I need support with this Health & Medical question so I can learn better.

1. What are some of the short and long term emotional impacts a child may face?

2. From the following list, pick one specific case – Non-English or English as a Second Language child, a technologically dependent child (one that uses advanced medical technology to sustain life), a child separated from parent or guardian and in need of medical attention or shelter, an emancipated child (think of the reasons they are emancipated) and identify at least three planning issues and solutions. Discuss them here with the class ??

here are different answers co all you need is just paraphrase them into one fine answer

Answer 1 #

1. What are some of the short and long term emotional impacts a child may face?

I just found this most excellent (to me) summary of what we are talking about: “A single disaster event is really part of a cascade of other events in a child’s life and results in cumulative impact and stress” (Wizeman et al, 2014).

A number of effects appear evident. In the short term, especially after disasters which hold the possibility of a “repeat” within hours or days – specifically earthquakes but also potentially tornadoes, floods, terror events etc. Early on, one would expect primarily fear, anxiety and a heightened fright/flight reflex. In the longer term, research (Bolton et al, 2000) has shown that some children who survived a one-off event (in this paper a shipping disaster with, obviously, a very very low probability of a repeat for a given individual) remained affected for years afterwards. Interestingly, Bolton’s group also found that the emotional impact was muted and indeed behaviour was statistically no different in the survivors of the shipping disaster who had not developed PTSD, compared to the control group. The development of PTSD appeared to be the critical difference. Rhetorical question: if we could avoid the development of PTSD, would we see a huge reduction in the long-term adverse psychological effects of disasters? Or are longer-lasting disasters i.e. not over quickly, much more likely to lead to PTSD?

Apart from the direct emotional impact of the threat ‘now’ and later, there are later / secondary emotional consequences to the other issues associated with surviving a disaster. For example, at an individual and very personal level, the loss of child’s a security blanket, favourite toys, access to familiar reassuring movies, loss of a comfortable home environment, interrupted educational opportunities – all of these will destabilise the child more or less immediately. Worse, the child could be dealing with or simply observing, the manifested grief of parents for the loss of other siblings (or the child grieving him or herself for the loss of one or both parents, siblings and friends).

As Kousky (2016) also points out, if the disaster is of sufficient scale, then forced migration, semipermanent or even permanent displacement, even the need to abandon education entirely and go to work in paid employment to help the family budget become very real possibilities. And as that author reminds us, we do a lot better at physical preparation than at mental preparation, both for ourselves and others.

2. From the following list, pick one specific case = a child separated from parent or guardian and in need of medical attention or shelter, and identify at least three planning issues and solutions.

I chose: ‘a child separated from parent or guardian and in need of medical attention’.

Planning for

1. what can we do to them, in their interests

2. can a child ever give consent to medical attention and if they do, is it legally valid

3. what can we not do to them… quite rightly!

I was surprised to find that nearly one out of every five children in the United States has special healthcare needs (CDC, 2018). So if we plan to do medical and surgical things to children in their interests after a disaster, not only do we need some form of consent unless it is a truly airway/breathing/circulation time-critical issue; we also need to work with their needs and not do things in the short term, which will go against them in the long-term. I would hope that there would be advocates who understand these extra needs of children, available; but if we are not planning for that to happen, it’s not likely. So: we need to include in the response team, early on, people who have the skill set in both paediatrics, special needs paediatrics, and who won’t be tasked for “other things”.

Speaking only for myself, I have persuaded young children in the presence of the parents or caregivers to let me do things which they would clearly rather not have happen to them. Even something as apparently simple as cleaning and dressing an abrasion – and certainly advanced procedures such as putting in central IV lines etc – takes a whole lot longer with children; but in the non-disaster situation we all regard the fact that our patient is a child as a perfectly good reason to spend that extra time with both them and their care giver. In the disaster situation, we don’t have that luxury of time. Or, thinking aloud, should that not be defined as a luxury but regarded as a pure necessity? But again if we are not planning for that extra time, we’re not likely to have it. So we need to include in the plan for our on-site or off site medical facility, not only a paediatric unit, but a paediatric philosophy of care embedded in that unit, best led by somebody again with the appropriate skill set and not somebody who says to him or herself “okay these are just little people”.

It was reassuring to read that – at least in the US – people have thought about planning for consent even in a disaster (Department of Education, State of California 2018). (There was a link in the previous CDC citation quoted, for the American College of Emergency Physicians’ emergency paediatric consent form; unfortunately, the link is broken… And when I searched, the document is now apparently behind a firewall). However, in California, the Department of Education has published a very useful 27-page guidelines for childcare providers who, as we were reminded in the course reading, a part of the group of professionals who often look after children for more than half of the children’s day away from their usual carers. On page 9 of the document links to forms – for example, obtaining parental consent for medication administration, and an emergency checklist to children with special needs. Both of these are excellent.

The lessons I learned from looking into this topic is that (1) there is a lot of helpful stuff out there that I never even knew existed and (2) if I or those I work with need this information we should download it, printed and store it above the waterline NOW because we won’t have time or access in a disaster later…

Resources:

Bolton, D., O’Ryan, D., Udwin, O., Boyle, S., & Yule, W. (2000). The Long-term Psychological Effects of a Disaster Experienced in Adolescence: II: General Psychopathology. The Journal of Child Psychology and Psychiatry and Allied Disciplines, 41(4), 513-523.

CDC. (2018). Children and Youth with Special Healthcare Needs in Emergencies. Retrieved September 6, 2018 from https://www.cdc.gov/childrenindisasters/children-w…

Kousky, C. (2016). Impact of Natural Disaster on Children. Retrieved September 6, 2018 from https://files.eric.ed.gov/fulltext/EJ1101425.pdf

Wizeman, T., Reeve, M., & Altevogt, B M. (2014). Preparedness, Response, and Recovery Considerations for Children and Families: Workshop Summary: 7 – Planning for Children and Families During Disaster Response. Retrieved September 6, 2018 from https://www.ncbi.nlm.nih.gov/books/NBK195877/

Answer 2 #

Children in the society are part of special needs population that needs to be treated with care during disasters. Whatever impact their mind sustains during disasters might be hard to delete from their memories and therefore they require a lot of care during disaster events. Despite governments around the world recognizing this by enacting laws that ensure children are provided with the best environment for their psychological well-being, many children have one or the other been affected by long and short-term emotional impacts. Some of the emotional impacts that occur within the short term include, having nightmares, shame, and hopelessness. On the other hand, the long-term impacts may lead to low self-esteem, insomnia and social withdrawal (Raver, 2003). Children can also get stressed and eventually be depressed when they lose their parents. It becomes hard for them to meet basic needs such as food and shelter. If for example in a war disaster children witnessed the killing of their parents, the trauma might stay with them up to adulthood.

Some certain planning issues for children who are technologically dependent include ensuring the technology they need is available throughout the disaster period. For example if a child uses hearing aid arrangements should be met to have the hearing aid charged whenever there is no power. In addition to this there should be proper notification plans for the child in case the technology fails. It is also important that the child is kept comfortable in case the technology they depend on is not available for some reason during the disaster (Unique Needs of Children in Disasters, 2010).

References

Raver, C. (2003). Young children’s emotional development and school readiness. Social policy report, 16(3), 3-19.

Unique Needs of Children in Disasters. (2010). Managing Children in Disasters. doi:10.1201/b10404-

Answer 3 #

When a child is separated from his or her guardians, it’s hard to deal with the loss. Most children end up feeling depressed. Trauma is a long-term emotional effect that makes a child feels unsafe in their present environment. They are always in fear and end up being depressed for an extended period, (Rutter 1971). When a parent is not near, no place is safe for the child. For the short term emotional impacts, the child may experience, short periods of anxiety and panic attacks from time to time. Psychological trauma may vary according to the age brackets. Children who were left at a younger age will find it difficult to cope emotionally and will suffer from elevated levels of stressful trauma.

One of the main reasons why many children in the United States are left homeless is because of the death of a parent. Moreover, parents may leave their children due to poverty. Parent separation as a result of divorce may also render the child homeless. (Mead, 1994), puts into consideration the issue of Immigrants from foreign countries. He continues to argue, and Immigrant children are separated from their parent in harrowing circumstances in international borders. When the parents of a child are poor, they find it hard to provide for that child thus end up leaving them. Parents who don’t want to take responsibility for their children due to early pregnancies also end up dumping the child in someone’s doorstep or the front of an orphanage. Most importantly a child may be separated from his guardians or parents when he or she goes missing or gets lost.To help solve the problem facing children who require shelter specific steps have to be considered. The government can provide enough housing shelters for homeless children. These housing shelters can be concerning orphanages.

According to, (Bassuk, 2010), parents should also be urged to take responsibility for their children. Parents who are not responsible should be punished and even jailed for intentionally separating themselves from their children and leaving them homeless. The police department is also urged always to conduct thorough investigations to try and find the missing parents of the child. Finally, the government can lower the housing subsidies and rates to allow the low-income families to be able to pay for rent. When separation occurs or even divorce, the custody rights should be given to the parent who can provide shelter and other basic need to the child.

Rutter, M. (1971). Parent‐child separation: psychological effects on the children. Journal of child psychology and psychiatry, 12(4), 233-260.

Mead, M. (1954). Some theoretical considerations on the problem of mother-child separation. American Journal of Orthopsychiatry, 24(3), 471.

Bassuk, E. L. (2010). Ending child homelessness in America. American Journal of Orthopsychiatry, 80(4), 496-504

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