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. AutismThree main clinically features:

onset within 2-3 years of lifeProfound alonenessObsessional 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 DisabilitiesFirst Dental VisitHome Dental Care

2. Medically compromised Cleft Lip and Palate