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Cerebral palsy in children

logosepikinonia — Sat, 20 Aug 2022 00:00:33 +0000

What is cerebral palsy?
Cerebral palsy is the most common motor disability of childhood. This term describes a group of disorders resulting from damage to the brain during development that affects a person’s ability to control their muscle function. This damage can occur during pregnancy, childbirth or the first years of the child’s life, which is, in short, during the period of maximum growth and maturation of the brain. Cerebral palsy only includes cases where the damage to the brain does not progress but remains stagnant, without getting better or worse. However, what changes is the clinical picture of the child as they grow up.
On the one hand, they may develop musculoskeletal problems as they grow, but on the other hand, therapeutic intervention can help them avoid deformities as much as possible and train them to improve their mobility and functionality.

Types of cerebral palsy
Cerebral palsy is classified into four main categories based on the quality of muscle tone and the nature of the movement disorder:

1. Spastic form: This is the most common type, characterized by increased muscle tone leading to spasticity. Muscles are often tight and constantly contracted, resulting in weakness and difficulty in movement.

2. Athetosis form: Athetosis refers to the inability to maintain a stable position or posture due to disruptions in muscle tone. Individuals with this form struggle to hold steady positions while sitting or standing, experiencing involuntary and sudden movements across a wide range that they cannot control.

3. Ataxic form: Ataxia entails difficulty in executing movements accurately, often accompanied by tremors when attempting to move. Movements may either overshoot the target, such as when trying to grasp an object, or fall short. Children with ataxia commonly face challenges with balance.

4. Hypotonic form: In this type, there is generalized hypotonia characterized by decreased muscle tone and loose joints. It is a relatively rare form of cerebral palsy.

5. Mixed forms: Combination of the types mentioned above.

Accompanying problems that may exist in children with cerebral palsy include:
• Hearing problems
• Vision problems
• Epilepsy
• Intellectual disability
• Gastroesophageal reflex
• Orthopedic problems
• Sensory- perceptual difficulties
• Nutritional challenges
• Constipation
• Frequent respiratory infections
• Speech difficulties
• Learning challenges

Treatment of cerebral palsy
In terms of treatment, individuals with cerebral palsy require therapeutic interventions from infancy and early childhood. Research indicates that early intervention and effective treatment improve the quality of life for the children and their families. It also helps prevent the accumulation of musculoskeletal deformities and serious complications that may necessitate prolonged hospitalizations or surgeries.
Cerebral palsy care places significant demands on health and social care systems due to the chronic and often severe nature of the condition.

Treatment approaches are tailored to each individual’s specific needs, considering the severity of the movement issues and any accompanying problems. Generally, the following treatments are necessary:
1. Physiotherapy, which should commence in the early years of life, ideally soon after diagnosis.

2. Occupational therapy, also beginning early in life.

3. Speech therapy to enhance both verbal and non-verbal communication abilities.

4. Interventions for feeding and saliva management issues, common among many patients.

5. Participation in physical education programs, sports activities, and creative endeavors to promote socialization among children.

Enhanced care for children with cerebral palsy not only improves their quality of life and that of their families but also fosters the realization of their potential for leading more fulfilling lives.

Sources: Cerebral Palsy: a guide for parents, PlusMED
What is cerebral palsy and how is it treated, IASO

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4 Behavioral Disorders in Children – Signs and Symptoms

logosepikinonia — Thu, 11 Nov 2021 10:35:45 +0000

It is typical for children to experience challenging phases as they grow up. Part of gaining dominance and asserting independence involves testing rules and boundaries.

However, behavioral disorders go beyond occasional outbursts of anger or defiant behavior. A child diagnosed with a behavioral disorder faces issues severe enough to impact their school performance or relationships with friends and family.

Without proper treatment, behavioral disorders can escalate over time. Therefore, it is crucial to have the child evaluated by a qualified mental health professional if a behavioral disorder is suspected.

Behavioral Disorders

When a child’s disruptive behaviors persist for six months or longer, affecting their school, home, and social life, seeking a specialist for diagnosis is advisable. Signs that may indicate a behavioral disorder include:

• Carelessness

• Hyperactivity

• Impulsivity

• Contempt

• Drug use

• Criminality

Diagnosis involves an evaluation to assess your child’s symptoms and medical history.

A child psychiatrist will gather information from both you and your child. They may also request to speak with your child’s teachers and other caregivers to gain a more comprehensive understanding of how your child behaves in various situations. It’s important to note that only a qualified professional can diagnose a behavioral disorder.

Attention Deficit Hyperactivity Disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD) stands as one of the most common behavioral disorders. While often perceived as a childhood disorder, it is not something an individual can outgrow.

ADHD is a neurodevelopmental disorder that impacts 11% of children aged 3 to 17 years.

Remarkably, 75% of people with ADHD continue to experience symptoms into adulthood.

Symptoms can range from mild to severe.

Types of Attention Deficit Hyperactivity Disorder:

• Hyperactive – Impulsive

• Careless

• Combination of Hyperactive-Impulsive with Careless

Symptoms:

ADHD symptoms vary based on the severity and type of the disorder. Manifestations can differ at different ages. For instance, a toddler may struggle with following directions and exhibit restlessness, while a teenager might face challenges in setting priorities and display withdrawal tendencies.

Symptoms of Inattentive ADHD:

• Careless mistakes

• Difficulty concentrating

• Difficulty following directions

• Disruption

• Avoidance of tasks requiring mental effort

• Frequently loses things

• Easily detached

• Forgetfulness

Symptoms of Hyperactive-Impulsive ADHD:

• Non-stop talking

• Inability to sit still

• Difficulty participating in quiet activities

• Impatience

• Hesitation in answers or making inappropriate comments

• Impulsive actions without considering consequences

Diagnosis and Treatment

The diagnosis of ADHD is crucial. Without appropriate support and treatment, children may encounter difficulties in academic, social, and emotional domains. To diagnose ADHD, a child psychiatrist conducts a comprehensive evaluation, including a thorough medical history and a general history of your child’s behavior. Perspectives from parents, teachers, and the child are essential.

A child psychiatrist can provide a diagnosis for children as young as 4 years old. During the assessment, they will determine whether your child’s symptoms primarily involve inattention, impulsivity, hyperactivity, or a combination of these. This information guides the development of a treatment plan.

Treatment for ADHD is often comprehensive, involving a combination of medication, behavioral therapy, parent education, and academic modifications and supports.

Oppositional Defiant Disorder

Oppositional Defiant Disorder (ODD) is characterized by persistent contempt and disobedience toward authority figures. Oppositional behavior is a normal developmental stage in infancy and adolescence. However, when this behavior becomes hostile, frequent, and extreme compared to others of the same age, it may indicate ODD.

Symptoms:

The symptoms of Oppositional Defiant Disorder are often more pronounced at home and at school. Between 1% and 16% of school-age children and adolescents have ODD.

Symptoms of ODD include:

• Frequent outbursts of anger

• Frequent arguments with adults

• Deliberately disturbing other people

• Frequent questioning and denial of rules

• Blaming others for mistakes

• Easily getting angry

• Revengeful behavior

Diagnosis and treatment

ODD often coexists with other behavioral disorders. Without intervention, ODD can progress into a conduct disorder, making early diagnosis and treatment crucial. To diagnose ODD, a child psychiatrist conducts a comprehensive evaluation, during which they also look for co-occurring disorders. Parents and caregivers play a key role in treatment. Learning how to manage a child with ODD requires training. Additionally, family and individual therapy are often components of treatment. Medications can also be used to control symptoms.

Conduct Disorder

Conduct disorder involves a repeated pattern of violating other people’s rights or persistently breaching social rules. Children with conduct disorder are often perceived as “bad” or delinquent, but they are in fact leaving with a mental illness. Certain factors can elevate a child’s risk of developing conduct disorder. Abuse or neglect, school failure, and traumatic experiences are all contributors to conduct disorder.

Symptoms:

Conduct disorder manifests as a disregard for rules and engaging in socially unacceptable behaviors. Children with conduct disorder often exhibit a lack of respect and empathy for others.

Symptoms of conduct disorder include:

• Physical aggression towards people and animals

• Destruction of property and vandalism

• Deception and lies

• Theft

• Serious rule violations (such as running away, getting expelled from school)

Children with conduct disorder may require intensive interventions, including support at home. A child with conduct disorder may struggle to trust adults, complicating the treatment process. Behavioral therapy, psychotherapy, academic support, and medication are all tools used to treat this disorder. Early intervention and treatment yield the best results.

Intermittent Explosive Disorder

Intermittent Explosive Disorder (IED) is a relatively under-researched mental illness in young people. It is characterized by recurrent acts of violence and destruction that are disproportionate to the situation. It stands as the only clinical disorder distinguished by impulsive aggression.

Symptoms:

IED may resemble simple tantrums. Children with IED may throw objects, engage in physical fights, and exhibit abusive behavior.

Symptoms of IED include:

• Anger

• Irritability

• Impulsive thoughts

• High energy

• Palpitations of the heart, tightness in the chest

• Explosions of anger

• Arguments and shouting matches

• Physical altercations

• Threats of violence

• Assaults on individuals or animals

• Destruction of property

Diagnosis and Treatment:

A child psychiatrist can diagnose Intermittent Explosive Disorder through a thorough evaluation of the child’s medical and psychiatric history, along with the presence of persistent symptoms meeting specific criteria. To receive a diagnosis of IED, a person must demonstrate verbal or physical aggression twice a week for three months or exhibit three episodes of property damage within 12 months or engage in three episodes of assault resulting in physical injury over the past 12 months. Treatment for IED typically involves a combination of medication and cognitive-behavioral therapy. Coping techniques such as relaxation, stress management in challenging situations, and avoidance of drugs and alcohol can also be beneficial.

Reasons

The precise cause of behavioral disorders remains unknown, although several theories exist regarding their development. It’s plausible that developmental, environmental, and genetic factors may contribute. Children with a family history of substance use, personality disorders, or mood disorders face an elevated risk of developing conduct disorders.

Treatment

Early intervention is key in treating behavioral disorders. If you observe symptoms of behavioral disorders in your child, prompt evaluation is advisable. Treatment approaches vary based on your child diagnosis and the severity of the disorder. Collaborate with your child’s doctor to devise a plan that suits your needs.

Psychotherapy

Psychotherapy often forms an integral part of behavioral disorder treatment. It provides a space to process thoughts and emotions, while also teaching social and behavioral skills, and appropriate anger management techniques. Cognitive-behavioral therapy can be beneficial in assisting individuals in modifying their behavior. Family therapy offers an opportunity to resolve interpersonal conflicts and acquire healthy communication strategies.

Medication

Medication is a powerful tool for managing many behavioral disorders and is often used with psychotherapy.

Common medications include:
• Stimulants
• Non- stimulants
• Antidepressants
• Anticonvulsants
• Tranquilizers

Parent Education
Parental education is crucial for the success of treatment. When a child has a behavioral disorder, learning effective communication and strategies for managing your child’s outbursts can contribute to maintaining a calm and stable environment. Parental involvement and understanding play a significant role in the overall well-being and progress of the child undergoing treatment.

Source: Amy Morin, LCSW, Signs and Symptoms of the Most Common Behavior Disorders in
Children, Verywell Family.

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Voice Disorders: A Short Guide for Adults and Children

gyuser — Fri, 04 Jun 2021 10:31:42 +0000

Do you experience hoarseness and weakness in your voice? Are there times when you find yourself unable to speak? Does your child have a notably hoarse voice? If so, this article is of interest to you.

“Dysphonia” is the medical term that denotes the inability to produce normal speech. Dysphonia commonly affects voice professionals, such as singers, actors, salespeople, and
teachers, but it can also occur in individuals of any age, including children, teenagers, and adults.

In normal speech, the voice’s quality should be pleasant, the pitch suitable for the person’s age or background. The volume should be appropriate for the communication environment, and
the speaking strength should meet the individual’s professional needs. If one or more of these aspects do not align with the individual’s requirements for an extended period, they may be
experiencing a speech disorder. The voice may manifest as hoarse, rough, monotonous, very high-pitched, or excessively breathy.

Symptoms that may be observed include the following:

Hoarseness in the throat.

Continuous throat clearing.

Persistent, bothersome cough.

Pain while swallowing.

Neck pain.

Sensation of a foreign body in the throat.

Fatigue during speech.

Voice changes throughout the day.

The causes can be categorized as follows:

Organic/Structural: dysplasia – laryngeal cancer, nodules, polyps, Reinke’s edema, cysts on the vocal cords, scar formation on the vocal cords due to voice trauma from poor
voice management.

Neurological voice disorders: spasmodic dysphonia, unilateral or bilateral paralysis of the vocal cords, paralysis of the superior laryngeal nerve.

Viral and traumatic voice disorders: acute and chronic laryngitis, contact ulcers.

Functional and idiopathic voice disorders: muscle tone dysphonia, biphonia, glottic insufficiency.

Hormonal disorders: menopause, hormonal imbalances.

The assessment of dysphonia patients is conducted collaboratively between the speech therapist and the ENT specialist. Otorhinolaryngological examinations, including video-
stroboscopy and video-endoscopy, are crucial for understanding the root cause of the problem. Through auditory and perceptual analysis, the speech therapist gathers objective evidence and
proceeds with therapeutic intervention.
The therapeutic treatment of dysphonias through phonotherapy is administered by qualified therapists, involving education on vocal hygiene and the training of techniques to reduce and
prevent symptom recurrence. Other intervention methods may include medication and surgical removal.

Some tips to protect your voice:

Avoid shouting and whispering; maintain a steady, low tone.

Stay well-hydrated by drinking water frequently to moisturize the vocal cords.

If you cough incessantly, try swallowing, drinking water, or chewing a piece of gum.

Reduce consumption of caffeinated drinks (coffee, tea, cola) as they can dehydrate the vocal cords.

At Speech & Communication, we possess the training and expertise to work in speech therapy with both adults and children. Regarding the latter, we also emphasize counseling, as they
often sustain injuries to their vocal cords due to challenging behavior and poor communication patterns at home.

The content featured on the Speech & Communication website is meant for informational purposes only. It does not constitute personalized treatment recommendations and cannot
replace the expert advice of a qualified therapist tailored to specific cases. In instances where the content is republished from another source, this is explicitly mentioned. The authors of
Speech & Communication assume no responsibility for any outcomes linked in any manner to any published post.

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