Empowering all to learn, create, contribute, and grow'

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Empowering all to learn, create, contribute, and
grow.

• -Livingston Public Schools Mission Statement

The mission statement of an organization provides
a clear guide of its goals, values, and even
priorities (Schermerhorn, 2007)
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An Overview for Educators Management of Students
with Chronic Medical Conditions

• Health Office Presentation
• Pao-Chu Tseng

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Goals and Objectives

• To understand the school districts mission
  statement and plan action related to childrens
  chronic medical conditions.
• To raise awareness of chronic medical conditions
  effect on the physical, mental, and
  social-emotional state of students.
• To provide the new faculty with information
  regarding the management of students with chronic
  medical conditions.

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Overview of School-Aged Chronic Medical Conditions

• By the age of 18 years, approximately 10 to 15
  of all children and adolescents experience one or
  more chronic medical conditions.

(Nelson, 2005)
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Chronic medical conditions may result in
compromised mental, cognitive, physical, and
social-emotional functioning and may be
life-threatening.
(Fritts, 2004)
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Outside of the family and medical team, educators
are important members to provide collaborative
support to a child diagnosed with a chronic
medical conditions.
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Educational personnel includethe teacher, aide,
nurse, counselor, coach, school psychologist,
administrator, bus driver.
(Selekman, 2005)
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Families and educators need to obtain the
knowledge and skills necessary for collaboration
in working with a child with chronic medical
conditions.
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Traumatic Experiences Post Diagnosis of a Chronic
Medical conditions

• Frustration
• Loneliness
• Anxiety
• Guilt

• Shock
• Disbelief
• Denial
• Anger
• Fear

(Garcia, 1995)
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Impacts of Chronic Medical Conditions
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Impact on the Child

• Pain
• Discomfort
• Risk of maladjustment
• Low self-esteem
• Poor academic adjustment

• Attention
• Concentration
• Memory
• Mathematic calculations
• Motor speed

(Kapoor, 2007 Moonie, 2006 petty,2007
Suli,2007)
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Impact on the Family

• Traumatic experiences
• Financial burden
• Sibling relationship
• Social isolation
• Loneliness

• Daily treatment regime
• Multiple appointments
• Stressful if life-threatening

(Cortina,2007 Fritts, 2004 Vasek, 2004)
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Impact on Educators

• Make- up work arrangements after absences.
• Classroom accommodations
• Extended time for tests and assignments
• Arrangement for preferential seating
• Observation of treatment lead to side-effects on
  cognition and behaviors
• Management of emergency situations
• 
  (Wright, 1999)

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Impact on Classmates

• Peer support from better understanding (sympathy)
• Discussion essential on how one may feel if in
  the same situation (empathy)
• Avenues to be a good friend or supporter

(Brown, 2005 Fritts,2004)
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Chronic Medical Conditions in Children

• Type 1 Diabetes
• (T1DM)
• Epilepsy
• ADD

• Food Allergies
• Asthma
• Obesity

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T1DM

• T1DM is a disease of the immune system. The
  immune system attacks the beta cells ( the
  insulin-producing cells of the pancreas) and
  destroys them.
• T1DM requires to inject insulin daily to live.
  (Insulin-dependent diabetes.)
• It usually occurs in children and teenagers.
  (Juvenile diabetes.)

(American Diabetes Association, 2008)
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T1DM Statistics

• There are an estimated 500,000 to 1 million
  people with Type 1 diabetes in the U.S. today.
• Prevalence 1.8/1000 youth
• Peak incidence occurs during puberty, around 10
  to 12 years of age in girls, and 12-14 years of
  age in boys.
• Type 1 diabetes accounts for 5-10 percent of
  diagnosed cases of diabetes.
• Every day 35 children are diagnosed with
  diabetes.

(Center of Disease Control and Prevention, 2004).
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T1DMSymptoms

• High levels of sugar in the blood and urine
• Unusual thirst
• Frequent urination
• Extreme hunger but loss of weight
• Blurred vision
• Nausea and vomiting
• Extreme weakness and tiredness
• Irritability and mood changes

(Center of Disease Control and Prevention, 2004)
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T1DM Management

• Monitoring of blood sugar injections of insulin.
  
• Dietary restriction on sugar and fat.
• Regular exercise, watching weight, controlling
  emotions.
• Caring for injury.
• Wearing medical ID bracelet.
• (Parent, 2007)

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T1DM Risks

• Emotional
• Depression
• Withdrawal
• Isolation
• Hostility
• Self-esteem

• Medical
• Blindness
• Lose limbs
• Heart diseases
• Kidney failure
• Early death

(Parent, 2007)
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Complications

• Hypoglycemia-sweating, palpitation, tremors,
  pallor, disorientation, seizure, coma.
• Hyperglycemia-Increased thirst, frequent
  urination, nausea, blurry vision, fatigue
• Ketoacidosis
• (DAndrea, 2001)

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Working with Students with Diabetes

• Build a trusting relationship.
• Listen be a good listener.
• Be supportive-not judgmental.
• Be positive to build teens confidence.
• Ask questions it shows that you care.

(CDC,2004).
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Asthma

• Definition
• Airflow obstruction (mucus plugging)
• Bronchial hyper responsiveness
• Airway inflammation
• Symptoms
• breathing difficulty
• wheezing
• coughing

(Kapoor, 2007)
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Asthma

• Prevalence 8-12
• Special note
• 90 of episode by age 10
• 30 of asthma children also with anxiety and
  hyperactive issues

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Asthma- Early Signs of Episode

• Changes in breathing Coughing, Wheezing, Mouth
  breathing, Shortness of breath.
• Verbal complains Chest tightness, chest pain,
  cannot catch breath, neck feels funny, simply
  doesnt feel well.
• Others itching neck, chin short choppy sentences

(American Lung Association, 2008)
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Asthma- Common Triggers

• Allergens pollen, furry and feathered pets,
  dust, molds
• Irritants cold air, weather changes, cigarette
  smoke, chalk dust, diesel fumes, ozone, strong
  orders
• Upper respiratory infections
• Physical Exercise
• Laughing or crying hard
• (American Lungs Association, 2008)

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Asthma-Go to ER When

• Persistent symptoms following treatment
• Long-standing asthma status
• Maximal therapy already initiated
• Inadequate/difficult assess to care
• Poor environment/psychosocial condition
• (Kapoor, 2007)

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Asthma-How teachers can help?

• Be helpful- reduce asthma triggers in the
  classroom
• Be observant- Notice the symptoms
• Be supportive- approach and support in a
  reassuring manner
• Be calm- call or send for help
• (www.pacnj.org)

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Epilepsy

• Definition-misfiring or abnormal discharge or
  neuronal activity in the brain, interrupted of
  electrical activities, results in a temporary
  change in consciousness, sensation, motor
  activity, or behavior.
• Prevalence-0.6 of population

(Suli, 2007)
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Epilepsy- First Aid

• DO
• Remain calm and stay with the person
• Protect the person from injury
• Loosen tight or restrictive clothing
• Time seizure
• Reorient person after seizure

• DO NOT
• Restrain movement
• Force anything into mouth
• Offer food or drink

(Epilepsy Foundation of America, 2007)
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Epilepsy-Call 911when

• There is no known history of seizure for this
  person
• A seizure is prolonged (more than 5 minutes) or
  occurs one after another
• The person is pregnant or diabetic
• Serious injury occurs during the seizure (head
  trauma)
• (www.epilepsyfoundation.org)

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Pediatric Food Allergy

• Prevalence 6 of children
• Food intolerance is Not Food allergy
• The most common foods cows milk, eggs, peanuts,
  soybeans, wheat, fish, tree nuts. (Milk, eggs,
  peanuts account 80 of pediatric allergies to
  food)

(American Allergy Association, 2008)
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Anaphylaxis

• Anaphylaxis is a sudden, severe allergic reaction
  that involves various areas of the body
  simultaneously.
• What cause an anaphylactic reaction?
• Food allergies
• Insect stings
• Medications
• Latex
• (Butler, 2005)

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Signs and Symptoms of an Anaphylactic Reaction

• Complain of a tingling, itchiness, or metallic
  taste in the mouth
• Hives
• Difficulty breathing
• Swelling and/or itching of the mouth and throat
  area

• Diarrhea
• Vomiting
• Cramps and stomach pain
• Paleness (drop in blood pressure)
• Loss of consciousness
• (www.foodallergy.org, 2008)

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How to Help a Student with Food Allergies?

• Take food allergies seriously
• Learn what your student is allergic to and help
  him or her avoid it
• Get help immediately if your student feels sick
  after eating something
• Dont pressure any one to eat any foods
• (www.foodallergy.org, 2008)

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Professional Relationship

• To cure - Sometimes
• To relieve - Often
• To comfort - Always

Campbell, A., Gillett, G., Jones, G.
(2005).Medical Ethics (4th ed.,pp33). New York
Oxford University Press.
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A ship in the harbor is safe but that is not
what ships are for.-by John A. Shedd
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Who you are may determine what you do, but what
you do, in fact changes who you are.
-by Stark Lattuca, 1997
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Questions Comments?
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Thank You for your time
And Attention