It is important to get to know your child, and to understand his/her special needs. As you work with these children you will realize they have many of the same desires, dreams, and feelings as you do.
The following categories and explanations will help provide an overview of many of the disabilities affecting children. It is not an exhaustive list. If you are working with a child, and do not fully understand his/her special needs, ask your Friendship Circle therapist for additional input.
Autism - Cerebral Palsy - Chromosonal Abnormalities
Developmental Delay - Epileptic Seizures - Fragile X Syndrome
Learning Disabilities - Pervasive Developmental Disorder
Physically / Orthopedically Disabled - Rett Syndrome
Sensory Deficits - Spina Bifida - Tuberous Sclerosis - Seizures
Autism is a severe disorder of communication and socialization. Individuals with autism may have limited verbal skills, or language that does not promote interaction. Autism can be thought of in a spectrum, with a wide range of functional abilities. Many individuals with autism are overly sensitive to sensory stimuli, such as loud noises, light touch, and/or bright or flashing lights. Individuals with autism also have difficulty making changes and transitions. They may have stereotypic, repetitive, and/or self stimulating behaviors.
Individuals with autism may lack awareness of the existence or feelings of others. They may show no, or little imitation of others’ behaviors. Play skills may be absent or abnormal. Individuals with autism may have an impairment in their ability to make peer friendships, and a restricted repertoire of activities and interest.
Interestingly, many individuals with autism can read (some with and some without comprehension), and may respond favorably to visual input. One child could not verbally express why she was having a tantrum, but could write a lengthy explanation. The act of writing had a calming effect on the child.
As a result of inadequate language skills, individuals with autism may be more prone to tantrums and acting out behaviors. Analyze behavior carefully. What is your friend trying to tell you? Does he/she need a break? Is the environment overwhelming? Are you in a new place or routine? Plan your interventions accordingly, and be creative.
Cerebral Palsy (CP) is a disability that occurs as the result of a trauma, or injury, to an area of the brain. The injury can occur before birth, at the time of birth, or even after birth. The manifestations of CP are varied, and the range of involvement is from mild to severe. Individuals with mild CP may have minor difficulty with motor coordination, including speech. Others may not be able to walk, speak, or have use of hands. Some individuals with CP have hypertinicity, or rigid muscle tone. Others may have hypotonicity, or unusually low tone. Spastic CP refers to uncontrolled sporadic movements.
There are three major types of CP. Ataxic CP is characterized by inadequate balance and kinesthetic sense, and accounts for 40% of cases. Athetoid CP is characterized by involuntary movements, and accounts for 40% of cases. Rigid CP is characterized by the persistence of any position, and accounts for 20% of cases.
Individuals with sever physical limitations due to CP may be cognitively normal to above normal. Do not assume retardation due to a lack of communication. Direct conversation toward your friend with CP. Think about ways of adapting activities so that your friend can participate. Use hand over hand techniques. When unsure, ask!
Use caution when handling and lifting a child with CP. Do not force limbs, or try to force a child into a particular position. There are relaxation techniques that will help loosen muscle tone. Ask your teacher to explain and demonstrate.
Chromosonal Abnormalities can result in the manifestation of syndromes that result in disabilities. Down’s Syndrome is an abnormality of the 21st pair of chromosomes. Individuals with Down’s Syndrome have a characteristic appearance which includes relatively small stature, oval shaped eyes, an oversized tongue and short neck. They may also have a flattening of the back of the head, small ears, and a broad, flat nose. Developmental delay is present, although in greatly varying levels. Hands tend to have a singular crease across the palm. Co-occurring conditions may include problems with hearing and or vision, looseness of joints, and heart defects. Individuals with Down Syndrome are usually very sweet and mild mannered.
Cru di Chat is a rare genetic disorder that results from an abnormality in the fifth chromosome. Individuals with Cru di chat are developmentally delayed, with variations in levels of functioning Language and motor skills are also impaired to various degrees. The term “Cru di Chat” means “Cry of the Cat.” Infants with Cru di Chat are often first identified by a high pitched, mewing cry that sounds like a cat’s whine.
Developmental Delay is a term that refers to children and adults who do not develop at the same pace or to the same extent as their peers. This delay is usually cognitive in nature, and may be mild, moderate, severe or profound. Many syndromes have developmental delay as a component. Developmental delay also refers to children who have mental retardation. In Illinois, individuals with mild developmental delay may be classified as Educable Mentally Handicapped (EMH). Moderately delayed individuals may be classified as Trainable Mentally Handicapped (TMH). These categories are used primarily for school placements and services, as well as teacher certification.
Epilepsy is characterized by repeated seizures and abnormal brain wave patterns. Many individuals with epilepsy have normal intelligence, and their seizures may be controlled with anticonvulsant medications.
A percentage of individuals, however, have epilepsy as part of a handicapping condition, including Cerebral Palsy and Developmental Delay. These individuals have a greater number of seizures which are harder to control.
A seizure, or convulsion, starts in an area of the brain that contains abnormal cells. These cells are more apt to discharge than are normal cells. As the cells discharge, surrounding areas become involved in the increased electrical activity, much like a fire spreads through the forest. Soon, an entire area of the brain is discharging, leading to a loss of consciousness, involuntary movements, and/or abnormal sensory phenomena.
These are several different types of seizures. Petit Mal seizures are of short duration and do not require immediate specific care. The individual with this type of seizures “blanks out” for thirty seconds or less. They may stare into space, blink, or lose consciousness for several seconds. Often the person will have no awareness that a petit mal seizures in a day.
Grand Mal seizures are the most common type of seizure. Prior to onset, the person may have an aura or feeling of an impending seizure. In a Grand Mal seizure, the individual will lose consciousness and fall to the floor. He/she may become rigid, and have uncontrolled movements or writhing. Breathing may become labored, or stop for a contort of bowel or bladder. Grand Mal seizures usually last about five minutes. Following the seizure, the person will be very drowsy, and may fall into a deep sleep. Upon recovery, the person will have no memory of the seizure taking place.
Grand Mal seizures are frightening to observe. It is important to keep calm, and follow these procedures:
Do not move the child from the place where the seizure occurred until the active part of the seizure has subsided.
He should be placed in such a position that he cannot injure himself by knocking his body against hard objects.
Tight clothing, especially around the neck should be removed or loosened.
If possible the child should be placed on side so that mucus and saliva will drain more freely from the mouth.
Do not place anything into the mouth.
Do not make an attempt to stop the seizure, consciousness will return on its own accord. If the child passes into a deep sleep after the seizure, allow him to rest.
Incoherent speech, restlessness, and confusion may follow a Grand Mal seizure.
Fragile X Syndrome is a disorder caused by a defect on the X chromosome. Typically, boys with Fragile X have delayed speech and language development, learning disabilities, and hyperactivity. Some males with Fragile X have no observable symptoms. Girls tend to be carriers, and therefore symptom-free. Individuals with Fragile X may have a liability of affect, meaning that their emotional state may fluctuate quickly and without apparent cause. Many individuals with Fragile X have difficulty tolerating changes in routine or making transitions between activities.
The most widely used definition of learning disabilities is incorporated in the Individual with Disabilities Education Act or IDEA. The term “specific learning disabilities” means those children who have a disorder in one or more basic psychological processes, including perception, memory, language and reasoning. These deficits impact upon the development of academic skills including understanding and using spoken language, reading (word recognition and comprehension), written language, spelling, and math. Learning disabilities may have an adverse effect on social perception and the development of social skills. Learning Disabilities are not primarily due to other handicapping conditions, although they may occur concomitantly. Intelligence is average to above average, and a severe discrepancy between potential and achievements exists. Learning disabilities are intrinsic, and are thought to be due to central nervous system dysfunction.
Pervasive Development Disorder (PDD)
Pervasive Development Disorder (PDD) refers to conditions that are along the spectrum of autism, but do not manifest all the symptoms of that disorder. PDD is a widely used label, and may refer to different behaviors in different children. Individuals with PDD have difficulty with language and socialization. They may or may not have cognitive delays. Motor skills may also be impaired.
Physically or Orthopedically Disabled
Individuals with physical and/or orthopedic disabilities have limitations in body movement. These individuals may have limited use of the arms and hands. Wheelchairs, crutches, walkers, canes, and braces are used to assist locomotion. The paralysis or spasticity which often defines the disability may be either congenital or a result of another syndrome, disease or accident.
Rett Syndrome is a neurological disorder affecting 1 in 15,000 live, female births. Development is normal until at least six months of age, followed by a period of regression that leads to severe physical disability and developmental delay. At present there is no cause, treatment or cure.
Sensory Deficit includes blindness and visual impairment, as well as deafness and hearing impairment.
Spina Bifida is a prenatal condition in which the spine fails to close completely. The resulting opening may be so small, that is causes no problems and the individual is symptom-free.
In these cases of Spina Bifida, the spinal opening may be large enough that the covering of the spinal cord, the meninges, protrudes. It is covered by a purplish-red cysts, known as meningocele, which can range in size from an inch to a grapefruit. In the most severe form of Spina Bifida the spinal spinal cord itself protrudes through the opening. This is known as a myelomeningocele. A myelomeningocle has little or no skin covering for protection, and spinal fluid may leak out. Individuals with Spina Bifida may have paralysis of the lower body, and incontinence. Cognitive abilities range from normal to developmentally delayed. Health problems may co-occur frequently.
Tuberous Sclerosis is a condition which results in physical disabilities and developmental delay due to the formation of calcium deposits in the brain. Individuals with TS may develop benign tumors in almost every portion of the body. For more information on TS contact the National Association for Tuberous Sclerosis.
A seizure is a temporary loss of control over certain body functions. It occurs when the electrical activity of the brain becomes irregular and causes sudden changes in sensation, behavior and movement. Seizures can be mild or severe and usually last only a short while.