Tag: cp

Cerebral Palsy – Symptoms, Causes, Diagnosis and Treatment of Cerebral Palsy #cerebral #palsy, #ataxic

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Cerebral Palsy – Topic Overview

What is cerebral palsy?

Cerebral palsy is a group of problems that affect body movement and posture. It is related to a brain injury or to problems with brain development. It is one of the most common causes of lasting disability in children.

Cerebral palsy causes reflex movements that a person can’t control and muscle tightness that may affect parts or all of the body. These problems can range from mild to severe. Intellectual disability. seizures. and vision and hearing problems can occur.

What causes cerebral palsy?

Cerebral palsy is caused by a brain injury or problem that occurs during pregnancy or birth or within the first 2 to 3 years of a child’s life. It can be caused by:

  • Problems from being born too early (premature birth).
  • Not getting enough blood. oxygen, or other nutrients before or during birth.
  • A serious head injury .
  • A serious infection that can affect the brain. such as meningitis .
  • Some problems passed from parent to child (genetic conditions ) that affect brain development.

In many cases, the exact cause of cerebral palsy is not known.

What are the symptoms?

Everyone with cerebral palsy has problems with body movement and posture. But the physical problems are worse for some people than for others.

Some people who have cerebral palsy have a slight limp or a hard time walking. Other people have little or no control over their arms and legs or other parts of the body, such as the mouth and tongue. which can cause problems with eating and speaking. People who have severe forms of cerebral palsy are more likely to have other problems, such as seizures or intellectual disability.

Babies with severe cerebral palsy often have problems with their posture. Their bodies may be either very floppy or very stiff. Birth defects sometimes occur along with cerebral palsy. Examples of birth defects include a spine that doesn’t have the normal shape, a small jawbone, or a small head.

The brain injury or problem that causes cerebral palsy doesn’t get worse over time. But new symptoms may appear, or symptoms may change or get worse as your child gets older. This is why some babies born with cerebral palsy don’t show clear signs of it right away.

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How is cerebral palsy diagnosed?

Your child’s doctor will do a physical exam and ask you about your child’s medical history. He or she will ask about your child’s growth and about any problems you may have noticed. The doctor may also ask about your child’s development.

Tests, such as a CT scan or an MRI of your child’s head, may also be done. Or the doctor may look at ultrasound pictures of the brain. These tests can sometimes help the doctor find the cause of cerebral palsy.

If your child has a severe form of cerebral palsy, a doctor may be able to pinpoint the problem within the first few weeks of your child’s life. But parents are often the first to notice that their baby does not have the abilities and skills that are common in other children in the same age group. These developmental delays can be early signs of cerebral palsy.

Even when the condition is present at birth, the signs of cerebral palsy may not be noticed until a child is 1 to 3 years old.

How is it treated?

Even though cerebral palsy can’t be cured, you and your child can do things to help deal with symptoms, prevent problems, and make the most of your child’s abilities. Physical therapy is one of the most important treatments. Medicines, surgery, and special equipment such as a walker can also help.

What can you do to cope?

Meeting the daily needs of a family member with cerebral palsy isn’t easy. If your child has cerebral palsy, seek family and community support. It may help to join a support group or talk with other parents who have a child with special needs, so you don’t feel alone.

You may also find counseling useful. It may help you understand and deal with the wide range of emotions you may feel. Your child will need help too. Providing emotional support for your child can help him or her cope with having cerebral palsy.

Learning that your child has cerebral palsy isn’t easy, and raising a child who has it can be hard. But the more you know, the better you can care for and provide for your child.

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Frequently Asked Questions





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Reflective Practice in Social Work #social #worker, #social #work, #clinical, #medical, #social #services, #addiction,

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Eye on Ethics

Reflective Practice in Social Work — The Ethical Dimension
By Frederic G. Reamer, PhD
April 2013

Recently, I received an urgent voicemail message from a hospital social worker: “Please get back to me as soon as possible. I have a meeting tomorrow morning with our head of human resources, and I’m very nervous about it.”

Later in the day, I connected with the social worker and learned the following: He had been employed by the hospital for seven years and had never been disciplined. His current predicament began when his immediate supervisor called him in to discuss concerns about possible boundary violations and an alleged inappropriate dual relationship with a hospital patient. The social worker explained to me that in his personal life he is actively involved in a community-based group of parents who adopted children from China. The group sponsors a wide range of activities to support and enhance the children’s ethnic identity. Through this involvement, the social worker said, he and his wife had become very friendly with several other adoptive parents.

About three weeks earlier, one of the parents who had become a good friend was admitted to the social worker’s hospital for treatment of a chronic, debilitating infection. The friend did not receive social work services. During the friend’s hospital stay, the social worker occasionally stopped by his room to say hello and inquire about the friend’s health. The patient’s attending physician had collaborated professionally with the social worker in other hospital cases and was well aware of the patient’s friendship with the social worker.

One afternoon during the patient’s hospital stay, the physician contacted the social worker and explained that the patient was distraught after having just learned that he was diagnosed with bone cancer. According to the social worker, the physician asked the social worker to visit the patient and offer emotional support. The social worker visited the patient in his room and spent about an hour helping his friend process the distressing medical news.

The social worker documented this patient encounter in the hospital chart. During a random quality-control review of social workers’ chart entries, the hospital’s social work supervisor read the note and became concerned because the social worker had not been assigned to provide social work services to this patient. The supervisor learned of the social worker and patient’s friendship and notified the director of human resources, who documented this “incident” in the social worker’s personnel record and asked to meet with the social worker.

The Nature of Reflective Practice
In 1983, the late scholar Donald Schon published his influential and groundbreaking book The Reflective Practitioner: How Professionals Think in Action . Schon’s thesis, based on his extensive empirical research, was that the most skilled and effective professionals have the ability to pay critical attention to the way they conduct their work at the same time that they do their work. Schon coined the terms “knowing-in-action” and “reflection-in-action,” which suggest that some professionals can take a step back and think hard about what they are doing while they are doing it. The concepts are akin to the widely used social work concept “use of self.”

Ordinarily the concepts of knowing-in-action and reflection-in-action are applied to practitioners’ cultivation and use of technical skill, whether in surgery, architecture, town planning, engineering, dentistry, or psychotherapy. In my view, and as the above case demonstrates, social workers would do well to extend the application of these compelling concepts to their identification and management of ethical issues in the profession. Ideally, effective practitioners would have the ability to recognize and address ethical issues and challenges as they arise in the immediate context of their work, not later when someone else points them out. Put another way, social workers would have a refined “ethics radar” that increases their ability to detect and respond to ethical issues.

Of course, the most important benefit is client protection. However, an important by-product is self-protection, that is, the increased likelihood that social workers will protect themselves from ethics-related complaints.

Implementing Reflective Ethics Practice
Certainly the hospital social worker who called me with panic in his voice would have benefited from reflective ethics practice and highly sensitive ethics radar. Had he reflected on the ethical dimensions of the boundary challenges that emerged when he interacted with his friend and hospital patient, it is likely that this well-meaning practitioner would have avoided his unpleasant encounter with the human resources department. The social worker’s decision to visit his friend was not the error; that was a humane and compassionate gesture. The error, rather, was not reflecting on his role in that moment and managing the boundaries carefully, including discussing them with his friend and his supervisor.

In my experience, ethics-related reflection-in-action entails three key elements.

Knowledge: Skillful management of many ethical dilemmas requires knowledge of core concepts and prevailing standards. Ethics concepts are addressed in professional literature and standards exist in several forms, including relevant codes of ethics, agency policies, statutes, and regulations. For example, the National Association of Social Workers’ Codeof Ethics includes explicit standards pertaining to boundaries, dual relationships, and conflicts of interest (especially section 1.06). It would have been best for the hospital-based social worker to consult relevant literature and standards with regard to conflicts that can arise when a social worker encounters a friend or social acquaintance in the work setting. The hospital’s personnel policies also prohibit dual relationships that involve conflicts of interest.

In some cases, although not all, statutes and regulations address ethical issues. In the United States, both federal and state laws address various ethical issues, such as confidentiality, privileged communication, informed consent, and social workers’ ethical conduct. Such laws would not have been particularly helpful in the hospital social worker’s case, but often they are helpful and critically important, for example, when social workers must decide whether to disclose confidential information without clients’ consent to protect a third party from harm or whether parental consent is necessary to provide services to minors who seek help with substance abuse but insist that this information be withheld from their parents.

Transparency: Reflective social workers who sense an ethical issue share their concern with supervisors, colleagues, and appropriate administrators. An effective way to protect clients and practitioners alike is to avoid any suggestion that the ethical issue is being handled “in the dark.” Such clarity demonstrates social workers’ good faith efforts to manage ethical dilemmas responsibly. When appropriate, clients should be included in the conversation.

Process: Although some ethical decisions are clear-cut, many are not. The hospital social worker who contacted me was unsure about the best way to manage his involvement with a good friend who had become a patient. Unfortunately, the social worker did not notify his supervisor about the dilemma or seek consultation. He documented his lengthy hospital-room encounter with the patient, but doing so in the client’s hospital chart created the impression that the social worker was functioning in his professional capacity, not as a friend. My hunch is that had the social worker notified his supervisor of his friendship with the patient and made clear that any contact with the patient occurred as a friend, the social worker may have avoided any adverse personnel issues. What I have learned is that many ethical decisions are not simple events; they require a considerable, often painstaking, process.

During the course of the profession’s history, social workers have refined the art of reflective practice. Historically, these skills have been applied primarily to clinical, policy, advocacy, and administrative functions. Clearly, reflective practice should extend to ethics as well.

— Frederic G. Reamer, PhD, is a professor in the graduate program of the School of Social Work, Rhode Island College. He is the author of many books and articles, and his research has addressed mental health, healthcare, criminal justice, and professional ethics.





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