Children with Special Needs |
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Children with developmental disabilities, chronic illness or weak immune systems warrant special consideration either because they are unusually susceptible to infection or because they may infect other children.
Children with Developmental Disabilities
In general, children with developmental disabilities are not usually vulnerable to infection and require no special precautions. A few categories of disabilities are associated with higher rates of infection, however, such as children with spina bifida, cerebral palsy or Down syndrome .
Children with Chronic Illness
Children with chronic illnesses, or malnutrition are particularly vulnerable to infection. For example, infants who were premature, children who have chronic lung disease and children with cystic fibrosis frequently have a higher than average incidence of respiratory infections. Similarly, children with congenital heart disease may have unusual difficulty with some respiratory viruses. Children with diseases or structural abnormalities of the urinary tract are highly vulnerable to infections of the bladder and kidneys. Although it is not always possible to prevent these diseases, providers should be alert to the symptoms of infection and notify the child's parents or doctor if they occur. Once treatment is started, these children should be able to participate in regular group care activities.
Children with Weak Immune Systems
Certain diseases or treatments can lower the body's natural defenses against infection. AIDS, cancer of the blood and some other diseases of the immune system significantly change the body's ability to fight infection, allowing even common organisms to quickly become life threatening. In children with previously normal immune systems, some drugs that are used to treat chronic conditions (e.g., steroids) suppress the body's ability to fight infection. Drugs used to prevent rejection of organ transplants or to temper the body's attack on its own organs can also interfere with the normal immune response. In a child with cancer, both the disease itself and the drugs used to treat it inhibit the body's defense mechanisms.
Children with diseases or treatments that affect the immune system may need to be isolated from other children during periods of particular sensitivity. Their doctors may prescribe special precautions regarding limited exposure to infection, particularly to chickenpox, since this disease can kill individuals with suppressed immunity. Keep in mind that vaccines with live viruses such as measles, rubella, chickenpox and polio (OPV) are not recommended for people with known weak immune systems.
Children with diseases or treatments that affect the immune system may need to be isolated from other children during periods of particular sensitivity. Their doctors may prescribe special precautions regarding limited exposure to infection, particularly to chickenpox, since this disease can kill individuals with suppressed immunity. Keep in mind that vaccines with live viruses such as measles, rubella, chickenpox and polio (OPV) are not recommended for people with known weak immune systems.
Despite the risks of spreading or getting infections, children in these special populations need to have opportunities for socialization that are as normal as possible. With care and planning, the majority of these children can be safely integrated into child care and school settings. Administrators, teachers and child care providers should work closely with parents and health care providers to establish a safe environment for these children, their peers and staff members who care for them. |