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(Emergency
Room Info) (Reporting
A Case) (Return
to Treatment)
[Potential Problems] [Coming
Home] [Dealing with Disability]
[Resources]
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After Reye's Syndrome
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The National Reye's Syndrome Foundation
offers the following information to parents of children who
have experienced Reye's Syndrome. It is furnished to provide
assistance in understanding
the potential needs of the RS survivor and the family
and, in addition, to provide guidance in securing any
necessary services.
It is possible for the RS survivor to recover completely
with no after-effects or observable changes. There may,
however, be recovery with brain damage and disability
ranging from very slight motor or learning disabilities to
profound brain injury.
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What are the Potential
Problems
of the Reye's Syndrome Survivor?
Reye's Syndrome can result in brain damage and disability
in some survivors. The number of cases of RS which fall into
this category is unrecorded. If damage occurs, it can range
from slight to profound, depending on the individual case.
Likewise, the rehabilitative requirements will range from
minimal remediation to institutional care. Since there is such
a wide range of possibilities, and since these possibilities
are to a certain extent unpredictable, parents need to become
aware of the potential problems and the appropriate services
which may be required. Early evaluation following
physiological recovery should be pursued for the purpose of
identifying problems and beginning any appropriate educational
remediation and/or therapy.
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Following are specific problem areas that may be observed:
- Problems with attention
- Problems with memory
- Difficulty with concentration
- Speech and language difficulties
- Problems with fine or gross motor skills
- Changes in the child's activity level
- Difficulty with task completion
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Elissa Bell Sargent
NRSF Poster Child
Age 4, 1999
Reye's Syndrome Survivor |
Any specific problem may occur individually or in
combination with others. Any or all of the above may manifest
themselves in learning or academic problems. For example, a
change in academic performance may reflect a change in the
ability to attend or to concentrate on a task. Difficulty with
math, spelling, writing, or reading may occur. A pre-existing
learning problem may become more severe following Reye's.
Also, some RS survivors may appear after recovery not to
have
any residual effects; however, problems may later be observed
in the areas mentioned above.
Evaluation for learning disabilities
requires a multi-disciplinary team consisting of the
child's pediatrician or primary care physician,
neurologist, psychologist, educators, the family and
possibly others such as a speech therapist, physical
therapist, and occupational therapist. This evaluation
can be requested by the parent through the local
school system. |
(Top of Page)
When the Child
Comes Home from the Hospital
There are many adjustments required by the family
suddenly faced with the fact of a brain-injured or
other special needs child. These children need a
great deal of attention, understanding and,
therefore,
use a great deal of the family's energy. Parents need
to realize that the child who returns from the
hospital can be a very different child from the one
who entered the hospital with Reye's. His or her
abilities may be very altered and, indeed, the child's
personality may seem to be changed.
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The following traits are
common following hospitalization:
- Overdependency, clinging
- Refusing to eat or overeating
- Sleep disturbances
- Bed wetting or soiling
- Regression to earlier levels of behavior
- Motor tics
- Depression, anxiety
- Fear of hospitals and medical personnel
- Restlessness
- Uncommunicative states
(withdrawal from contact with others)
- Over concerned with the body (hypochondria)
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Once home from the hospital, the child should not
become the center of attention. He or she should be
given responsibility equal to ability as soon as
possible. For the benefit of all family members, there
should be a return to normal family life.
The recovering child can reduce anxiety and fear
through play activities and verbalization, depending
upon his or her age. At the same time, such play can
help the child gain confidence and security through
the control of the play situation. Dramatic play using
modeling clay, dolls, cars/trucks, etc., can ease the
return to normal life as he or she comes to be treated
more as a well person and less as a patient. Listening
to the child patiently and lovingly will be very
helpful.
As there is a grieving process following the death of
a child, so there is also a grieving process for the
family of a child who survives with residual effects.
The entire family, not just parents, will experience a
wide range of emotions, including disbelief, sadness,
guilt, fear, frustration, loneliness, helplessness,
regret, despair, anger and isolation. It is critical
that these feelings be accepted as normal. There
are many possibilities for additional problems that
may result from the emotional turmoil of all of the
family members. There may be a tendency for the
parents, especially mothers, to dedicate themselves to
the child and neglect other family members. Or, there
may be the other extreme -- intolerance and actual
rejection. Emotional responses should be closely
monitored so that such feelings as jealousy and guilt
do not go unresolved. Family discussions of the
situation should be open and
frank, with all members participating and all members
being encouraged to share their feelings. The initial
denial and then despair experienced in the grieving
process will eventually give way to acceptance, if
these emotional responses are acknowledged and
resolved.
Whatever the reaction, a family with a child with
multiple special needs requires support emotionally as
well as financially. The family needs to know that
there are resources available to help them and what
these resources are. Family counseling may be in order
to assist in making the adjustments required by the
child's altered condition. Short-term intervention can
have profound effects in preventing future long-term
problems for the entire family. Local child and family
service agencies are a good resource. |
(Top of Page)
Dealing
with Disability
Although brain damage is not reversible, it is true
that much progress is possible. Parents must remember
that their child has the capacity to grow and change,
and that he or she must be given the room to do so.
The family of the brain-injured Reye's Syndrome
survivor should take steps to ensure that the child's
needs are met and, at the same time, ensure that the
family as a whole can continue to function normally.
Treatment options should be explored and, when a
decision is reached, should be supported by all family
members. The quality of life for the entire family can
and should remain at normal levels. It is very
important that a sense of balance be reached and
maintained as soon as possible.The hospital social services department can play a
vital role in assisting the family. That department,
in cooperation with the parents and medical team,
should prepare a discharge summary, detailing
recommendations for future evaluations and therapies
(speech, physical, occupational, etc.) and possible
educational needs, as well as service agencies in the
child's community which would assist in the
implementation of the discharge recommendations.
The local public library can also be useful to parents
who are trying to find services for their child. Many
communities publish directories of social service
agencies. A child with
disabilities, age 3 through 21, is entitled to a free
appropriate public education, individually tailored to
his or her needs. Federal law requires local school
districts to provide special education services and
includes any necessary therapies and/or
transportation. In addition, there are special
schools, private rehabilitation centers, and special
education settings in the private sector which for
various reasons may be better suited to a child's
needs. These facilities should be considered when
making a decision about the child's placement. If the child is under 3, available services vary
from state to state. Some states provide educational
and rehabilitative services to infants and toddlers in
a wide variety of settings. Contact the Special
Education Division of your state's Department of
Education for information on what is offered. The
social services department of the hospital should be
able to assist in carefully evaluating the available services
to select a program which is best suited to
the child's and the family's needs.
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A small percentage of RS survivors will require
extended institutional care. Usually, however, the
decision to institutionalize a severely disabled child
is not primarily a medical one, but one that should be
made based on the needs and capabilities of the child
and the family. Parents should be aware of the
different types of facilities available in their area
and should thoroughly investigate these facilities,
including on-site visits, to find a program
appropriate for the child. Family counseling may be
needed to help the family adjust to the decision to
institutionalize the disabled child.
It is recommended that parents become familiar with
the Individuals with Disabilities Education Act (Title
20, Chapter 33, Sec. 1400 and Sec. 701) of the
Rehabilitation Act of 1973 so that they
can ensure that their child receives the
benefits to which he or she is entitled.
Families may also contact the State
Developmental Disabilities Agency in their
state. The KDWB Variety Family Center,
University of Minnesota Gateway, can be a
worthwhile resource, providing up-to-date
facts on new state and federal laws and
offering
information on how to use legal rights to get
the best possible programs for handicapped
children.
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- Reye's Syndrome survivors may have NO
after-effects.
- If damage occurs, it can range from slight to
profound, depending on the individual case.
- Currently, available information indicates that
only a very small percentage of RS survivors will
develop RS again.
- YOU ARE NOT ALONE. HELP IS AVAILABLE.
(Top of Page) |
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- The Rehabilitation Act of 1973, Title 29, Chapter 16,
Sec. 701 United States Code
- Individuals with Disabilities Act, Title 20,
Chapter 33, Sec. 1400
- Equal Opportunities for Individuals With Disabilities
Act, Americans With Disabilities Act of 1990, Title 42,
Chapter 126, Sec. 12101-12213
- Americans with Disabilities Act Information Line, Phone
1-800-514-0301 or 1-800-514-0383 (TTY)
Internet: www.usdoj.gov/crt/ada
Provides information to businesses, states and local
government officials, persons with disabilities, and
others on Titles II and III of the Americans with
Disabilities Act.
- Heath Resource Center, Phone: 1-800-544-3284 or
1-800-544-3284 (TTY)
Provides information for people with disabilities who
are seeking education or training after high school.
- Job Accommodations Network, Phone: 1-800-526-7234,
1-800-ADA-WORK,
1-800-DIALJAN, 1-800-526-7234 (TTY)
E-mail: jan@jan.icdi.wvu.edu or Internet: http://janweb.icdi.wvu.edu
Provides information on accommodations for people with
disabilities in work settings.
Assists with information about equipment purchasing,
policy modification, and
compliance with the Americans with Disabilities Act.
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Contact your
local health department.
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Contact your Special Education Division of the local
school system.
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KDWB Variety Family Center, University of Minnesota Gateway,
200 Oak Street SE, Minneapolis, Minnesota 55455-2002.
Phone:
612-626-3087, FAX: 612-626-2134, E-mail: instihd@tc.umn.edu, web site: www.peds.umn.edu/peds-adol/kd.html
(Top of Page)
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