Wednesday, June 18, 2014

June 17 Post One

Thomas is about to be born to Mother, Taylor, and Father Marcus. Taylor and Marcus live together in small town Hoboken, NJ.  During a routine ultrasound, a cleft palate was found. With a substantial education, Taylor and Marcus knew that this was a birth defect affecting the orofacial cleft. The Cleft palate is categorized as an orofacial cleft which happens early during pregnancy (Center for Disease Control (CDC), 2014). The doctor explains that the roof of the mouth (palate) is formed between the sixth and ninth weeks of pregnancy (CDC, 2014). A cleft palate occurred because the tissue that makes up the roof of the mouth did not join together completely during pregnancy (CDC, 2014). For Thomas, both the front and back parts of the palate are open.
After finding out their child was going to have a cleft palate, Taylor and Marcus went home and research how the cleft palate happened and what the cause was. They found that the cause of orofacial clefts among most infants is unknown pregnancy. They also found that this could be due to changes in his genes. Cleft lip and cleft palate are thought to be caused by a combination of genes and other factors, such as things the mother comes in contact with in her environment, or what the mother eats or drinks, or certain medications she uses during pregnancy. Taylor rethinks what possible environmental factors that she could have been exposed to that may have caused this birth defect. Taylor’s father was an alcoholic and Taylor has been known to have some alcoholic tendencies. She recalls at one point having some alcoholic beverages because she couldn’t resist. Although this is not a known cause, Taylor and Marcus think that this may have triggered a birth defect pregnancy (CDC, 2014).
With this knowledge of a cleft palate, the parents have to decide if Thomas will have surgery to fix the cleft palate once he is born. There are a lot of factors that the parents need to take into consideration. After researching how cleft palates are treated, Taylor and Marcus find that even after surgery that is performed on an infant, he may need additional surgical procedures as he gets older. However, surgical repair can improve the look and appearance of a child’s face and might also improve breathing, hearing, and speech and language development. Children born with orofacial clefts might need other types of treatments and services, such as special dental or orthodontic care or speech therapy. Thomas may also need services such as audiology because of problems with hearing and speech therapy to help with how to feed and speak. With Thomas’s parents speaking two different first languages, this could pose an even greater challenge for the child learning to speak. Living in a small town in New Jersey there aren’t many services for cleft palate directly available. If Thomas was to need these services, they would have to travel in order to receive them. This adds a significant cost of transportation, much less the cost of the service. Since Taylor and Marcus are both working, this may be possible because of a substantial income, but because they both work, they may not be able to have the time to transport him to appointment after appointment. This is why they decided to have surgery done once Thomas is within the first 12 months. Marcus was diagnosed with ADHD when he was in grade school. He was diagnosed with the Predominantly Inattentive Presentation which means it is hard for Marcus to organize or finish a task, to pay attention to details, or to follow instructions or conversations. He also is easily distracted or forgets details of daily routines pregnancy (CDC, 2014). Although the cause and risk factors for ADHD are unknown, current research shows that genetics plays an important role. This concerns Marcus that is son may also be born with ADHD but there will be no way to no until Thomas begins developing and starts to show symptoms of ADHD such as forgetting or losing things a lot, has trouble taking turns, constantly fidgets, or daydreams a lot.
A prodigy is not known before birth but it means being able to function at an advanced adult level in some domain before age twelve. Since this case is still in the prenatal stage, there is no evidence or test that can show that the child will have a prodigy and the cause of prodigies are unknown. The most common types of prodigies are normally music and math pregnancy (Solomon, 2012).


1)    What should be the primary language spoken in the house?
2)    Should the Dad, Marcus, be worried that his son may have ADHD?
3)    How does having a first child with a disability impact a family’s decision to have more children? Cite relevant data in the literature.

DECISION POING: Do the parents decide to have the surgery for a cleft palate even with the implications?

1 comment:

  1. 1. Contrary to popular belief, an English language learner should speak their primary language at home. (Haynes). It is better for the child to learn fluent language than to hear choppy English which is what Marcus could possibly use. It is more difficult to teach a concept in English if the student does not know it in native language (EverythingESL, 2010). It is easier for a child to understand English when they have been taught the proper skills in their native language. This way, they can use those skills when learning English (EverythingESL, 2010). However, since Thomas’ mother speaks fluent English, and she is well educated, it is possible that she could help both Thomas and Marcus with their English. Though I cannot imagine how bad Marcus’ English could be when he has lived in the United States since he was 2, and he has a college degree. Regardless, teaching Marcus proper English will ensure that Thomas will learn proper English if they both use it correctly. Having much knowledge about the English language will only make life easier for Thomas.

    2. Children with ADHD can experience peer relationship issues, conduct disorder, learning disorder, and an increased risk of injuries (CDC.gov). ADHD will always be a concern for new parents but we are in such a different place with our medical field that there shouldn’t be as much worry about this condition as people are making it seem. Although medication for ADHD is dispensed way too frequently and easily, medication can absolutely help a person with this condition focus and be successful in whatever tasks they are trying to get done.

    3. Having a child with a disability can absolutely be a tough decision as to what the parents should do as far as having more children but they need to handle it like any other parent would with children. It is also important to take into consideration that having a child with a disability puts strain on the marriage. If this strain leads to divorce, then there is no possibility of the couple having another child. One study has shown that parents of eighth grade students with disabilities have higher rates of divorce than non-disabled children parents. (Havens, 2005). In addition, should take into consideration that there could sibling strain if they were to have another child. The non-disabled child could become jealous of their disabled sibling, because their parents’ attention might always be on that child (Havens, 2005). This creates strain and an unhealthy relationship between the non-disabled child and their parents. Parents need to make sure that they can financially afford having another child. In one study, researchers reported that individuals who had children with ADHD had annual medical expenses of $1,574 (Allan & Stabile, 2012). Parents need to take into account that their first child who has a disability is going to have a more substantial amount of bills than a child who was born completely normal. Finances needs to be a big part of a parent’s decision for having more children in addition to their time management. . Before making a rash decision to have another child, parents need to think about all of the pros and cons of having another child, especially with already having a child with a disability.

    Decision: The child should definitely have the surgery to fix the cleft palate. Getting this fixed will only help the child have a more “normal” life. The earlier the surgery is done, the better it will be for the child. Timing is everything, because the parents want their child to have time to recover before speech development(Medscape, 2012). As much as you want your child to not have to go through surgery’s, especially at such a young age, you have to think about their future. There is an agreement among surgeons that this surgery should be performed between 6 and 12 months old (Agrawal). Not only will it help their child fit in more with the other children, it will also be better for them medically in the long run.


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