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TERM

WILLIAM LITTLE (1862) SIGMUND FREUD (1897)

BAX (1964)
A DISORDER OF MOVEMENT AND POSTURE DUE TO A DEFECT OR LESION OF THE IMMATURE BRAIN

MUTCH (1992)
A GROUP OF NON-PROGRESSIVE, BUT OFTEN CHANGING, MOTOR IMPAIRMENT SYNDROMES SECONDARY TO LESIONS OR ANOMALIES OF THE BRAIN ARISING IN THE EARLY STAGES OF ITS DEVELOPMENT

CLINICAL SYNDROMES
ALTERNATION IN: MUSCLE TONES DEEP TENDON REFLEXES PRIMITIVE REFLEXES POSTURAL REACTIONS

THE ESSENTIAL DIAGNOSTIC SIGNS IS A MOTOR DEFICIT

EPIDEMIOLOGY
IS THE LEADING CAUSE OF CHILDHOOD

DISABILITY 1.5-2 PER 1000 LIVE BIRTHS

CAUSE
PRENATAL PERIOD PERINATAL PERIOD

POSTNATAL PERIOD

PRE NATAL PERIOD


CONGENITAL MALFORMATION MATERNAL INTRAUTERINE INFECTIONS REPRODUCTIVE INEFFICIENCY TOXIC OR TERATOGENIC AGENTS MATERNAL MENTAL RETARDATIONS MATERNAL SEIZURES MATERNAL HYPERTHYROIDISM PLACENTAL COMPLICATIONS MULTIPLE BIRTHS ABDOMINAL TRAUMA

PERI-NATAL PERIOD
PREMATURITY < 32 WEEKS BIRTH WEIGHT < 2500 GRAM GROWTH RETARDATION TRAUMA INFECTIONS SEIZURES HYPERBILIRUBINEMIA

POST NATAL PERIOD


TRAUMA
INFECTION INTRACRANIAL HEMORRHAGE COAGULOPATHIES

5 BASIC HYPOXIC ISCHEMIC NEUROPATHOLOGY (VOLPE)


PARASAGITAL CEREBRAL INJURY PERIVENTRICULAR LEUKOMALACIA

FOCAL AND MULTIFOCAL ISCHEMIC BRAIN

NECROSIS STATUS MARMORATUS SELECTIVE NEURONAL NECROSIS

CLASSIFICATION OF CP
SPASTIC

MONOPLEGIA HEMIPLEGIA DIPLEGIA TETRA/QUADRIPLEGIA ATAXIC DYSKINETIC/ATHETOID MIXED

EVALUATION THE CP CHILD


HISTORY CLINICAL EXAMINATION LABORATORY TEST DIAGNOSTIC IMAGING

HISTORY
A HISTORY IS A KEY COMPONENT IN EVALUATING

THE DISABLED CHILD INFORMATION OBTAINED CAN QUIDE ONE IN UNDERSTANDING CAUSE, DETERMINING UNDERLYING MEDICAL PROBLEMS, DETERMINING FUNCTION, AND DEVELOPING A MEDICAL TREATMENT PLAN

PRENATAL HISTORY
INFORMATION OF PREGNANCY
EXPOSURE OF TOXINS, ALCOHOL, OR DRUGS GESTATIONAL AGE (PREMATURITY) ACUTE MATERNAL ILLNESS PRENATAL CARE FETAL MOVEMENTS TRAUMA OR RADIATION EXPOSURE FAMILY HISTORY FAMILIAL DISEASE

PERINATAL HISTORY
DELIVERY TYPE AND PRESENTATION OF CHILD
BIRTH WEIGHT APGAR SCORES COMPLICATIONS

DEVELOPMENTAL HISTORY
DEVELOPMENTAL MILLESTONES
CURRENT GROSS MOTOR FUNCTION CURRENT FINE MOTOR FUNCTION CURRENT LANGUAGE CURRENT SOCIAL AND PERSONAL SKILLS PERSISTENT REFLEXS TONE AND PATTERNS

GENERAL INFORMATIONS
NUTRITION : FEEDING STYLE, ORAL SKILLS, BW,

HW. MEDICATIONS AND ALLERGIES PAST SURGERIES SEIZURES VISUAL DISTURBANCES HEARING DISTURBANCES IMMUNIZATION

CLINICAL EXAMINATION
MUSCULOSKELETAL EXAMINATION
NEUROLOGIC EXAMINATION

MUSCULOSKELETAL EXAM
STATIC AND DYNAMIC EVALUATION
STATIC : ISOLATING EACH JOINT, ASSESSING ROM

ALONG WITH TONE AND SPASTICITY DYNAMIC : MOVEMENT , FUNCTION AND GAIT

NEUROLOGIC EXAMINATION
TONE ASSESSMENT
POSTURAL AND REFLEX ASSESSMENT

ASSOCIATED PROBLEM IN CP
MENTAL RETARDATION
SEIZURES OROMOTOR GASTROINTESTINAL DENTAL VISUAL & HEARING IMPAIRMENT CORTICAL SENSORY DEFICIT PULMONARY PROBLEM

THERAPEUTIC MANAGEMENT
CP CHILD OFTEN HAVE MULTISYSTEM

INVOLVEMENT. REHABILITATION MANAGEMENT REQUIRES NUMEROUS PROFESSIONAL USING A VARIETY OF TECHNIQUES AND METHODS. PERIODIC REASSESSMENT AND PROGRAMMATIC UPDATING ARE ESSENTIAL. THE MAJOR GOALS OF THE REHABILITATION PROGRAM ARE ANTICIPATORY TREATMENT OF POTENTIAL COMPLICATION AND FOSTERING THE ACQUISITION OF NEW SKILLS

THERAPEUTIC MANAGEMENT
THERAPEUTIC EXERCISE
FUNCTIONAL TRAINING ORTHOSES AND DURABLE MEDICAL EQUIPMENT MANAGEMENT OF SPASTICITY ORTHOPEDIC SURGERY PSYCHOSOCIAL ISSUES

PREVENTION

THERAPEUTIC EXERCISE

ORTHOSIS MANAGEMENT

VOCATIONAL REHABILITATION
UNEMPLOYABLE/UNABLE TO WORK
SHELTERED EMPLOYMENT COMPETITIVE

UNEMPLOYABLE
UNABLE TO WORK
IQ LESS THAN 50 REQUIRED ASSISTANCE USING HAND

SHELTERED EMPLOYMENT
IQ BETWEEN 50 AND79
AMBULATION WITH OR WITHOUT ASSISTIVE

DEVICES SPEECH HARD TO UNDERSTAND TO NORMAL HAND USE NORMAL TO REQUIRING ASSISTANCE

COMPETITIVE
IQ GREATER THAN 80
AMBULATION WITH OR WITHOUT ASSISTIVE

DEVICES SPEECH HARD TO UNDERSTAND TO NORMAL HAND USE NORMAL TO REQUIRING ASSISTANCE

MENTAL RETARDATION

DEFINITION
SIGNIFICANTLY SUBAVERAGE GENERALLY

INTELECTUAL FUNCTIONING EXISTING CONCURRENTLY WITH DEFICITS IN ADAPTIVE BEHAVIOR AND MANIFESTED DURING THE DEVELOPMENTAL PERIOD (American Association of Mental Retardation)

MENTAL RETARDATION
CHILDREN WITH MENTAL RETARDATION

ENCOMPASS A WIDE RANGE OF PHYSICAL CONDITIONS, BEHAVIORS, AND SPEECH AND LANGUAGE ABILITIES

IQ LEVEL
69-55 MILD RETARDATION
54-40 _ MODERATE RETARDATION 39-25 _ SEVERE RETARDATION < 25

_ PROFOUND RETARDATION

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