Disturbances in movement, posture or growth in infancy and childhood

Chapter 2 Disturbances in movement, posture or growth in infancy and childhood



Case 2.1


You are consulted by a couple who wish to discuss with you a plan of management for their child who has been diagnosed with a serious lifelong disorder. Although under the care of the paediatrician, the need for co-management with a manual therapist is vital to the ongoing care of this condition.


The child was diagnosed by a regularly performed ‘heel prick’ or ‘Guthrie’ screening test within the first week of life.




Questions



1. What disorders does this test screen for?

2. You are told by the parents that the disorder is a hereditary one which involves exocrine glands. What disorder does the child have?

3. How is the disorder transmitted from one generation to another?

4. What is the incidence of this disorder? What is the current mean age of death?

5. Describe briefly the pathological changes that occur in this disorder on the structure and function of the following body systems:
a respiratory system

b digestive system

c integumentary system

d musculoskeletal system.

6. Why can this disorder affect the growth of the child?


Case 2.2


A mother brings her 11-year-old son, Hugh, to your clinic, concerned about his posture. She states that he has started to ‘slouch’, and is a little concerned that this may lead to long-term problems. Hugh is a very tall child, and his mother states that ‘he can’t seem to stop growing’. Further questioning reveals that his father is 190 cm tall, and his grandfather 185 cm.


Hugh is a well and happy child. Examination is normal, although you are concerned about his height, which you measure at 170 cm.




Questions



1. How will you determine if his height is within the normal distribution for his age?

2. Name some of the causes of tall stature.

3. In what circumstances would you refer Hugh to a paediatrician for further assessment?

4. Can ‘slouching’ lead to long-term problems?


Case 2.3


One of your regular patients expresses her concern about her 6-year-old daughter Amber, who is ‘small’ for her age. Further questioning reveals that she is especially concerned with her thinness, pallor and frail looking appearance. She also has intermittent abdominal bloating and bouts of diarrhoea, which do not last long, but are particularly smelly, pale-yellow in colour and hard to flush away. Amber is a little listless, and seems to lack energy. On examination, relevant findings are: BMI 16, tachycardia, BP 90/56 mm Hg, pale conjunctiva, a few small mouth ulcers, and a slightly distended, but non-tender, abdomen.




Questions



1. What information can you deduce from:
a the type of diarrhoea she has

b the pallor of the conjunctiva

c her BMI

d tachycardia.

2. What is the average pulse rate and blood pressure for a 6-year-old child?

3. What is your differential diagnosis?

4. Amber is referred to a medical practitioner. What investigations are required?

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Dec 26, 2016 | Posted by in MANUAL THERAPIST | Comments Off on Disturbances in movement, posture or growth in infancy and childhood

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