1. HANDICAP IN CHILDREN AND ADOLESCENTS

2. Definition
Handicap = somatic, mental, sensory or social limitation resulting from
defect of somatic development
defect of psychomotor development
acquired diseases with secondary irreversible abnormalities
pathological social environment

3. Types of handicap in childhood
Somatic and locomotor defects
Congenital anomalies
organs or systems (heart, lungs, kidney, brain…. )
locomotor system (dysplasia, hypoplasia, syndactyly..)
Acquired defects
posttraumatic
consequence of surgical treatment
Specific defects
growth defect (overgrowth, growth retardation )
abnormal onset of puberty (precocious, delayed)

4. Types of handicap in childhood
Sensory defects
Congenital defects
hearing, vision, speech, central nervous system
Acquired defects
consequence of trauma, inflammation, tumors of organs or CNS

5. Types of handicap in childhood
Mental defects
Congenital defects
Down syndrom, hypothyroidism, phenylketonuria, defects of CNS development
Pathological course of pregnancy and delivery
congenital CNS infection (CMV, rubella…)
prenatal, perinatal or early postnatal hypoxia of CNS
hyperbilirubinemia in newborns (kern-icterus)
prematurity

6. Types of handicap in childhood
Mental defects
Consequence of postnatal disease
meningitis
hyperpyrexia
epilepsy
degenerative CNS disease
poisoning
CNS tumors
CNS trauma
metabolic diseases

7. Types of handicap in childhood
Mental defects
Consequence of psychogenic deprivation
psychosocial disturbances or emotional problems
nutritional deficiency

8. Types of handicap in childhood
Chronic diseases
renal insufficiency
cystic fibrosis
diabetes mellitus
allergy
metabolic diseases
……….

9. Types of handicap in childhood
Social defects
family rejects the affected child
familly is unable to care for the affected child (parents in poor health, lack of financial sources, inadequate living space, lack of education…)

10. Team care for handicapped child
Family
pediatrician
physical specialist (consultant-neurologist…….
teacher
psychologist
social worker
societies or associations serving families or children with a specific handicap (diabetes, phenylketonuria, allergy, cystic fibrosis….)

11. Handicap from view of the child
Limitation of
sensory perception (blindness, deafness, deaf-mutism..)
movement
education and career limitation
repeated hospitalizations
diet
unpleasant and /or painfull diagnostic and therapeutic procedures
subjective difficulties and complaints
long term medication

12. Diagnostic and screening approaches
Prenatal :
ultrasound methods
prevention of blood antigens incompatibility
genetic counselling
amniocentesis
Postnatal:
screening of inborn metabolic errors
dysplasia of bones and joints (hip)
puls of aa. femorales (coarctation of the aortae)

13. Child´s handicap can modify the family clima
Family relations :
parents - handicapped child
parents - healthy sibling(s)
handicapped child - healthy sibling(s)
father - mother
parents - grandparents
Father frequently leaves the family
Danger of social isolation of handicapped child and his or her family

14. Educable children can be taught
It is important
to ensure an individual approach to the child´s access to education, depending on the type and severity of handicap.
Educable children can be taught
in special schools focusing on specific types of handicap, or
be integrated in regular schools among healthy children.