Encouraging the Family in Developmental Disability - A Physiotherapy Perspective .

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Facilitating the Family in Developmental Disability - A Physiotherapy Perspective. Aoife Bourke, Lonán Hughes, Catriona O’Dwyer & Aideen Shinners. Learning Outcomes. WHO International Classification of Function, Disability & Health (ICF)
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Encouraging the Family in Developmental Disability - A Physiotherapy Perspective Aoife Bourke, Lonán Hughes, Catriona O\'Dwyer & Aideen Shinners

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Learning Outcomes WHO International Classification of Function, Disability & Health (ICF) To apply the WHO ICF Model to Physiotherapy rehearse for formative incapacity Detection & Diagnosis To build information of the screening techniques for formative inabilities Coping To perceive components impacting a family\'s adapting capacity To distinguish & apply systems to encourage family adapting Challenging Behavior To perceive sorts of testing conduct To recognize & apply methodologies to address testing conduct Family Involvement To perceive boundaries to family contribution To distinguish & apply procedures to encourage family inclusion

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Course Outline Hour 1: WHO - ICF Detection & Diagnosis Family Coping 5 min break Hour 2: Challenging Behavior Family association 10 min break Hour 3: Group work Questions

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International Classification of Function, Disability & Health

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International Classification of Function, Disability & Health (ICF) Developed by WHO - 1992-2001. ICF display: " perceives handicap as an all inclusive human experience … . moving the center from cause to affect … .. considers the social parts of handicap" Primary capacity is to code the segments of wellbeing and their communications Purpose: Negative Neutral terms Expand thinking past essential debilitations Moves from medicinal to bio-psychosocial approach WHO 2001

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WHO ICF Model HANDBOOK.htm#Handbookpg8 WHO 2001

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Detection &

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Overview Neonatal evaluation Risk components for formative incapacity Formal neonatal appraisal Focus on Cerebral Palsy (CP) & Autism

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To distinguish babies at more serious hazard for formative inability To take into account occasional formative screening & for early mediation to streamline result Purpose of Neonatal Assessment

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Maternal: Education level achieved Maternal age Marital status Prenatal care Smoking amid pregnancy Alcohol consumption amid pregnancy Maternal restorative history Complications of work/conveyance Child: Gestational age <37 weeks Birth weight <2.5kg 5-min Apgar Score <7 Multiple births Presence of an infant condition Presence of an intrinsic irregularity Risk Factors HANDBOOK.htm#Handbookpg11 Chapman et al 2008; Delgado et al 2007

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Neonatal Assessment HANDBOOK.htm#Handbookpg22 Neurological Assessment Examines muscle tone direction & postural reflexes Amiel-Tison Neurobehavioral Assessment Examines unconstrained & inspired development designs, primitive reflexes & reaction to sound-related & visual jolts Neonatal Behavioral Assessment Scale Ohgi et al 2003

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Neonatal Assessment Medical Inventory Medically orientated stock Assesses chance elements for peri-natal mind harm Perinatal Risk Inventory Neuro-imaging MRI better than ultrasound because of higher affectability Abnormal discoveries on MRI unequivocally foresee antagonistic neuro-formative results at two years old Zaramella et al 2008; Mirmiran et al 2004; Scheiner & Sexton 1991

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Assessment of General Movements (GM) ought to be added to conventional neurologic evaluation, neuro-imaging & different trial of preterm newborn children for indicative & prognostic purposes. Unquestionably unusual GMs at 2-4 months (i.e. add up to nonappearance of uneasy developments) anticipate CP with a precision of 85-98% Neonatal Assessment Adde et al 2007; Hadders-Algra 2001; Cioni et al 1997

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Detection & Diagnosis of CP McMurray et al 2002

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HANDBOOK.htm#Handbookpg12 Detection & Diagnosis of Autism SIGN 2007

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Case Study Anna exhibited to the Physiotherapy Department at 9 months with an analysis of spastic diplegia (CP) Child Risk Factors Premature birth: week 32/40 Birth weight (2,300g) Maternal Factors Left school at 16; now matured 19 Continued associating all through pregnancy Neonatal Ax Absence of restless developments (4 months) Seizures Persistence of primitive reflexes

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Case Study Barry was alluded to the Physiotherapy Department at age 4 Presenting Complaint Balance & fine engine abilities shortages. Tyke & Maternal Risk Factors None clear Currently experiencing formal MDT Ax Clinical Clues Delay of verbal & non-verbal correspondence Lack of imagine play Unusual & dreary hand/finger quirks

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Definite Diagnosis v Uncertain Diagnosis HANDBOOK.htm#Handbookpg10 Label Etiology Prognosis Treatment alternatives Acceptance Social bolster Rosenthal et al 2001

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Family Coping

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Overview Initial response Barriers to family adapting Facilitators of family adapting

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Definitions of Coping: Cognitive and behavioral endeavors to oversee particular outer or inner requests (& clashes between them) that are assessed as saddling or surpassing the assets of a man Family Coping: Strategies & practices went for keeping up or fortifying the dependability of the family, acquiring assets to deal with the circumstance & starting endeavors to determine the hardships made by the stressor Lazarus 1991; McCubbin & McCubbin 1991

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Benefits of Parental Coping Parents with great adapting techniques illustrate: Better individual prosperity Increased contribution in treatment More positive communications in parent-youngster play More inspirational states of mind about their kid Result: Higher scores on formative tests The family is the quick ENVIRONMENT where the kid creates Boyd 2002

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Diagnosis of Developmental Disability: One of the most passionate encounters for guardians Recognized as an emergency occasion for a few guardians that viably smashs already held dreams in spite of existing inherent questions and concerns Initial Reaction Rentinck et al 2008; Dagenis et al 2006

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Parent Quote "… . you\'re all of a sudden confronted with the way that you haven\'t got an ordinary tyke, gracious, you know, I mean it\'s overwhelming. At the time you kind of lament for this, you think, "God this will be, I mean it\'s a deep rooted thing. It won\'t leave. It won\'t show signs of improvement. She\'s continually going to have cerebral paralysis." Piggot et al 2002

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Initial Reaction HANDBOOK.htm#Handbookpg29 Various models have been proposed in light of the phases of loss What have guardians of a youngster with an inability lost? The normal "immaculate" youngster The "typical" child rearing part Hedderly et al 2003

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Four principle reactions to analysis Heiman 2002

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Task Time

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Attitudes & Effect on Coping Parents felt immersed with negative messages Health Care Professionals gave miserable anticipation Parent\'s idealism to the future left them open to an allegation of \'foreswearing of reality\' " I knew her condition was not kidding and her visualization poor at the same time, to me, she was my firstborn, wonderful tyke. Each time I communicated my satisfaction to the staff at the healing center, they said, `She\'s denying reality\'. I comprehended the truth of my youngster\'s circumstance at the same time, for me, there was another reality " Parents felt they were not denying the determination, they denied and opposed the decision that should run with it Kearney & Griffin 2001

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Assessment of Family Coping Important to figure out whether adapting procedure will be sure or contrary after analysis Examine significant calculates the setting of every day life which include: Availability of inside & outside assets & systems to adapt Independent elements Recognize that family\'s encounters change over the long run Rentinck et al 2006; Taanila et al 2002

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Availability of assets & techniques: Service arrangement Social bolster Family attachment & working Personality factors Material assets Independent components: Nature & level of incapacity Gender parts Socio-financial status Experience of stretch & adapting Stage of family life Ambiguity of finding Delayed conclusion Expectations for kid Factors Influencing Family Coping

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Service Provision Family-focused administration (FCS) enhances adapting capacity Aspects of administration arrangement that impact adapting: Ability to address neglected issues Providing data re: kid\'s conclusion & future, administrations accessible & approaches to adapt Acknowledging the kid as profitable Acknowledging the vital part of the parent Providing a brought together administration Lindbald et al 2005; Law et al 2003; Kerr & Macintosh 2000; King et al 1999; Heaman 1995; Knussen & Sloper 1992

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Social Support Sources: Health benefit Spouse Family Friends Important perspectives: quality & size Rentinck et al 2006 ; King et al 1999; Knussen & Sloper 1992

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Family Cohesion & Functioning Co-operation in day by day exercises prompting a feeling of harmony Factors, for example, Maintaining typicality – maternal livelihood N.B. Conjugal conformity Spousal contribution Parents having comparable starting responses – idealistic Taanila et al 2002; Gavidia-Payne & Stoneman 1997; Heaman 1995

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Personality Variables Intrapersonal assets of: Strong feeling of soundness (locus of control) Emotional security Extraversion Agreeableness Type of adapting procedure utilized Associated with ensuring guardians of formatively impaired kids against child rearing anxiety Vermaes et al 2008; Margalit & Kleitmann 2006; Rentinck et al 2006; Knussen & Sloper 1992

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Independent Factors Nature & level of incapacity: Behavioral issues Level of free physical capacity Gender parts: Care-giving guardian encounters more push Socio-monetary status: Dem

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