THE PROBLEMSThe first problem faced

THE PROBLEMS
The first problem faced by the parent of a hurt child is to discover just what it is that their child is, or has. Whether the child's problem is discovered at birth, or a week, a month, or years after birth, or even if the problem is created by some trauma such as an automobile accident during the teenage years, the problem of discovering exactly what has happened is immense for most parents. Most people are extremely ignorant in regards to hurt children. Their limited information usually comprises a collection of "old wives tales," and a few details about a child belonging to some distant relative or neighbor. As traumatic as the discovery that you have a hurt child is, the lack of information intensifies that trauma all the more. The family physician who helped you through your last case of the flu, or who correctly diagnosed your neighbor's heart condition often disappoints you in regards to your hurt child. He frequently cannot even tell you what is wrong with your child, let alone what to do about it. All too often his suggestion is to institutionalize the child as soon as possible. Doctors commonly wish that the problem would simply go away. Either at your doctor's recommendation, or because of our own need for information, you may search further for answers by going to see a “specialist." The specialist usually takes the form of a neurologist, neurosurgeon, orthopedist, or a psychiatrist. The visit with the specialist often is an even more upsetting and frustrating experience than the visit with the family doctor, because the "specialist" should know. Why doesn't your doctor know? Why doesn't the specialist know? Quite frankly, they don't know because almost no one knows!
What is known about the brain today is extremely limited, and of what is known, much of it has just been learned in the last twenty years. Some diagnoses are relatively easy to make, such as Down syndrome, with physical signs which can be seen and chromosome tests which can be used for confirmation. Or to a lesser degree, cerebral palsy, which is used to describe most children with obvious motor problems. But even with these problems, if you ask the physician exactly where the problem is, or what is going to happen to the child, the answers will probably be vague. Unfortunately however, of all the questions asked, the one which is generally answered with the greatest frequency and confidence is the one about which the least is known. That is, what is to become of my child, or what is the prognosis (outlook). Every hurt child is different and almost every hurt child has a chance, if given the opportunity. If every doctor's response to the question of prognosis is simply that he doesn't know, and not that it is hopeless, many, many, more hurt children would improve, and some would have the opportunity for “normal" lives.
SYMPTOMATIC DIAGNOSIS
In order for the parent to begin to understand the nature of their child's problem, it will be necessary to explore the vague and contradictory terminology applied to children with problems. Of the many terms used to categorize children with problems, few are attempts to describe the source of the problem, rather they are descriptions of the symptoms. In that a child may possess a variety of symptoms, a number of different symptomatic labels may be attached to each child. In addition to the problem of more than one term being applicable to an individual child, there is within the fields dealing with such children tremendous difference of opinion and controversy over the definitions and applications of specific terms. A thorough discussion of terms could easily comprise an entire volume in itself, and is outside the scope of this particular text. I wish only to give the parent some understanding of terms which may be applied to their child. In order to simplify the parent's task of acquiring some understanding of the various terms, I will endeavor to define each specific term as it relates to the general term of cerebral palsy, and as it affects or relates to a child's functional abilities.
















CEREBRAL PALSY
Cerebral Palsy is a term applied to a group of individuals whose primary handicap is physical, as opposed to mental. These children, as a group, exhibit problems which affect their ability to gain mobility (crawling, creeping, walking), to use their hands (eating, writing, dressing), and to verbalize or talk. This large group is subdivided into lesser groups based primarily upon the specific way in which their muscles, or the control of their muscle function, is abnormal. Within each group the level of severity varies, as well as the areas of the body which are affected. There is also a great deal of overlap. That is, within one child you may see many types of cerebral palsy, or the child may exhibit different forms at various times during development. Except in very severe cases where an obvious injury has occurred (generally around the time of birth) a child may not be diagnosed until six to twenty-four months following birth, as it may be this long before the symptoms become obvious. Cerebral palsy may develop as the result of an injury to the central nervous system before, during, or after birth. Triplegia: Involvement of three extremities, usually both legs and one arm. Monoplegia: Involvement of only one limb. The classifications of cerebral palsy according to syndrome, and in order of frequency are:















SPASTIC
The most common form of cerebral palsy is spastic cerebral palsy. The term "spasticity" refers to the function of individual muscles within the child's body. When a child with spasticity attempts to move the involved limb, or if someone attempts to stretch an involved muscle, the muscle responds with a strong contraction, or tightening. In that the muscle flexion is centered in the flexor muscles, the opposing extensor muscles often become stretched and lose some of their functional ability. If a limb remains in a state of extreme tightening of the flexor muscle, causing a stretching of the extensor for extended periods of time, a condition develops which is known as a "contracture," in which the function of the limb is almost completely inhibited. Spastic involvement of the legs generally results in some degree of "scissoring." The spastic muscles of the legs tend to limit knee movement, while the spastic adductor muscles (inner thigh) of the legs draw the legs inward until they actually cross each other. This motion also tends to rotate the legs inward at the hips, pulling the leg away from the hip socket. In addition, the flexor within the calf tends to pull the heel up which pushes the toes down and rotates the foot inward.
Spastic involvement of the arms results in some degree of tightening of the flexor muscles, so as to pull the elbows in toward the sides of the body, and the hands and wrists toward the chin. The backs of the hands tend to come together, and the fingers flex into a tight fist. The thumb generally is flexed to such a degree as to draw it against the palm of the hand, with the spastic fingers curled over it. Associated with the spastic child one often finds an exaggerated startle response to stimulation, inefficient respiration, curvature of the spine (which results from remaining in an upright position without the necessary development of the trunk muscles which would permit the child to support his spine), and failure to develop normal hip sockets because of his difficulty in achieving normal movement of his legs. Various visual problems, such as nystagmus (vibration of the eyes) or strabismus (lack of convergence the eyes' inability to work together in unison), are also evident. In addition, many spastic children exhibit abnormal electrical activity in their brains with associated seizure activity. In some cases, spastic children also suffer from some loss of mental ability. The author would be remiss if he were not to mention the role of orthopedic surgery in the spastic child. Although orthopedic surgery is thought by many to be indicated in some spastic children, particularly for heel cords, hamstrings, adductors, and hips, it is becoming less popular due to the understanding that the spastic child's problem is his brain and not his muscles, per se, that rehabilitation can often correct such problems without surgery, and that surgery often presents not only a delay to rehabilitative therapy, but a complication often greater than the original problem. For every action, there is a reaction. If the orthopedist cuts a spastic muscle because it is producing an abnormal pull, when the child reaches the developmental age when the cut muscle should be doing its normal job, that developmental movement of the limb will be lost or will be very abnormal. For example, if spastic adductor muscles are cut because they are causing the legs to scissor, their later function of holding the legs directly under the body, when creeping on the hands and knees or walking, will be lost and the legs will tend to spread, causing the child to have difficulties trying to hold the body up straight.






















ATHETOSIS
The athetoid child is one of the most perplexing children there is to work with. He is generally an extremely happy child, a delightful, cheerful, optimistic, bright child, whose progress is often extremely slow and difficult. The athetoid child's muscles, although a bit hyper (increased) in tone, react in very abnormal fashion, and the harder the child tries to correct an activity the more uncontrolled his movements become The abnormal motor function of the athetoid is in the form of excessive movement and uncontrolled movement. This uncontrolled movement increases with the child's effort to move with his level of excitement or with environmental stimulation. With excessive stimulation, the athetoid's body flails rapidly and wildly. With relaxation, the abnormal function decreases, and with sleep, disappears. The ath

ผลลัพธ์ (ไทย) 1:

ปัญหาThe first problem faced by the parent of a hurt child is to discover just what it is that their child is, or has. Whether the child's problem is discovered at birth, or a week, a month, or years after birth, or even if the problem is created by some trauma such as an automobile accident during the teenage years, the problem of discovering exactly what has happened is immense for most parents. Most people are extremely ignorant in regards to hurt children. Their limited information usually comprises a collection of "old wives tales," and a few details about a child belonging to some distant relative or neighbor. As traumatic as the discovery that you have a hurt child is, the lack of information intensifies that trauma all the more. The family physician who helped you through your last case of the flu, or who correctly diagnosed your neighbor's heart condition often disappoints you in regards to your hurt child. He frequently cannot even tell you what is wrong with your child, let alone what to do about it. All too often his suggestion is to institutionalize the child as soon as possible. Doctors commonly wish that the problem would simply go away. Either at your doctor's recommendation, or because of our own need for information, you may search further for answers by going to see a “specialist." The specialist usually takes the form of a neurologist, neurosurgeon, orthopedist, or a psychiatrist. The visit with the specialist often is an even more upsetting and frustrating experience than the visit with the family doctor, because the "specialist" should know. Why doesn't your doctor know? Why doesn't the specialist know? Quite frankly, they don't know because almost no one knows! What is known about the brain today is extremely limited, and of what is known, much of it has just been learned in the last twenty years. Some diagnoses are relatively easy to make, such as Down syndrome, with physical signs which can be seen and chromosome tests which can be used for confirmation. Or to a lesser degree, cerebral palsy, which is used to describe most children with obvious motor problems. But even with these problems, if you ask the physician exactly where the problem is, or what is going to happen to the child, the answers will probably be vague. Unfortunately however, of all the questions asked, the one which is generally answered with the greatest frequency and confidence is the one about which the least is known. That is, what is to become of my child, or what is the prognosis (outlook). Every hurt child is different and almost every hurt child has a chance, if given the opportunity. If every doctor's response to the question of prognosis is simply that he doesn't know, and not that it is hopeless, many, many, more hurt children would improve, and some would have the opportunity for “normal" lives.SYMPTOMATIC DIAGNOSISIn order for the parent to begin to understand the nature of their child's problem, it will be necessary to explore the vague and contradictory terminology applied to children with problems. Of the many terms used to categorize children with problems, few are attempts to describe the source of the problem, rather they are descriptions of the symptoms. In that a child may possess a variety of symptoms, a number of different symptomatic labels may be attached to each child. In addition to the problem of more than one term being applicable to an individual child, there is within the fields dealing with such children tremendous difference of opinion and controversy over the definitions and applications of specific terms. A thorough discussion of terms could easily comprise an entire volume in itself, and is outside the scope of this particular text. I wish only to give the parent some understanding of terms which may be applied to their child. In order to simplify the parent's task of acquiring some understanding of the various terms, I will endeavor to define each specific term as it relates to the general term of cerebral palsy, and as it affects or relates to a child's functional abilities.CEREBRAL PALSYCerebral Palsy is a term applied to a group of individuals whose primary handicap is physical, as opposed to mental. These children, as a group, exhibit problems which affect their ability to gain mobility (crawling, creeping, walking), to use their hands (eating, writing, dressing), and to verbalize or talk. This large group is subdivided into lesser groups based primarily upon the specific way in which their muscles, or the control of their muscle function, is abnormal. Within each group the level of severity varies, as well as the areas of the body which are affected. There is also a great deal of overlap. That is, within one child you may see many types of cerebral palsy, or the child may exhibit different forms at various times during development. Except in very severe cases where an obvious injury has occurred (generally around the time of birth) a child may not be diagnosed until six to twenty-four months following birth, as it may be this long before the symptoms become obvious. Cerebral palsy may develop as the result of an injury to the central nervous system before, during, or after birth. Triplegia: Involvement of three extremities, usually both legs and one arm. Monoplegia: Involvement of only one limb. The classifications of cerebral palsy according to syndrome, and in order of frequency are:SPASTICThe most common form of cerebral palsy is spastic cerebral palsy. The term "spasticity" refers to the function of individual muscles within the child's body. When a child with spasticity attempts to move the involved limb, or if someone attempts to stretch an involved muscle, the muscle responds with a strong contraction, or tightening. In that the muscle flexion is centered in the flexor muscles, the opposing extensor muscles often become stretched and lose some of their functional ability. If a limb remains in a state of extreme tightening of the flexor muscle, causing a stretching of the extensor for extended periods of time, a condition develops which is known as a "contracture," in which the function of the limb is almost completely inhibited. Spastic involvement of the legs generally results in some degree of "scissoring." The spastic muscles of the legs tend to limit knee movement, while the spastic adductor muscles (inner thigh) of the legs draw the legs inward until they actually cross each other. This motion also tends to rotate the legs inward at the hips, pulling the leg away from the hip socket. In addition, the flexor within the calf tends to pull the heel up which pushes the toes down and rotates the foot inward.Spastic involvement of the arms results in some degree of tightening of the flexor muscles, so as to pull the elbows in toward the sides of the body, and the hands and wrists toward the chin. The backs of the hands tend to come together, and the fingers flex into a tight fist. The thumb generally is flexed to such a degree as to draw it against the palm of the hand, with the spastic fingers curled over it. Associated with the spastic child one often finds an exaggerated startle response to stimulation, inefficient respiration, curvature of the spine (which results from remaining in an upright position without the necessary development of the trunk muscles which would permit the child to support his spine), and failure to develop normal hip sockets because of his difficulty in achieving normal movement of his legs. Various visual problems, such as nystagmus (vibration of the eyes) or strabismus (lack of convergence the eyes' inability to work together in unison), are also evident. In addition, many spastic children exhibit abnormal electrical activity in their brains with associated seizure activity. In some cases, spastic children also suffer from some loss of mental ability. The author would be remiss if he were not to mention the role of orthopedic surgery in the spastic child. Although orthopedic surgery is thought by many to be indicated in some spastic children, particularly for heel cords, hamstrings, adductors, and hips, it is becoming less popular due to the understanding that the spastic child's problem is his brain and not his muscles, per se, that rehabilitation can often correct such problems without surgery, and that surgery often presents not only a delay to rehabilitative therapy, but a complication often greater than the original problem. For every action, there is a reaction. If the orthopedist cuts a spastic muscle because it is producing an abnormal pull, when the child reaches the developmental age when the cut muscle should be doing its normal job, that developmental movement of the limb will be lost or will be very abnormal. For example, if spastic adductor muscles are cut because they are causing the legs to scissor, their later function of holding the legs directly under the body, when creeping on the hands and knees or walking, will be lost and the legs will tend to spread, causing the child to have difficulties trying to hold the body up straight.





















ATHETOSIS
The athetoid child is one of the most perplexing children there is to work with. He is generally an extremely happy child, a delightful, cheerful, optimistic, bright child, whose progress is often extremely slow and difficult. The athetoid child's muscles, although a bit hyper (increased) in tone, react in very abnormal fashion, and the harder the child tries to correct an activity the more uncontrolled his movements become The abnormal motor function of the athetoid is in the form of excessive movement and uncontrolled movement. This uncontrolled movement increases with the child's effort to move with his level of excitement or with environmental stimulation. With excessive stimulation, the athetoid's body flails rapidly and wildly. With relaxation, the abnormal function decreases, and with sleep, disappears. The ath

ผลลัพธ์ (ไทย) 3:

ปัญหา
ปัญหาแรกที่เผชิญ โดยผู้ปกครองของเด็กจะเจ็บค้นพบเพียงแค่สิ่งที่มันเป็นว่า ลูกของตน หรือมี ว่าปัญหาของเด็กที่ถูกค้นพบตั้งแต่เกิด หรือเป็นสัปดาห์ เป็นเดือน หรือเป็นปีหลังคลอด หรือถ้าเป็นปัญหาที่สร้างขึ้นโดย บาดแผล เช่น อุบัติเหตุรถยนต์ในช่วงปีวัยรุ่นปัญหาของการค้นพบสิ่งที่เกิดขึ้นคืออันยิ่งใหญ่สำหรับผู้ปกครองมากที่สุด คนส่วนใหญ่เป็นสิ่งงมงาย เรื่องทำร้ายเด็ก ข้อมูลที่จำกัดของพวกเขามักจะประกอบด้วยคอลเลกชันของ " นิทาน " เก่า " และรายละเอียดบางอย่างเกี่ยวกับเด็กของบางญาติห่าง หรือเพื่อนบ้าน เป็นบาดแผลที่ค้นพบว่า มีเด็กถูกทำร้าย ,ขาดข้อมูล intensifies ที่บาดเจ็บทั้งหมดเพิ่มเติม ครอบครัวแพทย์ที่ช่วยให้คุณผ่านคดีล่าสุดของไข้หวัด หรือที่ถูกต้อง การวินิจฉัยภาวะหัวใจเพื่อนบ้านของคุณมักจะทำให้คุณผิดหวังในการไปถึงของคุณทำร้ายเด็ก เขามักไม่สามารถบอกคุณมีอะไรกับเด็ก ปล่อยให้อยู่คนเดียวจะทำอะไรเกี่ยวกับมันทั้งหมดบ่อยเกินไปข้อเสนอของเขาคือสถาบันของเด็กโดยเร็วที่สุด แพทย์มักหวังว่าปัญหาจะหายไป ที่แนะนำของคุณหมอ หรือเพราะความต้องการของเราเอง สำหรับข้อมูลเพิ่มเติม คุณอาจค้นหาคำตอบ โดยจะเห็นเป็น " ผู้เชี่ยวชาญ . " ผู้เชี่ยวชาญมักจะใช้รูปแบบของระบบประสาท ศัลยแพทย์ระบบประสาท หมอโรคกระดูก หรือจิตแพทย์เยี่ยม ผู้เชี่ยวชาญมักจะเป็นมากขึ้นและ upsetting ประสบการณ์ที่น่าผิดหวังกว่าเยี่ยมชมกับแพทย์ครอบครัว เพราะ " ผู้เชี่ยวชาญ " ที่ควรรู้ ทำไมไม่ให้หมอรู้มั้ย ทำไมไม่ให้ผู้เชี่ยวชาญที่รู้ ? พูดตรงๆนะ เขาไม่รู้ เพราะแทบไม่มีคนรู้
สิ่งที่เป็นที่รู้จักกันเกี่ยวกับสมองวันนี้น้อยมาก และสิ่งที่เป็นที่รู้จักกันเท่าไหร่จะได้รับเพียงแค่เรียนรู้ในช่วงยี่สิบปี บางโรคจะค่อนข้างง่ายในการสร้าง เช่น ดาวน์ ซินโดรม ด้วยสัญญาณทางกายภาพที่สามารถเห็นและตรวจโครโมโซมซึ่งสามารถใช้สำหรับการยืนยัน หรือในระดับน้อย , สมองพิการ , ซึ่งถูกใช้เพื่ออธิบายเด็กส่วนใหญ่มีปัญหามอเตอร์ที่ชัดเจน แต่ด้วยปัญหาเหล่านี้ถ้าคุณถามแพทย์ว่ามีปัญหา หรือเกิดอะไรขึ้นกับลูก คำตอบอาจจะคลุมเครือ แต่อย่างไรก็ตาม คำถามที่ทุกคนถามหนึ่งซึ่งโดยทั่วไปจะตอบกับความถี่มากที่สุด และมีความมั่นใจในเรื่อง ซึ่งก็เป็นที่รู้จัก นั่นคือสิ่งที่จะกลายเป็นของลูก หรือเกิดอาการ ( Outlook )ทุก ๆ ทำร้ายเด็ก ต่าง และ ทำร้ายลูกได้เกือบทุกโอกาส ถ้าได้รับโอกาส ถ้าหมอทุกคนตอบรับคำถามของการพยากรณ์เป็นเพียงว่าเขาไม่ได้รู้และไม่ได้ว่ามันเป็นสิ้นหวัง หลายหลายมากขึ้น ทำร้ายเด็กจะปรับปรุง และจะเปิดโอกาสให้ " ชีวิตปกติ " .

อาการ การวินิจฉัยในการสั่งซื้อสำหรับพ่อแม่ที่จะเริ่มเข้าใจธรรมชาติของปัญหาของลูก ก็จะต้องศึกษาศัพท์ที่คลุมเครือและไม่ใช้กับเด็กที่มีปัญหา ของหลายเงื่อนไขที่ใช้จัดกลุ่มเด็กที่มีปัญหาน้อยคือความพยายามที่จะอธิบายถึงแหล่งที่มาของปัญหา ค่อนข้าง จะเป็นลักษณะของอาการในเด็กอาจมีความหลากหลายของอาการ จำนวนป้าย อาการอื่นที่อาจจะแนบกับเด็กแต่ละคน นอกจากปัญหามากกว่าหนึ่งเงื่อนไขการใช้กับเด็กแต่ละคน มีเขตติดต่อกับเด็กภายในอย่างมากมาย ความแตกต่างของความคิดเห็นและการโต้เถียงในความหมายและการประยุกต์ใช้เงื่อนไขที่เฉพาะเจาะจงการอภิปรายอย่างละเอียดของข้อตกลงได้อย่างง่ายดายสามารถประกอบด้วยปริมาณทั้งในตัวเอง และอยู่ภายนอกขอบเขตของข้อความนี้โดยเฉพาะ ฉันเพียงแค่อยากให้พ่อแม่เข้าใจในแง่ซึ่งอาจจะใช้กับเด็กของพวกเขา เพื่อลดความซับซ้อนของงานผู้ปกครองรับความเข้าใจบางอย่างของเงื่อนไขต่าง ๆผมจะพยายามที่จะกำหนดแต่ละระยะเวลาที่เกี่ยวข้องกับเงื่อนไขทั่วไปของสมองพิการ และมันมีผลหรือสัมพันธ์กับความสามารถของเด็ก .
















สมองพิการ
สมองพิการเป็นศัพท์ที่ใช้ในกลุ่มของบุคคลที่มีความพิการทางกายเป็นหลัก ซึ่งตรงข้ามกับจิตใจ เด็กเหล่านี้ เป็น กลุ่ม