Transcript Lect.14 - ALTERATIONS IN SENSORIMOTOR FUNCTION

Alterations in
Sensorimotor Function
By Nataliya Haliyash, MD, BSN
• Alterations in sensory function can have a
profound effect on the child's ability to
achieve normal growth and development.
• Early identification of hearing, vision, and
communication defects enables early
intervention to assist the child and family
to achieve optimal growth and developmen
Lecture Objectives
• Nursing care of the child with sensory or cognitive
impairment:
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Impaired vision
Impaired hearing
Mental retardation
Down syndrome
• Nursing care of the child with neuromuscular
dysfunction:
– The child who is paralyzed
– Quadriplegia: special needs
– The child with cerebral palsy
• Nursing care of the child with musculoskeletal
alterations:
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The child with a fracture
Congenital hip dysplasia
Congenital acute clubfoot
Legg-Calvé-Perthes disease (coxa plana)
Duchenne muscular dystrophy
EAR
Structure And Age Peculiarities
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Three main sections:
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The eustaehian tube connects the
middle ear with the nasopharynx. It
allows fluid to drain into the
nasopharynx and equalizes pressure
between the outer and middle ear.
Infants and young children have
shorter, more
horizontal, and more flaccid
eustaehian tubes, predisposing
them to middle ear infections.
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the outer ear,
the middle ear,
the inner ear
EAR
Structure And Age Peculiarities
• Infants and young children:
– eustaehian tubes are shorter, more horizontal, and
more flaccid
– Predisposing factor to middle ear infections.
• 0-3 mo:
– Soothed by parent's voice
– Gives a startled response to loud sudden noises
• 3-6 mo:
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Looks to see where sounds come from
Becomes frightened by an angry voice
Smiles when spoken to
Wakes up when spoken to or when a loud noise is made
nearby
• 6-12 mo:
– Stops for a minute when someone says "nono," "bye-bye," and own name
– Looks at objects or pictures when someone
talks about them
– Enjoys rattle and similar toys for their
sounds
• 12-18 mo:
– Sings and hums spontaneously
– Discriminates between sounds such as
doorbell, telephone, barking dog, and so
forth
– "Dances" and makes sounds to music
• 18-24 mo:
– Brings objects to others when asked
– Hears and identifies sounds coming from
another room
Hearing impairment
• Disability that may range in severity
from mild to profound.
• Deafness is a hearing impairment
that is so severe that the child is
impaired in processing linguistic
information through hearing, with or
without amplification
Hearing impairment
• Hard-of-hearing – residual hearing,
with a hearing aid, sufficient to
enable successful processing of
linguistic information through
audition
Incidence of hearing loss
• The incidence of hearing loss in newborns
is 1 in 1,000, and is one of the most
common infant disabilities in the United
States.
• Each year 4,000 children are born
profoundly deaf,
• 4,000 others have some degree of hearing
loss
• One to two additional children per 1,000
become deaf during childhood
Hearing impairment
– Classification:
• Congenital
• Acquired
– Pathophysiological types of hearing loss:
• Conductive hearing loss (middle-ear) – interference
with transmission of sound to the middle ear, can be
temporary or permanent
• Sensorineural hearing loss (perceptive or nerve
deafness)
– results from damage or malformation of the inner ear
and/or auditory nerve.
– Can be a congenital defect or consequence of infection,
exposure to loud noises or ototoxic drugs, and
prematurity.
– Sounds are distorted, severely affecting
discrimination and comprehension
Hearing impairment
• Mixed conductive-sensorineural hearing loss:
– Interference with transmission of sound in the middle
ear and along neural pathways
– Frequently results from recurrent otitis media and its
complications
• Central hearing loss:
– All hearing losses that do not demonstrate defects in
the conductive or sensorineural structures
– Is caused by damage that interrupts sound
transmission between the brainstem and the cerebral
cortex,
– difficulty in sound discrimination, auditory association
of meaning to sound, auditory memory, and being able
to differentiate sound from its background.