Pediatric Conditions

Pediatric Conditions in Occupational Therapy

Cerebral palsy
Sensory processing disorder
Developmental delays
ADHD - Attention-Deficit - Hyperactivity Disorder
Down syndrome
Spina bifida
Learning disabilities
Feeding difficulties
Brachial plexus
Traumatic brain injury
Burns

Cancer
Fine motor delays
Difficulty balancing
Hand injuries
Muscular dystrophy
Spinal injury
Traumatic injuries
ADD
Cognitive disorders
Congenital hand deformities
Decreased eye hand coordination

Autism

Autistic Spectrum Disorders

Autism means your child may have: Difficulties interacting with other people or differences in how they interact with others. Trouble using and understanding nonverbal communication, like eye contact, gestures and facial expressions. Delayed or absent language development.

Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain.
People with ASD often have problems with social communication and interaction, and restricted or repetitive behaviors or interests.
People with ASD may also have different ways of learning, moving, or paying attention.
It is important to note that some people without ASD might also have some of these symptoms. But for people with ASD, these characteristics can make life very challenging.

Signs and Symptoms :

Avoids or does not keep eye contact
Does not show facial expressions such as happy, sad, angry, and surprised by 9 months of age
Does not play simple interactive games like pat-a-cake by 12 months of age
Uses few or no gestures by 12 months of age (for example, does not wave goodbye)
Does not share interests with others by 15 months of age (for example, shows you an object that they like)
Does not point to show you something interesting by 18 months of age
Does not notice when others are hurt or upset by 24 months (2 years) of age
Does not notice other children and join them in play by 36 months (3 years) of age
Does not pretend to be something else, like a teacher or superhero, during play by 48 months (4 years) of age
Does not sing, dance, or act for you by 60 months (5 years) of age

Treatment and Intervention for Autism Spectrum Disorder :

There are many types of treatments available. These treatments generally can be broken down into the following categories, although some treatments involve more than one approach:

Behavioral
Developmental
Educational
Social-relational
Pharmacological
Psychological
Complementary and alternative

Behavioral approaches :

It focus on changing behaviors by understanding what happens before and after the behavior. Behavioral approaches have the most evidence for treating symptoms of ASD. They have become widely accepted among educators and healthcare professionals and are used in many schools and treatment clinics. A notable behavioral treatment for people with ASD is called applied behavior analysis (ABA). ABA encourages desired behaviors and discourages undesired behaviors to improve a variety of skills. Progress is tracked and measured.

Two ABA teaching styles are discrete trial training (DTT) and pivotal response training (PRT).

DTT uses step-by-step instructions to teach a desired behavior or response. Lessons are broken down into their simplest parts, and desired answers and behaviors are rewarded. Undesired answers and behaviors are ignored.
PRT takes place in a natural setting rather than clinic setting. The goal of PRT is to improve a few “pivotal skills” that will help the person learn many other skills. One example of a pivotal skill is being able to initiate communication with others.

Developmental approaches :

Developmental approaches focus on improving specific developmental skills, such as language skills or physical skills, or a broader range of interconnected developmental abilities. Developmental approaches are often combined with behavioral approaches.

The most common developmental therapy for people with ASD is speech and language therapy. Speech and language therapy helps to improve the person’s understanding and use of speech and language. Some people with ASD communicate verbally. Others may communicate through the use of signs, gestures, pictures, or an electronic communication device.
Occupational therapy teaches skills that help the person live as independently as possible. Skills may include dressing, eating, bathing, and relating to people. Occupational therapy can also include:

Sensory integration therapy

Sensory integration therapy to help improve responses to sensory input that may be restrictive or overwhelming.

Physical therapy

Physical therapy can help improve physical skills, such as fine movements of the fingers or larger movements of the trunk and body.

The Early Start Denver Model (ESDM) is a broad developmental approach based on the principles of ABA. It is used with children 12–48 months of age. Parents and therapists use play, social exchanges, and shared attention in natural settings to improve language, social, and learning skills.

Educational approaches :

Educational treatments are given in a classroom setting. One type of educational approach is the Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH) approach.
TEACCH is based on the idea that people with autism thrive on consistency and visual learning. It provides teachers with ways to adjust the classroom structure and improve academic and other outcomes.
For example, daily routines can be written or drawn and placed in clear sight. Boundaries can be set around learning stations. Verbal instructions can be complemented with visual instructions or physical demonstrations.

Social-relational approaches :

Social-relational treatments focus on improving social skills and building emotional bonds. Some social-relational approaches involve parents or peer mentors.

The Developmental, Individual Differences, Relationship-Based model (also called DIR or “Floor Time”) encourages parents and therapists to follow the interests of the individual to expand opportunities for communication.
The Relationship Development Intervention (RDI) model involves activities that increase motivation, interest, and abilities to participate in shared social interactions.
Social Stories provide simple descriptions of what to expect in a social situation.
Social skills groups provide opportunities for people with ASD to practice social skills in a structured environment.

Pharmacological approaches :

Some medications treat co-occurring symptoms (those that happen along with ASD) and can help people with ASD function better.
For example, medication might help manage high energy levels, inability to focus, or self-harming behavior, such as head banging or hand biting. Medication can also help manage co-occurring psychological conditions, such as anxiety or depression, in addition to medical conditions such as seizures, sleep problems, or stomach or other gastrointestinal problems.
It is important to work with a doctor who has experience in treating people with ASD when considering the use of medication. This applies to both prescription medication and over-the-counter medication. Individuals, families, and doctors must work together to monitor progress and reactions to be sure any negative side effects of the medication do not outweigh the benefits.

Psychological approaches :

Psychological approaches can help people with ASD cope with anxiety, depression, and other mental health issues. Cognitive-behavior therapy (CBT) is one psychological approach that focuses on learning the connections between thoughts, feelings, and behaviors.
During CBT, a therapist and the individual work together to identify goals and then change how the person thinks about a situation to change how they react to the situation.

Complementary and alternative treatments :

Some people with ASD and their families use treatments that do not fit into any of the other categories. These treatments are known as complementary and alternative treatments.
Complementary and alternative treatments are often used to supplement more traditional approaches. They might include special diets, herbal supplements, chiropractic care, animal therapy, arts therapy, mindfulness, or relaxation therapies.
Individuals and families should always talk to their doctor before starting a complementary and alternative treatment.

Developmental, Individual Differences, Relationship-Based Approach (DIR) :

Treatment and Education of Autistic and Related Communication-handicapped Children (TEACCH) :

The Picture Exchange Communication System (PECS) :

This is another visual-based treatment, but it uses symbols instead of picture cards. Your child learns to ask questions and communicate through special symbols. Occupational Therapy. This kind of treatment helps your child learn life skills like feeding and dressing themselves, bathing, and understanding how to relate to other people. The skills they learn are meant to help them live as independently as they can.

Sensory Integration Therapy :

Medications :

There is no cure for autism spectrum disorder, and there’s currently no medication to treat it. But some medicines can help with related symptoms like depression, seizures, insomnia, and trouble focusing.
Studies have shown that medication is most effective when it’s combined with behavioral therapies.
Risperidone (Risperdal) and Aripiprazole (Abilify) are the only drugs approved by the FDA for children with autism spectrum disorder. Risperidone can be prescribed for children between 5 and 16 years old to help with irritability and aggression. Aripiprazole can be prescribed for children between 6 and 17 years old.

ADHD - Attention-Deficit / Hyperactivity Disorder

ADHD – Attention-Deficit / Hyperactivity Disorder

ADHD is one of the most common neurodevelopmental disorders of childhood. Neurodevelopmental means having to do with the way the brain grows and develops.
ADHD is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviours (may act without thinking about what the result will be), or be overly active.

ADHD Types :

There are three different ways ADHD presents itself, depending on which types of symptoms are strongest in the individual at the time of diagnosis:

Signs and symptoms :

It is normal to have trouble focusing and behaving at one time or another. However, children with ADHD do not grow out of these behaviors. The symptoms can continue, can be severe, and can cause difficulty at school, at home, or with friends.

Signs :

A child with ADHD might

Daydream a Lot
Forget or Lose Things a Lot
Squirm or Fidget
Talk Too Much
Make Careless Mistakes or Take Unnecessary Risks
Have a Hard Time Resisting Temptation
Have Trouble Taking Turns
Have Difficulty Getting Along With Others

Symptoms :

Based on the types of symptoms, three kinds (presentations) of ADHD can occur:

Treatment types :

Treating ADHD in children involves a combination of therapies.

Behavioral therapy

Parent training in behavior management

Therapists teach parents ways to manage their child’s behavior, including setting clear routines, positive reinforcement, and how to handle unwanted behavior. This is the only type of treatment recommended for young children since they aren’t yet able to control their behavior without their parent’s help.

Play/talk therapy

This kind of therapy is more useful for older children and teens. This provides them with a space to express their emotions and talk about their problems.

Medication

Stimulants

These are the most common medications for ADHD. Examples include dextroamphetamine and methylphenidate. They help improve focus and attention and reduce impulsiveness.

Non-stimulants

These may be used when stimulants don’t work well or cause side effects. Examples include atomoxetine, clonidine, and guanfacine. They take longer to work, but some of them can last up to 24 hours.

Treatment recommendations :

For children with ADHD younger than 6 years of age, the American Academy of Pediatrics (AAP) recommends parent training in behavior management as the first line of treatment, before medication is tried.
Cognitive behavioral therapy (CBT): This helps you reframe your negative thought patterns, manage your emotions, and develop coping skills for your ADHD symptoms.
ADHD coaching: A coach provides practical support for day-to-day living such as organization, time management, and completing tasks.
Medication
Stimulants Your doctor may prescribe amphetamine or methylphenidate.
Non-stimulant Options include atomoxetine, clonidine, and guanfacine.
Lifestyle changes
Regular exercise: Physical activity helps improve focus, lower impulsiveness, and boost your mood.
Sleep: Getting enough sleep is important to manage ADHD symptoms, as they can get worse when you are sleep deprived.
Stress management: Stress can make ADHD symptoms worse.

Cerebral Palsy

Types of Cerebral Palsy :

There are several types of cerebral palsy that are characterized by the location of the brain injury. Symptoms can vary depending on where and how badly the brain was damaged.

Ataxic cerebral palsy

This type is caused by damage to the cerebellum, resulting in motor control and movement issues.

Athetoid / dyskinetic cerebral palsy

Caused by damage to the basal ganglia and/or cerebellum, this condition results in fluctuating muscle tone and involuntary movements.

Hypotonic CP

This rare type, also connected to cerebellum damage, is characterized by floppy muscles, excess flexibility, and poor mobility.

Spastic CP

The most common type of cerebral palsy, this is caused by damage to the motor cortex and characterized by tight muscles and jerking movements.

Mixed CP

Multiple areas of brain damage can lead to patients having more than one type of CP.

Physical Symptoms :

Contractures (shortening of muscles)
Difficulties swallowing or sucking
Drooling
Exaggerated or jerky reflexes
Floppy muscle tone
Gastrointestinal problems (involving food digestion)
Incontinence (loss of bladder control)
Involuntary movements or tremors
Lack of coordination and balance
Problems with movement on one side of the body
Stiff muscles (spasticity) Check with your child’s Pediatrician if they are experiencing any of these symptoms

Neurological Symptoms :

These affect the brain and nervous system, leading to learning, communication, and sensory processing difficulties.

Build-up of pressure in the brain due to fluid imbalance (hydrocephalus)
Behavioural problems
Delayed motor skill development
Difficulty with speech and language (dysarthria)
Sensory impairments
Visual and hearing impairments

There are many different therapy options to help treat cerebral palsy symptoms. Therapy can be used to improve mobility and brain cognition.

Four main types of cerebral palsy treatment are :

Physical therapy

Physical therapy relieves pain, reduces muscle stiffness, and enhances balance, coordination, and overall mobility. Physical therapists use specialized equipment to help your child move freely and live independently.

Occupational therapy

Occupational therapy enables children with CP to master daily tasks and activities by developing fine motor skills and cognitive abilities.

Speech therapy

Speech therapy improves communication and language skills, fostering confidence in learning and socializing. It also assists children with eating and swallowing difficulties.

Alternative therapy

Alternative therapy encourages children to focus on personal growth and navigate physical and mental challenges. It includes methods like hippotherapy (horse riding), music therapy, aquatic therapy, and acupuncture.

Assistive devices

Assistive devices Specialized assistive devices can help individuals with CP who experience issues with communication, hearing, and vision.

Types of assistive devices for cerebral palsy include :

Cochlear implants to improve hearing
Computers and software for communication enhancement
Eye-tracking devices
Hearing aids and telephone amplifiers for clearer hearing
Picture books for visual communication aids
Vision aids like glasses, magnifiers, and large-print materials
Voice synthesizers for speech support
Writing and typing aids

Types of cerebral palsy mobility aids include :

Canes and crutches
Lifts for shoes
Motorized wheelchairs
Orthotic devices for muscle balance and mobility
Power scooters
Rolling walkers for mobility support
Cerebral palsy is a group of conditions that affect movement and posture. It’s caused by damage that occurs to the developing brain, most often before birth. Symptoms appear during infancy or preschool years and vary from very mild to serious.
Children with cerebral palsy may have exaggerated reflexes.

Sensory Processing Disorder

Examples of sensory input may include :

Children who have sensory issues may have an aversion to things that over stimyh ulate their senses, such as loud environments, bright lights, or intense smells. Or, they may seek out additional stimulation in settings that don’t stimulate their senses enough.

Proprioception

Proprioception is the “internal” sense of awareness you have for your body. It’s what helps you maintain posture and motor control, for example. It also tells you about how you’re moving and occupying space.

Vestibular

This term refers to the inner ear spatial recognition. It’s what keeps you balanced and coordinated.

Interoception

This is the sense of what’s happening in your body. It may be best understood as how you “feel.” This includes whether you feel hot or cold and whether you feel your emotions.

Five senses

Lastly, there are the 5 common senses — touch, hearing, taste, smell, and sigh.

Signs and symptoms of sensory processing disorder :

Children who are easily stimulated may have hypersensitivity. This means they have an increased sensitivity to sensory inputs like light, sound, and touch. These sensations may bother them more, cause them to lose focus in the presence of too much sensory information, or cause them to act out.
Children may also experience hyposensitivity. This means they may have reduced sensitivity to sensory output.

Sensory hypersensitivity may cause :

A Low Pain Threshold
Appearing Clumsy
Fleeing Without Regard to Safety
Covering Eyes or Ears Frequently
Picky Food Preferences or Gagging When Eating Foods of Certain Textures
Resisting Hugs or Sudden Touches
Feeling That Soft Touches Are Too Hard
Difficulty Controlling Their Emotions
Difficulty Focusing Attention
Difficulty Adapting Responses
Behaviour Problems

Sensory hyposensitivity may cause :

A High Pain Threshold
Bumping Into Walls
Touching Things
Putting Things Into Their Mouth
Giving Bear Hugs
Crashing Into Other People or Things
Not Regarding Personal Space
Rocking and Swaying

In most cases, sensory issues occur in children, but adults can experience them too. Many children with altered sensory processing are on the autism spectrum.

Autism spectrum disorder (ASD)

Autistic people may have changes to the neural pathways in their brain responsible for processing sensory information.

Attention deficit hyperactivity disorder (ADHD)

ADHD affects the ability to filter out unnecessary sensory information, which can lead to sensory overload.

Schizophrenia

In people with schizophrenia, abnormal mechanisms in the brain’s sensory pathway and in the way it creates and organizes connections between neurons can cause altered sensory and motor processing.

Sleep Disorders

Sleep disorders, such as sleep deprivation, may result in delirium, which can cause temporary sensory processing issues.

Developmental delay

Developmental delays are also not uncommon in people with sensory issues.

Brain injury

Traumatic brain injury (TBI) may be another potential cause of sensory processing disorder, according to 2019 research Trusted Source.

Sensory issues diagnosed :

Sensory processing disorder isn‘t an officially recognized neurological condition. This means there is no formal criteria for a diagnosis.
Instead, doctors, educators, or healthcare professionals who help children with issues processing sensory information work from what they see in the child’s behaviors and interactions to determine how to best support them. Generally, these sensory issues are highly visible.

Developmental Delays

A developmental delay refers to a child who has not gained the developmental skills expected of him or her, compared to others of the same age.
Delays may occur in the areas of motor function, speech and language, cognitive, play, and social skills.
Global developmental delay means a young child has significant delays in two or more of these areas of development.

Causes of Developmental Delay :

Genetic or hereditary conditions like Down syndrome
Metabolic disorders like phenylketonuria (PKU)
Trauma to the brain, such as shaken baby syndrome
Severe psychosocial trauma, such as post-traumatic stress disorder
Exposure to certain toxic substances like prenatal alcohol exposure or lead poisoning
Some very serious infections
Deprivation of food or environment

Symptoms of Developmental Delay :

Learning and developing more slowly than other children same age
Rolling over, sitting up, crawling, or walking much later than developmentally appropriate
Difficulty communicating or socializing with others
Lower than average scores on IQ tests
Difficulties talking or talking late
Having problems remembering things
Inability to connect actions with consequences
Difficulty with problem-solving or logical thinking
Trouble learning in school
Inability to do everyday tasks like getting dressed or using the restroom without help

Therapies for Developmental Delays :

Physical Therapy

Physical therapy is often helpful for children with delays in gross motor skills.

Occupational Therapy

This can addresses fine motor skills, sensory processing and self-help issues.

Speech and Language Therapy

Speech therapy is typically used to address problems in the areas of understanding and producing language and speech sounds.

Early Childhood Special Education

Early childhood special education provides stimulation for early developmental skills, including play skills.

Behavioural therapy

This may be needed in some children for behavioural difficulties that affect socially appropriate behaviours.

Down Syndrome

Down syndrome is a genetic condition that causes mild to significant physical and developmental problems.
People with Down syndrome (DS) are born with an extra chromosome. Chromosomes are bundles of genes, and your body relies on having just the right number of them. With Down syndrome, this extra chromosome leads to a range of issues that affect you both mentally and physically.

Types of Down Syndrome :

Trisomy 21

This is the most common type of Down syndrome, with 95% of people with DS having trisomy 21. Here, all your body’s cells have three copies of chromosome 21 instead of two.

Translocation Down syndrome

About 3% of people with Down syndrome have this type, where there’s an extra part or whole chromosome 21, but it’s attached to another chromosome instead of being a separate chromosome 21.

Mosaic Down syndrome

This type of Down syndrome, which affects about 2% of people with the condition, happens when only some cells in your body have an extra chromosome 21.

Symptoms :

Mental abilities vary, but most people with Down syndrome have mild to moderate issues with thinking, reasoning, and understanding. They’ll learn and pick up new skills their whole lives, but they may take longer to reach important goals like walking, talking, and developing social skills.

People with Down syndrome may also have trouble with behavior – they may not pay attention well, or can be obsessive about some things. That’s because it’s harder for them to control their impulses, relate to others, and manage their feelings when they get frustrated.

Features :

Eyes that slant up at the outer corner
Small ears
A flat nose
Tongue that sticks out
Tiny white spots in the colored part of the eyes
Short neck and overall height
Small hands and feet
Short stature
Loose joints
Weak muscle tone and joints
Small pinky fingers that curve
One crease across the palm of the hand

Down Syndrome Diagnosis :

After a baby is born, a doctor may suspect Down syndrome in a newborn based on the baby’s appearance. But some babies without DS may have similar physical features to a baby with Down syndrome.

A diagnosis can be confirmed by a blood test called a karyotype test that lines up the chromosomes and will show if there’s an extra chromosome 21.

Treatments for Down Syndrome :

There’s no specific treatment for Down syndrome. But there is a wide range of physical and developmental therapies designed to help people with Down syndrome reach their full potential.

The earlier you start treatment, the better. Children with Down syndrome can usually hit the same milestones as other children but at later stages.

Physical, occupational, and speech therapy

Physical and speech therapists can help your child with sitting and walking properly, developing speech, and learning to communicate. Occupational therapists teach everyday skills like how to get dressed, eat, or use a computer.

Behavioural counseling

Children with Down syndrome may also have conditions like ADHD, autism, or compulsive behaviours that need to be addressed.

Specialized education services

By law in the U.S., children with Down syndrome can get free educational services and devices to help with learning. This assistance lasts until age 21 or when they finish high school, whichever comes first.

Spina Bifida

Spina bifida is a birth defect in which an area of the spinal column doesn’t form properly, leaving a section of the spinal cord and spinal nerves exposed through an opening in the back.
The most common and serious form of spina bifida is called myelomeningocele (my•e•lo•me•nin•go•cele) (MMC), in which part of the spinal cord and surrounding nerves push through the open bones (vertebrae) in the spine and protrude from the fetus’ back.

Spina Bifida Symptoms :

The myelomeningocele lesion can occur at any level on the developing spine, but most are found in the lumbo-sacral region. Depending on the lesion’s location, myelomeningocele may cause:

Bladder and bowel problems (incontinence)
Sexual Dysfunction
Weakness and loss of sensation below the defect
Inability to move the lower legs (paralysis) and other cognitive impairments
Orthopaedic malformations such as club feet or problems of the knees or hips

Generally, the higher the defect is located on the spine, the more severe the complications.

In many cases, the brain develops an Arnold-Chiari II malformation, in which the hindbrain herniates or descends into the upper portion of the spinal canal in the neck. This herniation of the hindbrain blocks the circulation of cerebrospinal fluid, causing hydrocephalus (accumulation of fluid in the brain), which can injure the developing brain. Ventricular shunting (placement of a thin tube into the ventricles of the brain) is used to drain fluid and relieve hydrocephalus.

Evaluation and diagnosis of spina bifida :

Sonographic features suggestive of myelomeningocele include a cystic mass anywhere on the spine. If no skin covers the defect, abnormally high alpha-fetoprotein (AFP) levels in the blood and amniotic fluid will support the diagnosis. Mothers referred to CHOP’s Center for Fetal Diagnosis & Treatment for a spina bifida diagnosis undergo a comprehensive, one-day evaluation that includes:

High-resolution level II ultrasound – to confirm the diagnosis and determine the location of the lesion, and to assess for any other birth defects such as club feet
Ultrafast fetal MRI – to confirm presence of the Chiari II malformation and to screen for evidence of any other neurologic abnormalities
Fetal echocardiogram – to determine any problems with the heart
Amniocentesis – to confirm the presence of elevated amniotic fluid alpha-fetoprotein (AFAFP) levels and acetylcholinesterase (AChE), which indicate open neural tube defects

Spina Bifida Treatment :

The two main spina bifida treatment options are fetal surgery during pregnancy or surgery on the baby right after birth.

Deciding whether prenatal or postnatal spina bifida repair is appropriate is influenced by several considerations, including gestational age, the level of the myelomeningocele lesion on the spine, presence of the Chiari II malformation, and a number of important maternal health factors.

Prenatal repair also requires a significant commitment on the part of the mother and her support person. Read our criteria for fetal surgery to determine when fetal surgery for myelomeningocele is an option.

Our team helps each family fully understand the benefits and risks of spina bifida treatment so they can make the best decision for their unique situation. Our team also counsels and supports families who choose to terminate the pregnancy.

Learning Disability

Learning Disabilities

Types of Learning Disabilities :

Dyslexia

Dyslexia is the most common learning disability, accounting for 80% of all learning disability cases.

Dysgraphia

People with dysgraphia may have difficulty putting their thoughts into writing due to issues with vocabulary, spelling, grammar, memory, and critical thinking.

Dyscalculia

Sometimes known as “math dyslexia,” this condition includes learning disorders related to mathematics, such as difficulty with numbers, concepts, and reasoning.

Auditory processing disorder (APD)

People with APD may have difficulty processing sounds because their brain misinterprets auditory information received by the ear.

Language processing disorder (LPD)

This is a subset of APD, characterized by difficulties with processing spoken language.

Nonverbal learning disabilities (NVLD)

NVLD is characterized by difficulty interpreting nonverbal cues such as facial expressions, body language, tone of voice, and other nonverbal signals.

Visual perceptual/visual motor deficit

People with this condition may have difficulty with hand-eye coordination and motor activities.

Symptoms :

These are some of the symptoms of learning disabilities

Poor memory
Difficulty focusing
Short attention span
Difficulty with reading or writing
Inability to distinguish between sounds, letters, or numbers
Difficulty sounding out words
Tendency to put numbers or letters in the wrong sequence
Difficulty telling time
Confusion between right and left
Tendency to reverse letters
Difficulty grasping certain words and concepts
Disconnect between words and meaning (i.e.. saying one thing but meaning another)
Difficulty expressing thoughts and emotions
Poor hand-eye coordination
Delayed speech development
Disorganization
Trouble with listening and following instructions
Inappropriate responses
Restlessness and impulsiveness
Tendency to act out
Difficulty with discipline
Resistance to change
Inconsistent performance on a daily or weekly basis

Diagnosing Learning Disabilities :

A healthcare professional can diagnose learning disabilities. The diagnostic process might involve.

Academic testing

The healthcare provider may administer a standardized achievement test that checks the person’s reading, writing, and arithmetic skills, as well as an intelligence quotient (IQ) test. If the person performs well on the IQ test but has a lower score on the achievement test, it could indicate that they have a learning disability.

Performance review

The healthcare provider may review and evaluate the person’s academic, professional, social, and developmental performance.

Medical history

The healthcare provider will likely ask questions about the person’s personal and family medical history.

Physical and neurological exam

The healthcare provider may conduct a physical and neurological exam to check for other health conditions such as brain diseases, mental health conditions, and developmental and intellectual disabilities.

Treatment :

Special education

Children with learning disabilities may benefit from education by specially trained teachers who perform a comprehensive evaluation of the child’s abilities and then help the child build on their strengths while compensating for their disabilities.

Medication

Some people may need to take medication to improve their ability to focus and concentrate.

Therapy

Psychotherapy can help people with learning disabilities deal with emotional issues and develop coping skills.

Other interventions

People with learning disabilities may also benefit from other interventions such as speech and language therapy.

Support groups

People with learning disabilities as well as parents of children with learning disabilities may benefit from support group meetings that help them connect with others who have similar experiences. Learning difficulties can often lead to tension, misunderstandings, and conflicts among the family, particularly among families where the condition is hereditary.

Feeding Difficulties

Feeding can become a problem when your child is losing weight or having trouble gaining the right amount of weight for their age. Your child or baby has feeding problems when:

With a baby, you might have breastfeeding problems. Other baby feeding problems might come from your baby not being able to suck, chew, or swallow. Eating disorders in young children are called feeding disorders. They might also be called toddler eating disorders. (Usually, the term eating disorder is used for pre-teens, teenagers, and adults.)

With treatment, feeding disorders can get better. Eating can turn into a safer, easier, and happier experience for your child and the rest of the family. Treatment can also help your child become healthier.

Symptoms :

Not gaining weight well
Coughing, choking, or gagging when eating or drinking
Throwing up often
Choking on food or drink once during a meal and not eating again
Eating and breathing coordination problems
Not eating baby food purees by 8 months old
Not eating table foods by 12 months old
Not using a cup by 16 months old
Eating baby foods at 16 months old
Avoiding foods with a certain texture or from a certain food group (such as fruits and vegetables)
Eating fewer than 20 kinds of food, especially when they stop eating certain foods and don’t replace them with other foods
Crying or arching the back at most meals
Taking more than 30 minutes to eat meals on a regular basis
Arguing with your child about food and feeding
When feeding your child is difficult for everyone
Eating problems you have that your child may get from you

Feeding disorders are more than picky eating. Feeding difficulties in children are almost always caused by some other medical problem, including:

Gastroesophageal reflux. This is a condition where acid from the stomach flows back into the esophagus, the tube that connects your child’s mouth to their stomach.
Eosinophilic esophagitis or inflammation of the esophagus
Other stomach or intestine problems
Seizures
Nervous system problems
Premature birth
Sensory system problems
Autism
Craniofacial [CRAY-nee-oh-FAY-she-awl] syndromes or abnormalities of the face or head
Heart or lung problems
Face and mouth muscle problems
Problems swallowing certain liquids and food textures

Diagnosis and Tests :

Treatments :

After the feeding evaluations, the therapist may recommend several ways to help your child, including:

Putting your child in certain safe eating and drinking positions
Giving your child certain drinks and foods that are safe for them
Helping your child to eat a wider variety of foods, and drink assorted drinks
Teaching you and your child safe feeding and drinking skills
Coordinating services with other medical and therapy professionals

Prevention :

Most causes of feeding problems cannot be prevented. Some steps you can take to make eating a healthy time that your child likes include:

Brachial Plexus

The brachial plexus (BRAY-key-el PLEK-sis) is a network of nerves that provides movement and feeling to the shoulder, arm and hand. The nerves supporting the arm exit the spinal column high in the neck; those that support the hand and fingers exit lower in the neck.

This nerve complex is composed of four cervical nerve roots (C5-C8) and the first thoracic nerve root (T1). These roots combine to form three trunks. C5-C6 form the upper trunk, C7 continues as the middle trunk and C8-T1 form the lower trunk.

Each trunk splits into a division. Half the divisions globally supply flexor muscles (that lift and bend the arm). The others supply the extensor muscles (that straighten the arm and bring it down).

Causes of Brachial Plexus Injury :

A brachial plexus birth injury is thought to be caused by an injury involving the child’s brachial plexus during the delivery process. This injury may result in incomplete sensory and / or motor function of the involved arm.
Traumatic brachial plexus injuries may occur due to motor vehicle accidents, bike accidents, ATV accidents, sports, etc. Nerve injuries vary in severity from a mild stretch to the nerve root tearing away from the spinal cord.

Symptoms of Brachial Plexus Injury :

Types of Brachial Plexus Injuries :

Avulsion

The nerve is torn away from its attachment at the spinal cord; the most severe type. An eyelid droop suggests an avulsion of the lower brachial plexus (Horner’s syndrome).

Rupture

The nerve is torn, but not at the spinal cord attachment.

Neuroma

Scar tissue has grown around the injury site, putting pressure on the injured nerve and preventing the nerve from sending signals to the muscles.

Neurapraxia

The nerve has been stretched and damaged but not torn.

Conditions Related to Brachial Plexus Injuries :

Erb’s Palsy

C5, C6 and sometimes C7 nerves are involved
Often presents with arm straight and wrist fully bent (waiter’s tip)
May have good hand function but not full movement of the arm
May have instability of the shoulder joint
Often presents with weak biceps and deltoid muscles (unable to bend elbow or lift arm at the shoulder)
Includes about 75 percent of all brachial plexus injuries

Global Palsy

Horner Syndrome

Treatment for Brachial Plexus Injury :

Nonsurgical management is also an important part of the treatment process.

Occupational and / or physical therapy is often recommended including range of motion, strengthening, neuromuscular electrical simulation, Kinesio Taping, joint mobilization, aquatic therapy and use of or thoses.

Traumatic Brain Injury

A traumatic brain injury (TBI) is a serious medical issue that affects how your brain works.
You can get a TBI from a hard bump or jolt to your head or if you’re hit with something that penetrates your skull. Traumatic brain injuries are a major cause of death and disability.
They can cause short-term and long-term medical issues that can affect every part of your life.
There are treatments for TBI. More importantly, there are ways to prevent them from happening.

Types of Traumatic Brain Injury :

Hematoma

A hematoma is a blood clot within the brain or on its surface. Hematomas may occur anywhere within the brain. An epidural hematoma is a collection of blood between the dura mater (the protective covering of the brain) and the inside of the skull. A subdural hematoma is a collection of blood between the dura mater and the arachnoid layer, which sits directly on the surface of the brain.

Contusion

A cerebral contusion is bruising of brain tissue. When examined under a microscope, cerebral contusions are comparable to bruises in other parts of the body. They consist of areas of injured or swollen brain mixed with blood that has leaked from arteries, veins, or capillaries. Most commonly, contusions are at the base of the front parts of the brain, but may occur anywhere.

Intracerebral Hemorrhage

An intracerebral hemorrhage (ICH) describes bleeding within the brain tissue, may be related to other brain injuries, especially contusions. The size and location of the hemorrhage helps determine whether it can be removed surgically.

Subarachnoid Hemorrhage

Subarachnoid hemorrhage (SAH) is caused by bleeding into the subarachnoid space. It appears as diffuse blood spread thinly over the surface of the brain and commonly after TBI. Most cases of SAH associated with head trauma are mild. Hydrocephalus may result from severe traumatic SAH.

Diffuse Injuries

TBIs can produce microscopic changes that do not appear on CT scans and are scattered throughout the brain. This category of injuries, called diffuse brain injury, may occur with or without an associated mass lesion.

Diffuse Axonal Injury

Axonal injury refers to impaired function and gradual loss of axons. These long extensions of nerve cells enable them to communicate with each other. If enough axons are harmed in this way, the ability of nerve cells to communicate with each other and to integrate their function may be lost or greatly impaired, possibly leaving a patient with severe disabilities.

Ischemia

Another type of diffuse injury is ischemia or insufficient blood supply to certain parts of the brain. A decrease in blood supply to very low levels may occur commonly in a significant number of TBI patients. This is crucial since a brain that has just undergone a traumatic injury is especially sensitive to slight reductions in blood flow. Changes in blood pressure during the first few days after head injury can also have an adverse effect.

Skull Fractures

Linear skull fractures or simple breaks or “cracks” in the skull may accompany TBIs.

Symptoms :

Symptoms vary greatly depending on the severity of the head injury. They may include any of the following:

Vomiting
Lethargy
Headache
Confusion
Paralysis
Coma
Loss of consciousness
Dilated pupils
Vision changes (blurred vision or seeing double, unable to tolerate bright light, loss of eye movement, blindness)
Cerebrospinal fluid (CSF) (clear or blood-tinged) appear from the ears or nose
Dizziness and balance concerns
Breathing problems
Slow pulse
Slow breathing ratewith an increase in blood pressure
Ringing in the ears or changes in hearing
Cognitive difficulties
Inappropriate emotional responses
Speech difficulties (slurred speech, inability to understand and/or articulate words)
Difficulty swallowing
Body numbness or tingling
Droopy eyelid or facial weakness
Loss of bowel control or bladder control

Treatment :

In a mild case of TBI, symptoms normally go away without treatment. However, repeated, mild TBIs can be dangerous or fatalTrusted Source. This is why it is essential to rest and avoid further exposure until a doctor gives the go-ahead.
More severe cases will require hospitalization, possibly with intensive care.
Emergency care aims to stabilizeTrusted Source the patient’s condition and prevent any worsening of brain damage.
This will involve ensuring the airway is open, providing ventilation and oxygen, and maintaining blood pressure.
Medications may be used to help control symptoms.

Sedation

This can help prevent agitation and excess muscle activity and contribute to pain relief. Examples include profanol.

Pain relief

Opioids may be used.

Diuretics

These increase urine output and reduce the amount of fluid in tissue. These are administered intravenously. Mannitol is the most commonly used diuretic for TBI patients.

Anti-seizure medication

A person who has experienced moderate to severe TBI may have seizures for up to a week after the incident. Medication may help prevent further brain damage that may result from a seizure.

Coma-inducing medications

During a coma, a person needs less oxygen. Sometimes, a coma may be deliberately induced coma if the blood vessels are unable to supply adequate amounts of food and oxygen to the brain.

Surgery :

Surgery may be necessary in some cases

Removing a hematoma

Internal bleeding can cause partly or fully clotted blood to pool in some part of the brain, worsening the pressure on the brain tissue. Emergency surgery can remove a hematoma from between the skull and the brain, reducing pressure inside the skull and preventing further brain damage.

Repairing a skull fracture

Any part of the skull that is fractured and pressing into the brain will need to be surgically repaired. Skull fractures that are not pressing into the brain normally heal on their own. The main concern with a skull fracture is that forces strong enough to cause it may have caused further, underlying damage.

Creating an opening in the skull

This can relieve the pressure inside the skull if other interventions have not worked.

Burns

A burn is a traumatic injury to the skin (and sometimes the underlying tissues as well) caused by contact with extreme heat, chemicals, radiation or electricity.

Types of Burns :

Burns can be classified according to depth.

Superficial burns: involve the epidermis (the top layer of skin)
Partial-thickness burns: involve the epidermis and the dermis (the layer of skin underneath the epidermis that contains blood vessels, nerves, hair follicles and glands)
Full-thickness burns: involve both layers of skin; may extend into the subcutaneous tissue, muscle or bone underneath
Any burn that is more than superficial requires medical care. Many burns are potentially life-threatening and require EMS care.

Signs and Symptoms :

Burns through deep layers of skin, fat, muscle or bone*
Large body surface area burns
Burns to the face, mouth, nose, hands, feed, joints or groin*
Electrical, chemical, radiation or explosive burns*
Burns in people with medical conditions or other injuries*
Burns in very young or elderly*
Burns around limb, chest or neck*
Red, brown, black or white skin
Extreme to almost no pain
Swelling
Blisters that may ooze

Diagnosis :

If you go to a doctor for burn treatment, he or she will assess the severity of your burn by examining your skin. He or she may recommend that you be transferred to a burn center if your burn covers more than 10 percent of your total body surface area, is very deep, is on the face, feet or groin, or meets other criteria established by the American Burn Association.

Your doctor will check for other injuries and might order lab tests, X-rays or other diagnostic procedures.

Treatment :

Most minor burns can be treated at home. They usually heal within a couple of weeks.

For serious burns, after appropriate first aid and wound assessment, your treatment may involve medications, wound dressings, therapy and surgery. The goals of treatment are to control pain, remove dead tissue, prevent infection, reduce scarring risk and regain function.

People with severe burns may require treatment at specialized burn centers. They may need skin grafts to cover large wounds. And they may need emotional support and months of follow-up care, such as physical therapy.

Physical and occupational therapy :

Cancer

Childhood or pediatric cancer describes a group of cancers that affect children (infants to age 14) and teenagers (age 15 to age 19). Childhood cancer isn’t common, but when it happens, it changes the lives of children with the condition, their parents and caregivers.

Cancer Types :

Leukemias

Types of childhood cancer :

“Childhood cancer,” also called pediatric cancer, is a general term used to describe a range of cancer types found in children. Below are the most common types of cancer diagnosed in children under age 15:

Leukemia (accounts for about 28% of childhood cancer cases)

Symptoms :

Leukemia can cause a wide range of symptoms in kids. Some of the common ones include :

Tiredness
Weakness
Dizziness or lightheadedness
Shortness of breath
Pale skin
Infections that keep coming back or won’t go away
Bruises that happen easily
Nosebleeds
Bleeding gums
Joint pain
Swollen lymph nodes
Swollen stomach or abdomen

Children with Down syndrome or inherited immune system problems are at a higher risk for leukemia. So are kids who have a brother or sister — but not a parent — who has leukemia.

Other potential risks for leukemia include :

Radiation

There’s some evidence that CT scans, X-rays, and other sources of radiation are linked to a very small increased risk for leukemia. But the research here is mixed.

Chemicals

Some studies show that kids exposed to chemotherapy drugs, some manufacturing chemicals, or pesticides may have greater chances of getting leukemia. But more research is needed.

Immune suppression drugs

Kids who are on immune-suppressant treatments may be at a greater risk of leukemia.

Treatments :

There are treatments for childhood leukemia. The right one for your child will depend on the type of leukemia and other things.

Treatments include :

Physical symptoms

Contractures (shortening of muscles)
Difficulties swallowing or sucking
Drooling
Exaggerated or jerky reflexes
Floppy muscle tone
Gastrointestinal problems (involving food digestion)
Incontinence (loss of bladder control)
Involuntary movements or tremors
Lack of coordination and balance
Problems with movement on one side of the body
Stiff muscles (spasticity)

Check with your child’s Pediatrician if they are experiencing any of these symptoms.

Neurological symptoms

These affect the brain and nervous system, leading to learning, communication, and sensory processing difficulties.

Build-up of pressure in the brain due to fluid imbalance (hydrocephalus)
Behavioural problems
Delayed motor skill development
Difficulty with speech and language (dysarthria)
Sensory impairments
Visual and hearing impairments

There are many different therapy options to help treat cerebral palsy symptoms. Therapy can be used to improve mobility and brain cognition.

Fine Motor Delays

Fine motor developmental delays describe a lag in the ability to use the extremities (hands, fingers, wrists, tongue, lips, feet, and toes) as expected for a child’s age.

Fine motor skills involve the ability to hold, use, or manipulate objects using some of the smallest muscles of the body.

These skills require hand-eye coordination as well as nerve and muscle control. Children need fine muscle skills to complete tasks like coloring, picking up toys, using scissors, and even making a pucker face with the lips.

Fine motor skills :

Children rely on fine motor skills to complete basic tasks in school and everyday life. Without fine motor skills, children can struggle with classroom activities or morning self-care. Examples of why children how children use fine motor skills include the following:

Holding a pencil, crayon, marker, or paintbrush
Drawing a picture, writing neatly, filling in a bubble answer to a test question
Holding spoons and forks to eat
Playing with blocks or puzzles
Using scissors and rulers
Brushing teeth
Sticking out tongue to taste food
Buttoning clothes
Opening containers with lids

Fine Motor Developmental Delays :

Some children simply reach fine motor milestones later than others due to slower-developing muscles, and there is no long-term issue. However, some children may have a neurological and coordination problem known as developmental coordination disorder (DCD) or dyspraxia. This occurs when the brain and muscles have trouble working together. Other children may have dysgraphia, a writing challenge that affects coloring, drawing, or using utensils. If the fine motor delay is related to a medical issue, it typically involves one of the following:

Premature birth that causes muscles to develop more slowly
Genetic causes (such as Down syndrome)
Nerve and muscle disorders (such as muscular dystrophy or cerebral palsy)
Developmental diagnoses such as autism
Decreased finger, arm, and core strength from a pre-existing gross motor delay
Pre-existing cognitive delays
Vision problems

Treatment For Fine Motor Developmental Delays :

Treatment for fine motor developmental delays are multidisciplinary and can include occupational therapy as well as sensory-motor and sensory-processing therapy. A developmental-behavioral pediatrician may also get involved to recommend multisensory tips and techniques. Children may receive broad occupational therapy through an IEP or a 504 plan.

The occupational therapist may also recommend the following at-home activities:

Playing with Play doh
Using finger paint
Chores such as setting the table and wiping the table with a sponge
Placing pegs in a board
Playing with finger puppets
Pouring juice into a cup

Difficulty Balancing

Balance problems may cause dizziness and make you feel as though you’re spinning or moving when you’re actually standing or sitting still. As a result, you may not feel well. This can interfere with your daily life. It can also lead to falls, which can cause broken bones and other injuries.

Symptoms of balance problems :

The primary symptoms of balance problems are being unsteady while standing and walking. It may be difficult to walk without falling.

What causes balance problems :

Infections of Your Ear
Inner Ear Problems
Head Injury
Poor Blood Circulation
Certain Medications
Chemical Imbalance in Your Brain
Low Blood Pressure
High Blood Pressure
Neurological Conditions
Arthritis
Aging

Risk of balance problems :

You may be at risk of balance problems if you’re on medication, have a viral infection, experiencing inner ear problems, or recovering from a head injury.

Balance problems diagnosed :

Balance problems are difficult to address because they may be caused by numerous factors. Your doctor may ask about your symptoms and review your medical history for related conditions and medications. In some cases, you may be referred to an ear, nose, and throat specialist. They may run the following tests to pinpoint the cause and intensity of the problem:

Balance problems treated :

Balance problems are sometimes corrected by addressing the underlying health condition. They may be treated with:

Hand Injuries

Hand injuries are common and can involve a variety of structures such as the skin, tendons, nerves, blood vessels, bones and joints.
Many injuries resolve in time but there are certain types that require interventional treatment.
The most common cause of the injuries was blunt trauma, followed by injury from a sharp object.
Most hand injuries will heal without significant loss of function if evaluated by a doctor soon after the injury.

Hand Injury Causes :

Hand injuries can be divided into six general categories:

Lacerations (Cuts)
Fractures and Dislocations
Soft Tissue Injuries and Amputations
Infections
Burns
High-pressure Injuries (Grease and Paint Guns)

Hand Injury Symptoms :

The symptoms of hand injuries can vary depending on the type of injury, how the injury occurred (mechanism), depth, severity, and location.

Lacerations

Fractures and dislocations

Tenderness
Deformity
Swelling and Discoloration
Decrease Range of Motion
Numbness
Weakness
Bleeding

Soft tissue injuries and amputations

Infections

Tenderness
Local Warmth
Redness
Swelling
Fever (Rare in Hand Infections)
Deformity
Decrease Range of Motion

Burns

Tenderness or Complete Numbness
Deformity
Discoloration
Loss of Tissue
Change in Texture of the Skin
Redness
Blistering
Black Areas of Tissue

High-pressure injuries

Hand Injury Diagnosis :

Upon arriving at the emergency department or clinic, the medical evaluation may include a medical history and physical examination.

Hand Injury Treatment

Home care for hand injuries initially involves proper first aid techniques. In most cases, serious hand injuries will require medical attention.

Lacerations (cuts)

Apply pressure to the wound to stop bleeding
If possible, wash dirt or debris from the wound
Cover the wound to prevent further contamination or injury
Do not remove large foreign bodies such as nails, hooks, or knives
Seek medical attention

Fractures (broken bone) and dislocations

Immobilize or splint the hand, if possible.
Cover the injury if bone is exposed (open fracture), with a clean towel, cloth, or gauze.
Ice may help decrease the pain, but never apply ice for more than 20 minutes at one time, and never apply ice directly to skin.
Seek medical attention

Soft tissue injuries and amputations

Apply pressure to stop bleeding
Cover the injury with a damp bandage, if possible
Elevate the hand above the heart to reduce bleeding
Retrieve the amputated body part (if possible). If possible, cover the amputated body part, keep it damp, and place the part (for example, finger or thumb) near ice to cool. Do not place body part in direct contact with ice in order to prevent freezing
Seek medical attention

Infections

Burns

Muscular Dystrophy

Muscular Dystrophy is a group of diseases that make muscles weaker and less flexible over time. It is caused by a problem in the genes that control how the body keeps muscles healthy. For some people, the disease starts early in childhood. Others don’t have any symptoms until they are teenagers or middle-aged adults.

DMD

DMD) is the most common form. It mainly affects boys, and starts between ages 3 and 5

Becker muscular dystrophy

Becker muscular dystrophy is like Duchenne, except milder. It also affects boys but the symptoms start later — between ages 11 and 25

Myotonic muscular dystrophy

Myotonic muscular dystrophy is the most common form in adults. People who have it can’t relax their muscles after they contract. It can affect both men and women, and it usually starts when people are in their 20s.

Congenital muscular dystrophy

Congenital muscular dystrophy starts at birth or shortly afterwards.

Limb-Girdle muscular dystrophy

Limb-Girdle muscular dystrophy often starts in a person’s teens or 20s.

Facioscapulohumeral muscular dystrophy

Facioscapulohumeral muscular dystrophyaffects the muscles of the face, shoulders, and upper arms. It can affect anyone from teenagers to adults in their 40s.

Distal muscular dystrophy

Distal muscular dystrophy affects the muscles of the arms, legs, hands, and feet. It usually comes on later in life, between ages 40 and 60.

Oculopharyngeal muscular dystrophy

Oculopharyngeal muscular dystrophy starts in a person’s 40s or 50s. It causes weakness in the muscles of the face, neck, and shoulders, and droopy eyelids (ptosis), followed by difficulty swallowing (dysphagia).

Emery-Dreifuss muscular dystrophy

Emery-Dreifuss muscular dystrophy affects mainly boys, usually starting around age 10. People with this form often have heart problems along with muscle weakness.

Causes :

Muscular dystrophy can run in families, or you can be the first one in your family to have it. The condition is caused by problems in your genes. Genes contain the information your cells need to make proteins that control all of the different functions in the body. When a gene has a problem, your cells can make the wrong protein, the wrong amount of it, or a damaged protein. You can get muscular dystrophy even if neither of your parents had the disease. This happens when one of your genes gets a defect on its own. But it’s rare for someone to get it this way. In people with muscular dystrophy, the broken genes are the ones that make the proteins that keep muscles healthy and strong. For example, those with Duchenne or Becker muscular dystrophies make too little of a protein called dystrophin, which strengthens muscles and protects them from injury.

Symptoms :

For most types of muscular dystrophy, symptoms start to show up in childhood or in the teen years. In general, children with the condition:

Diagnosis :

Doctor will need to check different parts of your child’s body to know if they have muscular dystrophy. They’ll start with a general physical exam. They’ll also ask you questions about your family’s medical history and the kind of symptoms you’re noticing in your child. They may ask:

They also may ask you questions about how your child plays, moves, and speaks, as well as how they act at home and at school.

Treatment :

Although there’s no cure for any form of muscular dystrophy, treatment for some forms of the disease can help extend the time a person with the disease can remain mobile and help with heart and lung muscle strength.

Trials of new therapies are ongoing.
People with muscular dystrophy should be monitored throughout their lives.
Their care team should include a neurologist with expertise in neuromuscular diseases, a physical medicine and rehabilitation specialist, and physical and occupational therapists.
Some people might also need a lung specialist (pulmonologist), a heart specialist (cardiologist, a sleep specialist, a specialist in the endocrine system (endocrinologist), an orthopedic surgeon and other specialists.
Treatment options include medications, physical and occupational therapy, and surgical and other procedures.
Ongoing assessments of walking, swallowing, breathing and hand function enable the treatment team to adjust treatments as the disease progresses

Spinal Injury

A spinal cord injury is damage to the spinal cord. It’s an extremely serious type of physical trauma that’s likely to have a lasting and significant impact on most aspects of daily life.
The spinal cord is a bundle of nerves and other tissue that the vertebrae of the spine contains and protects.
The vertebrae are the bones stacked on top of each other that make up the spine
The spine contains many nerves, and extends from the brain’s base down the back, ending close to the buttocks
The spinal cord is responsible for sending messages from the brain to all parts of the body. It also sends messages from the body to the brain
We’re able to perceive pain and move our limbs because of messages sent through the spinal cord.

Symptoms :

Problems Walking
Loss of Control of the Bladder or Bowels
Inability to Move the Arms or Legs
Feelings of Spreading Numbness or Tingling in the Extremities
Unconsciousness
Headache
Pain, Pressure, and Stiffness in the Back or Neck Area
Signs of Shock
Unnatural Positioning of the Head

Treatment :

There’s no way to reverse damage to the spinal cord. But researchers are continually working on new treatments.
They include prostheses and medicines that might promote nerve cell regeneration or improve the function of the nerves that remain after a spinal cord injury.
In the meantime, spinal cord injury treatment focuses on preventing further injury and empowering people to return to an active and productive life.

Early stages of treatment :

In the emergency room, medical care focuses on:

Maintaining your ability to breathe.
Preventing shock
Immobilizing your neck to prevent further spinal cord damage.
Avoiding possible complications. Potential complications include stool or urine retention, respiratory or cardiovascular conditions, and the formation of deep vein blood clots.

Traumatic Injuries

Traumatic brain injury usually results from a violent blow or jolt to the head or body. An object that goes through brain tissue, such as a bullet or shattered piece of skull, also can cause traumatic brain injury.
Mild traumatic brain injury may affect your brain cells temporarily. More-serious traumatic brain injury can result in bruising, torn tissues, bleeding and other physical damage to the brain. These injuries can result in long-term complications or death.

Symptoms :

Traumatic brain injury can have wide-ranging physical and psychological effects. Some signs or symptoms may appear immediately after the traumatic event, while others may appear days or weeks later.

Physical symptoms :

Sensory Symptoms :

Cognitive, behavioral or mental symptoms :

Loss of consciousness for a few seconds to a few minutes
No loss of consciousness, but a state of being dazed, confused or disoriented
Memory or concentration problems
Mood changes or mood swings
Feeling depressed or anxious
Difficulty sleeping
Sleeping more than usual

Diagnosis :

Traumatic brain injuries may be emergencies. In the case of more-severe traumatic brain injuries (TBIs), consequences can worsen rapidly without treatment. Doctors or first responders need to assess the situation quickly.

Treatment :

Treatment is based on the severity of the injury.

Mild Injury :

Mild traumatic brain injuries usually require no treatment other than rest and over-the-counter pain relievers to treat a headache. However, a person with a mild traumatic brain injury usually needs to be monitored closely at home for any persistent, worsening or new symptoms. He or she may also have follow-up doctor appointments.

The doctor will indicate when a return to work, school or recreational activities is appropriate. Relative rest — which means limiting physical or thinking (cognitive) activities that make things worse — is usually recommended for the first few days or until your doctor advises that it’s OK to resume regular activities. It isn’t recommended that you rest completely from mental and physical activity. Most people return to normal routines gradually.

Immediate Emergency Care :

Emergency care for moderate to severe traumatic brain injuries focuses on making sure the person has enough oxygen and an adequate blood supply, maintaining blood pressure, and preventing any further injury to the head or neck. People with severe injuries may also have other injuries that need to be addressed. Additional treatments in the emergency room or intensive care unit of a hospital will focus on minimizing secondary damage due to inflammation, bleeding or reduced oxygen supply to the brain.

Medications :

Medications to limit secondary damage to the brain immediately after an injury may include:

Anti-seizure drugs

People who’ve had a moderate to severe traumatic brain injury are at risk of having seizures during the first week after their injury.
An anti-seizure drug may be given during the first week to avoid any additional brain damage that might be caused by a seizure. Continued anti-seizure treatments are used only if seizures occur.

Coma-inducing drugs

Doctors sometimes use drugs to put people into temporary comas because a comatose brain needs less oxygen to function. This is especially helpful if blood vessels, compressed by increased pressure in the brain, are unable to supply brain cells with normal amounts of nutrients and oxygen.

Diuretics

These drugs reduce the amount of fluid in tissues and increase urine output. Diuretics, given intravenously to people with traumatic brain injury, help reduce pressure inside the brain.

Surgery :

Emergency surgery may be needed to minimize additional damage to brain tissues. Surgery may be used to address the following problems:

Removing clotted blood (hematomas)

Bleeding outside or within the brain can result in a collection of clotted blood (hematoma) that puts pressure on the brain and damages brain tissue.

Repairing skull fractures

Surgery may be needed to repair severe skull fractures or to remove pieces of skull in the brain.

Bleeding in the brain

Head injuries that cause bleeding in the brain may need surgery to stop the bleeding.

Opening a window in the skull

Surgery may be used to relieve pressure inside the skull by draining accumulated cerebrospinal fluid or creating a window in the skull that provides more room for swollen tissues.

Cognitive Disorders

Cognitive disorders are a part of the neurocognitive disorder classification in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Cognitive disorders are defined as any disorder that significantly impairs the cognitive function of an individual to the point where normal functioning in society is impossible without treatment.

Common Cognitive Disorders :

Causes a Cognitive Disorder :

Signs of Cognitive Disorder :

Cognitive disorder signs vary according to the particular disorder, but some common signs and symptoms overlap in most disorders. Some of the most common signs of cognitive disorder include:

Some cognitive disorders develop in stages and symptoms increase in severity the further the disease progresses. Alzheimer’s disease, for example, begins with the patient showing very minor signs of forgetfulness. Sufferers may forget names they know well, or they may have trouble remembering what they did recently. The initial symptoms of early-onset Alzheimer’s disease are often indistinguishable from normal memory errors. However, as the disease progresses, the affected person’s memory becomes persistently impaired. They may have rare moments of clarity, but life is generally lived in a state of confusion.

Treatments and outcomes :

Each of the above approaches to cognitive treatment has its place in the constellation of medical and therapeutic interventions available to patients with cognition issues. Each has its supporters and its detractors as well.
Final authority regarding decisions on treatment options will ultimately rest in the hands of either the patient or the patient’s designated decision-maker, working in partnership with medical providers.
With such a wide variety of treatment options available, it becomes possible to tailor an approach to treatment that’s as unique as the person who seeks it.
If you have or somebody close to you has been showing any signs and symptoms of a cognitive disorder, it’s important to seek out help to quickly obtain a diagnosis. The sooner signs of potentially serious cognitive issues are identified, the better the treatment options to manage or even reverse the disability should be.
Finding such help isn’t always easy, particularly for people who have begun to show signs of neurological illnesses.

Congenital Hand Deformities

The term congenital hand difference refers to any condition of the hand and arm that is present at birth. Children can be born with many types of hand differences, and they vary greatly in how they impact the appearance and function of the hand.

Congenital hand differences develop early during pregnancy when the baby’s upper limbs are first forming. Sometimes, a difference runs in a family or is part of a medical condition. But in many cases, doctors are not able to determine the exact cause for a hand difference.

Having a hand difference can be both physically and emotionally challenging, but many children are able to adapt and function well without any treatment. Some children may need occupational therapy, surgery, or other treatments to function better and be more independent.

Congenital hand differences are often divided into four categories:

Malformations, in which a certain part of the hand or arm fails to develop normally while the baby is in the womb
Deformations, in which the hand and arm begin to develop normally but are prevented from doing so in some way
Dysplasias, including overgrowth of part or all of the hand/extremity, as well as conditions that cause tumors
Syndromes, in which the hand difference is part of a larger spectrum of disease

Types of Hand Differences :

Syndactyly

Syndactyly, the most common congenital hand difference, is an abnormal connection of the fingers to one another. In babies born with syndactyly, the fingers are webbed or fused together because they did not separate normally during development.

Polydactyly

Limb Deficiencies

A baby with an upper limb deficiency may be born with hands or arms that are smaller than normal or are missing. Some of the more common limb deficiencies are described below.

Radial Deficiency

In a radial deficiency, the radius bone and soft tissues in the forearm fail to develop properly. This causes the affected hand to be bent inward toward the thumb side of the forearm, giving it the appearance of a club hand.

Transverse Deficiency :

In a transverse deficiency, all of the elements below a certain level in the patient’s arm are missing. The condition has an appearance similar to that of an amputation and is sometimes known as congenital amputation. Doctors believe that a transverse deficiency occurs when a vascular problem, such as a blood clot in the limb, causes the affected arm to stop developing. The most common type of transverse deficiency is one in which the elements below the elbow are missing.

Amniotic Band Syndrome :

The amnion is the membrane that surrounds and protects the developing baby.
If the amnion ruptures or tears during pregnancy, it is possible for detached strands of the membrane to wrap around the growing baby’s body parts and cause injury — a condition known as amniotic band syndrome (ABS).
In milder cases, these strands, which are called amniotic bands, may cause only a minor groove or indentation in one of the baby’s fingers or limbs.

Treatment

The goal of treatment is to improve the function and appearance of the affected hand as much as possible. While some children are able to adapt to hand differences and function well without treatment, others may need therapy or surgery to be more independent and able to participate in certain activities. Your child’s doctor will consider many things when determining treatment, including:

Your child’s age and overall health
The type and extent of the condition
The cause of the condition
The needs and interests of your child and the goals of the family
Your preference for a specific therapy or procedure

Nonsurgical Treatment

Nonsurgical treatment for hand differences often includes one or more of the following:

Therapeutic Recreation

Play, sports, and other activities can help build confidence and improve a child’s emotional well-being.

Physical Therapy

Specific exercises can strengthen the arm and hand and improve motion in the wrist and fingers.

Occupational Therapy

Exercise and training can prevent stiffness in the hand and improve handwriting and other skills necessary for daily activities.

Assistive or adaptive devices

Using specialized devices can make eating, dressing, and other daily activities easier.

Prosthetics

Artificial devices can be used to replace or augment missing parts or limbs.

Surgical Treatment

There are several surgical procedures used to treat congenital hand differences. The procedure your child’s doctor recommends — as well as the age at which the procedure is performed — will depend upon your child’s specific condition and the type of surgery.

Surgical procedures for hand differences include:

Peer Support

Establishing peer contacts for both your child and your family is a very important part of treatment. Meeting other children with hand differences and their families will provide reassurance that you are not alone and can be an invaluable source of information and support.

You can find many support groups and discussion groups online. In addition, some children’s hospitals and other organizations sponsor Hand Camps for children with differences, such as the non profit Hands to Love. These camps provide a safe and encouraging environment for children to socialize and participate in camp activities with other children who have congenital hand differences.

Decreased Eye Hand Coordination

Hand-eye coordination is described as using our hands and vision at the same time to perform tasks such as grabbing and picking up objects, catching a ball or pushing and pulling activities. Hand-eye coordination is essential for the normal and healthy development of children and their academic progression. For adults, it is still important, as many tasks require hand-eye coordination.
It is worth noting that hand-eye coordination can be poor despite having clear and functioning vision. It may also be the case of having poor hand-eye coordination only when required to perform tasks or activities that involve using your motor skills and vision simultaneously.

Benefits of Having Good Hand-Eye Coordination :

The benefits of having good hand-eye coordination are better child development, increased productivity, and improved reaction times. For children, good hand-eye coordination is beneficial as it aids with sports and activity participation, handwriting and grasping objects.

Importance of Hand-Eye Coordination. The importance of hand-eye coordination is the enablement of daily tasks and a variety of physical activities. In sports activities coordination, balance and a fast reaction time are required according to a 2021 study published in the National Library of Medicine.

Best Sports to Improve Hand-Eye Coordination :

The best sports to improve hand-eye coordination are swimming, sports that involve balls such as basketball and tennis, non-contact boxing and tai chi according to Harvard Health Publishing. Swimming may be helpful for improving hand-eye coordination as it involves moving all parts of the body while relying on your visual fields, forcing the brain to picture what your hands need to do.
Non Contact boxing calls for quick and accurate hand movements as well as applying an appropriate amount of force in response to a moving target in front of you. Tai Chi demands balance, flexibility, strength and shifting body weight when changing poses, which can improve these elements after continuous practice.

Treatment For Hand-Eye Coordination :

The treatments for poor hand-eye coordination may include swimming, Tai Chi and other sports and activities. The treatments for poor hand-eye coordination are listed below.

Swimming

Swimming may help improve poor hand-eye coordination as it utilizes the movement of the whole body out of visual field range. Swimming can be described as using a combination of leg and arm movements and physical strength to propel through water.
The repetitive movements of swimming may also be helpful for enhancing balance and body stability as well as the connection between the brain and the body.

Tai Chi

Tai Chi’s use of weight shifting between poses and practice of core strength and balance may be beneficial for poor hand-eye coordination.
Tai Chi is a traditional Chinese martial art that is conducted for physical and mental health and self-defence. It typically involves performing slow and soft movements while shifting your body weight for each different pose which may improve balance and accuracy in finger-pointing according to the National Library of Medicine.

Sports

Sports may be helpful for poor hand-eye coordination as they involve repeated movements that can help the brain to anticipate and react in a timely manner. According to Harvard Health Publishing, engaging in sports often involves quickly reacting to your surroundings, monitoring the ball or other participators and moving your arms and body accordingly.

Activities

Activities such as juggling, video games and sewing may assist hand-eye coordination through the use of repeated hand motions, quick reaction times and eye focusing.

These types of activities may be beneficial for hand-eye coordination as they all involve a constant focus of the eyes and moving your hands and fingers in response to what you see.

ADD - Attention Deficit (Hyperactivity) Disorder

ADD – Attention Deficit (Hyperactivity) Disorder

Hyperactivity or attention deficit disorder is commonly known as ADD and is a neurological condition, often characterized by attention-related, impulse control or hyperactivity.Attention means notice taken of someone or something or regarding someone or something as interesting or important or the action of dealing with or taking special care of someone or something.
Difficulty in paying attention or maintaining focus is roughly called Attention Deficit Disorder.
People who have ADD generally lose focus or can sustain focus for a lesser span than an average person or are impulsive or hasty.

Symptoms :

The symptoms of ADD can begin around three years of age or even up to 6 years. The signs may remain as the child grows into an adolescent and adult. Children with ADD may have difficulties in coping up with studies, understanding tasks given and even have a problem in performing an organized step by step activity. Similarly, adults with ADD may be disorganized, poor performers at academics and work and may face difficulties to maintain a social life.

Signs to look out for in Children with Attention Deficit Disorder :

Unorganized or unable to get organized
Procrastination
Unable to complete any task or project till the end
Very impulsive
Easily bored
Unable to achieve any goals
Easily distracted
Overdo, overthink and overeat, etc.
Easily frustrated and impatient
Low self-esteem
Insensitive
Fidgety
Separation anxiety
Depression

The significance of Diagnosis in ADD :

Early diagnosis is critical for Attention Deficit Disorder. There is a risk of ignoring ADD as habitual inattentiveness in children or hyperactivity. However, these need attention when they are severe or start affecting the child more frequently and impact his or her performance significantly.
A correct diagnosis of Attention Deficit Disorder requires a complete evaluation by experts. Though there is no cure for ADD, it is a manageable condition.
There are certain medicines that help to reduce specific symptoms. Apart from medication, there are several therapies that will help improve the various problems the patient with ADD faces. Such treatments aim to help the person control his behaviour and become more mindful of his activities and speech.
Therapies also help the person grow more organized and exert better self-control.In the case of children, parents are educated and trained on the various ways in which they can help their child reduce inappropriate behaviours.
They are also advised on multiple tools which may help the child to cope up with studies and other activities. Parents are encouraged to inculcate small changes in daily life such as waiting for turns while playing, sharing things such as toys, books, etc., talking only when necessary.
Channelizing the child’s energy in a constructive task is also an important way of reducing hyperactivity positively. Calmly convincing the child about the consequences of their particular activities regularly may also help the child in reducing hasty actions.
In adults too, family members play an important role in helping the patient manage his or her condition. Practising meditation and a particular hobby or sport also helps a great deal in managing one’s behaviour.

Treatments for ADD :

Mental health therapists often use a combination of three ways recommended to treat the disorder:

Medication :

Stimulants

Boost and balance the neurotransmitter levels.

Antidepressants

Inhibit norepinephrine and dopamine reuptake. we can avoid ADHD in childhood to move further into ADD in adulthood through proper medication. Consult a mental therapist for proper medication.

Attention Enhancement Therapy

Treating a client with Attention Enhancement Therapy can have tangible successes – self-motivation, achieving goals, and a significant increase in attention.

Food Habits Management

Healthy eating habits are elusive for many adults with attention deficit hyperactivity disorder. Certain foods are better at keeping a person’s energy and blood sugar levels stable and improving concentration. Consult a mental therapist to get a proper diet chart and follow it correctly.

Cognitive Behaviour Therapy (CBT)

CBT is a common type of mental health counselling, during which you meet with a mental health practitioner on a structured schedule. These regular sessions involve working with your counsellor to talk through any anxiety, stress, or depression.
If any of the symptoms listed above continually disrupt your life, talk to a mental health practitioner about whether you might have ADD. Different types of health care professionals may diagnose and supervise treatment for ADHD. Seek a provider who has training and experience in caring for adults with ADD.

Pediatric Occupational Therapy

Pediatric Occupational Therapy helps a child reach goals and developmental milestones that improve their daily life. It focuses on how your child moves plays and communicates with the world around them. A healthcare provider may recommend occupational therapy after an injury or if your child has a neurological condition. Paediatric occupational therapy is to increase children’s’ participation and engagement in daily activities. There are many different kinds of intervention strategies, to help families and therapists make informed decisions about the best possible care for children with impairments.

Pediatric Occupational Therapy

Pediatric occupational therapy helps a child reach goals and developmental milestones that improve their daily life. It focuses on how your child moves, plays and communicates with the world around them. A healthcare provider may recommend occupational therapy after an injury or if your child has a neurological condition.

Moving (fine motor skills like using the small muscles of their hands)
Learning (Cognitive skills)
Playing (Social and emotional skills)
Activities of daily living (dressing and feeding )
Skills needed of their education ( Pre writing , writing and scissors skills)
A congenital (present at birth) conditions that affects physical or cognitive function
A condition that affects their development
A neurological conditions, such as autism spectrum disorder (ASD) or cerebral palsy
An injury that requires using adaptive equipment like prosthetics or mobility devices

Role of Occupational Therapy in Pediatrics

It helps children gain independence while also strengthening the development of fine motor skills, sensory motor skills, and visual motor skills that children need to function and socialize. Occupational therapists always strive to be evidence-based and client-centered in their practice. This means that whatever assessments and treatments they use with your child are backed by research and experience (evidence-based) and are specifically geared toward your child’s interests and needs (client-centered). Depending on the child’s age, interests and abilities, pediatric therapy can often look and feel like playing. In order to keep a child motivated, familiar tools are often used in therapy. Things like,

Role of Occupational Therapy in Pediatrics

It helps children gain independence while also strengthening the development of fine motor skills, sensory motor skills, and visual motor skills that children need to function and socialize.