Neuromotor Disabilities

Question 1

What is the theory why children with neuromotor disabilities have higher incidence of mental health problems?

Answer 1

It is likely an interaction between multiple biological, neuropsychological and social factors

Question 2

What are some examples of neuromotor disabilities

Answer 2

CP
Muscular dystrophy
Spina bifida

Question 3

How does the incidence of mental health problems in children with neuromotor disabilities compare with the general population?

Answer 3

It is higher in children with neuromotor disabilities.

Question 4

What are some examples of mental health problems children with neuromotor disabilities face?

Answer 4

ADHD
Self-esteem issues
Mood disorders
Anxieties
Behaviour difficulties
Poor social skills

Question 5

In children with CP, what are the mental health consequences of chronic pain?

Answer 5

Feelings of isolation, frustration, sadness
Caregiver anxiety
Difficulty concentrating
Lower activity levels

Question 6

What are some sources of pain in children with neuromotor disabilities?

Answer 6

Dystonia
Contractures
Hip dislocation

Question 7

What are some comorbid medical conditions for these children that can affect mental health?

Answer 7

Seizures and AED - can affect cognitive abilities
Dysphagia and feeding difficulties - increase aspiration, desaturations and hospital say
GERD and constipation - can lead to pain and nutritional problems
Voiding difficulties and UTI
Malnutrition - can lead to ulcers and pain
Sleep disorders and OSA - poor cognitive development and ADHD

Question 8

What is the perceived quality of life for children with motor impairment?

Answer 8

This is not a simple answer because children with CP, for example, have more positive perceptions about their situation that what may be expected by others, including parents. And impaired motor abilities can both positively and negatively affect QoL. So the interaction between motor impairment and QoL is complex.

Question 9

Does cognitive ability affect the risk of mental health problems?

Answer 9

Cognitive ability is strongly associated with mental health disorders.

Question 10

Why is determining a kids cognitive ability important?

Answer 10

Because it helps shape expectations for emotional and behavioural maturity, academic demands and peer interactions.

Question 11

What are some of the difficulties a family can face caring for children with neuromotor disabilities?

Answer 11

Problems with attachment
Parent's sense of competence
Parental stress
Spousal relationship difficulties
Caregiver depression

Question 12

What other health care professionals should be involved in the care of a child with neuromotor disabilities?

Answer 12

Ophthalmologist/optometrist
Audiologist
Orthopaedic surgeon - is MSK disorders
Dentist
Developmental paediatrician
OT and orthotist - supportive devices and AFOs
SLP - communication devices
Social worker
Psychologist - psychoeducational assessment.
Feeding and swallowing team - if concerns regarding aspiration

Question 13

How can a paediatrician help facilitate a good school environment and why is this important?

Answer 13

Provide an advocacy letter - outlining diagnosis and needs
Obtain a collateral history from school re classroom placement, schools understanding, interventions at school, use of assistive devices and participation
Support a positive parent-teacher relationship
Encourage the parent to meet regularly with school

This is important because a positive school environment and involvement is a protective factor.

Question 14

Apart from assessing the child’s medical and mental health, what other aspects of the child’s life should be assessed?

Answer 14

QoL
Family factors
School
Participation