Impairment and Disability Flashcards
Impairment
- functional limitation caused by physical, mental, sensory impairment
- problem with a structure or organ of the body
Disability
- loss/limitations of opportunities to participate in normal life of community at equal level with others due to physical/social barriers
- person-based
Handicap
- disadvantage suffered as consequence of impairment and disability
- refers to environmental factor preventing filling of normal life role
Inherited
genetically transmitted
Congenital
caused by mother’s infection or other disease during pregnancy, embryonic, fetal developmental irregularities, or by injury during/soon after birth
Acquired
illness or injury
__ have a disability in the US
20%
__ is the most common functional disability type
mobility limitation
Disability is especially common in __ and __
- women (25%)
2. minorities (30%)
People with disabilities are more likely to __
- have less than $15,000 income
- be unemployed
- have not completed a high school degree
- be obese, smoke, have high BP, be inactive
Main problems associated with discrimination
access to
- premises
- facilities
- health care
- education
- employment
- recreation
Possible consequences
- difficulties with stairs
- inappropriate stairs
- inadequately trained staff
- often lower wedges
Main problems with prejudice
- denied anonymity
- denied respect
- hostility
- patronization
- lower expectation of achievement
Possible consequences of prejudice
- stared at
- regarded as “burden”
- intolerant
Main problems with ignorance
- fear of people with disabilities
2. inadequate education of careers or professionals
Possible consequences of ignorance
- fear of aggression or being bitten
2. undergraduate training lacing or scarce
__ is the most common congenital physical handicap
cerebal palsy
What is cerebal palsy?
affects a person’s ability to move and maintain posture and balance
What causes cerebal palsy?
brain damage/abnormal brain development that happens before birth or early in life
How often does cerebal palsy occur?
1/323 babies
Risk Factors for Cerebral Palsy
- beech presentation
- low birth weight
- maternal infection
- meconium staining of amniotic fluid
* *caused by stool passed by fetus in utero - vaginal bleeding during pregnancy
__ is the most common type of cerebal palsy
SPASTIC
Monoplegia Spastic Cerebal Palsy
- affects one limb
2. usually affects the arm
Hemiplegia Spastic Cerebal Palsy
- affects one side of the body
2. usually affects the leg, trunk, and arm
Diplegia Spastic Cerebal Palsy
affects either both arms or both legs
Quadreplegia Spastic Cerebal Palsy
affects all four limbs of the body
__ is the most common subtype of spastic cerebal palsy
hemiplegia
Cerebral Palsy - Clinical Features
- delays/problems with motor skills development
- abnormal walking with one foot/leg dragging
- stiff muscles
- exaggerated/jerky reflexes
- lack of coordination/balance
- weakness
- drooling, difficulty swallowing
- wheelchairs
Cerebral Palsy - Coexisting Conditions
- epilepsy
- vision/hearing impairment
- learning disabilities
- autism
- chronic pain/discomfort
- ADHD
- speech disorders
- mental health disorders
Cerebral Palsy - Oral Health Problems
- bruxism/abnormal attrition
- spontaneous dislocation or subluxation of the TMJ
- drooling
- increased risk for oral trauma/injury
5 dilantin hyperplasia for those with epilepsy - mouth breathing
- malocclusion
- oral hypersensitivity (over-reaction to touch, taste, etc)
- hyperactive bite and gag reflex
Hydrocephalus
- hydro: water; cephalus=head
- neurological disorder
- caused by raised intracranial pressure due to accumulation of cerebrospinal fluid within ventricles and/or subarachnoid space
- congenital or acquired
Hydrocephalus - Signs
- large head
- headache
- vomiting
- mental changes
Hydrocephalus - Complications
- epilepsy
- spasticity
- learning impairment
- visual impairment
__ is the most common tx for hydrocephalus
CSF
Hydrocephalus - Dental Aspects
- weight/size of the hydrocephalic head
- provide a comfy position for the patient’s head
- shunted treated patients
* *don’t put pressure on drainage tube
* *antibiotic prophy may be needed - may have shunt infection/spina bifida/latex allergy/epilepsy/learning/visual impairment
Spina Bifida
- split spin
- fetus’ spine fails to close during first month of pregnancy
* *incomplete brain development/spinal cord/vertebrae’s protective coverings - deficiency of folic acid in pregnancy may pre-dispose
Spina bifida occulata
- rarely any obvious clinical or neurological disorder
- may be detected by small naevus of tuft of hair over lumbar spine in some patients
- found in about 50% of apparently healthy children
Spina bifida cystica
extensive vertebral defect through which spinal cord/coverings
Meningocoele
- protrusion of meninges as a sac covered by skin, rarely causing neurological defect
- 20% have hydrocephalus
Myelomeningocoele
- meninges and nerve tissue protruded and exposed
- liable to infection, particularly meningitis
- neurological defects (paralysis, loss of sensation/reflexes in lower limbs)
__ is the most serious type of spina bifida
myelomeningocele
Spina Bifida - Dental Aspects
- latex free environment
- wheelchair access
- limited radiation
- accommodation for comfort
Thalidomide Syndrome
babies born with birth defects
- blindness
- deafness
- cleft palate
- malformed internal organs
- phocomelia (seal-like limbs)
- enamel hypoplasia
- abnormalities in tongue morphology
Thalidomide was used to tx __
morning sickness
Learning Impairment
- limitations in mental functioning and communicating, self care, social skills
- IQ less than 70
- 3% affected
- often caused by brain damage
- can also cause physical problems
* *epilepsy
* *visual defects
* *hearing
* *speech
* *behavioral disorders
* *cardiac defects
* *pica
* *self-mutilation
People with learning impairments have different/similar patterns of caries compared to the general population of similar age
same pattern
Autism Spectrum Disorder
- developmental disability characterized by difficulties in social interaction and communication
- restricted/repetetive patterns of thought and behavior
Three parts of Autism Spectrum Disorder
- communication
- behavior
- social functioning
__ is the fastest-growing developmental disability
Autism Spectrum Disorder
ASD is more common in boys/girls
boys
ASD symptoms are recognized during what period of life?
first two years
ASD - Dental Aspects
- communication problems and mental capabilities
- behavior problems
- unusual response to stimuli
- unusual and unpredictable body movements
- bruxism
- tongue thrusting
- self-injury
- pica
- poor oral hygiene
People with ASD have different/similar patterns of caries compared to the general population of similar age
similar
ASD - Dental Management
- desensitization appointment
- quiet, short visits
- routine
- “tell-show-do”
- minimize distractions
Down Syndrome
- genetic disorder (extra full/partial copy of chromosome 21)
- ranges in severity, usually has medical and physical problems
- 1 in 800 live births
- commonly seen in older mothers
Down Syndrome - Dental Aspects
- usually friendly and cooperative
- macroglossia
- lip, tongue fissuring
- periodontal disease
- bruxism
- malocclusion
- drooling
- delayed eruption
- hypodontia/microdontia
10 omega shaped palate
