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PHYSICALLY CHALLENGED / HANDICAPPED CHILDREN INTRODUCTION Handicapped child is one who deviates from normal health Introduce status either physically, mentally or socially and requires topic special care, treatment and education. DEFINITION According to WHO, the sequence of events leading to Students will disability and handicapped conditions are as follows: be able to Injury or disease Impairement Disability Define Handicap. impairment, Impairement disability and It is defined as any loss or abnormality of psychological, handicap. physiological or anatomical structure or function. Eg: loss of vision, hearing. Disability It develops as the consequence of impairement. Eg: loss of limbs result in inability to walk. Disability is the inability to carry out certain activities which are considered as normal for the age and sex. Handicap It develops as the consequence of the disability. It is defined as a disadvantage for a given individual resulting from an impairement or a disability, that limits and prevents the fulfilment of a role which is normal for that individual, depending on age, sex, social and cultural factors. Primary handicap condition leads to secondary handicap condition. Eg: blindness leads to economical handicapped situation, i.e, poverty. The child may have single or multiple handicap condition. Physically handicapped children can be grouped according to the affected part of the body.  Orthopedically handicapped: congenital birth defect ( club foot), amputation due to accidental injury, bony defects following ricket, fracture, arthritis, leprosy, etc.  Sensory handicapped:  Visual problems: partial or complete blindness, refractory errors  Auditory problems: partial hearing loss, deaf and dumb  Speech problems: stammering, dysphonia  Neurologically handicapped: cerebral palsy, mental retardation, convulsive disorders, hydrocephalus, spina bifida, post ± meningitic, or post- encephalitic sequel, post-polio- residual paralysis, degenerative diseases of CNS, learning disabilities.  Handicapped condition due to chronic systemic disease: heart disease, bronchial asthma, diabetes mellitus, muscular dystrophy, etc.  Multiple physically handicapped children: having combination of orthopedically, sensory and  neurological handicaps. CAUSES - congenital anomalies, genetic disorders, poliomyelitis, Describe the other communicable diseases, perinatal conditions, , causes of infection, malnutrition, accidental injury, socio- cultural physical factors handicap PREVENTION OF HANDICAPPED CONDITIONS IN YOUNG CHILDREN

Lecture cum discussion

Lecture cum discussion

accidental injuries. perinatal and intranatal period along with preventive measures during infancy. MANAGEMENT OF HANDICAPPED CHILDREN Management of handicapped children requires multidisciplinary approach.  Physiotherapy and exercise to improve physical conditions. thorough physical examination and necessary investigations for early detection of handicapped conditions are improvement.  Essential care in antenatal . intranatal and neonatal periods. accidental injury.  Genetic screening of µat.eg: cataract.risk mothers and children. hyperbilirubinemia etc  Avoidance of teratogenic agents in antenatal periods and special care of high. pottery.  Medical termination of pregnancy of malformed fetus  Improvement of health awareness about the preventive measures of handicapped conditions in children by elimination of causes like malnutrition. PRIMARY PREVENTION  Genetic counselling: optimum maternal age for producing normal babies is between 20-30 years. this information should be explained to the couples along with prevention and different aspects of genetic and chromosomal problems. rickets. leprosy. the future mother. The aim of management is to safeguard against or halt the progression of the disease process from impairement to disability and handicap.  Occupational therapy according to the child¶s ability and that should be provided with music. haemophilia)  Reduction of consanguineous marriages by creating health awareness. Prevention of maternal and neonatal infections. wood-work.Explain the prevention of handicapped conditions in young children Describe management of handicapped children Handicapping conditions of children can be prevented by improvement of maternal health and adequate care during periconceptional. weaving.  Regular medical supervision and developmental assessment help to identify the abnormal condition early in initial stage by MCH or school health services. Lecture cum discussion Lecture cum discussion Lecture cum discussion . asphyxia.  Universal immunization coverage especially for poliomyelitis and MMR  Improvement of nutritional status of mother and children especially for girl child.acid deficiency conditions in periconceptional period.  Careful history. The approaches of management should include following aspects. Early diagnosis and treatment of the particular cause of handicapping condition along with disability limitation and rehabilitation should be promoted.  Correction of deformity. childhood and adolescents.  Treatment of particular handicapped condition by medical or surgical management . etc. congenital anomalies. Eg: visual or hearing problems by spectacles or hearing aids. birth injuries. otitis media.  Prevention of iodine deficiency and folic.risk¶people to prevent inherited diseases like chromosomal or sex linked congenital anomalies ( eg: Down¶s syndrome. painting.

sign language for deaf and dumb. research . These include day care centers. maintenance. rehabilitation Social rehabilitation includes restoration of family of and social relationship by replacement in the handicapped family. educational and social support. for special training and education. Vocational rehabilitation includes restoration of the capacity to earn a livelihood . tolerance. Govt. factories and other business establishment to the handicaps. (for blind. provides for the care. patience.  Prosthetics eg: provision of artificial limb in a child with amputed leg. special allowances. REHABILITATION OF HANDICAPPED CHILDREN Rehabilitation includes all measures to reduce the impact of disabled and handicapped conditions and to achieve social integration by active participation of the individual in the community. The process of rehabilitation should involve the following aspects: Medical rehabilitation includes restoration of Explain the functions by prosthesis. assistance for supply of aids and appliances to the handicapped and dissemination of informations. warmth. protection of right and full participation) Bill. Organisation are also working along with Govt.  Counselling and guidance to the parents and family members for continuation of care of the children with emotional. Speech therapy to improve communication ability. manpower development. 1995. protection.  Special care for mentally handicapped children with love. Non-govt.eg: braille for blind. discipline and avoidance of criticism. scholarship. vocational guidance. counselling.  Referal for services (Govt. The community needs to offer employment opportunities in shops. rehabilitation and support services like pension. The handicapped child needs to be trained for an independent living with special training and education. 1960. Psychological rehabilitation includes restoration of personal dignity and confidence during the period of growth and development and in adult life. special hospitals for crippled children. The Ministry of Welfare. NGOs) for assistance of aids and appliances. Of India provide support services to the handicapped individuals and enabling the families to assume a large share of rehabilitation within the family cycle. children Educational and rehabilitation includes specialised training and educational facilities.This can be achieved by community participation and social legislation for the handicapped individual. The Children Act. deaf and dumb) vocational training centers. Of India has introduced a comprehensive Bill in the parliament known as ³Persons with disabilities´ ( equal opportunities. The following National Institutes are working for the Lecture cum discussion Lecture cum discussion . Institutions for training . education and rehabilitation of socially handicapped children. These available welfare services of Govt.It deals with preventive and promotional aspects of rehabilitation. welfare. special school. artificial limbs etc.

feeding. assessment of parent ± child interaction and family coping.  Create awareness in the society about the prevention of handicaps. j National Institute for Rehabilitation. thorough physical and neurological examination. . visual/ auditory j Growth and development altered j Diversional activity deficit j Knowledge deficit related to continued care of handicapped children. special investigations. Munbai. special health care setting. Lecture cum Kolkotta j National Institute for Mentally Handicapped. bathing. The goal is to bring them as close to normality as possible. discussion Secunderabad j National Institute for visually Handicapped . Nursing Diagnosis j Ineffective family coping and altered parenting related to handicapped condition. j Potential for infection j Injury. Assist family to strengthen effective relationship and bondage to prevent children from becoming socially handicapped. socioeconomic status. Day care centers . the abilities of the handicapped child and the potentialities present in him. etc. Nursing Interventions  Handicapped children can be cared in the general hospitals.specific disabilities to provide care and welfare services in various aspects of the handicapped. j Communication impaired. j Anxiety of the parents and family members j Altered nutrition. special school. deaf and dumb) vocational training centers . available support facilities. community health care centers in primary level and at home.  Nurses are key person for home based or hospital based care to guide and assist the parents and family members to promote optimum health of the handicapped children. Describe the nursing management of handicapped children. j Physical mobility impaired j Elimination pattern. risk for j Self. j National Institute for Orthopedically Handicapped. (for blind. dressing. toileting.care deficit. hygienic care. review of developmental screening. j Ali Yavar Jung National Institute for the Hearing Handicapped. New Delhi and Dehradun. Cuttack. altered j Activity intolerance j Altered sleep pattern j Sensory alteration. Training and Research. less than body requirements. NURSING MANAGEMENT OF HANDICAPPED CHILDREN Nursing Assessment Complete assessment of a handicapped child include detailed history of the condition. mentally and socially. physically. occupational therapy also can provide various services to these children.

however.6th edition. Text book of Pediatric Nursin.2001 . Most phys ical challenges. Missouri:Mosby Publishers.1998 j Gupte Suraj.CONCLUSION The t er m ³phys ically challenged chil d´ indicat es t hat a child has a li mitation in perfor mance of mot or funct ion. Marilyn Hockenberry.Dorothy.1998 j Wong. per sist ing t o var yi ng degr ees t hr oughout childhood des pit e i mpr ovement s achi eved wit h int er vent ion. In t he mildest expr es sions of t hes e diagnost ic ent ities.L. Essentials of pediatric Nursing. Redding Barbara. REFERENCE j Lecture cum discussion Marlow.R.B of Pediatrics. T.A.NewDelhi: Jaypee Brothers (P) Ltd. ar e chr onic. Singapore: Harcourt Brace & Company Asia PTE LTD.6th edition.8 th edition.Donna. a chil d act ually may over come t he condit ion. Eaton.


nursing CENTRAL OBJECTIVE The students will gain an indepth knowledge on Physically challenged.Judy Handly A. early detection and management SPECIFIC OBJECTIVE The students will be able to: .NUINS CON. NUINS CON BACK GROUND INFORMATION Topic: Physically challenged. causes.V AIDS: Power point presentation PREVIOUS KNOWLEDGE OF THE GROUP Students have had formal class on in iii yr Bsc . causes. features. early detection and management Subject: Child Health Nursing Method: Lecture cum discussion Venue: II yr MSc (N) Date : 23 -7-10 Hour : 1 HOUR Subject teacher : Ms.nursing in iii yr Bsc . features.

                describe the meaning of neonatal seizures explain the mechanism enumerate types describe the etiology explain the pathogenesis differentiate seizures and jitterness explain the management define hypoxic ischemic encephalopathy describe the etiology explain the pathophysiology describe clinical features enumerate diagnostic measures explain sarnat staging system describe the management explain newer modalities of treatment describe the nursing management .

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