Special needs 2 Flashcards

1
Q

Who is a disabled person

A

A disabled person is someone with a physical or mental impairment which has substantial and long term adverse effects on how/her ability to carry out normal day to day activities

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2
Q

How do we classify disability

A
  1. Intellectual impairment
  2. Physical impairment
  3. Medical impairment
    4, Sensory impairment
  4. Emotional
  5. Oral developmental problems
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3
Q

What do we mean by intellectual impairment

A

Children with learning difficulties/ disabilities

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4
Q

How common are learning difficulties

A

2-3%

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5
Q

How is intellectual impairment classified

A
  1. Mild

2. Severe/profound

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6
Q

What do we mean by mild intellectual impairment

A

Moderate impairment (IQ 50-70)

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7
Q

How many people have mild intellectual impairment

A

1.2 million

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8
Q

What do we mean by severe/ profound intellectual impairment

A

IQ<50

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9
Q

How many people have severe/ profound intellectual impairment

A

65,000 children/ young adults

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10
Q

List some common intellectual impairments

A
  1. Down syndrome
  2. Cerebral palsy
  3. Meningitis, rubella
  4. Autism, microcephaly
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11
Q

What does the mental capacity act of 2005 say

A

For patients 18+ obtaining adequate consent requires that the patient has adequate mental capacity (MC) to make a decision about any proposed treatment/intervention

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12
Q

How do we assess mental capacity

A

In 2 stages:

  1. Does the person have an impairment that could affect mind/brain or decision making
  2. Is the impairment affecting the ability of the person to understand or make a decision
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13
Q

How do we obtain consent for patient who lack mental capacity

A

A nominated friend or family member or an independently appointed advocate (IMCA) may be required to help with the decision

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14
Q

What is the aetiology of Down syndrome

A

Trisomy 21

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15
Q

How common is Down syndrome

A

1:1000 live births

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16
Q

What Craniofacial anomalies can be associated with Down syndrome

A

1, Oval, mongoloid face

  1. Flat face and occiput
  2. Epicanthic folds with mongoloid slant to eyes
  3. Straight hair
  4. Abnormal hand creases
  5. Large protruding fissured tongue
17
Q

What abnormalities may you see in the oral cavity in a patient with downs syndrome

A
  1. Small maxilla
  2. Abnormal tooth morphology and tooth number
  3. Delayed eruption
  4. Prone to periodontal disease
  5. Could be less likely to develop dental caries
18
Q

Other than intellectual impairment what else may be seen in a patient with cerebral palsy

A

Physical impairment

19
Q

What physical impairment may be seen in a patient with cerebral palsy

A

Motor manifestation of cerebral damage

20
Q

What is cerebral palsy commonly a result of

A

Birth anoxia

21
Q

What can happen in cerebral palsy

A
  1. Abnormal muscle tone/ reflexes eg spasticity, athetoid

2. May have mental impairment but IQ often normal

22
Q

What can medical impairment include

A
  1. Heart disease
  2. Bleeding disorders
  3. Diabetes
  4. Kidney disease
  5. Respiratory disease
  6. Malignancy
  7. Drugs
23
Q

List some common childhood cardiovascular disease

A
  1. Endocarditis
  2. Cyanotic heart disease
  3. Anxiety
24
Q

Give examples of cyanotic heart disease

A
  1. Polycythaemia
  2. Thrombocytopoenia
  3. Abnormal clotting
  4. GA risk
25
What emotional trauma may children have that could mean they need special dental needs
1. Neglect | 2. Non accidental injury/ abuse
26
Give examples of oral decelopemtnal problems
1. Cleft lip and palate | 2. Ectodermal dysplasia
27
What is ectodermal dysplasia
Primary defects of 2 or more structures derived from ectoderm eg: 1. Skin 2. Hair 3. Nails 4. Sweat glands 5. Teeth
28
Give an example of a type of ectodermal dysplasia
Hypohydrotic ectodermal dysplasia
29
What is Hypohydrotic ectodermal dysplasia associated with
Commonly X linked
30
How common is Hypohydrotic ectodermal dysplasia
1 in 100,000
31
What happens in Hypohydrotic ectodermal dysplasia
Absent sweat glands
32
What abnormalities may we present in the oral cavity in a patient with Hypohydrotic ectodermal dysplasia
1. Absent teeth | 2. Abnormal morphology eg conical teeth
33
What dental problems may disabled patients have
They may have poorer plaque control an increased risk of periodontal disease
34
How should we come up with a treatment plan for a patient with a disability
1. Initial plan should be formulated ignoring the disability 2. Discuss with patient, parent or carer and modify for individual 3. Use guidelines 4. Done get distracted by disability
35
What proactive prevention should we jeep in mind for children with special needs
1. Help with toothbrushing/ .plaque control 2. Systemic/ topical floruides 3. Fissure sealents 4. Practical dietary advice
36
What problems may children with special needs face
1. Oral hygiene may be Low priority 2. Lack of provision made to provide necessary care 3. Practical difficulties in delivery of dental caries