Santa Anita Derby 5k

At the Santa Anita Derby…supporting children and adults with disabilities.

Mental Retardation/Intellectual Disability

Did you know the long-used term “mental retardation” has been changed to “intellectual disability”?

Due to the undesirable social stigma the term “mental retardation” has acquired, Doctors and health care practitioners have begun replacing it with the term “intellectual disability.” Because this change is recent, the term “mental retardation/intellectual disability” (MR/ID) is used to mark the transition in terminology.

MR/ID is not a specific medical disorder like pneumonia or strep throat, and it is not a mental health disorder. People with MR/ID have significantly below average intellectual functioning that limits their ability to cope with two or more activities of normal daily living (adaptive skills). These activities include the ability to communicate; live at home; take care of oneself, including making decisions; participate in leisure, social, school, and work activities; and be aware of personal health and safety.

People with MR/ID have varying degrees of impairment. While recognizing each person’s individuality, doctors find it helpful to classify a person’s level of functioning. Intellectual functioning levels can be based on the results of developmental quotient (DQ) tests and intelligence quotient (IQ) tests or on the level of support needed. Support is categorized as intermittent, limited, extensive, or pervasive. Intermittent means occasional support; limited means support such as a day program in a sheltered workshop; extensive means daily, ongoing support; and pervasive means a high level of support for all activities of daily living, possibly including full-time nursing care.

Based only on IQ test scores, about 3% of the total population are considered to have MR/ID. However, if classification is based on the need for support, only about 1% of people are classified as having significant mental (cognitive) limitation.

Causes

A wide variety of medical and environmental conditions can cause MR/ID. Some are genetic; some are present before or at the time of conception; and others occur during pregnancy, during birth, or after birth. The common factor is that something interferes with the growth and development of the brain. However, doctors can identify a specific cause in only about one third of people with mild MR/ID and in two thirds of people with moderate to profound MR/ID.

Some Causes of Mental Retardation/Intellectual Disability

Before or At Conception

• Inherited disorders (such as phenylketonuria, Tay-Sachs disease, neurofibromatosis, hypothyroidism, and fragile X syndrome)
• Chromosome abnormalities (such as Down syndrome)

During Pregnancy

• Severe maternal malnutrition
• Infections with HIV, cytomegalovirus, herpes simplex, toxoplasmosis, rubella virus
• Toxins (such as alcohol, lead, and methylmercury)
• Drugs (such as phenytoin, valproate, isotretinoin, and cancer chemotherapy)
• Abnormal brain development (such as porencephalic cyst, grey matter heterotopia, and encephalocele)
• Preeclampsia and multiple births

During Birth

• Insufficient oxygen (hypoxia)
• Extreme prematurity

After Birth

• Brain infections (such as meningitis and encephalitis)
• Severe head injury
• Malnutrition of the child
• Severe emotional neglect or abuse
• Toxins (such as lead and mercury)
• Brain tumors and their treatments

Symptoms

Some children with MR/ID have abnormalities apparent at birth or shortly thereafter. These abnormalities may be physical as well as neurologic and may include unusual facial features, a head that is too large or too small, deformities of the hands or feet, and various other abnormalities. Sometimes children have an outwardly normal appearance but have other signs of serious illness, such as seizures, lethargy, vomiting, abnormal urine odor, and failure to feed and grow normally. During their first year, many children with more severe MR/ID have delayed development of motor skills, and are slow to roll, sit, and stand.

However, most children with MR/ID do not develop symptoms that are noticeable until the preschool period. Symptoms become apparent at a younger age in those more severely affected. Usually, the first problem parents notice is a delay in language development. Children with MR/ID are slower to use words, put words together, and speak in complete sentences. Their social development is sometimes slow, because of cognitive impairment and language deficiencies. Children with MR/ID may be slow to learn to dress and feed themselves. Some parents may not consider the possibility of cognitive impairment until the child is in school or preschool and is unable to keep up with age-appropriate expectations.

Children with MR/ID are somewhat more likely than other children to have behavioral problems, such as explosive outbursts, temper tantrums, and physically aggressive behavior. These behaviors are often related to specific frustrating situations compounded by an impaired ability to communicate and control impulses. Older children may be gullible and easily taken advantage of or led into minor misbehavior.

About 10 to 40% of people with MR/ID also have a mental health disorder (dual diagnosis). In particular, anxiety and depression are common, especially in children who are aware that they are different from their peers or who are maligned and mistreated because of their disability.

Diagnosis

Many children are evaluated by teams of professionals, including a pediatric neurologist or developmental pediatrician, a psychologist, speech pathologist, occupational or physical therapist, special educator, social worker, or nurse.

Doctors evaluate a child suspected of having MR/ID by testing intellectual functioning and looking for a cause. Even though the cause of the child’s MR/ID may be irreversible, identifying a disorder that caused the disability may allow doctors to predict the child’s future course, prevent further loss of skills, plan any interventions that can increase the child’s level of functioning, and counsel parents on the risk of having another child with that disorder.

Newborns with physical abnormalities or other symptoms suggestive of a condition associated with MR/ID often need laboratory tests to help detect metabolic and genetic disorders. Imaging tests, such as computed tomography (CT) or magnetic resonance imaging (MRI), may be performed to look for structural problems within the brain. An electroencephalogram (EEG) records the brain’s electrical activity and is used to evaluate a child for possible seizures. A chromosome analysis, urine and blood tests, and x-rays of bones can also help rule out suspected causes of MR/ID.

Some children who are delayed in learning language and mastering social skills have conditions other than MR/ID. Because hearing problems interfere with language and social development, a hearing evaluation is typically performed. Emotional problems and learning disorders also can be mistaken for MR/ID. Children who have been severely deprived of normal love and attention (see Child Neglect and Abuse: Physical Neglect) for long periods of time may seem to have MR/ID. A child with delays in sitting or walking (gross motor skills) or in manipulating objects (fine motor skills) may have a neurologic disorder not associated with MR/ID.

Because mild developmental problems are not always noticed by parents, doctors routinely perform developmental screening tests during well-child visits. Doctors use simple questionnaires, such as the Ages and Stages Questionnaires or Child Development Inventories, to quickly evaluate the child’s cognitive, verbal, and motor skills. Parents can help the doctor determine the child’s level of functioning by completing a Parents’ Evaluation of Developmental Status (PEDS) test. Children who perform significantly below their age level on these screening tests are referred for formal testing.

Formal testing has three components: interviews with parents, observations of the child, and norm-referenced tests. Some tests, such as the Stanford-Binet Intelligence Test and the Wechsler Intelligence Scale for Children-IV (WISC-IV), measure intellectual ability. Other tests, such as the Vineland Adaptive Behavior Scales, assess areas such as communication, daily living skills, social abilities, and motor skills. Generally, these formal tests accurately compare a child’s intellectual and social abilities with those of others in the same age group. However, children of different cultural backgrounds, non–English-speaking families, and very low socioeconomic status are more likely to perform poorly on these tests. For these reasons, a diagnosis of MR/ID requires that the doctor integrate the test data with information obtained from parents and direct observations of the child. A diagnosis of MR/ID is appropriate only when both intellectual and adaptive skills are significantly below average.

Prevention and Prognosis

Prevention applies to environmental, genetic, and infectious disorders as well as to accidental injuries. Fetal alcohol syndrome is a highly common and totally preventable cause of MR/ID. The March of Dimes and other groups concerned about the prevention of MR/ID focus much of their efforts on alerting women to the seriously damaging effects of drinking alcohol during pregnancy. Doctors may recommend genetic testing for people who have a family member or other child with a known inherited disorder, particularly ones related to MR/ID, such as phenylketonuria, Tay-Sachs disease, or fragile X syndrome. Identification of a gene for an inherited disorder allows genetic counselors to help parents evaluate the risk of having an affected child. Women who plan to get pregnant should receive necessary vaccinations, particularly against rubella. Women who are at risk for infectious disorders that may be harmful to a fetus, such as rubella and human immunodeficiency virus (HIV), should be tested before getting pregnant.

Proper prenatal care lowers the risk of having a child with MR/ID. Folic acid, a vitamin supplement, taken before conception and early in pregnancy can help prevent certain kinds of brain abnormalities. Advances in the practices of labor and delivery and in the care of premature infants have helped to reduce the rate of MR/ID related to prematurity.

Certain tests, such as ultrasound, amniocentesis, chorionic villus sampling, and various blood tests, can be performed during pregnancy to identify conditions that often result in MR/ID. Amniocentesis or chorionic villus sampling is often used for women at high risk of having a baby with Down syndrome, especially those aged 35 and older, and for women with family histories of metabolic disorders. Maternal serum alpha-fetoprotein is a helpful screen for neural tube defects, Down syndrome, and other abnormalities. A few conditions, such as hydrocephalus and severe Rh incompatibility (see Pregnancy at High Risk: Rh Incompatibility), may be treated during pregnancy. Most conditions, however, cannot be treated, and early recognition can serve only to prepare the parents and allow them to consider the option of abortion.

Because MR/ID sometimes coexists with serious physical problems, the life expectancy of children with MR/ID may be shortened, depending on the specific condition. In general, the more severe the cognitive disability and the more physical problems the child has, the shorter the life expectancy. However, a child with mild MR/ID has a relatively normal life expectancy, and health care is improving long-term health outcomes for people with all types of developmental disabilities. Many people with mild to moderate MR/ID can support themselves, can live independently, and can be successful at jobs that require basic intellectual skills.

Treatment

A child with MR/ID is best cared for by a multidisciplinary team consisting of the primary care doctor; social workers; speech, occupational, and physical therapists; neurologists or developmental pediatricians; psychologists; nutritionists; educators; and others. Together with the family, these people develop a comprehensive, individualized program for the child, which is begun as soon as the diagnosis of MR/ID is suspected. The parents and siblings of the child also need emotional support and sometimes counseling. The whole family should be an integral part of the program.

The full array of a child’s strengths and weaknesses must be considered in determining what kind of support is needed. Factors such as physical disabilities, personality problems, mental illness, and interpersonal skills are all taken into consideration. Affected children with coexisting mental health disorders such as depression may be given appropriate drugs in dosages similar to those given to children without MR/ID. However, giving a child drugs without also instituting behavioral therapy and environmental changes is usually not helpful.

All children with MR/ID benefit from special education. The federal Individuals with Disabilities Education Act (IDEA) requires public schools to provide free and appropriate education to children and adolescents with MR/ID or other developmental disorders. Education must be provided in the least restrictive, most inclusive setting possible–where the children have every opportunity to interact with non-disabled peers and have equal access to community resources.

A child with MR/ID usually does best living at home. However, some families cannot provide care at home, especially for children with severe, complex disabilities. This decision is difficult and requires extensive discussion between the family and their entire support team. Having a child with severe disabilities at home requires dedicated care that some parents may not be able to provide. The family may need psychologic support. A social worker can organize services to assist the family. Help can be provided by day care centers, housekeepers, child caregivers, and respite care facilities. Most adults with MR/ID live in community-based residences that provide services appropriate to the person’s needs, as well as work and recreational opportunities.

For more information about this article go to: Intellectual Disability

What is microcephaly?

What is microcephaly?

Microcephaly is a medical condition in which the circumference of the head is smaller than normal because the brain has not developed properly or has stopped growing. Microcephaly can be present at birth or it may develop in the first few years of life.

What causes microcephaly?

It is most often caused by genetic abnormalities that interfere with the growth of the cerebral cortex during the early months of fetal development. It is associated with Down’s syndrome, chromosomal syndromes, and neurometabolic syndromes. Babies may also be born with microcephaly if, during pregnancy, their mother:

* abused drugs or alcohol,
* became infected with a cytomegalovirus,
* rubella (German measles), or varicella (chickenpox) virus,
* was exposed to certain toxic chemicals, or
* had untreated phenylketonuria (PKU).

Babies born with microcephaly will have a smaller than normal head that will fail to grow as they progress through infancy.

What are the signs and symptoms of microcephaly?

Depending on the severity of the accompanying syndrome, children with microcephaly may have:

* mental retardation,
* delayed motor functions and speech,
* facial distortions,
* dwarfism or short stature,
* hyperactivity,
* seizures,
* difficulties with coordination and balance, and
* other brain or neurological abnormalities.

Some children with microcephaly will have normal intelligence and a head that will grow bigger, but they will track below the normal growth curves for head circumference.

Is there any treatment for microcephaly?

There is no treatment for microcephaly that can return a child’s head to a normal size or shape. Treatment focuses on ways to decrease the impact of the associated deformities and neurological disabilities. Children with microcephaly and developmental delays are usually evaluated by a pediatric neurologist and followed by a medical management team.
Early childhood intervention programs that involve physical, speech, and occupational therapists help to maximize abilities and minimize dysfunction. Medications are often used to control seizures, hyperactivity, and neuromuscular symptoms. Genetic counseling may help families understand the risk for microcephaly in subsequent pregnancies.

What is the prognosis for microcephaly?

Some children will only have mild disability. Others, especially if they are otherwise growing and developing normally, will have normal intelligence and continue to develop and meet regular age-appropriate milestones.

What research is being done on microcephaly?

The National Institute of Neurological Disorders and Stroke (NINDS) conducts research relating to microcephaly in its laboratories at the National Institutes of Health (NIH) and supports additional research through grants to major medical institutions across the country. A small group of researchers studying a rare neurometabolic syndrome (3-PGDH), which causes microcephaly, have successfully used amino acid replacement therapy to reduce and prevent seizures.

For more information, please visit : Microcephaly

Dyslexia

Peter works so hard at reading, but it just never gets easier. He knows he’s smart so why can’t he read like the other kids? Peter has a problem called dyslexia.

Dyslexia (say: dis-lek-see-uh) is a learning problem some kids have. Dyslexia makes it tough to read and spell. The problem is inside the brain, but it doesn’t mean the person is dumb. Plenty of smart and talented people struggle with dyslexia.

But dyslexia doesn’t have to keep a kid down. With some help and a lot of hard work, a kid who has dyslexia can learn to read and spell.

How Does Reading Happen?

To understand dyslexia, it helps to understand reading. Reading is a real workout for your brain. You need to do the following steps — and all at once:

1. Understand the way speech sounds make up words.
2. Focus on printed marks (letters and words).
3. Connect speech sounds to letters.
4. Blend letter sounds smoothly into words.
5. Control eye movements across the page.
6. Build images and ideas.
7. Compare new ideas with what is already known.
8. Store the ideas in memory.

Phew! Kids who have dyslexia struggle with the beginning steps, so that makes doing the rest of the steps even harder. It’s no surprise, then, that trying to read and dealing with dyslexia makes a kid’s brain really tired really fast.

How Kids Become Readers

Most kids start learning to read by learning how speech sounds make up words. Then they connect those sounds to alphabet letters. For example, they learn that the letter “b” makes a “buh” sound.

Then kids learn to blend those sounds into words. They learn that “b” and “at” makes “bat.” Eventually, most kids don’t have to sound words out and can instantly recognize words they’ve seen many times before.

But it’s tougher for kids who have dyslexia. They may struggle to remember simple words they have seen many times and to sound out longer words. Why is it so hard?

Dyslexia means that a person’s brain has trouble processing letters and sounds. That makes it tough to break words into separate speech sounds, like b-a-t for bat. When it’s hard to do that, it’s really hard to connect speech sounds to different letters, like “buh” for b, and blend them into words.

So a kid who has dyslexia will read slowly and might make a lot of mistakes. Sometimes he or she will mix up letters in a word, such as reading the word “was” as “saw.” Words may blend together wrong and look like this:

What’s It Like to Have Dyslexia?

Even before kindergarten, a kid who has dyslexia usually has trouble with letters and sounds. Later, a teacher might say that the kid is smart, but doesn’t seem to be getting the hang of reading. Other times, it’s a parent who notices the kid is struggling. The best thing to do is to go to a specialist who can help figure out what’s wrong.

A specialist in learning disabilities knows a lot about learning problems that kids have and what to do about them. During a visit with a specialist, a kid might take some tests. But the idea isn’t to get a good grade; it’s to spot problems. Discovering a learning disability is the first step toward getting help that will make it easier for the kid to learn.

Making Reading Easier

Most kids with dyslexia can learn to read with the right kind of teaching. They might learn new ways for remembering sounds. For example, “p” and “b” are called brother sounds because they’re both “lip poppers.” You have to press your lips together to make the sound.

Thinking about the way the mouth needs to move to make sounds can help kids read more easily. Learning specialists know lots of special activities like this to teach reading to kids who have dyslexia.

Kids with dyslexia also might use flash cards or tape classroom lessons and homework assignments instead of taking notes about them. They may need parents and tutors to help them stay caught up.

Extra time for tests is really important, so kids with dyslexia have enough time to finish and show their teacher how much they have learned. Computers help a lot, too. You can get programs that “read” books out loud from the computer or even download recorded books to an iPod!

How Do Kids With Dyslexia Feel?

Kids who have dyslexia might get frustrated, angry, or sad because reading and spelling are so hard. They may not like being in a different reading group than their friends or having to see a special reading tutor.

But getting this help is so important and will help them go on to do great things in life. Some of the most creative and successful people have dyslexia, but it didn’t stop them from chasing their dreams!

For more information, please visit : Dyslexia

Meconium aspiration syndrome

Definition

Meconium is the first feces (stool) of the newborn. Meconium aspiration syndrome is when a serious condition in which a newborn breathes a mixture of meconium and amniotic fluid into the lungs around the time of delivery.

Causes

Meconium aspiration syndrome is a leading cause of severe illness and death in the newborn. The possibility of inhaling meconium occurs in about 5-10% of births. It typically occurs when the fetus is stressed during labor, especially when the infant is past its due date.

Stress during labor can cause increased movement of the infant’s intestines and relaxation of the anal sphincter, causing meconium to pass into the surrounding amniotic fluid. If the infant breathes while still in the uterus or while still covered by this fluid after birth, the mixture can enter the lungs and partially or completely block the infant’s airways.

Risk factors include:

• Fetal distress
• Decreased oxygen to the infant while in the uterus
• Diabetes in the pregnant mother
• Difficult delivery
• High blood pressure in the pregnant mother

Symptoms

• Bluish skin color in the infant
• Breathing problems

1. Difficulty breathing (the infant needs to work hard to breathe)
2. No breathing
3. Rapid breathing

• Dark, greenish staining or streaking of the amniotic fluid or the obvious presence of meconium in the amniotic fluid
• Limpness in infant at birth
• Greenish-stained skin in infant (occurs if meconium passed a long period before delivery)
• Skin peeling
• Weight loss

Exams and Tests

Before birth, the fetal monitor may show a slow heart rate. At birth, meconium can be seen in the amniotic fluid. The infant may have a low Apgar score.

The most accurate test to check for possible meconium aspiration involves looking for meconium staining on the vocal cords. This is done in the delivery room using a device called a laryngoscope.

The health care team will listening to the infant’s chest with a stethoscope and may hear abnormal breath sounds, especially coarse, crackly sounds.

A blood gas analysis shows low blood acidity, decreased oxygen, and increased carbon dioxide.

A chest x-ray may show patchy or streaky areas on lungs.

Treatment

The newborn’s mouth should be suctioned as soon as the head can be seen during delivery.

Further treatment is necessary if there is thick meconium staining and fetal distress. A tube is placed in the infant’s trachea and suction is applied as the endotracheal tube is withdrawn. This procedure is repeated until meconium is no longer seen in the suction contents.

The infant may be placed in the special care nursery or newborn intensive care unit. Other treatments may include:

• Antibiotics to treat infection
• Breathing machine to keep the lungs inflated
• Use of a warmer to maintain body temperature
• Tapping on the chest to loosen secretions

If there have been no signs of fetal distress during pregnancy and the baby is a vigorous full-term newborn, experts recommend against deep suctioning of the windpipe for fear of causing a certain type of pneumonia. Occasionally, a saline solution is used to wash the airway of particularly thick meconium.

Outlook (Prognosis)

In most cases, the outlook is excellent and there are no bad side effects.

In more severe cases, breathing problems may occur. They generally go away in 2 to 4 days. However, rapid breathing may persist for days.

An infant with severe aspiration who requires a breathing machine may have a more guarded outcome. Lack of oxygen in the uterus or from complications of meconium aspiration may lead to brain damage. The outcome depends on the degree of brain damage.

Meconium aspiration rarely leads to permanent lung damage.

Possible Complications

• Aspiration pneumonia
• Brain damage due to lack of oxygen
• Breathing difficulty that lasting for several days
• Collapsed lung
• Persistent pulmonary hypertension of the newborn

When to Contact a Medical Professional

If the baby is born outside of the hospital and shows any signs of distress, seek immediate medical care.

Prevention

Risk factors should be identified as early as possible. If the mother’s water broke at home, she should tell the health care provider whether the fluid was clear or stained with a dark substance.

Fetal monitoring is started so that any signs of fetal distress can be recognized early. Immediate intervention in the delivery room can sometimes help prevent this condition.

For more information, please visit : Meconium aspiration syndrome

The Autism Puzzle Ribbon – What does it symbolize?

The autism awareness ribbon puzzle piece pattern is said to symbolize the mystery and complexity of autism. The different colors and shapes represent the diversity of people and families living with this developmental disorder. The brightness of this awareness ribbon signals hope. Hope that through research we will soon identify the causes and a cure for autism. And hope that through increasing awareness of autism, persons with the disorder will lead fuller and more complete lives.

Therapy and Treatment for Cerebral Palsy

Therapy and Treatment for Cerebral Palsy

Following your child’s interdisciplinary assessment, the professionals providing care for your child will develop recommendations for his or her treatment. Many treatments are available to help a child function at the highest level possible. Although many treatments are available, we will touch upon a few of the most basic approaches used today to help a child achieve their optimal level of functioning.

Since no two children are affected by cerebral palsy in exactly the same way, individual treatment programs vary widely. But because all children with cerebral palsy have movement problems, you can expect that an important component of your child’s treatment will be a therapeutic exercise program. Depending on your child’s needs, a physical therapist, an occupational therapist, and a speech-language pathologist will work with your child to help him or her improve posture and movement.

At first, your child will likely see his or her therapist quite often, sometimes at least twice a week. As your child grows, he or she may need a less intensive program. The therapists will probably expect you to work on the child’s movement skills at home, and will train you in special exercises and handling techniques. Because the time commitment to a therapy program is tremendous, it is wise for both parents, or other caretakers, to be involved. In general, it is considered very early intervention if a baby begins therapy before six months of age. Most infants are not referred until later in the first year or sometime in the second year of life. Of course, the age at which your child is referred will depend to some extent on how quickly the physicians diagnose cerebral palsy, or other problems requiring therapy. Researchers are still studying the long term benefits therapy can offer. But it is generally agreed that children who receive good treatment not only have fewer movement limitations, but also have better postures, better muscle development, and better abilities in toileting, feeding, and dressing themselves. Furthermore, therapy programs enrich children’s lives by enabling them to explore and experience activities that they might not otherwise be able to do independently.

Physical Therapy

Physical Therapy: A physical therapist specializes in improving the development of the large muscles of the body, such as those in the legs, arms and abdomen (gross motor skills). Physical therapists help children learn better ways to move and balance. They may help children with cerebral palsy learn to walk, use a wheelchair, stand by themselves, or go up and down stairs safely. Physical therapists will also work on fun skills such as running, kicking and throwing, or learning to ride a bike. Physical therapy usually begins in the first few years of life, or soon after the diagnosis of cerebral palsy is made. These therapists use specific sets of exercises to work toward the prevention of musculoskeletal complications. An example of this is preventing the weakening or deterioration of muscles that can develop with lack of use. Also, physical therapy will help avoid contractures, in which muscles become fixed in a rigid, abnormal position. Physical therapy will help prevent muskuloskeletal problems, as well as helping your child perform common everyday activities.

Occupational Therapy

Occupational Therapy: An occupational therapist specializes in improving the development of the small muscles of the body, such as the hands, feet, face, fingers and toes. These therapists also teach daily living skills such as dressing and eating, as well as making sure children are properly positioned in wheelchairs. They may teach your child better or easier ways to write, draw, cut with scissors, brush their teeth, dress, and feed themselves. Occupational therapists will also help your child find the right special equipment to make everyday jobs a little easier.

Speech and Language Therapy

Speech / Language Therapist: A speech and language therapist helps develop better control of the jaw and mouth muscles, which can improve speech and language skills and eating abilities. They also help develop creative communication methods for those who can not speak. A speech and language therapist will work with your child on communication skills. This means talking, using sign language, or using a communication aid. Children who are able to talk may work with a speech therapist on making their speech clearer, or on building their language skills by learning new words, learning to speak in sentences, or improving their listening skills. Children who can not talk may learn sign language, or how to use special equipment such as a computer that actually talks for you.

Medical Treatment: Surgery

Surgery: Surgery is not always necessary, but it is sometimes recommended to improve muscle development, correct contractures, and reduce spasticity in the legs. Before selecting any surgical procedure, make sure the doctor thoroughly discusses the risks involved, long-term effects and postoperative follow-up. Also, always get a second opinion and speak with other parents whose children have had the same surgical procedure.

Children with cerebral palsy often walk on their toes. This may indicate a tight heel cord. When other treatments for this fail, such as splints and braces, surgery may help correct it by lengthening the tendon. This surgery may help improve the child’s ability to walk, improve balance, and prevent further deformity. Surgery is also available to relieve spacticity in the legs and hips of children. This surgery involves identifying sensory nerve fibers being the spinal cord, and then selectively cutting those nerve fibers therefor reducing spacticity. Research on this surgery is still being conducted. The adductors are muscle groups that bring the legs together. If a child’s physician determines that the adductors are causing deformities or problems with walking, he or she may suggest a surgical procedure to cut the tendon, which can release muscle contractures and improve mobility. Again, surgery may not always be necessary, but in many instances it can help your child achieve his or her optimal level of functioning.

Medical Treatment: Drug Therapy

Drug Therapy: Your child’s doctor may prescribe drugs to prevent or control seizures associated with cerebral palsy. These drugs are very effective in preventing seizures in many children. Because there are different types of seizures, different drugs may be prescribed because no one drug prevents or controls all types of seizures. Such drugs may include Tegretol, Dilantin and Phenobarbital. Drug therapy can also help reduce spasticity associated with cerebral palsy. These drugs include Diazepam, Baclofen, and Dantrolene. If surgery is contradicted, these drugs can help reduce spasticity for short periods, however, their long term value is still being researched. Although drug therapy may not completely correct complications associated with cerebral palsy, evidence does show that it helps manage problems such as seizures and spasticity. Consult with a physician to find out if drug therapy is appropriate for your child.

Sensory Integration Therapy

Sensory Integration Therapy: One other approach to help children with cerebral palsy achieve their optimal level of functioning is Sensory Integration Therapy. This therapy helps to overcome problems experienced by many young children in absorbing and processing sensory information. Encouraging these abilities ultimately improves balance and steady movement. Therapies include stimulating touch sensations and pressures on different parts of the body. With the use of certain items, such as Styrofoam chips, water, or textured toys, this therapy will also motivate children to learn sequences of movements.

Adaptive Equipment

Adaptive Equipment: Special equipment is also available for children with cerebral palsy. Because of the muscle problems children with cerebral palsy have, your child’s doctor or therapist may recommend that they use some special equipment to help them get around or do everyday activities.

A Wheelchair is sometimes used when a child cannot walk. This will allow the child to move from one place to another. Many children with cerebral palsy can use their arms to roll the wheels of their wheelchair themselves, and can move around without much difficulty at all. There are also wheelchairs available that are motorized. This type of wheelchair has a motor that moves the wheels for the child. There may be a joystick on one arm rest that the child can operate on his or her own.

A Walker is a piece of equipment usually made out of light metal. It most often will have four legs that are adjustable in height. Some children with cerebral palsy can walk, but have poor balance and may fall. They use a walker to help them balance and get around without the use of a wheelchair. You may also see a walker with wheels on it, as well as a basket to put some of the child’s belongs in.

Because of the fine motor problems often associated with cerebral palsy, children may have a hard time using utensils for eating. Special handles or grips are available for children who have trouble holding onto small objects, such as a fork or spoon. You may also find eating utensils that are specially designed for children with fine motor problems. They may be curved or bent, and are usually designed to fit the child’s needs. Special grips and handles are also used on pencils and pens to make them easier for the child to hold and use.

For more information, please visit : Cerebral Palsy

Cerebral Palsy A-Z

Cerebral Palsy Definition

Cerebral palsy is a term used to describe a group of chronic conditions affecting body movements and muscle coordination. It is caused by damage to one or more specific areas of the brain, usually occurring during fetal development, or during infancy. It can also occur before, during or shortly following birth.

“Cerebral” refers to the brain and “Palsy” to a disorder of movement or posture. If someone has cerebral palsy it means that because of an injury to their brain (cerebral) they are not able to use some of the muscles in their body in the normal way (palsy). Children with cerebral palsy may not be able to walk, talk, eat or play in the same ways as most other children.

Cerebral palsy is neither progressive nor communicable. It is also not “curable” in the accepted sense, although education, therapy and applied technology can help persons with cerebral palsy lead productive lives. It is important to know that cerebral palsy is not a disease or illness. It isn’t contagious and it doesn’t get worse. Children who have cerebral palsy will have it all their lives.

Cerebral palsy is characterized by an inability to fully control motor function, particularly muscle control and coordination. Depending on which areas of the brain have been damaged, one or more of the following may occur:

• muscle tightness or spasm
• involuntary movement
• disturbance in gait and mobility
• abnormal sensation and perception
• impairment of sight, hearing or speech
• seizures

Types of Cerebral Palsy

Cerebral palsy is a broad term which encompasses many different disorders of movement and posture. To describe particular types of movement disorders covered by the term, pediatricians, neurologists, and therapists use several classification systems and many labels. To understand different types of cerebral palsy more clearly, you must first understand what professionals mean by muscle tone.

All children with cerebral palsy have damage to the area of the brain that controls muscle tone. As a result, they may have increased muscle tone, reduced muscle tone, or a combination of the two (fluctuating tone). Which parts of their bodies are affected by the abnormal muscle tone depends upon where the brain damage occurs.

There are four types of cerebral palsy:

Spastic Cerebral Palsy (stiff and difficult movement)

Spastic cerebral palsy is the most common type of cerebral palsy, accounting for nearl 80 percent of all cerebral palsy cases. Children with this type of cerebral palsy have one or more tight muscle groups which limit movement. Children with spastic cerebral palsy have stiff and jerky movements. They often have a hard time moving from one position to another. They may also have a hard time holding and letting go of objects.

Athetoid Cerebral Palsy) (involuntary and uncontrolled movement)

About 10 percent of children with cerebral palsy have athetoid cerebral palsy. Athetoid cerebral palsy is caused by damage to the cerebellum or basal ganglia. These areas of the brain are responsible for processing the signals that enable smooth, coordinated movements as well as maintaining body posture. Damage to these areas may cause a child to develop involuntary, purposeless movements, especially in the face, arms, and trunk. These involuntary movements often interfere with speaking, feeding, reaching, grasping, and other skills requiring coordinated movements. For example, involuntary grimacing and tongue thrusting may lead to swallowing problems, drooling and slurred speech. The movements often increase during periods of emotional stress and disappear during sleep. In addition, children with athetoid cerebral palsy often have low muscle tone and have problems maintaining posture for sitting and walking.

Ataxic Cerebral Palsy (disturbed sense of balance and depth perception)

Low muscle tone and poor coordination of movements is described as ataxic cerebral palsy. Children with ataxic cerebral palsy look very unsteady and shaky. This rare form of cerebral palsy affects the sense of balance and depth perception. Affected persons often have poor coordination and walk unsteadily with a wide based gait, placing their feet unusually far apart. They have a lot of shakiness, like a tremor you might have seen in a very old person, especially when they are trying to handle or hold a small object such as a pen. Because of the shaky movements and problems coordinating their muscles, children with ataxic cerebral palsy may take longer than other children to complete certain tasks such and writing a sentence. This form affects about 5-10 percent of the children diagnosed with cerebral palsy.

Mixed Cerebral Palsy (there may be a combination of these types for any one person)

About 10 percent of children with cerebral palsy have what is known a mixed-type cerebral palsy. These children have both the tight muscle tone of spastic cerebral palsy and the involuntary movements of athetoid cerebral palsy. This is because they have injuries to both the pyramidal and extrapyramidal areas of the brain. Usually the spasticity is more obvious at first, with involuntary movements increasing when the child is between nine months and three years old. The most common mixed form includes spasticity and athetoid movements, but other combinations are also possible.

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WHAT PART OF THE BODY IS AFFECTED BY CP?

This is different from one person to another. In cerebral palsy, certain words are used to describe the parts affected:

Hemiplegia – the leg and arm on one side of the body are affected.

Diplegia – both legs are affected significantly more than the arms. Children with diplegia usually have some clumsiness with their hand movements.

Quadriplegia – Both arms and legs are affected. The muscles of the trunk, face and mouth can also be affected.

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Adult ADD/ADHD

Last night I did not have time to explain the reasons I recommended “Driven to Distraction.” Here is why this book is so good! This book was written by a psychiatrist (Edward M. Hallowell, M.D.) who discover he had ADD when he was thirty-one years old. This book is about ADD by two psychiatrist who have ADD, written to help people diagnosed with ADD. This book describes the host of problems associated with ADD, and the advantages of having it, such as high energy and creativity. Overall, this book provides education, family perspectives, diagnosis and treatment, and subtypes.

Adult ADD/ADHD

RECOGNIZING THE SIGNS, SYMPTOMS, AND EFFECTS

Adult ADD / ADHD Symptoms

Most children with ADD / ADHD don’t outgrow their disorders; rather, they become disorganized, inattentive adults. If you’re an adult with ADD / ADHD, your symptoms may be holding you back at work, impacting your relationships, and keeping you from accomplishing your goals. Happily, once you recognize the signs and symptoms of adult ADD / ADHD, you can begin to address your areas of weakness and make your strengths work for you.

ADD / ADHD in adults

Many people have a stereotypical picture in their head of what someone with attention deficit disorder looks like: hyperactive, loud, a whirlwind of energy and unchecked impulses. And let’s face it: it’s probably a kid they’re picturing in their mind’s eye. However, ADD / ADHD is not just a childhood disorder. Kids don’t simply grow out of ADHD, as if it’s a phase. In fact, the symptoms of ADD / ADHD typically get worse as children grow into adulthood and face life’s increasing pressures and demands.

Adults with ADD / ADHD struggle daily with self-regulation: regulating their attention, regulating their impulses in talking and action, and regulating their emotions. If you have trouble staying focused, getting organized, starting and completing your work, managing your time and money, and remembering all the little things in your daily life, you may very well be one of these people.

The chaos of living with unrecognized and untreated ADD / ADHD can take its toll: never-ending to-do lists, the stress of missed deadlines and forgotten appointments, aggravated friends and family members who just don’t understand why you can’t pull it together and self-recrimination over your lack of accomplishments.

The good news: life doesn’t have to be this way. Treatment can go a long way toward getting ADD / ADHD in check. But before you can manage the problem, you have to be able to identify it, starting with a thorough understanding of what ADD / ADHD looks like in adults.

Adult ADD Myths: Fact or Fiction

MYTH: ADD is just a lack of willpower. Persons with ADD focus well on things that interest them; they could focus on any other tasks if they really wanted to.

FACT: ADD looks very much like a willpower problem, but it isn’t. It’s essentially a chemical problem in the management systems of the brain.

MYTH: Everybody has the symptoms of ADD, and anyone with adequate intelligence can overcome these difficulties.

FACT: ADD affects persons of all levels of intelligence. And although everyone sometimes has symptoms of ADD, only those with chronic impairments from these symptoms warrant an ADD diagnosis.

MYTH: Someone can’t have ADD and also have depression, anxiety, or other psychiatric problems.

FACT: A person with ADD is six times more likely to have another psychiatric or learning disorder than most other people. ADD usually overlaps with other disorders.

MYTH: ADD doesn’t really cause much damage to a person’s life.

FACT: Untreated or inadequately treated ADD syndrome often severely impairs learning, family life, education, work life, social interactions, and driving safely.

MYTH: Unless you have been diagnosed with ADD as a child, you can’t have it as an adult.

FACT: Many adults have struggled all their lives with unrecognized ADD impairments. They haven’t received help because they assumed that their chronic difficulties, like depression or anxiety, were caused by other impairments that did not respond to the usual treatments.

Adult vs. childhood ADD / ADHD

The symptoms of ADD / ADHD change as someone with ADD / ADHD develops from a child into a teenager and then into an adult. While the core problems of hyperactivity, impulsiveness, and inattentiveness remain the same, the specific symptoms manifest differently. Typically, the symptoms of hyperactivity decrease and become more subtle, while problems related to concentration and organization become more dominant.

Hyperactivity in adults:

• inability to relax
• restlessness, nervous energy
• talking excessively

Impulsiveness in adults:

• volatile moods
• blurting out rude or insulting remarks
• interrupting others

Inattentiveness in adults:

• “tuning out” unintentionally
• inability to focus on mundane tasks
• constantly losing and forgetting things

Signs and symptoms of adult ADD / ADHD

According to Dr. Thomas E. Brown of the Yale University School of Medicine, “ADHD is essentially a name for developmental impairment of executive function.” Executive functions are the skills involved in planning, selective attention, motivation, and impulse control. Adults with ADHD have problems in six major areas of executive functioning:

• Activation – Problems with organization, prioritizing, and starting tasks.
• Focus – Problems with sustaining focus and resisting distraction, especially with reading.
• Effort – Problems with motivation, sustained effort, and persistence.
• Emotion – Difficulty regulating emotions and managing stress.
• Memory – Problems with short-term memory and memory retrieval.
• Action – Problems with self-control and self-regulation.

Signs and Symptoms of ADD / ADHD

Activation

• Procrastination; difficulty getting started on projects
• Excessive disorganization and messiness
• Inability to prioritize tasks
• Underestimating the time needed to finish a task

Focus

• Inability to screen out distractions
• “Zoning out” when others are talking
• Randomly skipping from topic to topic in conversation
• Reading words over and over in order to grasp the meaning

Effort

• Difficulty sustaining effort over long periods of time
• Starting multiple tasks, but never completing any of them
• Missing deadlines
• Trouble going to sleep at night and staying alert during the day.

Emotion

• Easily bored
• Low tolerance for frustration and stress
• Unstable, unpredictable moods
• Quick temper
• Constant worrying

Memory

• Trouble remembering things, even for a short time
• Doesn’t recall conversations, things others said
• Forgetting appointments
• Constantly losing or misplacing things

Action

• Inability to delay gratification
• Speaking without thinking
• Acting impulsively (e.g. impulsive spending, sudden change of plans) without regard for consequences
• Jumping to conclusions

Effects of adult ADD / ADHD

Left untreated, ADD can wreak havoc in your life, disrupting everything from your career to your social life, love life, and financial stability.
Work

ADD / ADHD can be a big stumbling block on the road to career success. The symptoms of disorganization and inattention, in particular, pose problems in the workplace. If you have ADD / ADHD, you may:

• be chronically late to work
• miss or forget deadlines and meetings
• have a hard time organizing projects and delegating work
• have difficulty completing projects on time
• spend hours at work, but get very little done
• get distracted by trivial tasks, while neglecting the most important ones
• have trouble paying attention in meetings or in conversations with your boss and colleagues

Relationships

ADD / ADHD can put a strain on your relationships. The chaos that surrounds the disorder is particularly hard on romantic relationships. The spouse or partner without ADD may feel resentful if he or she is the one who has to take care of all the planning, organizing, cleaning, bill paying, and other household responsibilities. And you may resent your partner’s constant nagging to tidy up, get organized, and take care of business.

Friends and family members may also take it personally when you tune them out, forget conversations or commitments, speak a little too bluntly, or keep them waiting.
Finance

The ADD / ADHD symptoms of procrastination, disorganization, and impulsivity can interfere with good money management. If you have ADD / ADHD, you may find that you:

• forget to pay bills
• run up huge balances on your credit cards
• cannot save money
• are unable to follow through on long-term financial goals
• shop impulsively
• have difficulty keeping financial paperwork in order
• fail at budgeting and recordkeeping

Eating behaviors

The impulsivity of ADD / ADHD can extend to eating, and many adults with the condition also suffer from overeating, obesity, or disordered eating. talks about the connection between ADHD (ADD) and disordered eating:

If you have ADD / ADHD, you may:

• eat snacks throughout the day, rather than eating at planned meals
• be unable to stick with a diet
• have intense cravings for carbohydrates and caffeine (in coffee and chocolate)
• eat a lot of fast food and “junk food” (cookies, chips, soda, fries, ice cream)
• ignore hunger signs, waiting until you’re too hungry to plan a healthy meal and then eating whatever you can find

The Connection between ADD and Disordered Eating

Healthy dietary regulation requires organization and planning—two areas of cognitive functioning that are typically difficult for those with ADD. Good eating habits also require self-awareness: awareness of when one is hungry, awareness of when one is full. Many individuals with ADD report that they skip meals because they were busy and distracted; these same individuals often report that later their hunger becomes so intense that they swing in the opposite direction, overeating well beyond the point of reasonable intake because they don’t know when to stop until they feel “stuffed.”

Positive characteristics of adults with ADD / ADHD

The symptoms of ADD / ADHD are not all negative. People with ADD / ADHD also have many POSITIVE traits that are directly tied to their active, impulsive minds:

• Creativity – People with ADD excel at thinking outside of the box, brainstorming, and finding creative solutions to problems. Because of their flexible way of thinking about things, they tend to be more open-minded, independent, and ready to improvise.
• Enthusiasm and spontaneity – People with ADD are free spirits with lively minds—qualities that makes for good company and engrossing conversation. Their enthusiasm and spontaneous approach to life can be infectious.
• A quick mind – People with ADD have the ability to think on their feet, quickly absorb new information (as long as it’s interesting), and multitask with ease. Their rapid-fire minds thrive on stimulation. They adapt well to change and are great in a crisis.
• High energy level – People with ADD have loads of energy. When their attention is captured by something that interests them, they can have virtually unlimited stamina and drive.

Hyperfocus: A Positive Symptom of ADD / ADHD

While adults with ADHD have great difficulty maintaining attention, those same individuals often are able to “hyperfocus” for long periods of time on tasks or projects that they find interesting. This is particularly true of interactive or hands-on activities. They may even be compulsive about it, spending hours immersed in the activity without a thought to anything or anyone else.

When they’re “in the zone,” people with ADD often lose all concept of time. Hours pass as if they are minutes. This single-minded ability to hyperfocus can lead to significant accomplishments, discoveries, and creative breakthroughs.

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