Some Common Diagnoses in Pediatric Population

  • Sensory Integration Dysfunction

    • The ability of the nervous system to process sensory
      input, recognize sensory information, achieve sensory
      integration and react appropriately to make an
      adaptive response

  • Basic Premise of Sensory Integration

    • The brain must EXPERIENCE sensation
      before it can learn to RESPOND to it

    • Play = Practice

    Child must develop self-regulation or the ability to
    calm  and sustain a balance or equilibrium
    internally/emotionally regardless of environmental
    stress – “just right state”

    Sensory Processing Systems

    • Vestibular

    • Oldest system biogenetical

    • Sense of balance and movement

      • Located in inner ear
        Influences maturity of ALL OTHER
        SENSORY SYSTEMS

    • Proprioceptive

      • Information from joints about your body

      • Unconscious “sense of self”

    • Tactile

      • Largest sensory receptor is the body

      • Most mature system at birth

      • At 8-10 weeks, the fetus will respond to
        tactile stimulus

      • Will develop first in the areas if the areas
        of the body that are the most exploratory
        (mouth, hands, feet)

    • Olfactory (smell)

      • Often heightened in neonatal children

      • Infants can discriminate mother’s milk via smell

    • Taste

      • Develops primarily following birth

    • Visual (sight)

      • Highly sophisticated in neonatal children

      • At 32 weeks of gestational age, babies
        are attracted to red objects

      • Children can fixate on objects for
        approximately 10 seconds on an object
        that is 6-9 inches from the face

      • Visual scanning will begin to develop a
        dominant side of the brain and one side
        will become more often used and more
        acute on one side versus the other

      • Visual input can affect a child’s “state”

    • Auditory (sound)

      • Well developed in utero which is highly
        rich in sound

      • Amniotic fluid amplifies sound

      • Consistent repetitive sounds (i.e.
        mother’s heartbeat) have been found to
        be more soothing versus intermittent
        sounds/noise which tend to elicit alert
        behaviors

      • Often found to affect a child’s “state”

  • AUTISM

  • A severe developmental disorder of neurobiological origin that begins in early childhood and results in seriously impaired social interaction, communication, and behavioral functioning.

  • Increased occurrence in males versus females

  • Strikes approximately 1 in 150 children

  • Unknown origins or cause

  • Spectrum disorder includes but not limited to:

    • Pervasive Developmental Disorder (PDD)

    • PDD NOS (not otherwise specified)

    • Childhood Disintegrative Disorder

    • Asperger’s Disorder

    • High Functioning Autism

    • Rett Syndrome

  • Onset typically occurs prior to age of 3

    Characteristics include:

    • Decreased social interaction

    • Increased risk for seizures

    • Displaying ritualistic, repetitive behaviors

    • Delayed communication skills

    • Disturbances in behavior

    • Disturbances in sensory processing skill
      development and processing

    • Obsessive and/or compulsive behaviors

    • Lack of eye contact

    • Limited facial expressions

    • Echolalia

    • Preoccupied with particular items or parts
      of items

    • Toe walking

  • Intracranial Hemorrhage

    • Site of hemorrhage and extent of bleeding affect
      prognosis

    • May occur before, during, and/or after birth

  • Intraventricular Hemorrhage

    • Bleeding into the ventricular system of the brain

    • Common in premature infants

    • Occurs shortly after birth

    • Clinical Signs:

      • Apnea (inability to breathe)

      • Seizures

      • Bradycardia (decreased heart rate)

      • High blood pressure

      • Hydrocephalus (fluid on the brain)

      • Muscle tone

      Classified according to the extent of the lesion: Grades I through IV bleeds

  • Cerebral Palsy

    • “Nonprogressive abnormalities or lesions in the
      developing brain that create a series of neurologic,
      motor, and postural deficits in a developing child”

    • Trauma/injury can occur prior to (congenital CP),
      during, and/or after birth (acquired CP)

    • TIME of insult (pre, during, or post birth trauma)
      appears to have a predictive factor in the types of
      problems that may occur

    • Possible indicators of CP – Each child with CP
      displays unique characteristics of their particular
      disorder

      • Variable muscle tone (increased or
        decreased in appropriate amounts)

      • Retained primitive reflexes and delayed
        development of “normal” movement
        patterns

      • Poor suck

      • Increased tendon reflexes

      • Involuntary movements

      • Asymmetrical use of extremities

      • Poor head control

    • Common causes:

      • Asphyxia or anoxia

      • Substance abuse

      • Toxemia

      • Poor prenatal care

      • Metabolic difficulties of mother

        ***** Up to 40% of cases of Cerebral Palsy have NO KNOWN CAUSE *****

  • Prematurity

    • Infant born prior to 38 weeks gestational age (GA)

    • Lack of development in utero do not prepare children to appropriately interact with their environment

    • Decreased controlled responses and function primarily on reflexive reactions/responses

    • Inappropriate sensory overload and a decreased
      sensory processing system leave a child with the
      inability to process the outside world

    • Common source of feeding difficulties

      • Oral structures may not be fully developed

      • Lungs may not be fully developed

      • Inappropriate nervous system functioning

      • Increased likelihood of apnea and bradycardia

      • Irregular suck

      • Inability to coordinate suck/swallow/breathe

      • Decreased tongue mobility

      • Decreased sensory processing skills

  • Downs Syndrome

    • Most common; 1 of 800 live births (approximated)

    • Results from the failure of the 21st pair of
      chromosomes to separate; in less frequent forms, an
      extra broken pieces of chromosome 21 is present

    • Distinct features: short stocky build, flattened face,
      protruding tongue, almond shaped eyes, unusual
      crease across he palm of hand

    • Common delays: mental retardation, speech/language
      delays, low tone, eye cataracts, heart and intestinal
      defects

    • Can be tested for during pregnancy