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Children's Medical Services - Special services for children with special needs
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Infant Toddler Development Training
Module 1, Lesson 5

Effect of Multiple Disabilities on Child Development

Many times children exhibit multiple disabilities (i.e. mental retardation/vision impairment/congenital heart defect). Children with multiple disabilities have unique needs due to the combined effect of several impairments that present unique challenges. The combination of the characteristics of the multiple impairments causes each individual child to have a unique response to different situations. Different influences, both environmental and psychological, will cause an individual child to react and respond differently to a specific situation. Differences due to personal stamina, cognitive abilities, and self-esteem can create different outcomes for children with the same multiple disabilities (Heller, Alberto, Forney, & Schwartzman, 1996). Therefore, it is important for the ITDS to take into account each child's specific needs when considering and planning interventions. It is important that an atmosphere which is positive and nurturing be created where independence and success is promoted.

Adaptations effect on child development

Due to advanced medical technology and technology in general, children with developmental disabilities need to have access to adaptations that can enhance daily functioning and living. Some children will be dependent on the assistive devices for all their life; some will be dependent just temporarily. The good news is that these assistive devices are available for young children and can improve their growth and development and increase their independence.

Nutritional assistive devices

Baby chewing on toyKnowing how important good nutrition is for proper growth and health of a child, it is crucial for children with chronic illnesses and developmental disorders to have access to good nutrition. Several nutritional assistive devices are available for providing proper nutrition to children who have feeding problems such as feeding tubes (temporary, permanent or long-term). Temporary feeding tubes (nasogastric tube or NG tube) can be inserted into one nostril and passed into the stomach or intestine. Permanent or long-term feeding tubes can be inserted directly into the stomach (gastrostomy tube) or intestine (oral gastic (OG) tube or a nasojejunal (NJ) tube. Once the feeding tubes are in place, nutritional formulas and or blenderized foods can be consumed by the child. (Levy & O'Rourke, 1997).

Surveillance devices

Surveillance devices provide early warnings of potential problems for children who have heart or lung disorders. Two common types of surveillance devices are oximeters (measures oxygen saturation) and cardiorespiratory monitors (records heart and respiratory rate) (Poets & Southall, 1994; Silvestri, Weese-Mayer, & Kenny, 1994). Both of these devices can be used in the home environment and offer some sense of security by providing an early warning system of equipment malfunctions or breathing/respiratory emergencies.

Respiratory technology assistance

For children with chronic respiratory failure, normal oxygen levels in the blood are necessary to promote growth and development and prevent lung injury. Respiratory technology assistance is necessary for children who cannot maintain adequate gas exchange (intake of oxygen, output of carbon dioxide). The respiratory pump provides the action to adequately exchange the necessary gases (oxygen and carbon dioxide). Tracheostomies are another form of providing respiratory assistance. The tracheostomy tube (inserted in the trachea) provides an open airway passage where a ventilator or similar device provides a mixture of air and oxygen. Due to its direct access, blockages and secretions can be removed and/or suctioned (Duncan, Howell, deLorimier, et al., 1992).


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