrying, giving assistance, and physically supporting younger children and arranging play materials for them based on their impairment is not only important for preventing injury, pain, and discomfort; it also enables them to receive instruction better and to manipulate materials and perform most efficiently. Preschoolers with physical impairments also tend to have difficulty with communication skills, so educators should give particular attention to facilitating and developing these.
Identify some factors that can lead to developmental delays in babies and young children.
Developmental delays can come from genetic or environmental causes or both. Infants and young children with intellectual disabilities are most likely to exhibit developmental delays. Their development generally proceeds similarly to that of normal children but at slower rates; milestones are manifested at later-than-typical ages. Sensory impairments such as with hearing and vision can also delay many aspects of children’s development. Children with physical and health impairments are likely to exhibit delays in their motor development and performance of physical activities. Another factor is environmental: Children deprived of adequate environmental stimulation commonly show delays in cognitive, speech-language, and emotional and social development. Children with autism spectrum disorders often have markedly delayed language and speech development; many are nonverbal. Autistic children also typically have impaired social development, caused by and inability or difficulty with understanding others’ emotional and social nonverbal communications. When they cannot interpret these, they do not know how to respond and also cannot imitate them; however, they can often learn these skills with special instruction.
Give the IDEA’s legal definition of traumatic brain injury (TBI). Identify some of the things that can cause traumatic brain injuries in babies and young children.
TB! is defined by the IDEA law (the Individuals with Disabilities Education Act) as “an acquired injury to the brain from external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affect a child’s educational performance.” This definition excludes injuries from birth trauma, congenital injuries, and degenerative conditions. TB! is the foremost cause of death and disability in children (and teens) in the USA. The most common causes of TB! in children include falls, motor vehicle accidents, and physical abuse. In spite of the IDEA’s definition, aneurysms and strokes are three examples of internal traumas that can also cause TB! in babies and young children. External head injuries that can result in TB! include both open and closed head injuries. Shaken baby syndrome is caused by forcibly shaking an infant. This causes the brain literally to bounce against the insides of the skull, causing rebound injuries, resulting in TB! and even death.
Identify some of the etiologies and characteristics of multiple disabilities in babies and young children.
The term multiple disabilities refers to any combination of more than one disabling condition. For example, a child may be both blind and deaf due to causes such as having rheumatic fever in infancy or early childhood. Anything causing neurological damage before, during, or shortly after birth can result in multiple disabilities, particularly if it is widespread rather than localized. For example, infants deprived of oxygen or suffering traumatic brain injuries in utero, during labor or delivery, or postnatally can sustain severe brain damage. So can babies having encephalitis or meningitis and those whose mothers abused drugs prenatally. Infants with this type of extensive damage can often present with multiple disabilities, including intellectual disabilities, cerebral palsy, physical paralysis, mobility impairment, visual impairment, hearing impairment, and speech-language disorders. They may have any combination of or all of these disabilities as well as others. In addition to a difficulty or inability with normal physical performance, multiply disabled children often have difficulty acquiring and retaining cognitive skills and transferring or generalizing skills among settings and situations.
