Who is a disabled person
A disabled person is someone with a physical or mental impairment which has substantial and long term adverse effects on how/her ability to carry out normal day to day activities
How do we classify disability
- Intellectual impairment
- Physical impairment
- Medical impairment
4, Sensory impairment - Emotional
- Oral developmental problems
What do we mean by intellectual impairment
Children with learning difficulties/ disabilities
How common are learning difficulties
2-3%
How is intellectual impairment classified
- Mild
2. Severe/profound
What do we mean by mild intellectual impairment
Moderate impairment (IQ 50-70)
How many people have mild intellectual impairment
1.2 million
What do we mean by severe/ profound intellectual impairment
IQ<50
How many people have severe/ profound intellectual impairment
65,000 children/ young adults
List some common intellectual impairments
- Down syndrome
- Cerebral palsy
- Meningitis, rubella
- Autism, microcephaly
What does the mental capacity act of 2005 say
For patients 18+ obtaining adequate consent requires that the patient has adequate mental capacity (MC) to make a decision about any proposed treatment/intervention
How do we assess mental capacity
In 2 stages:
- Does the person have an impairment that could affect mind/brain or decision making
- Is the impairment affecting the ability of the person to understand or make a decision
How do we obtain consent for patient who lack mental capacity
A nominated friend or family member or an independently appointed advocate (IMCA) may be required to help with the decision
What is the aetiology of Down syndrome
Trisomy 21
How common is Down syndrome
1:1000 live births
What Craniofacial anomalies can be associated with Down syndrome
1, Oval, mongoloid face
- Flat face and occiput
- Epicanthic folds with mongoloid slant to eyes
- Straight hair
- Abnormal hand creases
- Large protruding fissured tongue
What abnormalities may you see in the oral cavity in a patient with downs syndrome
- Small maxilla
- Abnormal tooth morphology and tooth number
- Delayed eruption
- Prone to periodontal disease
- Could be less likely to develop dental caries
Other than intellectual impairment what else may be seen in a patient with cerebral palsy
Physical impairment
What physical impairment may be seen in a patient with cerebral palsy
Motor manifestation of cerebral damage
What is cerebral palsy commonly a result of
Birth anoxia
What can happen in cerebral palsy
- Abnormal muscle tone/ reflexes eg spasticity, athetoid
2. May have mental impairment but IQ often normal
What can medical impairment include
- Heart disease
- Bleeding disorders
- Diabetes
- Kidney disease
- Respiratory disease
- Malignancy
- Drugs
List some common childhood cardiovascular disease
- Endocarditis
- Cyanotic heart disease
- Anxiety
Give examples of cyanotic heart disease
- Polycythaemia
- Thrombocytopoenia
- Abnormal clotting
- GA risk
