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Physical and sensory effectsPPhysical and sensory effectsPhysical and sensory effectsEnglishDevelopmentalPremature;Newborn (0-28 days);Baby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years)NANANAPrenatal Adult (19+)NA2009-10-31T04:00:00ZHilary Whyte, MSc, MB, BCh, BAO, MRCPI, FRCPC12.000000000000046.0000000000000350.000000000000Flat ContentHealth A-Z<p>Although most premature babies will grow to be normal, healthy children, some will have a disability. This chance is dependent on several factors.</p><p>Although most premature babies will grow to be normal, healthy children, some will have a disability. The chance that this will occur in any individual baby is dependent on several factors. Physical and sensory problems can also have multiple causes and range in severity.</p><h2>Key points</h2> <ul><li>The most common complications that lead to ongoing disability include intraventricular hemorrhage (IVH), asphyxia, severe jaundice, hypoglycemia, severe infections, long-term use of ventilation, chronic lung disease.</li> <li>Physical and sensory problems can be due to a problem with the organ itself or due to a brain injury that affects the function of that organ.</li> <li>Prematurity can affect hearing, vision, and movement and coordination.</li></ul>
Conséquences physiques et sensoriellesCConséquences physiques et sensoriellesPhysical and sensory effectsFrenchNAPremature;Newborn (0-28 days);Baby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years)NANANAPrenatal Adult (19+)NA2009-10-31T04:00:00ZHilary Whyte, MSc, MB, BCh, BAO, MRCPI, FRCPC12.000000000000046.0000000000000350.000000000000Flat ContentHealth A-Z<p>Même si la majorité des bébés prématurés deviendront des enfants normaux et en santé, certains auront une incapacité. Le risque dépend de plusieurs facteurs.</p><p>Même si la majorité des bébés prématurés deviendront des enfants normaux et en santé, certains auront une incapacité. Le risque que cela se produise dépend de plusieurs facteurs. </p><h2>À retenir</h2> <ul><li>On compte parmi les complications les plus courantes entraînant une incapacité continue l’hémorragie intraventriculaire (HIV), l’asphyxie, la jaunisse grave, l’hypoglycémie, les infections graves, le besoin de ventilation à long terme et la maladie pulmonaire chronique.</li> <li>Les troubles physiques et sensoriels peuvent être causés par un trouble particulier de l’organe ou peuvent être causés par une lésion au cerveau qui nuit à la fonction de cet organe. </li> <li>La prématurité peut affecter l’ouïe, la vision, le mouvement et la coordination.</li></ul>

 

 

Physical and sensory effects1878.00000000000Physical and sensory effectsPhysical and sensory effectsPEnglishDevelopmentalPremature;Newborn (0-28 days);Baby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years)NANANAPrenatal Adult (19+)NA2009-10-31T04:00:00ZHilary Whyte, MSc, MB, BCh, BAO, MRCPI, FRCPC12.000000000000046.0000000000000350.000000000000Flat ContentHealth A-Z<p>Although most premature babies will grow to be normal, healthy children, some will have a disability. This chance is dependent on several factors.</p><p>Although most premature babies will grow to be normal, healthy children, some will have a disability. The chance that this will occur in any individual baby is dependent on several factors. Physical and sensory problems can also have multiple causes and range in severity.</p><h2>Key points</h2> <ul><li>The most common complications that lead to ongoing disability include intraventricular hemorrhage (IVH), asphyxia, severe jaundice, hypoglycemia, severe infections, long-term use of ventilation, chronic lung disease.</li> <li>Physical and sensory problems can be due to a problem with the organ itself or due to a brain injury that affects the function of that organ.</li> <li>Prematurity can affect hearing, vision, and movement and coordination.</li></ul><p>In general, the most premature and lowest birth weight babies are at highest risk for ongoing problems. In addition, those babies who have had specific complications of prematurity are also at risk. The most common complications that lead to ongoing disability include intraventricular hemorrhage (IVH) or bleeding in the brain, asphyxia or a lack of oxygen to the brain, severe jaundice, hypoglycemia or a low blood sugar level, severe infections, long-term use of ventilation, and chronic lung disease known as bronchopulmonary dysplasia (BPD) </p><p>The range of possible long-term effects is large. Some babies will have a nearly unnoticeable disability that barely interferes with a normal fulfilling life, others will be disabled to the point that they will be incapable of being independent and face the prospect of a very poor quality of life. Thankfully, very few premature babies fall into the latter category. Moreover, with the right help from parents, other caregivers, and health care workers, many premature babies with a disability can be encouraged to live a full and happy life despite any handicap. </p><h2>Body and mind</h2><p>Physical and sensory problems can be due to a specific problem with the organ itself, such as the eye, or can be due to a brain injury that affects the function of that organ. A good analogy is the computer: if your monitor goes blank, it could be that a computer glitch has prevented the monitor from working, though there is nothing actually wrong with the monitor per se, or the computer could be just fine but the monitor itself may be broken. It is in these same two ways that the body can be affected. </p><h2>Effects on hearing</h2><p>As with most complications due to prematurity, the chance that a baby will suffer some sort of hearing loss increases with the degree of prematurity. The organs involved with hearing, the eardrum, the Eustachian tube and so on, mature relatively late in the womb. The entire hearing system is still maturing as late as the 26 <sup>th</sup> week of pregnancy and remains vulnerable to injury for a time after that. It is for this reason that noise levels in the neonatal intensive care unit (NICU) are kept to a minimum.</p><p>Hearing loss in premature babies can be due to injury, infection, or a congenital defect.</p><p>Babies should be given a hearing test before they leave the NICU and several months afterwards. Identifying hearing problems is extremely important: babies and children experiencing hearing loss will be at a great disadvantage in terms of learning and development. An unidentified hearing problem makes the potential for problems worse. For example, children with hearing loss may seem to have behavioural problems when in reality they just can’t hear instructions. If the true source of the problem remains unidentified, the child will be treated for a behavioural problem rather than have their hearing deficit treated. </p><h3>Types of hearing problems</h3><p>Hearing loss comes in several forms and can be mild to severe, sometimes resulting in deafness. Some types of hearing problems can be treated. Even if treatment is not successful or not as successful as would be hoped, it is always better to know that the problem exists so that other steps to improve their life and learning can be taken. </p><h3>Sensorineural hearing loss</h3><p>Sensorineural hearing problems originate in the inner ear. They are frequently due to prenatal infections, asphyxia either during or shortly after birth, or genetic factors. Additionally, certain drugs used to treat serious neonatal infections may cause or make sensorineural hearing loss worse. In most cases, sensorineural hearing loss cannot be reversed medically or surgically. However, hearing aids and possibly cochlear implants can often limit or minimize the impact of the condition. </p><h3>Conduction hearing loss</h3><p>Conduction hearing problems originate in the middle or outer ear. Simply put, some types of obstructions prevent sound from being conducted into the inner ear. Most commonly, this obstruction is caused by wax, fluid, or a rupture or puncture of the ear drum. In most cases, these problems can be treated medically or with surgery. If the obstruction is caused by fluid, this is usually due to an infection acquired sometime after birth. This infection is known as otitis media. </p><h3>What to look for</h3><p>In addition to hearing tests, parents should be on the look out for potential hearing problems, which include:</p><ul><li>no response to loud noises or a parent’s voice at six months corrected age </li><li>delayed babbling and initial words such as “mama” and “dada” at 12 months corrected age </li><li>delayed speech and an inability to identify the source of sounds by two years corrected age </li></ul><h2>Effects on vision</h2><p>Of all the problems affecting premature babies, vision problems are among the most common. Although some premature babies may end up blind or functionally blind, it is a rare event. For most, vision problems are correctable with glasses or contact lenses.</p><p>Retinopathy of prematurity (ROP), a condition in which the blood vessels in the eye grow abnormally, can cause sometimes vision problems that have lasting effects. While many babies with ROP will go on to have excellent or near excellent vision, a severe case of ROP can cause the retina to detach or partially detach, which will result in profound and probably permanent vision loss. </p><p>Milder cases of ROP usually resolve themselves. Severe cases may require laser or other forms of surgery to correct vision problems. </p><p>Some cases of ROP may leave a child with conditions reducing vision either in the form of sharpness of vision, known as acuity, or a visual field deficit affecting the ability to see within a full field of view. Although not only caused by ROP, these conditions may include: </p><ul><li>Short-sightedness, also called myopia. Having this condition means that the eye cannot focus on distant objects. Many adults have this condition, which is usually corrected with glasses. It can sometimes be corrected, or diminished, with laser surgery when older. </li><li>Strabismus. This condition is sometimes referred to as being “cross eyed.” One or both eyes may turn in or out. Sometimes this eye turn can be corrected with corrective glasses. If this is not possible, surgery on the eye muscles may be performed to achieve eye alignment.</li><li>Astigmatism. This is a condition where the cornea is asymmetrical, which makes focusing difficult. Astigmatism is very common; many people are born with astigmatism and have it to some degree without significant vision problems. The condition also appears with either short- or long-sightedness. Special lenses may be required to help correct the problem. </li></ul><p>All premature babies should have their eyes checked regularly. Parents can be on the look out for eye problems. Common signs of eye problems include: </p><ul><li>not being able to follow an object at six weeks corrected age and beyond </li><li>a constant jiggling movement of the eyes </li><li>frequent eye crossing beyond three months corrected age </li><li>not blinking when flash photography is used </li><li>an aversion to normal lighting </li></ul><p>With regular check-ups and parents on the look out for trouble in between medical visits, many vision problems can be treated. It is important to identify these problems early as some of these conditions are best treated while the child is very young. Indeed, some of these conditions have a “window of opportunity” in that they can only be effectively treated when the patient is young.</p><h2>Effects on movement and coordination</h2><h3>Movement and muscle tone</h3><p>Premature babies tend to have unusual muscle tone. This is because their muscles matured in the outside world where they were subject to gravity, as opposed to the muscles of a full-term baby who matured while floating in amniotic fluid. It may be as long as a year before a baby’s muscles resemble those of a full-term baby. </p><p>Unusual muscle tone may mean that a premature baby’s arms and legs are floppier than what would normally be expected. It may also mean that their arms and legs are much stiffer than a full-term baby’s. In many cases, these issues resolve themselves over time. However, for some babies, muscle tone issues do not resolve over a year. Sometimes, the cause of this problem is cerebral palsy (CP). CP occurs when a brain injury affects the mind’s ability to control the body. The range of severity of CP is large: in a mild case, a baby may have the occasional muscle spasm or her muscles may remain abnormally stiff or floppy. If a baby with unusual muscle tone also had a brain injury such as asphyxia or intraventricular hemorrhage (IVH), the possibility of CP will be investigated. Some cases of CP are easily recognized early in the first year of life. </p><p>If a premature baby has unusual muscle tone, it does not necessarily follow that they will be diagnosed with CP. However, if CP is diagnosed, it is likely that it will be associated with other muscle control effects as well such as difficulty grasping and eating. Speech may also be affected. </p><p>Most premature babies who are diagnosed with CP have a mild form of the condition. Common physical effects may include trouble sitting, crawling, walking, and balancing. Children with CP may also have trouble with their coordination. For example, they may have difficulty reaching out and grasping small objects. In addition to stiff or floppy muscles, babies with CP may have musculoskeletal problems such as flat feet, in-toeing or being pigeon toed, dislocated hips, or a deformity of the spine. </p><p>Some children with CP are very intelligent but may have difficulty learning due to their disability.</p><p>Sometimes, some of the functional limitations caused by CP can be diminished with physiotherapy. Parents can learn stretching exercises to help their child increase their flexibility and range of motion. </p><h3>Gross and fine motor control</h3><p>How much CP will limit a child’s activities and learning as they grow cannot always be predicted. Movement in general is classified into two groups: gross motor control and fine motor control. </p><p>Gross motor control is the ability to make large movements such as waving an arm or a leg. It develops first as a baby begins to take control of thier jerky and apparently random movements. For gross motor control to develop, muscles, bones, and nerve function must be working together. Ultimately, this results in the ability to sit up, stand and walk. </p><p>Fine motor control comes as a refinement of gross motor control. Examples are picking up small objects and using a pencil to write or draw. In addition to the coordination between body parts and systems required for gross motor control, fine motor control implies an awareness and a certain degree of planning as the task is about to take place. </p><p>The development of gross and fine motor control are considered major milestones in a child’s development. In more extreme cases, as the child grows, they may be fitted with braces to help with walking. Braces may be applied to the feet and ankles or to more of the leg if extra support is needed. Additionally, surgery may be recommended to release tension in muscle tendons around stiff joints to help improve flexibility. </p>https://assets.aboutkidshealth.ca/AKHAssets/physical_and_sensory_effects.jpgPhysical and sensory effects

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