This document discusses intellectual disability, including definitions, classifications, prevalence, causes, assessment, management, and issues faced by children with intellectual disability in the MENA region. It provides details on the DSM-5 and ICD-11 classifications and describes the assessment process. It notes that intellectual disability is often co-occurring with other neurological or mental health conditions. The document also discusses prevention, early intervention, education, and support services that can help children with intellectual disability and their families.
Specific learning disorder - reading disorder, mathematics disorder, and disorder of written expression and learning disorder NOS .
neurodevelopmental disorder produced by the interactions of genetic and environmental factors that influence the brain's ability to perceive or process verbal and nonverbal information efficiently.
Autism Spectrum Disorder (ASD) previously known as pervasive developmental disorder is a childhood disorder characterized by lack of communication skills and social interactions resulting in social withdrawal
Specific learning disorder - reading disorder, mathematics disorder, and disorder of written expression and learning disorder NOS .
neurodevelopmental disorder produced by the interactions of genetic and environmental factors that influence the brain's ability to perceive or process verbal and nonverbal information efficiently.
Autism Spectrum Disorder (ASD) previously known as pervasive developmental disorder is a childhood disorder characterized by lack of communication skills and social interactions resulting in social withdrawal
Children with disabilities: concept of disability, definitions, categories, causes, rights, health and community care, prevention, community-based rehabilitation.
Children with disabilities: concept of disability, definitions, categories, causes, rights, health and community care, prevention, community-based rehabilitation.
This slide contains information regarding Childhood Psychiatric Disorders (Mental Retardation and Attention Deficit Hyperactive Disorder). This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
Classification
Mild, moderate, severe and profound mental retardation
Mental retardation F70-F79
F70- mild mental retardation
F71- moderate mental retardation
F72- severe mental retardation
F73- profound mental retardation
F78- other mental retardation
F79- unspecified mental retardation
Definition
Significantly subaverage general intellectual functioning, associated with significant deficit or impairment in adaptive functioning, which manifests during the developmental period - American association (1983)
Intellectual functioning – Result of standardized Intelligence Tests
Subaverage – Below 70 IQ
Adaptive behavior – Ability to meet the responsibilities of social, personal, occupational and interpersonal areas of life according to his age and socio cultural background
Developmental Period – Below 18 years
Genetic Causes
Perinatal Causes
Acquired Physical Disorders in childhood
Socio cultural causes
Psychiatric disorders
Mild MR
Commonest type
Accounts for 85 – 90% of all cases
Minimal retardation in sensory - motor areas
They can progress up to VI standard
They can achieve vocational skills
They can achieve social self-sufficiency
They can develop social and communication skills
But they have deficits in cognitive function like poor ability for abstraction and egocentric thinking
Moderate MR
Accounts for 10% of all cases
They have poor social awareness during early years
Communication skills develop very slowly in these individuals
They drop out of school after 2nd Grade
They can be trained to perform semi skilled or unskilled work under supervision
Even mild stress can destabilize them
Severe MR
Recognized early in life
Significantly delayed developmental mile stones
Absent or markedly delayed speech or communication skills
Self care (ADL) can be taught
They can perform very simple tasks under supervision
They require a great amount of assistance for living
They require a structured environment
Profound MR
Accounts for 1-2% of all cases
Often associated with physical disorders
Marked delay in developmental milestones
They need nursing care or life support
Usually cared in a residential setting
Diagnosis
History collection from Parents and Care Takers
Physical Examination
Neurological examination
Assessing milestones development
Investigations
Urine and blood examination for metabolic disorders
Culture for cytogenic and biochemical studies
Amniocentesis in infant chromosomal disorders
Chorionic villi sampling
Hearing and speech evaluation
EEG, especially seizures present
CT scan or MRI brain (Tuberous sclerosis)
Thyroid function test (Cretinism)
Psychological Tests
Stanford Binet Intelligence Test
Wechsler Intelligence Scale for Children (WISC)
Prevention
Primary
Secondary
Tertiary
Complications
Seizures
Cerebral palsy
Sensory deficit
Communication disorders (speech and language)
Neuron degenerative disorders
Psychiatric illnesses
Care
Team approach
Fostering (bring up)
Boarding school / residential care
Special education
Developmental delay is the spectrum of problems encompassing delay in the cognitive, social, emotional, sexual and physical developmental skills. This presentation briefs the Cognitive developmental delay
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
3. •a group of disorders
that have in common
deficits of adaptive
and intellectual
function and an age
of onset before
maturity is reached.
4. Country and/or language Term
United States Intellectual disability
Australia Intellectual disability
Canada (English, French) Mental deficiency, intellectual handicap
England
Learning disability*, intellectual disability,
developmental disability•
France Mental deficiency, mental apraxia
Germany Mental handicap, mental retardation
Italy Mental delay, mentally deficient
Estonia Mental retardation
Puerto Rico Mentally slowed down
Spain Mental delay
8. Global Developmental Delay
• Diagnosed reserved for individuals under 5
when clinical severity level cannot be reliably
assessed.
• Diagnosed when an individual fails to meet
expected developmental milestones in several
areas of intellectual functioning, and applies to
individuals who are unable to undergo
systematic assessments of intellectual
functioning, including children who are too
young to participate in standardized testing.
• Requires reassessment after a period of time.
9. Unspecified Intellectual Disability
• Diagnosed in individuals over 5 when assessment of
the degree of intellectual disability by means of
locally available procedures is difficult or impossible
because of:
- associated sensory or physical impairments, as in
blindness or prelingual deafness; locomotor disability;
or
- presence of severe problem behaviors or co-occurring
mental disorder.
- Should only be used in exceptional circumstances
and requires reassessment after a period of time.
10. ICD 11
• ICD-11 uses the term intellectual developmental
disorders to indicate that these are disorders that
involve impaired brain functioning early in life.
These disorders are described in ICD-11 as a meta
syndrome occurring in the developmental period
analogous to dementia or neurocognitive
disorder in later life.
• There are four subtypes in ICD-11: mild,
moderate, severe, and profound.
11.
12. Intellectual disability has an overall
general population prevalence of
approximately 1%, and prevalence
rates vary by age
Prevalence for severe intellectual
disability is approximately 6 per 1,000
males are more likely than females to
be diagnosed with both mild MR
(average male: female ratio 1.6:1) and
severe MR (average male: female ratio
1.2:1)
13.
14. Country (Reference)
Source of study
population
Definition used
Total study
population
Prevalence per 1000
population
Australia
(Beange & Taplin
1996)
Administrative data on 20-50
year olds
AAMR classification of
1983
104584
3.3
Male = 3.4
Female = 3.2
Australia
(Leonard et al. 2003)
Administrative data on children
6-15 years
DSM-IV TR 240358 14.3
Canada
(Bradley et al. 2002)
Administrative data and
population based study on 14-
20 year old adolescents
ICD 10 35485 7.2
China
(Zuo et al. 1986)
Survey of 0-14 year old childrenAAMR definition 7150
7.8
Male = 7.8
Female = 7.9
China
(Xie et al. 2008)
Household survey of children
aged 0-6 years
Specific disability criteria 60124
9.3
Male = 10.1
Female = 8.3
Ethiopia
(Fitaw et al. 2006)
Population based study on
adults
ICF 24453 3.9
Finland
(Rantakallio et al.
1986)
Administrative data on specific
birth cohort of children
ICD 9 12058
5.6 (Mild mental
retardation)
6.3 (Moderate-severe
mental retardation)
Ireland
(including Northern
Ireland, UK)
(McConkey et al.
2006)
Administrative data of adults ICD 10 3961701 6.3
Norway
(Stromme et al. 1998)
Administrative data on specific
birth cohort of children
DSM-IV 30037
6.2
Male = 8.4
Female = 5.7
USA Administrative data on 10 year
DSM-III 89534
12
Male = 13.8
21. Mild MR
– 55-70 IQ
– Adaptive limitations in 2 or more domains
Moderate MR
– 35-54 IQ
– Adaptive limitations in 2 or more domains
Severe MR
– 20-34 IQ
– Adaptive limitations in all domains
Profound MR
– Below 20 IQ
– Adaptive limitations in all domains
24. Severity mental
age as
adult
Adult adaptation
Mild 9-11 yr Reads at 4th-5th grade level; simple multiplication and division; writes
simple letter, lists; completes job application; basic independent job skills
(arrive on time, stay at task, interact with coworkers); uses public
transportation, might qualify for driver's license; keeps house, cooks using
recipes
Moderate 6-8 yr Sight-word reading; copies information, e.g., address from card to job
application; matches written number to number of items; recognizes time
on clock; communicates; some independence in self-care; housekeeping
with supervision or cue cards; meal preparation, can follow picture recipe
cards; job skills learned with much repetition; uses public transportation
with some supervision
Sever 3-5 yr Needs continuous support and supervision; might communicate wants
and needs, sometimes with augmentative communication techniques
Profound <3 yr Limitations of self-care, continence, communication, and mobility; might
need complete custodial or nursing care
International Statistical Classification of Diseases and Related Health Problems, 10th edition (World
Health Organization).
25.
26. Co-occurring mental, neurodevelopmental,
medical, and physical conditions are
frequent in intellectual disability, with rates
of some conditions (e.g., mental disorders,
cerebral palsy, and epilepsy) three to four
times higher than in the general
population.
27. The most common co-occurring mental and
neurodevelopmental disorders are:
- attention-deficit/hyperactivity disorder
- depressive and bipolar disorders
- anxiety disorders
- autism spectrum disorder
- stereotypic movement disorder (with or
without self-injurious behavior)
- impulse-control disorders
- major neurocognitive disorder
28. • Different studies in the review showed that
among children with mental retardation, autism is
present in about 25%, ADHD in about 10%, and
cerebral palsy in 7-30%, depending on the
severity of mental retardation.
• Among adults with Down's Syndrome, dementia
is the most common cause of mortality and
morbidity, and research from The Netherlands has
found that often it has an earlier age of onset
(8.9% in 45-49 year old age-group) compared to
the general population
29.
30. • Dysmorphic syndromes, (multiple congenital anomalies),
microcephaly
• Major organ system dysfunction (e.g., feeding and breathing)
Newborn
• Failure to interact with the environment
• Concerns about vision and hearing impairmentsEarly infancy (2-4 mo)
• Gross motor delay
Later infancy (6-18 mo)
• Language delays or difficulties
Toddlers (2-3 yr)
• Language difficulties or delays
• Behavior difficulties, including play
• Delays in fine motor skills: cutting, coloring, drawing
Preschool (3-5 yr)
• Academic underachievement
• Behavior difficulties (attention, anxiety, mood, conduct,
etc.)
School age (>5 yr)
31. Associated Features Supporting Diagnosis:
• Difficulties with social judgment; assessment of risk; self-
management of behavior, emotions, or interpersonal
relationships; or motivation in school or work
environments.
• Lack of communication skills ….. disruptive and
aggressive behaviors.
• Gullibility and lack of awareness of risk may result in
exploitation by others and possible victimization, fraud,
unintentional criminal involvement, false confessions, and
risk for physical and sexual abuse.
• Individuals with a diagnosis of intellectual disability with
co-occurring mental disorders are at risk for suicide. Thus,
screening for suicidal thoughts is essential in the
assessment process.
• Because of a lack of awareness of risk and danger,
accidental injury rates may be increased.
32. • A comprehensive evaluation includes
- An assessment of intellectual capacity and
adaptive functioning.
- Identification of genetic and non-genetic
etiologies.
- Evaluation for associated medical conditions
(e.g., cerebral palsy, seizure disorder).
- Evaluation for co-occurring mental, emotional,
and behavioral disorders.
33. Cognitive Ability Assessment:
WISC Series (WISC IV; WAIS II; WPPSI, etc.)
Stanford-Binet V
Woodcock-Johnson Test of Cognitive Abilities
Bayley Scales of Infant Development
Kaufman Assessment Battery for Children
35. Basic pre- and perinatal medical history
Three-generational family pedigree
Physical examination
Genetic evaluation (e.g., karyotype or
chromosomal microarray analysis and
testing for specific genetic syndromes)
Metabolic screening
Neuroimaging assessment
36.
37. In many countries of the MENA region
disabled children are facing:
health, educational, social and psychological
problems. For example, disabled children are
facing low enrolment ratios, limited health care
and low health awareness among families of
disabled children.
Some disabled children in MENA region face
problems of stigmatization, social exclusion
and isolation, thus they become deprived of
active participation in social, economic and
community life.
38. The 2000 Demographic and Health Survey in Egypt
has estimated the total number of children in need of
special education at 600,000.
However, according to Ministry of Education, only
15% of them receive education in regular schools.
Girls are even more disadvantaged than boys.
The low level of enrolment is partially due to the
unavailability of appropriate education and partially to
the fact that some parents do not send their disable
children to schools.
Some families believe that disabled children are not
capable of receiving education.
39. - Many countries in the MENA region have
insufficient health facilities and poor
training for medical personnel working with
disabled children.
- The lack of community education programs
leave many undetected child disabilities.
- Many communities, especially in rural areas,
lack rehabilitative services for disabled
children
40. Because of the stigma associated with intellectual
disability, they may use euphemisms to avoid being
thought of as “stupid” or “retarded” and refer to
themselves as learning disabled, dyslexic, language
disordered, or slow learners.
Some people with intellectual disability emulate their
social milieu to be accepted. They may be social
chameleons and assume the morals of the group to
which they are attached. Some would rather be thought
“bad” than “incompetent.”
41. Some disabled children in countries of MENA
region are also vulnerable to:
maltreatment and humiliation particularly
those living in rehabilitative care institutions
where emotional, physical and sometimes
even sexual abuses are not uncommon
42. Challenging behaviors (aggression, self-injury,
oppositional defiant behavior) and mental illness
(mood and anxiety disorders) occur with greater
frequency in this population than among children
with typical intelligence. These behavioral and
emotional disorders are the primary cause for
out-of-home placements, reduced employment
prospects, and decreased opportunities for
social integration
43. In many countries of the MENA region these laws and
decrees have neglected issues related to
prevention
early detection
community based rehabilitation (CBR)
information and registration
issues concerning cooperation and integration
between governmental agencies, NGO’s and
international organizations working in the field of
child disability
46. Pre symptomatic detection of certain disorders
lead surveillance
dietary restriction in metabolic diseases
thyroid hormone replacement
Treatment of associated conditions including vision and hearing
impairment, seizures, and other co-morbid medical disorders
47. Access to and
provision of
appropriate
comprehensive
services and
resources
Early detection
of
complications
Treatment of
comorbid
conditions
Prevention and
treatment of
psychosocial
disorders
48. phenylketonuria………newborn screening, dietary treatment
Galactosemia …………newborn screening, dietary treatment
Congenital hypothyroidism…….. newborn screening and
thyroid hormone replacement therapy
use of anti-Rh immune globulin to prevent Rh disease and
severe jaundice in newborn infants
Hib diseases by using the Hib vaccine
measles encephalitis ………… measles vaccine
German measles during pregnancy………. Rubella vaccine
Fetal alcohol syndrome
49.
50. Early intervention programs
Special education services ( individualized educational
programs)
Family support services (Counseling, Training, Home
visitation, Social services)
Pharmacotherapy
Health services, including hearing and vision
Nutrition counseling
Assistive technology (which may include tape-recorded
texts, reading scanners, or voice-activated computer
programs)
Medical diagnostic services
Transportation and other assistive technology
51. For children with an intellectual disability, primary care
has a number of important components:
- Provision of the same primary care received by all
other children of similar chronological age
- Anticipatory guidance relevant to the child's level of
function: feeding, toileting, school, accident prevention,
sexuality education
- Assessment of issues that are relevant to that child's
disorder: e.g., examination of the teeth in children who
exhibit bruxism, thyroid function in children with
Down syndrome, cardiac function in Williams
syndrome
52.
53. • Shapiro B., Batshaw M. intellectual disability. In: kliegman R. (eds.) Nelson
Textbook of Pediatrics. 19th ed. USA: Elsevier; 2011. p505- 524
• American Psychiatric Association. Diagnostic and Statistical Manual of Mental
Disorders. 5th ed. Arlington. American psychiatric association; 2013
• El Deeb B.. National Report on Disability Statistics in Egypt 21-23 March 2005.
Central Agency for Public Mobilization & Statistics (Egypt).
• Pivaliza P., Miller G.. Intellectual disability (mental retardation) in children:
Management; outcomes;and prevention.
http://cursoenarm.net/UPTODATE/contents/mobipreview.htm?34/13/35039?sour
ce=HISTORY (accessed 14 March 2015).
• Maulik P., Harbour C. Epidemiology of Intellectual Disability.
http://cirrie.buffalo.edu/encyclopedia/en/article/144/ ( accessed 21 March 2015)
• Nour O. Child Disability in some countries of the MENA region: Magnitude,
Characteristics, Problems and Attempts to alleviate Consequences of impairments.
Paper Presented at the XXV th IUSSP International Population Conference, 2005.