health

1. Definition .
   
2. Description .
   
3. Demographics .
   
4. Causes and Symptoms .
   
5. Diagnosis .
   
6. Treatment .
   
7. Prognosis .
8. Prevention .
   
9. The Future .

Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability Developmental Disability

Developmental disability is a term applied to a group of chronic disorders
caused by physical and/or mental impairments that occur before age
twenty-two and typically last for a lifetime. These disorders affect a person’s
ability to learn, speak effectively, take care of themselves, hold a job,
and live independently.
Developmental disabilities are defined as mild, moderate, severe, or
profound on the basis of how much social support the person needs.
A person with mild developmental disabilities, for example, may be able
to benefit from special education programs, finish high school or a vocational
training program, work in certain types of jobs, and live with their
family or in the community. Those with profound disabilities, on the other
hand, may require twenty-four-hour care in a group home or institution.

Developmental disabilities can be described as falling into one of several
types:

• Disabilities involving the brain, spinal cord, and nervous system.
  These developmental disabilities include mental retardation (Down
  syndrome, fragile X syndrome) and autism spectrum disorders.
  
• Disabilities related to hearing or vision loss.
• Disabilities related to metabolic disorders. Metabolism refers to
  the sum total of the chemical changes in the body that are needed
  to provide energy and repair or grow tissues. Metabolic disorders
  that affect children’s development include thyroid diseases and
  phenylketonuria.
  
• Disabilities related to degenerative disorders. Degenerative
  disorders are those in which a child appears normal at birth and
  reaches some developmental milestones but then starts to lose
  the abilities theyhave attained.

Developmental disabilities have been recognized for centuries even
though people did not always understand their causes. Before
the eighteenth century, people suffering from mental retardation
and other disabilities were often cared for by their families or
in religious institutions like monasteries. After the Industrial
Revolution in the nineteenth century, people with developmental
disabilities were more likely to be taken from their families in
childhood and placed in large asylums—some containing as many
as several thousand people. Some of these institutions
provided an elementary education as well as food, shelter,
and clothing, but most met only the basic needs of the children
and adults in their care. It was not until the 1960s that doctors
and teachers began to question the effectiveness of placing
people with disabilities in large institutions.
Between the 1960s and the 1990s, the United States and other
developed countries moved toward individualized education and
social support for people with developmental disabilities.
Instead of separating these persons from the wider community,
doctors and teachers now focus on each individual’s gifts and talents
as well as their needs, and try to place them in classroom and
work settings where they can interact with others. In 2000 the U.S.
Congress passed the Developmental Disabilities Assistance
and Bill of Rights Act, which funds four grant
programs to assist people with developmental disabilities and their
families.
There are still several challenges to teaching and treating or supporting
people with developmental disabilities. One is that these children
and adults are vulnerable to abuse by others. They also have a higher
than normal rate of mental health issues, not only because they are often
hurt or abused but also because they frequently become dependent on
drugs or alcohol. Third, people with developmental disabilities sometimes
behave in ways that are upsetting or dangerous to others, such as
hitting, screaming, kicking, being sexually inappropriate, stealing or
throwing objects, or injuring themselves. Treatment of people with
developmental disabilities often has to include medications or psychotherapy
to help them control problem behaviors.

According to the U.S. Administration on Developmental Disabilities
(ADD), there were about 4.5 million children and adults in the United
States with developmental disorders as of 2008. Some statistics for specific
disorders are as follows:

• Autism: 560,000 persons between the ages of one and twenty-one
  years.
  
• Cerebral palsy: 800,000 children and adults.
  
• Hearing loss: 72,000 children between the ages of six and
  twenty-one.
  
• Mental retardation: 2 million children and adults between the ages
  of six and sixty-four.
  

Developmental disabilities can be caused by a number of different
factors:

• Injury to the baby’s brain before birth or during the birth
  process.
  
• Mother’s lifestyle. Heavy drinking, drug use, or smoking can lead
  to fetal alcohol syndrome or other forms of brain damage.
  
• Rubella or other infectious diseases.
  
• Extreme prematurity.
  
• Child abuse.
• Genetic disorders. Down syndrome, phenylketonuria, fragile X
  syndrome, and some degenerative disorders are all caused by
  genetic mutations or an extra copy of a chromosome.
  
• Poor diet and health care.

Developmental disabilities are defined by the U.S. government as
disabilities that affect the individual’s functioning in three or more of the
following areas:

• The ability to live on one’s own
  
• The ability to support oneself financially
  
• The ability to learn in school
  
• The ability to get around on one’s own, by walking, driving, or
  using public transportation
  
• The ability to use and understand spoken language
  The ability to take care of one’s personal needs (dressing, eating,
  washing, using the toilet, doing laundry)
  
• Self-direction (the ability to make decisions, evaluate situations,
  and generally be in charge of one’s life)
  

The diagnosis of developmental disabilities is made at different points
before or after the child’s birth, depending on the specific disorder. Some
genetic disorders, like Down syndrome, can be diagnosed before the
baby is born. Metabolic disorders like phenylketonuria can be detected
by a blood test used to screen babies shortly after birth.
In other cases, developmental disabilities may be identified by the
baby’s doctor during periodic checkups. The doctor can observe how the
child interacts with its caregiver; can test his or her vision and hearing;
and see whether the child has attained specific developmental milestones.
Parents who have noticed that their child does not seem to be walking,
talking, or responding to them at the age at which these abilities usually
appear will often consult a specialist in child development for an evaluation
of the child. Some learning disabilities may not become evident until
after the child starts school and may be first noticed by a teacher.

There is no cure for developmental disabilities. Treatment of developmental
disabilities is tailored to the individual child and his or her
specific type of disability. It may include one or more of the following
types of treatment or care:

• Medications or surgery for specific physical or emotional
  problems.
  
• Special education programs.
  
• Vocational training for future employment.
  
• Speech and language therapy.
  
• Physical therapy.
  
• Psychotherapy and counseling for behavioral problems.
  
• Support services for people who are profoundly disabled. These
  may include nursing care as well as assistance with housekeeping,
  personal cleanliness, shopping, and handling money.

Although many people with developmental disabilities cannot be
completely self-sufficient in all aspects of daily life, treatment is aimed
at helping them achieve as much independence as possible.

The prognosis for children with developmental disabilities depends on
the severity of the child’s specific disability; whether it is progressive (gets
worse over time); and the extent to which it affects his or her ability to
get along with other people, finish school or train for a job, and live independently.
In general, developmental disabilities shorten a person’s life
expectancy by about twenty years, although improvements in technology
as well as medicine are helping people with disabilities have a better
quality of life as well as live longer.

Not all developmental disabilities can be prevented. Some measures that
people can take, however, to lower their risk of having a child with developmental
disabilities include:

• Genetic screening for both parents, particularly if either father or
  mother comes from a family with a history of genetic disorders
  
• Proper nutrition and health care for the mother during pregnancy
  
• Avoidance of drinking, smoking, and drug use during pregnancy
  
• Vaccination against rubella before pregnancy if the mother has not
  been exposed to it
  

Developmental disabilities are likely to become a serious concern for
caregivers and health care professionals in the years ahead. One reason
is that some developmental disabilities, such as autism and hearing loss,
are becoming more rather than less common. Another reason is that
people with developmental disabilities are living longer, which means
that they will require treatment and support services for many more years
than was the case in the 1960s. The needs of adults over fifty with developmental
disabilities are presently being studied by policy makers as well
as medical researchers.
Another rapidly expanding area of research is finding better
screening instruments to identify children with developmental disabilities
as early as possible. The available evidence indicates that the earlier these
children are diagnosed and treated, the more likely they are to develop
their full potential as they grow older.