SPECIAL HEALTH CARE NEEDS – PREVALENCE, CATEGORIES AND ETIOLOGY

By: Andrea, Felesha, Kristina and Lee Ann

DEFINITIONS

It is very difficult to define special health care needs, as there is such a wide variation of such disorders; many of these display overlapping conditions (Winzer, 2008, p. 395).

Those withhealth impairments display serious problems such as heart trouble, tuberculosis, rheumatic fever, nephritis, asthma, sickle cell anemia, pediatric aids, and allergies. Other needs include those resulting from children suffering from abuse or neglect (Winzer, 2008, p. 394).

Physical disabilities refer to health impairments affecting a student’s mobility and/or motor skills; some examples include cerebral palsy, muscular dystrophy, and spina bifida (Winzer, 2008, p.396).

Musculoskeletal Impairments involve impairments of bones or muscles that make movement difficult (Winzer, 2008, p.397).

Neuromuscular diseases involve impairments with cells in the spinal cord, motor nerves and functions between nerves and muscles (Winzer, 2008, p.397).

Those who are technology dependent require technological devices to aid with their disabilities; some of these devices include a heart monitor or ventilator (Winzer, 2008, p.397).

Those who are medically fragile require specific special health care and/or equipment throughout the day (Winzer, 2008, p. 397).

PREVALENCE

The prevalence of those with special health care needs is extremely difficult to measure for many reasons. These include differing methods for data gathering among provinces, which may lead to different results. Also skewing results is the wide variety of impairments and existing definitions for these conditions, and also the tendency for them to overlap with other disorders. It is known, however, that for whatever reason, special health impairments are increasing among students. (Winzer, 2008, p. 397).

CATEGORIES AND ETIOLOGY

Allergies

Allergies refer to an altered reaction with a substance; some of these reactions can be life threatening. There are many known allergens, which can be divided into groups of inhalants (dust, pollen) contactants, (metal, cosmetics), injectants (bee stings, bites), and ingestants (food, drugs). Students with allergies may require an Epipen, and thus, educators will need to know procedures for its use. Allergies may be atopic (hereditary) or non-atopic (non-hereditary). This latter type of allergy is the result of one’s previous experiences with an allergen. Allergies are very common and affect about 1 in 5 students in Canada (Winzer, 2008, p. 406).

Arthritis

There are a variety of arthritic conditions, which are characterized by joint inflammation. In children, this disease is called juvenile arthritis. Kids often suffer from joint pain, eye or respiratory infections, enlarged spleen and heart tissue inflammation. The worst kind of arthritis is juvenile rheumatoid arthritis, which involves the heart muscles and is potentially fatal; this form affects more girls than boys. The cause of arthritis is not known and there is no known cure (Winzer, 2008, p. 415).

Asthma

Those with asthma suffer from lung problems, and often experience wheezing or breathing difficulties. Asthma involves an abnormal reaction following contact with a variety of environmental allergens. Students experiencing an asthma attack may require immediate attention to avoid serious complications. These kids may also require an inhaler, for which educators will need to know procedures for its use. The cause of asthma most likely carries a genetic and/or environmental component. This chronic disease is the most common ailment among today’s children, affecting twice as many boys as girls (Winzer, 2008, pp. 406-407).

Cancer

Cancer involves abnormal cell growth. While kids generally experience better outcomes with this serious illness than do adults, it is still a large cause of child death in Canada – with about 2/3 of cancer deaths being leukemia. The causes of most childhood cancers remain unknown (Winzer, 2008, p. 402).

Cerebral Palsy

This condition is characterized by floppy muscle tone and impaired motor ability. Kids may also display intellectual and developmental delays, speech, visual and auditory problems. It is caused by a brain injury before, during or after birth. Therapy may be helpful, though there is no known cure (Bennet et al., 2008, p. 180).

Child Abuse

Child abuse is a continuing problem in Canada, which results in physical and/or emotional harm. Child abuse includes physical and sexual abuse, and/or neglect and emotional neglect. Signs of abuse include aggression, depression, self-mutilation, alcohol and/or drug abuse (Winzer, 2008, p. 409). Educators will need to be aware of the signs and reporting procedures of suspected cases. There are a variety of possible causes for child abuse including the cycle of abuse theory, or parental drug and/or alcohol abuse. Kids with special needs, especially those with behavioural disorders, are at a higher risk of being abused (Winzer, 2008, p. 411).

Cystic Fibrosis

While affected students are not intellectually impaired, this disorder impairs lung, digestive system and many organ functions. These children will often battle repeated lung infections and thus may be frequently absent from school, and may have difficulty thriving. They will also likely require inhalers and extra snacks throughout the school day. Cystic Fibrosis is a genetic defect affecting about 1 – 1800 North American Caucasian births. There is no cure (Winzer, 2008, p. 398).

Diabetes Mellitus

Type 1 diabetes usually occurs between 6 months and 25 years of age. This disease involves the failure of the pancreas to make sufficient insulin. Students will need insulin injections at least once a day for the rest of their lives. Diet and exercise will also have to be monitored throughout the school day. Type 1 diabetes is an autoimmune disorder and is a growing problem in Canada. It affects about 1 in 600 children under the age of 10. (Winzer, 2008, p. 400).

Limb Deficiencies

Loss of one or more limbs will result in a musculoskeletal impairment. In other words, body movements and functions will be impaired through causes not involving the brain. Some children are born without one or more limbs and thus have a congenital amputation. However, most kids suffering from loss of limb(s) were involved in some kind of accident (Winzer, 2008, pp. 413-414).

Muscular Dystrophy

The most common form of this disease is Duchenne’s muscular dystrophy (Bennet et al., 2008, p. 181). It involves the muscle tissue wasting away and being replaced with fatty tissue. Children with this disease will often suffer from muscle weakness, and are eventually confined to a wheelchair. Lifespan is usually shortened to 20 or 30 years. Duchenne’s is inherited through a recessive gene and usually affects boys rather than girls (Winzer, 2008, p. 414).

Pediatric Aids

Pediatric Aids is caused by the HIV virus, which significantly impairs the immune system. While affected students won’t necessarily require special education, they will often suffer from chronic health problems, such as frequent infections, hearing impairments and speech or language delays. Most kids with aids acquired it at birth; others acquired it as adolescents either sexually or through drug use; still others may have been infected through blood transfusions (Winzer, 2008, p. 405).

Scoliosis

Scoliosis is a spinal impairment, which involves an abnormal lateral curve in the spine. It is characterized with prominent shoulder blades, poor posture, uneven shoulders, and a flat back. It is the most common form of spinal curvature, which can adversely affect motor ability (Winzer, 2008, p.414). In most cases, according to Medical News Today (2010), the cause of scoliosis is unknown.(para 2).

Sickle Cell Anemia

This is a genetic disorder, and is more common in those with African or Hispanic ancestry. This disease results in defective hemoglobin and red blood cells; thus circulation is adversely affected and many organs do not receive adequate oxygen. Students may require medication, rest, blood transfusions, or oxygen therapy. Those dealing with this serious disease, often die in childhood. Sickle cell anemia is caused by 2 defective genes, and is not to be confused with the far less serious Sickle-hemoglobin C disease, which does not reduce one’s lifespan (Winzer, 2008, p. 404).

Spina Bifida

This condition is the result of the vertebrae not properly closing during prenatal development (Bennet et al., 2008, p. 181). There are many variations in the severity of this condition, some of which may be corrected after birth. The least severe form is also the most common and results in no visible impairment. The most severe cases may involve lower body paralysis and incontinence, and may be accompanied with hydrocephalus, where excessive fluid collects in the brain. While the cause of spina bifida is not known, it is thought that both heredity and the environment are involved (Winzer, 2008, p. 433). The Public Health Agency of Canada (2003), also advises pregnant women to make sure they are receiving an adequate intake of folic acid to reduce the incidence of spina bifida. (para. 4). About .1 to just over 4 babies worldwide are born with this condition (Winzer, 2008, p. 433).

Bennett, S., Dworet, D., Weber, K. (2008). Special education in Ontario schools ( 6th ed.). St. Davids, Canada: Highland Press, pp. 180-181.

Medical News Today. (2010). What is scoliosis? What causes scoliosis? Retrieved May 14, 2013, from http://www.medicalnewstoday.com/articles/190940.php

Public Health Agency of Canada. (2003). Congenital anomalies. What are we talking about?Retrieved May 13, 2013, from http://www.phac-aspc.gc.ca/fa- af/report/background-eng.php

Winser, M. (2008). Children with exceptionalities in Canadian classrooms (8th ed.). Toronto, Canada: Pearson Prentice Hall, pp. 394-415, 433.