1. Terms Failure to Thrive (FTT) Low Birth Weight (LBW) Cerebral Palsy (CP) Respiratory Distress Syndrome (RDS) Cyanosis Bluish color skin and lips Bronchopulmonary dysplasia (BPD) Gastroesophageal reflux (GER) neonatal intensive care unit (NICU) Pediatric intensive care unit (PICU)

2. Some Developmental Disabilities Cerebral palsy Mental retardation Communication disorders autism deafness Chronic childhood neurological disorders – Seizures – Degenerative CNS – Myopathies (MS)

3. Causes of Developmental Disabilities Congenital – Genetic – Infections – Toxic/metabolic – other Acquired – Head trauma – Perinatal – Infections – Toxic/metabolic – Other diseases

4. High Risk Babies Born prematurely – 3 or more weeks before the end of 38 weeks of pregnancy-or who weigh less that 5 ½ lbs (2,500 grams) – Less than 3 ½ lbs or (1,500 grams(VLBW) Broad array of problems at birth – BPD, RDS, cynanosis – Gastrointestinal problems – hernias VLBW –severe anemia

5. IDEA-Individuals with Disabilities Act Public Law 99-457 – 0-3 – developmentally delayed – biologically at risk – natural environments

7. Illnesses and Medical Conditions with hospitalization Birth Injuries Jaundice Umbilical Hernia Eye Infections Ear Infections Upper Respiratory Infections (URI) Sepsis Fractures

8. Illnesses and Medical Conditions with hospitalization Down Syndrome Neural Tube Defects (NTDs) Heart Defects Speech and Language Difficulties Seizures Near Drowning Burns Poisoning Choking

9. Components in Service Delivery Medical Setting The Family/Home Setting The School/Educational Setting

10. Technology Assistance Intravenous Lines (IV) Suctioning Tube feeding Monitors Oxygen Ventilators

11. Issues for the Hospitalized Child Infants Toddlers Preschoolers

12. Issues for Infants with Medical Needs Disruption in normal routines (fussiness and irritability Immediate response to pain needs and seeks comfort (comfort strategies demonstrated) Stranger anxiety begins (around 6 months)

13. Toddler with Medical Needs Separation Anxiety Fear of Strangers Immediate response to pain and unfamiliarity Regression in skills (motor, language, Potty training)

14. Preschoolers with Medical Needs Separation anxiety Anxiety about intrusions and mutilation Anxiety aroused by egocentric thought, fantasies, magical thinking Fear of punishment aroused by guilt ( child may feel that he or she is the cause of illness

15. The Family Parents Grandparents Siblings

16. Stress Stress Model

17. Stress in Parents Anxiety about caregiver role Equipment and other children’s cries Behavioral changes Appearance and health of child in NICU/PICU Spouse/family members’ health Spending more time with spouse Financial strain in providing basic needs

18. Stressors in Mothers Child’s diagnosis period Repeated hospitalization Daily management and child rearing Medical difficulties and withdrawal episodes

19. Stressors in Fathers Understanding the child’s diagnosis Child’s pain

20. Stressors in Siblings Feeling lonely Observing stress in parents Increased responsibilities Change in residence Feeling ill

21. Stressors in Grandparents Inability to advise parents with caregiving Lack of information about disability or disease

22. Cultural Factors and Caregivers Differences in Communication Methods Differences in Meaning of Disability Differences in Perceptions of Medical and Educational Staff Traditional Healing Practices

24. Good? Or Bad?

25. Cultural Health Practices Closely linked to beliefs and family values Folk medicine Spirits Unity of nature Preventive

26. Recommendations for Early Childhood Educators Recognize the need for communication and collaboration of services and professionals that work with the young child Seek out best communication method for family members and utilize it Assist in developing parent workshops on stress management, resources and services Assist child in maintaining normal developmental patterns Be sensitive to cultural and ethical differences in illness, disability and the family