Management of Children with Disabled Conditions Part I Maha AL-SARHEED

INTRODUCTION World-wide 1:10 child is born with a physical, mental or sensory impairment 3.5% of the world’s population affected with disability are children In Saudi population 3.76/1000 of the total population had a severe impairment 42.8/1000 had a minor impairment

Continued Terminology of Disability (Halbertsma et al., 2000 ) Disease or disorder Impairment (body level) Disability (person level) Handicap (society level )

Classification of Disability 1.Intellectually impairment 2.Physical impaired 3.Sensory impaired 4.Medically compromised

1. Intellectually impairment Causes of Intellectually impairment are numerous and may never be identified Can be divided into those who either mental disability or having learning disability subgroup where cause and features are known namely Down and Fragile X syndrome It may be present in some children with physical disability and those who suffered birth anoxia and sever infection for example meningitis

A.Down’s Syndrome It is a chromosomal disorder (1:600) Occurs as result of either: Extra chromosome is added in the 21 position (trisomy 21) due to chromosomal non-dysjunction -- 95% Chromosome mutation known translocation where only part of chromosome 21 present-- 5%

B.Fragile X-syndrome Commonest cause of mental disability It appears to be ex-linked dominant trait where male are more vulnerable because they only have one X-chromosome and affected more than female Most children have a history of developmental delay, hyperactivity, cardiac defect (mitral valve prolapse) and physical features

C.Autism Three main clinically features: onset within 2-3 years of life Profound aloneness Obsessional desire for unchanging environment Disorder beginning in the first 30 months of life Failure to develop interpersonal relationships, delayed development of speech and language and development of compulsive behaviour Children appear to be isolated

II.Learning Disability It’s due to incomplete development of mind, particularly of intelligence to such degree Delay in academic performance (2 years behind child’s ability) Causes: -Minimal brain injury -Damage of central nervous system -Genetic factors

A.Dyslexia Children whose reading skills are delayed for any reason 3-16% Associated with number of cognitive skills

Dental management of children with Disabilities First Dental Visit Home Dental Care

2.Medically compromised Cleft Lip and Palate