Special Health Care Needs - Assessments

This topic covers such a vast number of conditions that it is impossible to define how each individual student will be assessed.  As many of the health conditions and musculoskeletal impairments do not impede cognitive development, strategies used to assess "typical" students may be considered an appropriate practise for assessment.

Allergies

 

Allergic reactions begin when the immune system mistakenly responds to an otherwise harmless substance as if it were a serious threat, triggering the release of histamines and other chemicals that can lead to following symptoms (see chart below).

Anaphylactic shock is an allergic reaction that cause rapid and sometimes life-threatening symptoms. (see chart below).

 

For EA's, any of these symptoms should be considered a red flag; as they could lead to the need for more invasive medical intervention.  

 

 

From a non-medical perspective the preceding symptoms may be indicative of an allergic reaction to food or environmental irritants.

 

 

According to http://www.anaphylaxis.ca a medical assessment will involve the following stages of diagnosis:

"Patient History: 

• What happened when the reaction occurred (e.g., symptoms)?
• Where did it happen?
• When did the reaction first start?
• How long did it last?
• What treatments were used?
• Do any other family members have allergies?"

Skin Prick Test:

The most common of allergy tests;  a small drop of the allergen is placed on a person's arm and then the skin is pricked with a special needle to allow the body to absorb the allergen. After a wait time of roughly 15-20 minutes the skin is examined for any redness or swelling. 

Blood Tests:

When an allergen is present the immune system reacts by making antibodies called IgE (immunoglobulin E) specific to the allergen. Blood tests measure the level of IgE in the body.  The blood sample is mixed with the allergen to see if there is a reaction.

The following are both articles from The Globe and Mail regarding food allergies and their prominence in Canada:

 

http://www.theglobeandmail.com/life/health-and-fitness/tests-for-food-allergies-sensitivities-a-waste-of-money-doctor-says/article535082/

 

http://www.theglobeandmail.com/life/health-and-fitness/one-in-13-canadians-has-serious-food-allergy/article599131/

Arthritis

 

As there is no single test to diagnose Juvenile Arthritis (JA). and JA may be a part of many different illnesses, it is important to exclude those other conditions. The following steps are involved in making a diagnosis:

 

More information can be found here: http://www.aboutkidshealth.ca/En/ResourceCentres/JuvenileIdiopathicArthritis/Pages/default.aspx

Red flags for EA:

While working with a student diagnosed with JA, be alert for:

• Change in ability to keep up with normal activities, such as sports or school work that can be attributed to joint swelling and/or pain, stiffness of the joints
• Refusal to walk, limping, or a child who knows how to walk may return to crawling
• Student tire easily or complains of fatigue
• Changes in vision or appearance of the eyes
• Signs of depression

• Irritability, especially in a young child who is in pain

Article http://www.newswire.ca/en/story/930195/many-canadian-children-with-arthritis-wait-too-long-before-seeing-a-specialist

About Amanda http://amandascruise.ca/about_amanda.html and http://amandaja.blogspot.ca/

Asthma

Currently the leading chronic illness in children, Asthma affects 12.5% of all children. 

Most asthma attacks are brought on due to allergies, air conditions, or viral infections. The following symptoms may present in an asthma attack in a variety of combinations:

The EA should consider any of the above as a red flag for an oncoming attack that may require following a pre-established medical intervention plan.

http://www.lung.ca/_resources/asthma_action_plan.pdf

Medical assessment will involve a detailed medical history, a physical examination including an examination of the nasal passages and a listening to the lungs with a stethoscope. For patients over the age of 5 (due to co-ordination concerns) a spirometry test will be issued.
http://www.youtube.com/watch?v=dqe4blg0I0c

The doctor may also order allergy testing, chest x-rays, labwork on the blood and sputum and/or challenge tests to determine how hyper-responsive the airways are.

Cancer

Childhood cancer is not always easy to detect as many symptoms can easily be mistaken for other issues, if there are any symptoms at all. 

 

From a non-medical diagnostic, the following can be used to trigger concerns prior to medical intervention:

 

 

During the initial visit a doctor will ask about the symptoms, previous test results and examine the child. The following test may then be ordered:

Diabetes

 

Hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) are known to affect students’ learning, behaviour and participation in activities. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Once concerns are noted regarding the potential for either hypo or hyperglycemia (also known as type 1 and type 2 diabetes) the medical testing is the same for either diagnosis. The doctor will request labwork be done in the form of a urine dipstick  test, and a random blood sugar test. Should these tests come back inconclusive, but diabetes is still suspected, a Glycated hemoglobin (A1C) test and/or a Fasting Blood Sugar test will also be performed.  

 

Paediatric AIDS

 

Paediatric AIDS diagnosed by performing a Standard HIV blood test. It is anonymous and confidential. There is also Rapid (POC) HIV Testing available, not anonymous.

HIV testing locations in Waterloo Region http://www.acckwa.com/HIV-testing/

Students with AIDS can exhibit following symptoms:

 

 

Due to the problems above many children with paediatric AIDS qualify for Special Education programs and services. Students can succeed with instruction designed based on their strengths and broken down into small, manageable steps.

     https://wrfn.info/resources/advocacy-and-support/ support in Waterloo Region