Pediatric Patient Resources: Difference between revisions
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== Cerebral Palsy (CP) == | == Cerebral Palsy (CP) [[Image:Cerebral-palsy-awareness-ribbon.jpg.png|120x132px]] == | ||
'''Definition''': Disorder of movement, muscle tone or posture that is caused by injury or abnormal development in the immature brain<ref name="Mayo">Mayo Clinic. Cerebral Palsy. Mayo Clinic Staff. http://www.mayoclinic.com/health/cerebral-palsy/DS00302/DSECTION=complications. Accessed 06/30/2013.</ref><br> | '''Definition''': Disorder of movement, muscle tone or posture that is caused by injury or abnormal development in the immature brain<ref name="Mayo">Mayo Clinic. Cerebral Palsy. Mayo Clinic Staff. http://www.mayoclinic.com/health/cerebral-palsy/DS00302/DSECTION=complications. Accessed 06/30/2013.</ref><br> | ||
<br> '''How common is CP? <ref name="American Prego">American Pregnancy Association: Promoting Pregnancy Wellness. Cerebral Palsy. United Cerebral Palsy. http://americanpregnancy.org/birthdefects/cerebralpalsy.htm. Updated 03/2006. Accessed 06/30/2013.</ref>''' | |||
'''How common is CP? <ref name="American Prego">American Pregnancy Association: Promoting Pregnancy Wellness. Cerebral Palsy. United Cerebral Palsy. http://americanpregnancy.org/birthdefects/cerebralpalsy.htm. Updated 03/2006. Accessed 06/30/2013.</ref>''' | |||
<br> • Usually not diagnosed until the age of 2 or 3<br> • ~2-3:1,000 children over the age of three have the condition<br> • ~500,000 children and adults have CP in the United States<br> | <br> • Usually not diagnosed until the age of 2 or 3<br> • ~2-3:1,000 children over the age of three have the condition<br> • ~500,000 children and adults have CP in the United States<br> | ||
<br> '''Types<ref name="American Prego" /> ''' | |||
'''Types<ref name="American Prego" /> ''' | |||
<br> • Spastic<br> o ~70-80% of cases<br> o Associated with stiff muscles, making movement difficult<br> o Spastic diplegia<br> Both legs are affected<br> Causes tight muscles in the hips and legs <br> Inward turned legs leading to crossed knees (scissoring)<br> o Spastic hemiplegia <br> One side of the body affected<br> Arm often more affected than the leg<br> o Spastic quadriplegia <br> Most severe<br> All four limbs and the trunk are affected<br> Often also affect muscle of tongue and mouth<br> | <br> • Spastic<br> o ~70-80% of cases<br> o Associated with stiff muscles, making movement difficult<br> o Spastic diplegia<br> Both legs are affected<br> Causes tight muscles in the hips and legs <br> Inward turned legs leading to crossed knees (scissoring)<br> o Spastic hemiplegia <br> One side of the body affected<br> Arm often more affected than the leg<br> o Spastic quadriplegia <br> Most severe<br> All four limbs and the trunk are affected<br> Often also affect muscle of tongue and mouth<br> | ||
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• Ataxic <br> o 5-10% of cases<br> o Affects balance and coordination<br> Unsteady gait<br> Difficulty with motions that require precise coordination<br> | • Ataxic <br> o 5-10% of cases<br> o Affects balance and coordination<br> Unsteady gait<br> Difficulty with motions that require precise coordination<br> | ||
<br> '''Causes<ref name="Mayo" />''' | |||
'''Causes<ref name="Mayo" />''' | |||
<br> • Abnormality or disruption in brain development<br> • Random mutations in genes<br> • Infections of the mother that would affect the developing baby<br> • Disruption of blood supply to the developing brain<br> • Lack of oxygen to the baby’s brain<br> • Infant infections leading to inflammation around the brain<br> • Traumatic head injury<br> | <br> • Abnormality or disruption in brain development<br> • Random mutations in genes<br> • Infections of the mother that would affect the developing baby<br> • Disruption of blood supply to the developing brain<br> • Lack of oxygen to the baby’s brain<br> • Infant infections leading to inflammation around the brain<br> • Traumatic head injury<br> | ||
<br> '''Risk factors<ref name="Mayo" />''' | |||
'''Risk factors<ref name="Mayo" />''' | |||
<br> • Mother’s health<br> o Certain infections or health problems significantly increase the chance to giving birth to a baby with CP<br> Rubella<br> Syphilis<br> Chickenpox<br> Other conditions can be found at [http://www.mayoclinic.com/health/cerebral-palsy/DS00302/DSECTION=risk-factors http://www.mayoclinic.com/health/cerebral-palsy/DS00302/DSECTION=risk-factors] | <br> • Mother’s health<br> o Certain infections or health problems significantly increase the chance to giving birth to a baby with CP<br> Rubella<br> Syphilis<br> Chickenpox<br> Other conditions can be found at [http://www.mayoclinic.com/health/cerebral-palsy/DS00302/DSECTION=risk-factors http://www.mayoclinic.com/health/cerebral-palsy/DS00302/DSECTION=risk-factors] | ||
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• Other factors<br> o Premature birth<br> o Low birth weight<br> o Breech births<br> o Multiple babies | • Other factors<br> o Premature birth<br> o Low birth weight<br> o Breech births<br> o Multiple babies | ||
<br> '''How is CP diagnosed?<ref name="Mayo" />''' | |||
'''How is CP diagnosed?<ref name="Mayo" />''' | |||
<br> • Signs and symptoms usually appear during infancy or preschool years<br> o Impaired movement associated with:<br> Exaggerated reflexes or rigidity of the limbs and trunk<br> Abnormal posture<br> Involuntary movements<br> Unsteadiness of walking<br> Combination of these<br> o Other signs and symptoms can be viewed at [http://www.mayoclinic.com/health/cerebral-palsy/DS00302/DSECTION=symptoms http://www.mayoclinic.com/health/cerebral-palsy/DS00302/DSECTION=symptoms]<br> | <br> • Signs and symptoms usually appear during infancy or preschool years<br> o Impaired movement associated with:<br> Exaggerated reflexes or rigidity of the limbs and trunk<br> Abnormal posture<br> Involuntary movements<br> Unsteadiness of walking<br> Combination of these<br> o Other signs and symptoms can be viewed at [http://www.mayoclinic.com/health/cerebral-palsy/DS00302/DSECTION=symptoms http://www.mayoclinic.com/health/cerebral-palsy/DS00302/DSECTION=symptoms]<br> | ||
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• Additional tests<br> o If diagnosed with CP, may go through these other tests to screen for other associated conditions<br> Vision impairment<br> Hearing impairment<br> Speech delays or impairments<br> Intellectual disabilities or mental retardation<br> Other developmental delays<br> | • Additional tests<br> o If diagnosed with CP, may go through these other tests to screen for other associated conditions<br> Vision impairment<br> Hearing impairment<br> Speech delays or impairments<br> Intellectual disabilities or mental retardation<br> Other developmental delays<br> | ||
<br> '''Resources'''<br> | |||
'''Resources'''<br> | |||
• '''MyChild™'''<br> o Their mission: “to provide you with the most comprehensive resource and compassionate voice for all things related to caring for a child with cerebral palsy, and other neurological conditions. We strive, everyday, to be your ULTIMATE Resource for EVERYTHING Cerebral Palsy.”<br> o [http://cerebralpalsy.org/ http://cerebralpalsy.org/] | • '''MyChild™'''<br> o Their mission: “to provide you with the most comprehensive resource and compassionate voice for all things related to caring for a child with cerebral palsy, and other neurological conditions. We strive, everyday, to be your ULTIMATE Resource for EVERYTHING Cerebral Palsy.”<br> o [http://cerebralpalsy.org/ http://cerebralpalsy.org/] | ||
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<br> • '''Cerebral Palsy Resources'''<br> o [http://cerebralpalsy.org/ http://cerebralpalsyresources.com/kentucky]<br> | <br> • '''Cerebral Palsy Resources'''<br> o [http://cerebralpalsy.org/ http://cerebralpalsyresources.com/kentucky]<br> | ||
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• '''Mattingly Center, Inc.'''<br> o Cerebral Palsy School of Louisville, Inc.<br> o Their mission “To provide the highest quality of structured day services for adults with severe developmental disabilities.”<br> o [http://www.mattinglycenter.org/aboutus.html http://www.mattinglycenter.org/aboutus.html]<br> | • '''Mattingly Center, Inc.'''<br> o Cerebral Palsy School of Louisville, Inc.<br> o Their mission “To provide the highest quality of structured day services for adults with severe developmental disabilities.”<br> o [http://www.mattinglycenter.org/aboutus.html http://www.mattinglycenter.org/aboutus.html]<br> | ||
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• '''Kids Center for Pediatric Therapies'''<br> o Links you to their services, events and resources<br> o [http://www.kidscenterky.org/ http://www.kidscenterky.org/]<br><br> | • '''Kids Center for Pediatric Therapies'''<br> o Links you to their services, events and resources<br> o [http://www.kidscenterky.org/ http://www.kidscenterky.org/]<br><br> |
Revision as of 17:41, 30 June 2013
Top Contributors - Alicia Dupilka
Original Editors - Alicia Dupilka, Elaine Lonnemann, Kim Jackson, Leana Louw, WikiSysop, Scott Buxton and Admin
Resources for Physiotherapists and the Families of their Pediatric Clients
[edit | edit source]
Autism Spectrum Disorder and Autism[1] [edit | edit source]
Definition: Group of complex disorders of the brain. Varying degrees of characteristics including: difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors.
• Autism Spectrum Disorder (ASD): can display with intellectual disabilities, difficulties in coordination and attention and physical health issues.
• Autism: most obvious signs and symptoms tend to emerge between 2 and 3 years old
How common is Autism and ASD?
• ASD
o Affects over 2 million individuals in the United States
• Autism
o Effects ~1:88 children
o ~4-5 more times likely in boys than girls
o An estimated 1 out of 54 boys and 1 in 252 girls are diagnosed in the United States
Causes
• No one cause
• Rare gene changes
• Most cases are a combination of gene changes and environmental factors
• Risk factors (do not cause autism by themselves, but could have an influence when combined with genetic risk factors)
o Clearest evidence involve events before and during birth
o Advance age at conception
o Maternal illness during pregnancy
o Difficulties during birth (ie. Oxygen deprivation)
• Genetic risk factors (Autism tends to happen more frequently in the following conditions)[2]
o Fragile X Syndrome
o Tuberous sclerosis
o Congenital rubella syndrome
o Untreated phenylketonuria (PKU)
How is ASD/Autism diagnosed?
• No specific medical test
• Administer autism-specific behavioral evaluations
• Parents usually notice:
o Failure to make eye contact
o Not responding to their name
o Playing with toys in unusual or repetitive ways
o Other signs visit http://www.autismspeaks.org/what-autism/learn-signs
• The Modified Checklist of Autism in Toddlers
o List of informative questions about child
o Answers can indicate whether further evaluation by a specialist is needed
o Utilize this screening tool at www.autismspeaks.org/what-autism/diagnosis/screen-your-child
• Typical diagnosis involves a multidisciplinary team
• Genetic testing may be recommended
Resources
• Kentucky Autism Training Center
o Find specific services by region or county
o Examples of services include: hippo therapy, social skills group, community living supports and day care
o http://katcproviders.louisville.edu/
• Autism Society of Kentuckiana
o Become a memerb
o Find resources, learn about news and events
o Offers an autism dad’s group
o http://www.ask-lou.org/
• Autism Speaks
o Has information on current news and research, family services and events around the United States
o There is also a blog available; as well as ideas for autism apps
o http://www.autismspeaks.org/?utm_source=autismspeaks.org&utm_medium=web&utm_campaign=primarymenu
• National Institute of Neurological Disorders and Stroke
o Fact sheet on ASD and Autism
o http://www.ninds.nih.gov/disorders/autism/detail_autism.htm
• Autism Research Institute
o Find out about current research
o http://www.autism.com/
• Autism Society
o Has news, research and ways to get involved
o Section about living with Autism
o http://www.autism-society.org/
Cerebral Palsy (CP) [edit | edit source]
Definition: Disorder of movement, muscle tone or posture that is caused by injury or abnormal development in the immature brain[3]
How common is CP? [4]
• Usually not diagnosed until the age of 2 or 3
• ~2-3:1,000 children over the age of three have the condition
• ~500,000 children and adults have CP in the United States
Types[4]
• Spastic
o ~70-80% of cases
o Associated with stiff muscles, making movement difficult
o Spastic diplegia
Both legs are affected
Causes tight muscles in the hips and legs
Inward turned legs leading to crossed knees (scissoring)
o Spastic hemiplegia
One side of the body affected
Arm often more affected than the leg
o Spastic quadriplegia
Most severe
All four limbs and the trunk are affected
Often also affect muscle of tongue and mouth
• Athetoid or Dyskinetic
o 10-20% of cases
o Affects entire body
o Fluctuations in muscle tone
o Uncontrolled movements
o Difficulty with
Learning to control body
Sucking
Swallowing
Speech
• Ataxic
o 5-10% of cases
o Affects balance and coordination
Unsteady gait
Difficulty with motions that require precise coordination
Causes[3]
• Abnormality or disruption in brain development
• Random mutations in genes
• Infections of the mother that would affect the developing baby
• Disruption of blood supply to the developing brain
• Lack of oxygen to the baby’s brain
• Infant infections leading to inflammation around the brain
• Traumatic head injury
Risk factors[3]
• Mother’s health
o Certain infections or health problems significantly increase the chance to giving birth to a baby with CP
Rubella
Syphilis
Chickenpox
Other conditions can be found at http://www.mayoclinic.com/health/cerebral-palsy/DS00302/DSECTION=risk-factors
• Infant’s health
o Certain illnesses in a newborn significantly increase the chance of the baby developing CP
Bacterial meningitis
Severe or untreated jaundice (yellowing of the skin)
Viral encephalitis
• Other factors
o Premature birth
o Low birth weight
o Breech births
o Multiple babies
How is CP diagnosed?[3]
• Signs and symptoms usually appear during infancy or preschool years
o Impaired movement associated with:
Exaggerated reflexes or rigidity of the limbs and trunk
Abnormal posture
Involuntary movements
Unsteadiness of walking
Combination of these
o Other signs and symptoms can be viewed at http://www.mayoclinic.com/health/cerebral-palsy/DS00302/DSECTION=symptoms
• Brain scans
o MRI: usually the preferred test to use, will usually be given a mild sedative to remain still
o Cranial ultrasound: can provide a preliminary assessment, placed over the soft spot (fontanel) of the baby’s head
o CT scan: will likely be given a mild sedative to remain still
• Electroencephalogram (EEG)
o Done if the child has a history of seizures
o Records the electrical activity of the brain
o Used to determine if child has epilepsy
• Lab tests
o Blood is checked to rule out other conditions
o May also screen for metabolic or genetic problems
• Additional tests
o If diagnosed with CP, may go through these other tests to screen for other associated conditions
Vision impairment
Hearing impairment
Speech delays or impairments
Intellectual disabilities or mental retardation
Other developmental delays
Resources
• MyChild™
o Their mission: “to provide you with the most comprehensive resource and compassionate voice for all things related to caring for a child with cerebral palsy, and other neurological conditions. We strive, everyday, to be your ULTIMATE Resource for EVERYTHING Cerebral Palsy.”
o http://cerebralpalsy.org/
• Cerebral Palsy Resources
o http://cerebralpalsyresources.com/kentucky
• Mattingly Center, Inc.
o Cerebral Palsy School of Louisville, Inc.
o Their mission “To provide the highest quality of structured day services for adults with severe developmental disabilities.”
o http://www.mattinglycenter.org/aboutus.html
• Kids Center for Pediatric Therapies
o Links you to their services, events and resources
o http://www.kidscenterky.org/
Down Syndrome [5] [edit | edit source]
Definition: Genetic disorder occurring when the individual has full or a partial copy of chromosome 21. This extra genetic material causes an alteration in the development of the child.
How common is Down Syndrome?
• Most common genetic disorder
• ~1:691 babies are born each year with Down’s Syndrome
• ~6,000 babies are born each year with Down’s Syndrome
Types
• Trisomy 21 (Nondisjunction)
o The pair of the 21st chromosome fails to separate
o Extra chromosome is replicated in every cell in the body
o Accounts for ~95% of cases
• Mosaicism
o Nondisjunction takes place in chromosome 21 in one cell but not all cells
o Accounts for ~1% of cases
o May have fewer characteristics than other types of Down’s Syndrome
• Translocation
o Part of chromosome 21 breaks off during cell division and attaches to another chromosome, typically chromosome 14
o Accounts for ~4% of cases
Causes
• Cause of nondisjunction is currently unknown
o Research suggests the likelihood increases as women age
o No definitive research suggesting environmental factors of the parents before or during pregnancy
- Note: Age 34 is not accurate. NDSS has noted the error but has yet to find out the correct information.
How is Down’s Syndrome Diagnosed?
• Prenatally
o Screening tests
Most only provide a probability
Blood test: measures quantities of various substances in the mother’s blood
Ultrasound: checks for “markers”
o Diagnostic tests
Can provide a definite diagnosis with almost 100% accuracy
Carry up to a 1% risk of causing a spontaneous termination
Chorionic villus sampling (CVS): usually performed in first trimester between 9 and 11 weeks
Amniocentesis: usually performed in the second trimester after 15 weeks
• At birth
o Usually identified by certain physical traits
Low muscle tone
Single deep crease across the palm of the hand
Slightly flattened facial profile
Upward slant to the eyes
o Chromosomal analysis may also need to be done to confirm the diagnosis
This is done by drawing a sample of the baby’s blood
Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
- ↑ Autism Speaks. It's Time to Listen. Autism Speaks. http://www.autismspeaks.org/. Accessed June 27, 2013.
- ↑ Autism Society. Improving the Lives of All Affected by Autism. Autism Society. http://www.autism-society.org/. Accessed June 27, 2013.
- ↑ 3.0 3.1 3.2 3.3 Mayo Clinic. Cerebral Palsy. Mayo Clinic Staff. http://www.mayoclinic.com/health/cerebral-palsy/DS00302/DSECTION=complications. Accessed 06/30/2013.
- ↑ 4.0 4.1 American Pregnancy Association: Promoting Pregnancy Wellness. Cerebral Palsy. United Cerebral Palsy. http://americanpregnancy.org/birthdefects/cerebralpalsy.htm. Updated 03/2006. Accessed 06/30/2013.
- ↑ National Down Syndrome Society. Down Syndrome. National Down Syndrome Society. http://www.ndss.org/Down-Syndrome/What-Is-Down-Syndrome/. Published 2012. Accessed June 24, 2013.