Good day and welcome to today's Dr. Inyo House podcast. Today I'm going to be talking about how to maximize care in children with disability. Disability can come in different areas. Some children can have intellectual disability, some can have physical disability, and some can have combination of intellectual and physical disability. Examples of physical disability will be kids who have problems are the head and neck regions like kids with cleft lips or cleft palate that struggle with feeding. Also kids with hand and foot disabilities that prevent them from walking properly. Kids with extreme ball legs is an example or kids with extreme care leg or genital valgum is another example or kids who have feeding difficulties. kids will have gastrostomy tubes that is tubes inserted into the stomach directly through the abdomen. All kids can have a problem with breathing, and they have breathing tubes things like tracheostomy tubes that help children in breathing until they are respiratory apparatus could be corrected properly. So there are different types of physical disabilities, hundreds and hundreds of physical disabilities. So this is an example of physical disability. Kids with seizure could come under physical disabilities. Also, there are specific disabilities, like a speech disability, a kid who cannot communicate, or language disabilities, kids who have problems using their language, or hearing disability, a kid cannot hear. or visual disabilities they cannot see. So, these are all part of physical disabilities that we see kids. On the other side there is intellectual disabilities that has to do with brain functions. In other words, the child is unable to understand things around him as expected of a child of that age. These are all intellectual disabilities. The causes of disabilities in children could be congenital, in other words, the kids are born with it. Or it could be acquired, in other words, the kids develop it after birth. Those are broad categories. Children are born with disabilities, or they get disabilities after they're born. Both intellectual disability or physical disability, people could be born with that, or people could get that after they're born. Some of these causes could be through the genes. They could be inherited, like genetic factors. Genetic causes could cause both brain dysfunction or physical dysfunction. Things related to genes, like I said, could cause either intellectual disability or physical disability, or both. There are also intellectual disability and physical disability that occurs after somebody is born or begins in the womb and continues when a child is born. Things like infection in pregnancy could lead to cognitive or intellectual disability. and it can also lead to physical disability. And of course, when a child is born, they continue to be exposed to things that can cause both intellectual disability and physical disability. For example, accident is a, who is involved in an accident can have both intellectual disability and physical disability, and infection also, malnutrition also. There's a host of things that could. continue to cause intellectual or physical disabilities or both undiagnosed diseases like hypothyroidism. Hypothyroidism is good one. If it's undiagnosed at birth, that can lead to both intellectual and physical disability as well. So there's a whole bunch of things that can lead to either intellectual disability where a child does not function as expected or physical disability where a child doesn't communicate or get around like other kids. of course, a host of medical conditions like seizure disorders, asthma, host of medical diseases diagnosed later in child could also lead to both physical and intellectual disability. The aspect of this lecture or presentation or podcast is to give the listeners ways to navigate or to help a child with physical disability or mental disability. or cognitive disability or intellectual disability. That is actually the main purpose of this podcast to share with the listeners how to navigate the system because sometimes it's very difficult for parents to navigate through the system of trying to help their kids with either intellectual disability or physical disability. Now the most important thing is to, of course, to be able to recognize this condition early, to recognize this condition early and to make early diagnosis. Okay, that's the most important thing to recognize this condition early and to make diagnosis early. Now the diagnosis could be made by specialized, at least in the United States where I practice, diagnosis is either suspected by the primary care doctor, the pediatrician, or suspected by the mother that this child is not developing very well. This child has intellectual disability, the child is not talking, the child is not walking, the child is, I don't think the child is hearing. Or sometimes this could be anticipated right from birth because of all the screening done during pregnancy and after birth. Babies, at least in the United States, have screening for some of these conditions that can cause intellectual disability and physical disability. Those are the ways this is diagnosed, and that's screening. or true mother's suspicion or parent's suspicions or father's suspicions or pediatrician's suspicion that this child has some disability. Idol, cognitive, which is intellectual, feasible. So, suspicion is most important thing. And then the child is referred to a specialized agency. At least in the United States, we have practice. We have a local birth to three agency where we refer children with suspect. physical or intellectual disability. So, the birth to three agency who are the expert could make a formal diagnosis. Also, formal diagnosis could be made by, especially if the child is older, by a school psychologist. There's nothing wrong with a school psychologist in making that diagnosis, especially in an older child who is about five, six, who is already in school. Some schools have a psychologist who can make a diagnosis of intellectual disability, especially in things like autism, spectrum disorder, and attention deficit disorders, and so on. So, the school psychologist can make a formal diagnosis. Where I practice, there are agencies that specialize in making diagnosis, or they're interested in evaluating children for autism, autism disorders, autism spectrum conditions. And parents could also take their kids to these agencies, or the pediatrician can refer the parents or the child to this agency. Getting a formal diagnosis is very important and of course giving the child all they need to succeed, all they need to triumph against those disabilities, which is what we call intervention. In other words, you try to provide care, you try to provide services to help mitigate some of these disabilities. How do you mitigate some of these conditions. How do you alleviate it? How do you support a child to grow to their maximum intellectual capacity given their background of either physical or intellectual disability? How do you do that? Do that by referring them to appropriate intervention specialists. Basic referral programs or basic referral pathways include refer out to speech pathologist if a child is not speaking appropriately according to age. A speech pathologist occupational pathologists to help work with the kids on motor movement, fine motor movement, coordination, walking, using their hands, and even eating. A physical therapist is also part of this team that help ameliorate or mitigate against some of these physical physical challenges, physical disability in a child. So speech pathologist is part of the solution. Especially for kids who has speech impediment, physical therapists, I've referred kids to, for example, who are not working at age to physical therapists and occupational therapists as well. And of course, kids who have problem with speaking and language impediment, we referred them to speech pathologist to help them with those as well. School is a very important part of this program. schools in the United States have time for kids who are in special education who have challenges, either intellectual challenges or behavioral challenges, and they can allot some hours, they can spend some hours teaching them how to speak, guiding them, and providing speech and language intervention to some of these kids. the time they spend in school is the time they could they could use to sharpen their language skills as well. parents to take advantage of that. Take advantage of that. Some parents like some extra, extra hours. That is okay. Usually I have parents who tell me that the two or three hours a child spend with speech pathology in school is not enough. And of course the parents could find extra help, extra speech pathologists, extra help with speech pathologists outside of school. And of course the parents can also educate the child based on what they learn from the speech pathologist as well. At home, parents can do a lot, I said, parents can do a lot in continuing with whatever speech pathologist has started at school or at other institutions. is a combined effort to help a child who has a disability. Siblings help a lot, especially if they're motivated they can help. part of the care. And of course kids with behavioral problems, mental health challenges like depression, disruptive behavior, anxiety, school phobia is also a form of disability. And these kids can also get some help either at school or outside school in a specialized program. Some institutions have behavioral health departments where they who help kids with anxiety, school phobia, disruptive behaviors, and attention deficit, and productive disorders. It's always good to access whatever the school has and also for parents to seek extra help if they think they need extra help. This is very important. This could be arranged by either the parent himself or herself, or the pediatrician can help
