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Characteristics of Physically Handicapped Children

There are many children who are born with physical disabilities. However, the di
sabilities do not have to limit their life or natural talents if they are suppor
ted and encouraged correctly. Although physically handicapped children do have t
o endure certain challenges, they are capable of fulfilling their dreams by lear
ning how to adapt and adjust to certain situations instead of giving up.
Physical Limitations
Physically handicapped children are all challenged with physical limitations to
some degree. The Livestrong website explains that it is important for parents to
monitor a baby or child's development in order to recognize a physical handicap
as soon as possible and find treatment options. Many physically handicapped chi
ldren suffer from a lack of coordination, weak muscles, stiff muscles, or no mus
cle strength at all. Rehabilitation and physical therapy can greatly assist phys
ically handicap children in lessening and even resolving the handicap over time.
All of the necessary equipment and safety measures should be taken in order to
allow the child to be as mobile and independent as possible.
Emotional Challenges
It is important for parents, family members, friends, and teachers to monitor a
physically disabled child's emotional state. At times, physical limitations can
lead to frustration, anger and sadness. The emotional outlook of the child is of
ten directly impacted by the level of support and encouragement that is received
from the people around him. According to the Livestrong website, it is importan
t for physically disabled children to have people that they can talk to openly i
n order to discuss, understand, and resolve emotional issues. In some cases, it
is beneficial for the child to see a therapist or enroll in a therapy program wi
th animals or physical activities that increase his confidence.
Learning Abilities
Although some children with physical disabilities also have mental disabilities
many children are mentally strong and just as capable as any other child. It is
important that parents and teachers encourage physically handicapped children to
excel in school and discover their individual talents and strengths. The Twice
Gifted website explains that with the correct support and encouragement physical
ly handicapped children can succeed in school and even surpass other classmates.
Parents and teachers must recognize the gifts of the child and not limit them m
entally because of a physical disabilities.
Mental retardation
Definition
Mental retardation (MR) is a developmental disability that first appears in chil
dren under the age of 18. It is defined as a level of intellectual functioning (
as measured by standard intelligence tests ) that is well below average and resu
lts in significant limitations in the person's daily living skills (adaptive fun
ctioning).
Description
Mental retardation begins in childhood or adolescence before the age of 18. In m
ost cases, it persists throughout adult life. A diagnosis of mental retardation
is made if an individual has an intellectual functioning level well below averag
e, as well as significant limitations in two or more adaptive skill areas. Intel
lectual functioning level is defined by standardized tests that measure the abil
ity to reason in terms of mental age (intelligence quotient or IQ). Mental retar
dation is defined as an IQ score below 70â75. Adaptive skills is a term that refers
to skills needed for daily life. Such skills include the ability to produce and
understand language (communication); home-living skills; use of community resour
ces; health, safety, leisure, self-care, and social skills; self-direction; func
tional academic skills (reading, writing, and arithmetic); and job-related skill
s.
In general, mentally retarded children reach such developmental milestones as wa
lking and talking much later than children in the general population. Symptoms o
f mental retardation may appear at birth or later in childhood. The child's age
at onset depends on the suspected cause of the disability. Some cases of mild me
ntal retardation are not diagnosed before the child enters preschool or kinderga
rten. These children typically have difficulties with social, communication, and
functional academic skills. Children who have a neurological disorder or illnes
s such as encephalitis or meningitis may suddenly show signs of cognitive impair
ment and adaptive difficulties.
Mental retardation varies in severity. The Diagnostic and Statistical Manual of
Mental Disorders , fourth edition, text revision ( DSM-IV-TR ), which is the dia
gnostic standard for mental health care professionals in the United States, clas
sifies four different degrees of mental retardation: mild, moderate, severe , an
d profound . These categories are based on the person's level of functioning.
Mild mental retardation
Approximately 85% of the mentally retarded population is in the mildly retarded
category. Their IQ score ranges from 50â70, and they can often acquire academic skil
ls up to about the sixth-grade level. They can become fairly self-sufficient and
in some cases live independently, with community and social support.
Moderate mental retardation
About 10% of the mentally retarded population is considered moderately retarded.
Moderately retarded persons have IQ scores ranging from 35â55. They can carry out w
ork and self-care tasks with moderate supervision. They typically acquire commun
ication skills in childhood and are able to live and function successfully withi
n the community in such supervised environments as group homes .
Severe mental retardation
About 3â4% of the mentally retarded population is severely retarded. Severely retard
ed persons have IQ scores of 20â40. They may master very basic self-care skills and
some communication skills. Many severely retarded individuals are able to live i
n a group home.
Profound mental retardation
Only 1â2% of the mentally retarded population is classified as profoundly retarded.
Profoundly retarded individuals have IQ scores under 20â25. They may be able to deve
lop basic self-care and communication skills with appropriate support and traini
ng. Their retardation is often caused by an accompanying neurological disorder.
Profoundly retarded people need a high level of structure and supervision.
The American Association on Mental Retardation (AAMR) has developed another wide
ly accepted diagnostic classification system for mental retardation. The AAMR cl
assification system focuses on the capabilities of the retarded individual rathe
r than on his or her limitations. The categories describe the level of support r
equired. They are: intermittent support; limited support; extensive support , an
d pervasive support . To some extent, the AAMR classification mirrors the DSM-IV
-TR classification. Intermittent support, for example, is support that is needed
only occasionally, perhaps during times of stress or crisis for the retarded pe
rson. It is the type of support typically required for most mildly retarded peop
le. At the other end of the spectrum, pervasive support, or life-long, daily sup
port for most adaptive areas, would be required for profoundly retarded persons.
The AAMR classification system refers to the "below-average intellectual functi
on" as an IQ of 70â75 or below.
Demographics
The prevalence of mental retardation in North America is a subject of heated deb
ate. It is thought to be between 1%â3% depending upon the population, methods of ass
essment, and criteria of assessment that are used. Many people believe that the
actual prevalence is probably closer to 1%, and that the 3% figure is based on m
isleading mortality rates; cases that are diagnosed in early infancy; and the in
stability of the diagnosis across the age span. If the 1% figure is accepted, ho
wever, it means that 2.5 million mentally retarded people reside in the United S
tates. The three most common causes of mental retardation, accounting for about
30% of cases, are Down syndrome, fragile X, and fetal alcohol syndrome. Males ar
e more likely than females to have MR in a 1.5:1 ratio.
Causes and symptoms
Low IQ scores and limitations in adaptive skills are the hallmarks of mental ret
ardation. Aggression, self-injury, and mood disorders are sometimes associated w
ith the disability. The severity of the symptoms and the age at which they first
appear depend on the cause. Children who are mentally retarded reach developmen
tal milestones significantly later than expected, if at all. If retardation is c
aused by chromosomal or other genetic disorders, it is often apparent from infan
cy. If retardation is caused by childhood illnesses or injuries, learning and ad
aptive skills that were once easy may suddenly become difficult or impossible to
master.
In about 40% of cases, the cause of mental retardation cannot be found. Biologic
al and environmental factors that can cause mental retardation include:
Genetic factors
About 30% of cases of mental retardation is caused by hereditary factors. Mental
retardation may be caused by an inherited genetic abnormality, such as fragile
X syndrome. Fragile X, a defect in the chromosome that determines sex, is the mo
st common inherited cause of mental retardation. Single-gene defects such as phe
nylketonuria (PKU) and other inborn errors of metabolism may also cause mental r
etardation if they are not discovered and treated early. An accident or mutation
in genetic development may also cause retardation. Examples of such accidents a
re development of an extra
Prenatal illnesses and issues
Fetal alcohol syndrome (FAS) affects one in 3,000 children in Western countries.
It is caused by the mother's heavy drinking during the first twelve weeks (trim
ester) of pregnancy. Some studies have shown that even moderate alcohol use duri
ng pregnancy may cause learning disabilities in children. Drug abuse and cigaret
te smoking during pregnancy have also been linked to mental retardation.
Maternal infections and such illnesses as glandular disorders, rubella, toxoplas
mosis, and cytomegalovirus (CMV) infection may cause mental retardation. When th
e mother has high blood pressure (hypertension) or blood poisoning (toxemia), th
e flow of oxygen to the fetus may be reduced, causing brain damage and mental re
tardation.
Birth defects that cause physical deformities of the head, brain, and central ne
rvous system frequently cause mental retardation. Neural tube defect, for exampl
e, is a birth defect in which the neural tube that forms the spinal cord does no
t close completely. This defect may cause children to develop an accumulation of
cerebrospinal fluid inside the skull (hydrocephalus). Hydrocephalus can cause l
earning impairment by putting pressure on the brain.
Childhood illnesses and injuries
Hyperthyroidism, whooping cough, chickenpox, measles, and Hib disease (a bacteri
al infection) may cause mental retardation if they are not treated adequately. A
n infection of the membrane covering the brain (meningitis) or an inflammation o
f the brain itself (encephalitis) can cause swelling that in turn may cause brai
n damage and mental retardation. Traumatic brain injury caused by a blow to the
head or by violent shaking of the upper body may also cause brain damage and men
tal retardation in children.
Environmental factors
Ignored or neglected infants who are not provided with the mental and physical s
timulation required for normal development may suffer irreversible learning impa
irment. Children who live in poverty and suffer from malnutrition, unhealthy liv
ing conditions, abuse, and improper or inadequate medical care are at a higher r
isk. Exposure to lead or mercury can also cause mental retardation. Many childre
n have developed lead poisoning from eating the flaking lead-based paint often f
ound in older buildings.
Diagnosis
If mental retardation is suspected, a comprehensive physical examination and med
ical history should be done immediately to discover any organic cause of symptom
s. Such conditions as hyperthyroidism and PKU are treatable. If these conditions
are discovered early, the progression of retardation can be stopped and, in som
e cases, partially reversed. If a neurological cause such as brain injury is sus
pected, the child may be referred to a neurologist or neuropsychologist for test
ing.
A complete medical, family, social, and educational history is compiled from exi
sting medical and school records (if applicable) and from interviews with parent
s. Children are given intelligence tests to measure their learning abilities and
intellectual functioning. Such tests include the Stanford-Binet Intelligence Sc
ale , the Wechsler Intelligence Scales, the Wechsler Preschool and Primary Scale
of Intelligence, and the Kaufman Assessment Battery for Children . For infants,
the Bayley Scales of Infant Development may be used to assess motor, language,
and problem-solving skills. Interviews with parents or other caregivers are used
to assess the child's daily living, muscle control, communication, and social s
kills. The Woodcock-Johnson Scales of Independent Behavior and the Vineland Adap
tive Behavior Scale (VABS) are frequently used to evaluate these skills.
Treatment
Federal legislation entitles mentally retarded children to free testing and appr
opriate, individualized education and skills training within the school system f
rom ages three to 21. For children under the age of three, many states have esta
blished early intervention programs that assess children, make recommendations,
and begin treatment programs. Many day schools are available to help train retar
ded children in such basic skills as bathing and feeding themselves. Extracurric
ular activities and social programs are also important in helping retarded child
ren and adolescents gain self-esteem.
Training in independent living and job skills is often begun in early adulthood.
The level of training depends on the degree of retardation. Mildly retarded peo
ple can often acquire the skills needed to live independently and hold an outsid
e job. Moderate to profoundly retarded persons usually require supervised commun
ity living in a group home or other residential setting.
Family therapy can help relatives of the mentally retarded develop coping skills
. It can also help parents deal with feelings of guilt or anger. A supportive, w
arm home environment is essential to help the mentally retarded reach their full
potential.
Prognosis
People with mild to moderate mental retardation are frequently able to achieve s
ome self-sufficiency and to lead happy and fulfilling lives. To reach these goal
s, they need appropriate and consistent educational, community, social, family,
and vocational supports. The outlook is less promising for those with severe to
profound retardation. Studies have shown that these persons have a shortened lif
e expectancy. The diseases that are usually associated with severe retardation m
ay cause the shorter life span. People with Down syndrome will develop the brain
changes that characterize Alzheimer's disease in later life and may develop the
clinical symptoms of this disease as well.
Prevention
Immunization against diseases such as measles and Hib prevents many of the illne
sses that can cause mental retardation. In addition, all children should undergo
routine developmental screening as part of their pediatric care. Screening is p
articularly critical for those children who may be neglected or undernourished o
r may live in disease-producing conditions. Newborn screening and immediate trea
tment for PKU and hyperthyroidism can usually catch these disorders early enough
to prevent retardation.
Good prenatal care can also help prevent retardation. Pregnant women should be e
ducated about the risks of alcohol consumption and the need to maintain good nut
rition during pregnancy. Such tests as amniocentesis and ultrasonography can det
ermine whether a fetus is developing normally in the womb.