Aubrey Berk

Infectious Diseases  An infectious disease is when a disease- producing organism invades a host. This organism may be in the form of a virus, bacteria, fungus, or parasite.  A communicable disease is an infectious disease that may be transmitted from one person to another either directly or indirectly.  Examples- hepatitis B, influenza, and measles.  Most infectious diseases are communicable!

Susceptibility and Effects  Communicable diseases are a particular concern for many children with severe and multiple disabilities for two reasons  1- Even though some children with disabilities have normal resistance to infection, many contract communicable diseases more frequently than children without.  2- If infected, these children often experience more severe symptoms and/or are ill longer than a child without a disability.

Increased vulnerability  Some children with severe and multiple disabilities have genetic and metabolic conditions that reduce their resistance to infection.  Nutritional problems and reduced levels of physical activity also contribute to the vulnerability.  Also, many medicines that are used for children with disabilities can produce side effects that inhibit the body’s natural defenses against infection.

Controlling Communicable Diseases  A lot of progress has taken within controlling the spread.  Improvements in personal hygiene, public sanitation, new and better immunization agents, more effective treatments, epidemic control measures ( quarantine measures), and generally improved living conditions.  Educators and other team members who are working with children with severe and multiple disabilities have a responsibility to do their part in protecting themselves and the children they care for.  Sanitation and Hygiene are important skills to teach and practice!

Immunizations  Vaccines can provide complete immunity against some infections and partial immunity against others.  Many schools require proof of vaccination against some diseases ( measles, mumps, chicken pox) for all student to prevent the spread of disease.  However, some students can not be immunized against some diseases because of conditions that compromise their immune responses or because vaccines may cause allergic or adverse reactions.  Immunizations have come under scrutiny because some have suggested the idea that autism can result from a reaction to routine immunizations.

Seizure Disorders  Seizures are sudden changes in behavior, sensation, or motor function caused by rapid and disorderly electrochemical discharges in the brain.  Epilepsy is a condition in which seizures occur usually spontaneously. It is diagnosed when an individual had repeated seizures that are not the result of another current medical condition.

Epilepsy  Epilepsy occurs much more frequently among children with severe and multiple disabilities than among children without such disabilities.  As many as 30% of people with mental retardation and up to 50% of children and adults with multiple disabilities also have epilepsy!

Causes of Epilepsy  Many of the known causes of epilepsy also are causes of cerebral palsy and mental retardation, and many children have more than one of these disabilities.  Typically, these causes are divided into three major categories:  1) Prenatal (occurring before the child’s birth)  2) Perinatal (occurring during or very close to birth  3) Postnatal (occurring later in life)

Teacher’s Role when a Seizure Occurs  When a seizure occurs in the classroom, teacher should record observations of the child’s behavior as precisely and quickly as possible in order to provide the most useful information to the medical team.  They should avoid trying to interpret the behaviors, however.

Types of Seizures and First Aid  Partial complex seizures- Usually produce loss of consciousness and automatisms (complex, involuntary movements that occur during loss of awareness). These can look like sucking movements, lip smacking, looking around, grimacing, fumbling with clothes or sheets, or scratching movements Some children may hum or vocalize. Do: Remove hazards from area or pathway, supervise until fully conscious. Do Not: Restrain movements, Approach if agitated, unless necessary!, Give food or fluids until fully conscious

Types of Seizures and First Aid  Generalized Absence seizures (Petit mal)- without convulsions. When they occur, the child suddenly loses consciousness for a brief period. Typically staring into space without moving and a glazed appearance. These kinds of seizures can go unnoticed much of the time b/c they cause few problems. Do: Protect child from environmental hazards. Do Not: Give food or fluids until fully conscious.

Types of Seizures and First Aid  Generalized Tonic-Clonic (Grand mal) seizures- are the most common seizure. They are characterized by sudden, jerky movements of the muscles. Followed by loss of consciousness and a shaking phase. Do: During: Ease to the floor, Remove hazards, Cushion vulnerable body parts. After: Position for clear airway if required, Check for injuries, Allow rest. Do Not: During: Put anything in the person’s mouth, Move the person, unless absolutely necessary, Restrain the person’s movements. After: Give food or fluids until fully conscious.

Educational Implications for Epilepsy  Epilepsy can affect learning for the child. Symptoms of confusion, mental impairment, headache, or fatigue following a seizure may interfere with learning. There also are social implications with epilepsy. Epilepsy has a long history of social stigma. Lack of social acceptance and negative public opinion are problems with public opinion.

Self-Injurious Behavior(SIB)  Self-Injurious behavior (SIB) is seen in some student with severe or multiple disabilities. These students harm themselves through their own repetitive, stereotypic, or intense episodic behavior. They may bang their heads, poke their eyes, scratch or tear their skin, bite their arms or fingers, or engage in other self damaging behavior.  SIB is very disruptive to activities and demoralizing to parents, staff, classmates, and others

SIB continued…  Causes: No single cause appears to explain all SIB among children with disabilities. In some individuals, SIB has a social function, such as gaining attention or escaping from demands.  Some theories say that self inflicted pain helps block other more aversive sensations, may increase the production of natural opiates in the system and thus be reinforced, or may be used by the individual to raise the general level of arousal to alert themselves.

Classroom Emergencies Despite the best prevention efforts, emergencies do occur, and all staff working with children with severe and multiple disabilities should be aware and prepared to respond to them. Some other emergencies to be aware of include:  Choking/Airway obstruction  Brain Injury (Concussions)  Poisoning  Bleeding

Abuse  The incidence of child abuse and neglect among children with disabilities appears to be at least twice as high as it is for the general population.  Most all states require educational and health care professionals to report suspected abuse to police or child protection agencies. (Pa. has Child line).

Abuse  Abuse appears to be more extensive then previously believed.  The direct effects of traumatic injuries due to child abuse can be devastating, the psychological trauma caused by more subtle mechanisms can be equally tragic.  Research has made it clear that physical, sexual, or emotional abuse or severe neglect also affects the development of children's nervous systems by producing biochemical changes related to extreme stress or trauma.  These changes can cause disabilities or increase the complexity and severity of existing disabilities.