Health
Disabilities
346 - Psychology of Exceptional Children
(11-17-05)
IDEA: orthopedically impaired--physical disabilities
other health impaired--medical disabilities
Quality of Life
Edwards, Patrick, & Topolski (2003) suggest that 3 primary aspects of a person's life are related to their quality of life: well-being, environment, and standard of living. In a study of self-rated quality of life in a sample of disabled secondary school youth they found that health status, depressive symptoms, and contextual factors (social inclusion, family communication) significantly related to perceived quality of life. The contextual factors are very appropriate targets for counseling interventions, education, and advocacy to increase peer support for and empowerment of disabled adolescent.
Conceptual Framework
Categories of biological contribution to phenotypical development (Cattell, 1950)
Hereditary-direct parental contribution
Innate-mutation and segregation
Congenital-acquired in uterus
Constitutional-alteration by life experience
Hereditary Influences: Mechanisms of Genetic Transmission
Biological foundation
chromosome, genes, alleles, DNA
karyotype: arrangement of chromosomes in standard order
mitosis: common cell reproduction
meiosis: cell division from germ cells (46 chromosomes) to gametes (sex cells)
(23 chromosomes)
Classical genetic principles: Gregor Mendel, 1866
dominant and recessive characteristics
phenotype, genotype
Exceptions to Mendelian Inheritance
additivity: blood type
polygenetic inheritance: height, neural tube defects, intelligence?
Autosomes and Sex Chromosomes
Sex-linked characteristics
Hemophilia
Red-green color blindness
Baldness
Some forms of muscular dystrophy, anemia, albinism
Hereditary Influences
Recessive gene disorders (947 catalogued)
Phenylketonuria (PKU)
one of over 23 Overflow Aminocidurias
gene incidence app. 1 in 100
IQ usually below 50, often below 20
treatment by 65 days, mean IQ 93+16
treatment 1st month: 95
treatment 2nd month: 85
Glactosemia
inborn error carbohydrate metabolism
Tay-Sachs Disease (Amaurotic Family Idiocy)
one of a number of recessive lipid diseases characterized by a regressive course
Family Microcephalus
anomaly of cranial formation: sever MR
Inherited Cretinism
absence, insufficiency, or error in production of thyroid hormone
Dominant Gene Disorders (1218 catalogued)
Epiloia
tumors of brain & skin
Huntington's Chorea
progressive neurological deterioration
Primary Microcephaly
likely mild MR or borderline intellectual functioning
Neurofibromatosis
(NFI) chromosome 17
Innate Influences
Autosomal nondysjuctions
Down's Syndrome (Trisomy 21, Mongolism)
moderate MR
"distinctive" face (epicanthan fold, large tongue and lips, furrowed tongue), broad hands with short fingers, congenital heart defects
Mother's Age------------ Incidence per 1,000 Live Births
15-19 -----------------------0.6
20-24------------------------0.5
25-29------------------------0.8
30-34------------------------0.8
35-39------------------------2.8
40-44------------------------7.6
45-49-----------------------27.5
Trisomy 22, 18, 13, 14, 15, 8
Trisomy 18: Trisomy E; Edward's Syndrome
Trisomy 13: Patau Syndrome, Bartholin-Patau
MR and physical defects
Sex Chromosome Nondysjunctions
Klinefelter's Syndrome (XXY)
Turner's Syndrome (XO or X_)
XYY Syndrome
Structural Abnormalities
Ring Chromosomes (usually Ring 18): MR
Chi du Chat's Syndrome (short arm one #5)
William's Syndrome (#7)
Prader-Willi Syndrome
most involve deletions or rearrangement of chromosome 15
40% deletion, 30% rearrangement, 30% no discernable chromosomal abnormality
mild to borderline MR, poor visual-spatial skills, appetite disorder, physical features
Congenital Influences
Prenatal
General Condition of the Mother
Malnutrition
Specific Dietary Deficits
Vitamin D: Rickets
Iodine: Cretinism
Maternal Illness
TORCH group (Toxoplasmosis, Rubella, Cytomegalovirus, Herpes, Syphillis)
Blood Type Incompatibility
ROGAM
Drugs: quantitative vs. qualitative effects
Thalidomide
Progestines: Progestine-induced hermaphroditism
Alcohol: Fetal Alcohol Syndrome
Nicotine
Chemical Toxins: PCB's and IQ
Radiation
Natal
Anoxia
Fetal Distress
Cerebral Palsy
Prematurity (& Postmaturity)
Gestation age vs. gestation weight
Birth Weight (premature)--% Disability (IQ<70, CP)
<1,500 grams ----------------4%
<1,000 grams ----------------10%
< 750 grams -----------------18%
Constitutional Influences
Illness
Toxic Exposure
Brain Injury
Illustrative physical and medical disabilities affecting children
Cerebral Palsy: neurological condition associated with motor problems, weakness, lack of coordination
often other disabilities are comorbid: hearing defects, speech and language problems, intellectual deficits, visual disabilities, perceptual problems--CP is usually considered multidisabled
prevalence: 4-5 per 1,000 live births
Spina Bifida: birth defect involving abnormal opening in the spinal column
both mild and serious forms occur
no association with intelligence
most common birth defect
Muscular Dystrophy: group of hereditary conditions, progressive, characterized by myodegeneration
Duchenne muscular dystrophy (DMD): most serious form
Spinal cord injuries
approximately 10,000 new cases a year
85-90% males aged 16-30
MVA cause approximately 36%
gunshot wounds cause approximately 29%
falls cause approximately 21%
Acquired Immune Deficiency Syndrome (AIDS)
disease caused by the human immunodeficiency virus (HIV), which attacks the immune system
leads to opportunistic infections and tumors
AIDS complex dementia (ACD)
Prevalence: 19.9 per 100,000
approximately 8,600 children under 13
approximately 420,000 citizens of U.S. die each year from AIDS; 5,000 of these are under 15 years of age
Seizure Disorders (Epilepsy)
Approximately 2,500,000 people in the U.S. have some type of seizure disorder, about 30% are children
Diabetes
difficulty with regulation of blood insulin levels affecting metabolism of glucose
secondary complication: blindness, cardivascular disease, kidney disease, neuropathies may occur over time
juvenile onset diabetes tends to be more severe and progressive
brittle diabetes have very limited tolerance for dietary intake
approximately 6% of U.S. population have diabetes
Cystic Fibrosis
Inherited, systemic disorder of secretion glands
obstructs the functions of the lungs, pancreas, and sweat glands
occurs primarily in Caucasians, affects approximately 30,000 children and adults in U.S., app. 3 in every 10,000 live births
Sickle Cell Anemia
abnormality of hemoglobin molecule found in red blood cells
block microvascular channels causing anoxia
approximately 1 in 400 African-American infants has sickle cell anemia; 7-10% of African Americans carry a single recessive gene for Sickle Cell Anemia
Society & Health Related Issues
Child Abuse & Neglect
neglect
abusepsychological abuse
physical abuse
episodic/explosive
male
femalerole of alcohol abuse/dependence
psychotic
sadistic
sexual abuse
incident
chronic
incest
Maternal Drug and Alcohol Abuse
Fetal Alcohol Syndrome (FAS) & Fetal Alcohol Effects (FAE)
Health education and prevention efforts
teenage pregnancy
substance use prvention
wellness education
physical education
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