Los Angeles Mission College



← Outline Chapter 28

The New Face of

Developmental Disabilities

← What is the relationship between developmental disabilities and other medical conditions?

← Sickle Cell Disease

← Autosomal recessive disorder, results in the production of an abnormal hemoglobin

← Crescent-shaped cells

← Most common in those with sub-Saharan African ancestry

← Prevalent in 1 in 2,647 births

← 41 states screen newborns at birth

← Includes neurological complications and abnormal immune functioning

← Clinical manifestations of Sickle Cell Disease

← Anemia

← Jaundice

← Gall stones

← Restrictive lung disease

← Pulmonary hypertension

← Retinopathy

← Leg ulcers

← Delays in physical growth and sexual maturation

← Developmental and behavioral manifestations of Sickle Cell Disease

← Developmental disability in cognitive and academic domains

← High proportion born into low socioeconomic status

← Produces family stress,

← Increased school absenteeism

← Behavior problems (aggression, oppositional defiant disorder, conduct disorder, depression)

← Treatment

← Penicillin to prevent bacterial infections

← Bone marrow transplantation

← Regular doctor visits, immunizations, documentation of spleen size/baseline blood counts

← Medication for pain management

← Life expectancy significantly increases with early identification and individualized therapies

Cancer and Brain Tumors

← Most common: leukemias (blood cell cancers) and central nervous system (CNS) tumors

← 2,000 children under 15 diagnosed in U.S. each year

← More frequent in boys

← Peak incidence: 2–6 years of age

← Symptoms include anorexia, fatigue, bone pain, irritability, fever, persistent and severe headache, vomiting

← Treatment for Cancer and Brain Tumors:

← Bone marrow transfussions

← Central Nervous System prophylactic treatment to prevent relapses

← Maintenance of chemotherapy for 2–3 years

← Affects academic progress in reading and math

← Poor neurocognitive outcomes

← Psychological adjustment problems

← Survival rate is nearly 80%

← For Cancers in the Central Nervous System, survival depends on tumor type

← Greatly decreased mortality and morbidity

← Challenges in continuing academic education (repeat grades) and adult employment

Human Immunodeficiency Virus/ HIV

← It is a viral infection transmitted by sexual contact, blood exposure/needles, mucous membrane exposure, mother-to-child, contaminated blood products

← Transmission can be prevented in 98% of cases

← Severe clinical presentation: AIDS

← Clinical manifestations of HIV

← During Infancy: enlargement of lymph glands, enlarged liver, poor weight gain, diarrhea, pneumonia, thrush

← During Childhood: recurrent bacterial infections, chronic swelling of parotid, lymphocytic interstitial pneumonia (LIP), progressive neurologic deterioration

← Biomedical factors: amount of viral load, age at time of infection, clinical symptoms at diagnosis, and treatment

← Biosocial factors: prenatal drug exposure, malnutrition, prematurity, poverty, neglect, family stress, developmental disabilities

← Behavior problems: learning deficits, hyperactivity, impulsive-hyperactive behavior, conduct disorder, and anxiety

← Society challenges related to stigma…….

← Treatment

← Highly active antiretroviral therapy (ART)

← In developing countries ART is not available

← Prognosis worst in children who have opportunistic infections, encephalopathy, or wasting syndrome

← 75% mortality rate before age 3

Chronic Kidney Disease

← It is a progressive and irreversible loss of renal (kidney) function

← In Children affects neurodevelopment and cognitive function

← Can result from congenital causes, acquired diseases, and genetic disorders

← Prevalence is15 per million, twice as many boys as girls

← Symptoms include anorexia, vomiting, weakness, fatigue, and deficits in neurocognitive function

← Clinical manifestations

← Kidney no longer able to balance electrolytes, filter waste from blood, and regulate blood pressure

← Stages 1 and 2: renal function deteriorates

← Can produce Polyuria (excessive passage of urine), oliguria (decreased passage of urine), anuria (absence of urine), edema (abnormal accumulation of fluid in body tissues), hypertension (elevated blood pressure), hematuria (blood in urine), proteinuria (protein in urine)

← Treatments include nutritional and hormonal support for growth failure, and preparation for renal replacement therapy

← Kidney transplantation

← Management of condition as there is no cure, but can have improvements with medical treatment

← For children, school needs to support academics due to poor physical, social, emotional, and educational functioning

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