Children and their common medical issues

Foetal alcohol syndrome

A clear association has been established between maternal alcohol abuse and foetal damage. Children with foetal alcohol syndrome start small and stay small, remaining below normal height and weight throughout life. Many are misdiagnosed as having cerebral palsy because of mental retardation, hypotonia or hypertonia and delayed motor milestones. Approximately half of all these children have orthopaedic problems. Ten percent have dislocation of the hip. Other joints have restricted motion, most marked in the elbows and fingers. Congenital spinal deformities, including scoliosis, occur in the cervical, thoracic or lumbar spine.

Haemophilia is a sex-linked disorder characterized by a deficiency in the activity of antihaemophilic globulin factor VIII. In severely affected patients spontaneous bleeding occurs. The most affected joints are the ankles, knees and elbows. Maintaining a career, social life and physical fitness requires knowledge of the treatment and prevention of bleeding episodes. Intramuscular injections and drugs that interfere with platelets function, such as aspirin, should be avoided. All patients should carry a card containing their diagnosis and blood group.

Congenital muscular torticollis or “ wry neck “ results in the head being tilted toward the affected side, with the chin rotated to the opposite side and slightly raised. The most significant problem with congenital muscular torticollis is asymmetry of the face and skull. In a case of suitable treatment during the first year of life - stretching of the effected muscle is effective treatment for most patients. Surgical release of the muscle is generally recommended for children over one year of age with persistent, significant restriction of motion.

MENTAL RETARDATION

Mental retardation is a disorder in which a person’s overall intellectual functioning is well below

average, with an intelligence quotient (IQ) around 70 or less. Individuals with mental retardation also have a significantly impaired ability to cope with common life demands and lack some daily living skills expected of people in their age group and culture. The impairment may interfere with learning, communication, self-care, independent living, social interaction, play, work, and safety. Mental

retardation appears in childhood, before age 18. About 1 percent of the general population has mental retardation. Mental retardation is slightly more common in males than in females. Mental health specialists have defined four degrees of severity of mental retardation based on IQ score. These are:

mild retardation (IQ range 50 – 55 to about 70), moderate (IQ range 35 - 40 to 50-55), severe (IQ range 20 - 25 to 35 - 40), and profound (IQ level below 20-25). The average intelligence quotient in people is from about 90 – 110.

A. Mild

Mildly affected individuals comprise about 85 % of people with retardation. They often cannot be distinguished from normal children. They learn more slowly. As adults, they can work and live in the community if helped when they experience unusual social or economic stress. Some marry and have children.