Health Related Issues

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Health Related Issues
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Health Related Issues

• Sleep problems
• Elimination problems
• Chronic Illnesses

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Sleep Disorders

• The Regulatory Functions of Sleep
• main activity of brain in first years
• essential for brain development
• deprivation impairs functioning of the prefrontal
  cortex, leading to
• decreased concentration
• diminished ability to control basic drives,
  impulses, and emotions

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Sleep Disorders (cont.)

• Maturational Changes
• change over the course of maturation
• adolescents often chronically sleep-deprived

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Dyssomnias

• Disorders of initiating or maintaining sleep
• Quite common in childhood
• See chart in book (next slide)

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Table 12.1 Dyssomnias
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Parasomnias

• Disorders in which behavioral or physiological
  events intrude upon ongoing sleep
• Common afflictions of early to mid-childhood
  children typically grow out of them
• Partial wakings during various sleep cycles

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Parasomnnias

• Sleep terrors
• Following stage IV sleep early in night
• Early childhood crying, sobbing, thrashing, not
  able to comfort
• fatigue
• Later childhood/adolesc. screaming, panic, fear,
  possible wild running
• Psychological factors usually relevant
• Nightmares- scary dreams REM sleep early
  morning
• Often reflect normal emotional struggles
• Sleepwalking see sleep terror

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Table 12.2 Parasomnias
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Reid et al. - Quiz

• A friend has a 2 year old that wont go to sleep
  at night by himself. Your friend has to lie in
  bed with him until he finally falls asleep, then
  she sneaks out of the room, hoping that he will
  not wake up. If he does wake up, she has to go
  through the whole process again. She is quite
  tired and frustrated. What would you suggest she
  do? Be as specific as possible. Why do you
  suggest what you suggest?

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Sleep Disorders (cont.)

• Treatment
• Sleep hygiene
• behavioral interventions
• Night Terrors/Sleepwalking
• Nightmares
• Provide comfort
• Reduce stress

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Elimination Disorders

• Enuresis
• involuntary discharge of urine
• twice a week for three months or
• accompanied by significant distress or
  impairment,
• 5 years old
• Ratio or girls/boys night/day
• Primary/secondary

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Elimination Disorders (cont.)

• Enuresis
• Causes
• deficiency of antidiuretic hormone
• genetic predisposition
• immature signaling mechanism
• treatments
• behavioral training methods
• Bell and pad alarm
• medication

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Elimination Disorders (cont.)

• Encopresis
• passage of feces into inappropriate places
• once per month for 3 months
• at least 4 years old
• 2 subtypes
• with or without constipation and overflow
  incontinence
• primary or secondary
• psychological problems likely result from, rather
  than cause it

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Elimination Disorders (cont.)

• Encopresis (cont.)
• causes
• untreated constipation
• abnormal defecation dynamics

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Chronic Childhood Illness

• persists for more than 3 months or requires
  hospitalization for more than 1 month
• DSM-IV categories have limited applicability to
  children
• Adjustment Disorder

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Chronic illnesses

• Affect 10 to 20 of child population
• Asthma most common
• Low incidence of psychological problems but some
  increased risk of psychological adjustment
  difficulties

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Factors affecting adjustment

• Parental stress and adjustment
• Family resources
• Social support
• Illness conditions severity, prognosis, ability
  to function

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Interventions

• Problem focused coping for family
• Reduce stress
• Coping skills for pain/procedure management

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Table 12.3 Estimated Population Prevalence of
Selected Chronic Diseases and Conditions in
Children, Ages 0-20 in the United States