- April 6, 2020
Childhood Condition Report
CHILDHOOD CONDITION REPORT 1
Microcephaly refers to a rare condition where a baby’s head issmaller than those of similar children. The neurological disorderresults due to the abnormal growth of the brain in the womb (Mlakaret al., 2016). The condition can also manifest after the child isborn. Microcephaly occurs due to several environmental and geneticfactors. The primary sign of the condition is the relatively smallerhead size in comparison to children of the same sex and gender("Microcephaly in Infants, Pernambuco State, Brazil, 2015",2016). The image below shows the comparison between a baby with atypical head size, one with microcephaly, and another with a severeform of the condition.
Microcephaly can be detected at the child’s birth or duringcustomary checkups. In this regard, the doctor will examine theprenatal, birth, and family history. A physical exam may also be doneto measure the child’s head. Subsequently, growth charts will beused to make comparisons and determine whether the baby has a typicalhead size ("Microcephaly in Infants, Pernambuco State, Brazil,2015", 2016). Doctors may also request for blood tests and headCT scans to examine cases where children manifest developmentaldelays.
Although the condition can occur genetically, other causes includeuntreated phenylketonuria, severe malnutrition and exposure to drugsor particular toxic chemicals. Infections such as cytomegalovirus,toxoplasmosis, chickenpox and German measles may also cause the fetusto develop microcephaly. Moreover, prenatal complications can occurdue to exposure to the Zika virus (Johansson et al., 2016). Thelatter infection is noted to destroy immature neurons during thefirst semester of pregnancy. Decreased supply of oxygen to the brainmay result in craniosynostosis. Furthermore, chromosomalabnormalities such as Down syndrome may lead to microcephaly("Microcephaly in Infants, Pernambuco State, Brazil, 2015",2016).
Most of the forms of treatment focus on how to manage the baby’scondition. Medication may be recommended for certain complicationssuch as hyperactivity and seizures. However, some doctors can performsurgery to eradicate craniosynostosis. Intervention programs may alsobe implemented during early childhood to strengthen the child’sabilities ("Microcephaly in Infants, Pernambuco State, Brazil,2015", 2016). Some of these initiatives include physical,speech, and occupational therapy.
Microcephaly has wide-ranging effects on a client’s occupationalperformance. For example, many children manifest mild to significantlearning disabilities ("Microcephaly in Infants, PernambucoState, Brazil, 2015", 2016). In this regard, they may find itdifficult to grasp new information. Children with microcephaly mayalso have memory deficiencies that hinder their ability to rememberimportant details. Besides, the client could have impaired motorfunction. Hence, microcephaly hampers the person’s ability to writeor hold objects ("Microcephaly in Infants, Pernambuco State,Brazil, 2015", 2016). Normal individuals can perform someinstrumental activities of daily living. However, parents andcaregivers are forced to feed and wash children with microcephaly.
In many instances, patients experience difficulties with balance andmovement ("Microcephaly in Infants, Pernambuco State, Brazil,2015", 2016). Since clients with microcephaly cannot walk, theyhave to use supports. Children are customarily carried or fitted withwheelchairs. Movement problems also limit the client’s ability toplay with his peers. Additionally, children with microcephalyordinarily suffer hearing and vision problems ("Microcephaly inInfants, Pernambuco State, Brazil, 2015", 2016). In thisrespect, clients cannot make eye contact with their caregivers.Hearing problems make it difficult to listen and respond toinstructions. Speech delays may also hinder the child’s ability toexpress their feelings ("Microcephaly in Infants, PernambucoState, Brazil, 2015", 2016). Therefore, clients withmicrocephaly may appear reclusive or disinterested in theirsurroundings.
Moreover, affected children experience failure to thrive throughvarious forms of stunted growth. In particular, clients may haverelatively short stature compared to peers of the same age andgender. Consequently, such children may be unable to reach out foritems on different surfaces within the house. Microcephaly may alsocause frequent seizures that hinder the client’s ability toconcentrate on an activity. Facial and joint deformities may alsooccur, especially where the parents contracted the Zika virus(Ventura et al., 2016). Hence, frequent bouts of pain may result inthe fingers, toes, elbow, and ankles. Cognitive delays may requirethe child to have lifelong intensive care.
The OTR can focus on occupational performance areas such as leisure,productive procedures, and activities of daily living. Besides, theintervention frame of reference (FOR) can include personal care,mobility, and education. Notably, the occupational therapist can usethe FOR to formulate an intervention plan that would address thechild’s challenges. Firstly, the OTR can implement strategies toimprove the client’s learning abilities. In this regard, variousprograms can be used to help the child understand the use of itemswithin their environment. Caregivers can be instructed to issuerepetitive commands to capture the client’s attention (Johansson etal., 2016). Secondly, the occupational therapist could develop someactivities designed to improve the child’s motor function. Forexample, the client may be asked to draw certain items or walk forshort distances. Such strategies would help to improve the child’smobility. Besides, the occupational therapist can implement programsto enhance the client’s cognitive abilities. Consequently, thechild can perform some activities of daily living and alsoparticipate in playful endeavors with peers.
Inevitably, the duration and context of service delivery will dependon the severity of the condition. Children with mild disabilities candevelop normal intelligence and motor function. Therefore, suchclients can usually receive home-based care with occasional visits tothe occupational therapist. On the other hand, children with severemicrocephaly may have significant cognitive delays and learningdisabilities. Consequently, they may require hospital-based care forseveral years.
Various assessment techniques could be used to review the client’sprogress. For example, the occupational therapist can test thechild’s progressive ability to learn and remember. In this regard,the OTR can show the client pictures of several objects.Subsequently, the child can be asked to identify or draw the itemsbased on their memory. If the client can progressively mention moreobjects, then their learning disabilities would be improving (Venturaet al., 2016). The occupational therapist could also evaluate thedistance which the child can walk without experiencing a fall. Suchassessment would highlight the client’s progress in terms of motorfunction and stability.
The occupational therapist can formulate several goals for theclient. In the short-term, the child should aim at improving theircognitive capabilities. The OTR could also aim to reduce speechdelays and hence enhance the child’s learning capacity. In thelong-term, the client could aim at improving their performance ofinstrumental activities of daily living (Ventura et al., 2016).Furthermore, the occupational therapist could require the child toimprove their balance and motor function.
In many instances, children with severe microcephaly need lifelongintensive care. Such clients may experience significant learningdisabilities and other neurological disorders ("Microcephaly inInfants, Pernambuco State, Brazil, 2015", 2016). Cognitivedelays may also make it impossible to discharge children with severemicrocephaly. Nevertheless, clients who experience mild disabilitiescan develop normal intelligence ("Microcephaly in Infants,Pernambuco State, Brazil, 2015", 2016). Therefore, an OTpractitioner can draft a discharge plan that satisfies theoccupational needs of the patient. The work schedule of the parent orcaregiver should also be considered before formulating a list ofactivities.
The National Institute of Neurological Disorders and Stroke (NINDS)conducts research aimed at highlighting the key components of normalbrain development (Ventura et al., 2016). The organizationcollaborates with other bodies to identify genetic mechanisms thatlead to microcephaly. The client can benefit from the localinitiatives developed by NINDS to improve occupational performance.
Johansson, M., Mier-y-Teran-Romero, L., Reefhuis, J., Gilboa, S., &Hills, S. (2016). Zika and the Risk of Microcephaly. New EnglandJournal of Medicine, 375(1), 1-4.http://dx.doi.org/10.1056/nejmp1605367
Mlakar, J., Korva, M., Tul, N., Popović, M., Poljšak-Prijatelj, M.,Mraz, J., Kolenc, M., Resman Rus, K., Vesnaver Vipotnik, T., FabjanVodušek, V. and Vizjak, A. (2016). Zika virus associated withmicrocephaly. New England Journal of Medicine, 374(10),951-958.
Microcephaly in Infants, Pernambuco State, Brazil, 2015. (2016).Emerg. Infect. Dis., 22(6), 1090-1093.http://dx.doi.org/10.3201/eid2206.160062
Ventura, C., Maia, M., Bravo-Filho, V., Góis, A., & Belfort, R.(2016). Zika virus in Brazil and macular atrophy in a child withmicrocephaly. The Lancet, 387(10015), 228.http://dx.doi.org/10.1016/s0140-6736(16)00006-4