# data[].attributes.body
- Stroke
- Acute chest syndrome
- high blood pressure in lungs
- organ damage
- blindness
- leg ulcers
- gallstones
- priapism (painful, long-lasting erection in men)

# data[].attributes.body
- first works on stabilizing condition
- make sure patient understand the disease and how to avoid crises
- work to prevent vaso-occlusive crises by doing blood exchange programs to provide blood that is less likely to go into crisis

# data[].attributes.body
Booth, C., Inusa, B., & Obaro, S. K. (2010). Infection in sickle cell disease: a review. International Journal of Infectious Diseases, 14(1), e2-e12.
(https://ac.els-cdn.com/S1201971209001453/1-s2.0-S1201971209001453-main.pdf?_tid=2043a2cd-0df0-43b6-9394-5243391a43d3&acdnat=1544848564_6f03c123634c45af060b40e57b4311f1)

Sickle cell anemia. (2018, March 08). Retrieved from https://www.mayoclinic.org/diseases-conditions/sickle-cell-anemia/symptoms-causes/syc-20355876
(https://www.mayoclinic.org/diseases-conditions/sickle-cell-anemia/symptoms-causes/syc-20355876)

Porter, H. R. (2015). Recreational therapy for specific diagnoses and conditions. Enumclaw, WA: Idyll Arbor.

# data[].attributes.body
Causes
- Inherited condition (2 copies of the gene needed)
- goes through different events (vaso-occlusive, cycles of remission, and acute crises) due to the environment and life choices

Signs/Symptoms
- Anemia
- Episodes of pain
- Painful swelling of hands and feet
- Frequent infections
- Delayed growth
- Vision problems

# data[].attributes.body
"... an inherited blood disorder that affects red blood cells" (Porter, 345).

"Sickle cell disease (SCD) is a collective term for a number of
genetic disorders in which hemoglobin is structurally abnormal,
resulting in the episodic formation of sickle-shaped red
blood cells (RBCs) and a wide range of clinical manifestations" (Booth, Inusa, & Obaro, 2009).

# data[].attributes.body
https://www.youtube.com/watch?v=7loyUjIMGcg

https://www.epilepsy.com/learn/seizure-first-aid-and-safety/staying-safe

https://www.childrenscolorado.org/doctors-and-departments/departments/neuroscience-institute/resources-for-families/seizure-safety/

# data[].attributes.body
"... a medical condition that affects brain neurons and causes abnormal signals... may be caused by an imbalance of neurotransmitters or defects in the connections between neurons in the brain" (131).
- When abnormal signals cause a brief, strong surge of electrical activity that affects a portion or all of the brain, called a seizure
- Seizures are classified in 2 ways:
1. Focal seizures: begin in a localized area of the brain, labeled by the location in which they originate
2. Generalized seizures: result from abnormal neuronal activity that occurs in more than one area of the brain, may cause loss of consciousness, falls, or muscle spasms
Status Epilepticus: a dangerous condition in which epileptic seizures follow one another without recovery of consciousness between them.

# data[].attributes.body
"... a chronic disease that involves inflammation of the lining of joint, causing joint damage, chronic pain, loss of function and possibly permanent disability" (327).
1. swelling of the synovial lining, causing pain, warmth, stiffness, redness and swelling around the joint
2. rapid division of growth of cells, which causes the synovium to thicken
3. inflamed cells release enzymes that may digest bone and cartilage, often causing the involved joint to lose its shape and alignment leading to increased pain and loss of movement
Causes:
Genetic factors: specific genes may play a role in whether a person develops RA and the severity (one of many variables)
Environmental factors: virus, bacteria, or mycobacterium may trigger the disease process
Hormones: deficiencies or changes in certain hormones may promote the development of RA
Systems affected:
- musculoskeletal system
- sensory changes
- other organs
- low energy levels
- psychological issues
- wrist and finger joints, neck, shoulders, elbows, hips, knees, ankles, and feet
- Additional symptoms/problems: anemia, depression, fatigue, functional limitations, impaired range of motion, inflammation, joint deformity, malaise, neck pain, rheumatoid nodules, fever, dry eyes and mouth
Secondary problems:
- bone loss
- cardiopulmonary endurance
- muscle atrophy
- life tasks
- psychological changes
- sexual dysfunction

# data[].attributes.body
"... a condition that makes it difficult to breathe" (115)

Chronic bronchitis: Chronic inflammation of the bronchial tubes with an increase in mucus and mucus secreting cells. This mucus obstructs the bronchioles, making it difficult to inhale and exhale
Emphysema: The walls of the alveoli begin to break down and the lung loses its elasticity, so only a few large air sacs remain creating less surface area for the exchange of oxygen and carbon dioxide
Causes:
- smoking
- air allergens (fumes, chemicals, secondhand smoke)
- alpha 1 antitrypsin deficiency (gene-related disorder in which low levels of alpha 1 antitrypsin lead to deterioration of the lung)
Secondary Problems:
- limits of work ability, physical ability, household chores, sleeping, and family activities
- respiratory infections
- high blood pressure in the arteries that brings blood to the lungs
- heart problems
- lung problems
- depression
- poor nutrition
- poor muscle strength and endurance
- anxiety, learned helplessness, loos of internal locus of control, etc

# data[].attributes.body
"Cancer is the generic name given to a group of more than 100 diseases where abnormal cells divide  and grow out of control"(79).
- The location from where the cancer originates dictates the name of the cancer
Secondary Problems
Surgery complications: pain, partially collapsed lung, blood clots, fatigue, muscle atrophy, anesthesia affects, etc...
Chemotherapy: nausea, vomiting, loss of appetite, hair loss, mouth sores, low blood cell counts that can lead to infection, bleeding, bruising and anemia
Stages (81):
Stage 0: carcinoma in situ
Stage 1, 2, 3: higher numbers indicate more extensive disease, as seen by larger tumor size and spread of the cancer beyond the organ which it first developed
Stage 4: The cancer has spread to distant tissues or organs

# data[].attributes.body
- Individuals with congenital heart defects will have other physical, developmental, or cognitive disorders
- Anxiety disorders (panic attacks and phobias), mood disorders, depressive episodes
- Contraindicated sexual activity
- Back problems

# data[].attributes.body
Heart disease: umbrella term that includes a range of medical conditions that involve the heart in one way or another
Blood vessel disease: narrowed, blocked, or stiffened blood vessels that impair circulation
Heart arrhythmia: an abnormal heartbeat
Congenital heart defects: structural problems of the heart or major blood vessels
Cardiomyopathy: thickening and stiffening of the heart muscle
Heart infections:
- Pericarditis: infection of the tissue surrounding the heart
- Myocarditis: infection of the muscular middle layer of the heart walls
- Endocarditis: infection of the inner membrane that separates the chambers and heart valves
Valvular heart disease: functions of one or more heart valves are damaged leading to narrowing, leaking or improper closing

# data[].attributes.body
"An autoimmune disease that causes chronic inflammation of the central nervous system" (227).
"The body's own defense system attacks the myelin that surrounds and protects the nerve fibers of the brain... As the damage occurs, the myelin covering of the nerves becomes inflamed, swollen and detached from the fibers.. eventually the myelin is destroyed"
"Nerve impulses do not travel as fast or accurately across the scarred areas, so impulses are blocked or delayed from traveling to or from the brain".
Causes:
Immunologic: MS is an autoimmune process where the body's immune system attacks its own CNS destroying the myelin sheath
Environmental: early exposure to an environmental agent may be a trigger for people who are predisposed by genetic factors to develop MS
Viral: when a virus is a triggering agent that causes demyelination and inflammation
Genetic: a genetic marker has been shown to increase the chances of developing MS
Systems Affected:
- CNS
- Any system directly related to the CNS
- Weakness, numbness, tingling, tremor, visual problems, etc...

# data[].attributes.body
Type 1: "Insulin dependent diabetes mellitus and juvenile-onset diabetes... develops when the body's immune system destroys the pancreatic beta cells that make insulin" (121).
Type 2: "Non-insulin dependent diabetes mellitus and adult-onset diabetes...most common form... the body does not produce enough insulin or the cells cannot use the insulin properly so there is a build-up of glucose in the bloodstream"
Cause:
T1D: Autoimmune disease, predominately hereditary, attacks and destroys beta cells in the pancreas
- Triggers: viruses, infections, and certain foods (122)
T2D: Combination of genetic, personal, and environmental factors, and heredity
Secondary problems:
1. Hypoglycemia: blood sugar becoming too low
2. Hyperglycemia: blood sugar becoming too high
3. Ketoacidosis: excess ketones and acidosis develop due to faulty carbohydrate metabolism
4. Hyperosmolar hyperglycemic nonketotic syndrome: brought on by illness or infection, blood glucose levels rise and the body attempts to secrete the excess glucose through urination
5. Hypertension: high blood pressure

# data[].attributes.body
Anoxic injury- results in absence of oxygen to the brain
Hypoxic injury- results from decrease of oxygen to the brain
Cranial nerve dysfunction- injury to nerves in the brain (impairments in taste, smell, visual, auditory or vestibular senses)
Hematomas- collection/pooling of blood that can increase pressure in the brain
Hydrocephalus- CSF build up dialating the cerebral ventricles

# data[].attributes.body
- structure of the brain
- physical changes (impairments such as weakness, muscle tone, and coordination problems)
- Cognitive changes (impairments in arousal and attention)
- Emotional/behavioral changes (social skills, inappropriate or self-centered behavior, disinhibited behavior, etc)

# data[].attributes.body
Mild- concussion or minor brain injury (occurs when an impact or forceful motion of the head results in a brief alteration of mental status)
Moderate- loss of consciousness, along with persistent confusion and functional impairments in one of the 4 domains
Severe- prolonged unconscious state or coma

# data[].attributes.body
"... a form of acquired brain injury that occurs from a direct trauma" (407).

# data[].attributes.body
- inactivity
- lack of independence and participation
- post-stroke depression
- emotional liability

# data[].attributes.body
- Brain damage
- Motor impairments (hemiplegia, motor planning, muscle power, muscle tone, reflexes, coordination, etc)
- Sensory impairments (decreased sensory awareness, numbness, tingling, astereognosis, etc)
- Cognitive impairments (decreases in consciousness functions, calculation abilities, attention, concentration, etc)
- Language impairments (dysphasia in comprehension, reading and writing, etc)

# data[].attributes.body
- blood clot that develops in the brain and blocks blood flow (thrombosis)
- a blood clot that originates elsewhere in the vascular system and travels to the brain, where it becomes lodged and blocks blood flow (embolism)
- a blood vessel breaks or rupture, which causes bleeding in the brain (hemorrhage)

# data[].attributes.body
"A CVA occurs when a blood vessel that carries oxygen and nutrients to the brain ruptures or is blocked by a clot...when that happens, parts of the brain do not receive the oxygen they require... due to lack of oxygen, the brain cells in that part of the brain die" (103).
Face dropping
Arm weakness
Speech difficulty
Time to call 911
Left CVA: right hemiplegia, language deficits, low and cautious behavior style
Right CVA: left hemiplegia, visual deficits, quick and impulsive behavior style

# data[].attributes.body
- Affects others
- Concurrent disorders or dual diagnosis (Ex: substance disorders & mental health concerns)
- Other disorders such as anxiety, depression, ADHD, Psychosis, etc...

# data[].attributes.body
Physical:
- illness, injuries, hyperactivity of the autonomic nervous system, physical damage to the body
Mental health:
- anxiety, depression, loss of motivation, anger, agitation, irritability
Social health:
-strained, unhappy relationships
-problems at work or school
Cognitive health:
- short-term confusion, learning problems, memory loss
Additional:
- poor impulse control, poor judgment, poor sleep quality

# data[].attributes.body
Familial, social, cultural:
- when a persons surrounding groups tolerate/models substance use or related behaviors
Personality:
- more likely in those experiencing depression, high levels of stress, challenges in self-regulating behaviors, and poor coping skills
Cognitive:
- substance produce a positive effect that reinforces the behavior
Genetic:
- Person with a parent who has a substance use disorder are more at risk
Biological:
- neurotransmitters affect the reward pathway of the brain

# data[].attributes.body
Cardiac arrhythmia
Cardiac arrest
Brain damage
Osteoporosis
Infertility
Death
Difficulties with temperature regulations
Premature labor
Low birth weight babies
Miscarriage
Preeclampsia
Electrolyte imbalance
Esophageal ulcers

# data[].attributes.body
Social, cognitive, emotional, physical

Socially isolated
Nutritional issues
Denial of illness
Body image issues
Perfectionism
Anxiety
Depression
Dehydration
Low blood pressure
Osteoporosis
Stomach & Digestive complications

# data[].attributes.body
Genetics
- run in families
Biological issues
- serotonin
- altered brain structure, metabolism and neurochemistry
Psychological/interpersonal
- searching for control
- coping with stress/trauma
- personality factors
- family issues
- low self-esteem
- lack of control in life
- depression, anxiety, anger, stress, loneliness, etc.
Social/societal
- peer pressure
- media
Cultural
- value on obtaining a "perfect body"

# data[].attributes.body
Anorexia Nervosa: An eating disorder causing people to obsess about weight and what they eat.
Bulimia nervosa: A serious eating disorder marked by binging, followed by methods to avoid weight gain.
Binge-eating disorder: eating disorder characterized by recurrent episodes of eating large quantities of food
Pica: persistent eating of substances such as dirt or paint that have no nutritional value

# data[].attributes.body
- social/relationship difficulties
- occupational difficulties
- criminal behavior
- antisocial behavioral
- financial troubles
- affective and substance related issues

# data[].attributes.body
-chasing behavior: betting larger sums of money, taking greater risks
- irrational cognitive processes
- memories of past experiences
- anticipation of future gambling
- impact on relationships
- emotional difficulties
- substance misuse

# data[].attributes.body
Behaviorally conditioned problem gambler: cycle of losing, but believing they can gain their money back.
- "lower level of gambling problems and are more likely to comply with treatment"
Emotionally vulnerable problem gambler: have pre-existing vulnerabilities (anxiety, depression, poor coping, poor problem-solving skills).
Antisocial, impulsive problem gamblers: neurological and neurochemical disorders, impulsivity, ADD and Antisocial personality disorder

# data[].attributes.body
"Gambling disorder has been shown to be associated with problems in health, social isolation, or altered social roles, depression, suicide ideation and suicide, and limited preparation for adulthood and work" (161).

- Now considered a substance-related and addictive disorder
- "gambling effects the brain reward system in a way that is similar to substance abuse".

# data[].attributes.body
- mental functions (mood, cognition, and social functioning)
- various systems in the body through the influence of emotional state

# data[].attributes.body
"Characterized by excessive and uncontrollable worry about everyday things more days than not for at least six months" (169).

Mild- sharpens the senses and expands the perceptual field, preparing us for action
Moderate- decreases the perceptual field (5 senses)
Severe- constricts the perceptual field so that an individual's focus is limited to one specific detail

# data[].attributes.body
- physical and mental conditions
- chronic pain, illness, disability, cardiovascular disease
- anxiety, substance abuse, eating disorders, dementia, personality disorders

# data[].attributes.body
- diminished quality of life
- lost work productivity
- cognitive and emotional impairment
- short-term and long-term relationships
- daily activities
- self-care

# data[].attributes.body
"May manifest with somewhat diverse symptomatology and occur as a single episode or as a recurrent condition" (215).

"Pervasive disorder, and even when the onset is triggered by situational factors, the person with MDD displays symptoms that are more severe than would be expected by such triggers"

Symptoms: (5 of the following)
- depressed mood most of the day
- diminished interest or pleasure in most or all activities
- significant unintentional increase or decrease in weight or appetite
- lack of sleep or sleeping excessively
- psychomotor changes noticed by others
- fatigue and/or loss of energy
- feelings of guilt and/or worthlessness
- diminished cognitive abilities
- recurrent thoughts of death

# data[].attributes.body
Hallucinations: vivid perceptions of something that is occurring in the real  world, even though nothing in the environment is causing the perceptions
Delusions: beliefs that the client will not change even though they are contradicted by evidence in the current situation
Psychosis: a severe mental disorder in which thought and emotions are so impaired that contact is lost with external reality
Anhedonia: inability to feel pleasure

# data[].attributes.body
Cognitive functioning: delusion and disordered thinking and speech
Perceptual functioning: sensory hallucinations
Emotional functioning: negative symptoms often involve blunted or flattened affect
Social functioning: affects the individual's ability to empathize with others

# data[].attributes.body
- Genetics
- Structural and chemical composition of the brain (enlarged ventricles, less activity in the frontal cortex)
- Environmental factors (stressful settings, lower socioeconomic groups, immigrants)
- Psychosocial factors

# data[].attributes.body
1. Delusions: beliefs that the client will not change even though they are contradicted by evidence in the current situation (335).
2. Hallucinations: vivid perceptions of something that is occurring in the real  world, even though nothing in the environment is causing the perceptions
3. Disordered thinking and speech: speech must be disordered enough to substantially impair communication
4. Motor behavior: when the behavior interferes with activities of daily living or other goal-directed behaviors (336).
5. Negative symptoms: cited when something seems to be missing from the person with SSD

# data[].attributes.body
- Increased risk for agoraphobia, OCD, social phobia, specific phobia, depression, somatization disorder and substance-related disorders)
- "Individuals with PTSD are 80% more likely than those without PTSD to have symptoms that meet diagnostic criteria for at least one other mental disorder" (313).
- Panic disorder
- Suicidal thoughts
- Fibromyalgia
- TBI (48%)

Children: comorbidity related to separation anxiety and oppositional defiant disorder

# data[].attributes.body
- Mood and ability to cope with stressful events
(loss of interest, distressing recollections, lonely feelings, negative thoughts about the future)
- Social functioning (loneliness, avoidance of people, places and activities)
- Cognitive difficulties (poor concentration and focus)

# data[].attributes.body
"The essential feature of post-traumatic stress disorder is the development of characteristic symptoms following exposure to one or more traumatic events" (309).

- Many Causes
- Traumatic event or injury
- Witnessing other persons being injured or killed, the sudden unexpected death of a loved one
- Loss of job, home
- Terrorist incidents
- Rape
- Some other life-threatening event

# data[].attributes.body
To explain the essence of the effect of how neurocognitive diseases affect the family life, here are some quotes from a website titled 'Clinical and Experimental Psychology- Neurocognitive Disorder as a Family Illness'
"It is heartbreaking and painful to watch an important member of family lose his attitudes and his cognitive capacities"

"It requires training and an attitude that allows you to take care of yourself as well as your own. It’s not simple. Caregiving can affect the psychological and physical state, the relationship, the productivity of labor. Caregiving can lead to stress and can be dangerous for the caregiver. Prolonged periods of stress can lead to the situation called “burn-out”. The burn-out is a severe condition that affects humor. A caregiver in “burn-out” can feel exhausted, listless, and unable to cope. This condition might affect the relation with loved one"

"The caregivers passes through a lot of emotions. They may feel scared, frustrated, angry, depressed, resigned because it is difficult to accept the disease of the loved one. To prevent the burn-out of caregivers it is of vital importance to seek professional help. It’s of vital importance to know as much as we can about the illness."

https://www.omicsonline.org/open-access/neurocognitive-disorder-as-a-family-illness-2471-2701-1000158.php?aid=93513

# data[].attributes.body
Considerations:
Therapeutic goals
Age
Personality style
Stage of disease
Cognitive and physical function
Behavioral problems
Individual's leisure interests and skill level

"Meaningful activities for people with NCDs promote well-being and prevent excess disability" (248).

To increase participation, consider past and current leisure interests

Planned therapeutic programs based on personality styles may lead to more active physical or social involvements and may enable residents to experience more enjoyment

# data[].attributes.body
An umbrella term for two related diagnoses (242)

It refers to both Parkinson's disease NCD and NCD with Lewy Bodies

Lewy body and Parkinson's disease NCD occur most frequently over the age of 65

# data[].attributes.body
According to information found on the Alzheimers Association website, "
Alzheimer's is the most common cause of dementia, a general term for memory loss and other cognitive abilities serious enough to interfere with daily life. Alzheimer's disease accounts for 60 percent to 80 percent of dementia cases."

The greatest risk factor for Alzheimers is age. The majority of people affected by Alzheimers are over the age of 65. However, people under the age of 65 can be affected, in this case, it is called younger-onset Alzheimers.

Microscopic changes in the brain begin long before the first signs of memory loss.
- The Alzheimers Association states, "Scientists believe Alzheimer's disease prevents parts of a cell's factory from running well. They are not sure where the trouble starts. But just like a real factory, backups and breakdowns in one system cause problems in other areas. As damage spreads, cells lose their ability to do their jobs and, eventually die, causing irreversible changes in the brain"

Some common risk factors include:
Age
Family History
Genetics (Heredity)
Head Injuries
Heart Health

# data[].attributes.body
Pressure Ulcer: localized damage to the skin and/or underlying tissue that usually occur over a bony prominence as a result of pressure or pressure in combination with shear and/or friction.
Incontinence: lack of voluntary control over urination or defecation
Delirium: an acutely disturbed state of mind that occurs in fever, intoxication, and other disorders and is characterized by restlessness, illusions, and incoherence of thought and speech

Dementia: A group of thinking and social symptoms that interferes with daily functioning.

# data[].attributes.body
Tetraplegia: both upper and lower extremities are impacted; may also include facial and trunk muscles, injury in C1-C8
Paraplegia: paralysis of the legs and lower body
Complete vs. incomplete injury:
- Complete SCI: if a client exhibits no motor or sensory function below the level of injury (370)
- Incomplete SCI: if the client exhibits some motor and/or sensory function below the level of injury
Autonomic dysreflexia: a life threatening rise in blood pressure that can occur in individuals with a level of injury at or above T6
Pressure ulcer: when too much pressure builds up on the skin in a particular area, the flow of blood to that area is halted and the skin begins to die

# data[].attributes.body
Autonomic dysreflexia or hyperreflexia: a life threatening rise in blood pressure that can occur in individuals with a level of injury at or above T6
Pressure ulcers: when too much pressure builds up on the skin in a particular area, the flow of blood to that area is halted and the skin begins to die
Respiratory Complications: Injuries to the upper thoracic and cervical spinal cord impact the respiratory muscles
Spasticity or spastic hypertonia: The interruption of messages to the reflex center of the brain may result in the overcompensation of the spinal cord reflex system
Temperature regulation: the body is unable to effectively sweat to cool the body in situations of high heat, and the body's inability to send normal temperature sensations to the brain, resulting in feeling cold in normal temperatures.
Heterotopic Ossification: the growth of new bone in soft tissue areas
Deep vein thrombosis: when a blood clot forms in the vein
Orthostatic hypotension: decrease in blood pressure when changing from the supine to an upright position

# data[].attributes.body
Tetraplegia: formally quadriplegia, injury in C1-C8
Paraplegia: injury to T1-S5

C1-C3: limited neck flexion, extension, and rotation.
C4: increased control of neck flexion, extension, and rotation; scapula elevation (shoulder shrug); inspiration
C5: elbow flexion and supination (can bend arms at elbow and turn palms face up); increased shoulder control, including shoulder flexion, abduction, and extension; and can raise arms
C6: increased strength and control of arms, including scapular protraction and elevation, forearm supination, radial wrist extension; tenodesis resulting in thumb and index finger natural opposition with flexion
C7-C8: radial and ulnar wrist extension, elbow extension, partial finger extension and thumb abduction, partial finger flexors with C8 SCI
T1-T7: upper extremity muscle function intact; some trunk control and stability
T8-L1: improved trunk flexion, extension, and rotation
L2-S5: partial to full control of lower extremities as hip flexors, knee extenders, ankle dorsiflexors, and plantar flexors return with each level of SCI

# data[].attributes.body
SCI is classified by level of injury and type of injury (the types of paralysis and related function depend on the level of injury) (369).
Level of Injury:
The vertebral column is divided into five segments, the spinal cord runs through the vertebral column
> To determine the level of injury, several tests are performed to assess the vertebral column and spinal cord including x-rays, CT scans, and MRI's
> This is followed by a neurological exam to determine the level of injury and type of impairment
Type of Injury
- Complete SCI: if a client exhibits no motor or sensory function below the level of injury (370)
- Incomplete SCI: if the client exhibits some motor and/or sensory function below the level of injury
> Result of a bruise on the spinal cord, displaced bone, or edema

# data[].attributes.body
The spinal cord transmits information from the brain to all parts of the human body and back to the brain (369).

A spinal cord injury occurs when the spinal cord is damaged as a result of trauma, disease or disorder.

When the spinal cord is damaged, communication is interrupted and can result in temporary or permanent loss of movement and/or sensation

# data[].attributes.body
Diplegia: only the legs are impacted
Hemiplegia: only half the body is impacted, usually one side of the body in both extremities
Quadriplegia: both upper and lower extremities are impacted; may also include facial and trunk muscles
Ataxia: the loss of full control of bodily movements
Dysarthria: difficult or unclear articulation of speech that is otherwise linguistically normal
Spasticity: a condition in which muscles are continuously contracted
Contractures: a condition of shortening and hardening of muscles, tendons, or other tissue, often leading to deformity and rigidity of joints
Osteopenia: a condition that occurs when the body doesn't make new bone as quickly as it reabsorbs old bone.

# data[].attributes.body
Functional Skills:
- Exercise/stretching/fitness
- Aquatic therapy
- Hippotherapy: "... the use of a horse as part of an integrated treatment strategy...performed by health professionals"
- Therapeutic horseback riding
Education, Training, and Counseling:
- Adaptive sports
- Community integration skills and resources
> Accessibility
> Advocacy
> Removal of barriers
- Mobile devices as adaptive equipment
- Leisure and health education
Community Integration and Inclusion
- Social skills and inclusion
- Participation and inclusion
- Advocacy skills
Health Promotion:
- Adaptive sports

- Animal-assisted Therapy
- Volunteerism
- Therapeutic recreation camping program

# data[].attributes.body
Intellectual disabilities
Epilepsy/Seizures
Intellectual disabilities and a seizure disorder
Behavioral Problems (ADD/ADHD, Oppositional defiance disorder, general hyperactivity)
Learning disailities
Sensory impairments (hearing, visual, 75% of children develop a lazy eye)
Feeding difficulties/Malnutrition
Lung problems
Chronic pain
Autism
Balance issues
Fatigue & Cardiovascular disease
ETC...

# data[].attributes.body
Nervous System: decreased muscle control, involuntary movement and/or spasticity, seizures, sensory processing and hyper-responsiveness, cognitive impairment or delay, hearing or vision impairments, sensation and perception abnormalities
Skeletal System: joint pain/discomfort, hyper-extensive joints
Muscular System: hypo/hypertonic tone, spasticity, poor control, poor/low/delayed coordination, hyperextension of extremities, fine and/or gross motor impairments, impaired balance
Digestive System: swallowing problems (may require a feeding tube)
Respiratory System: breath support, may need ventilator or respirator depending on muscle involvement and tone, decreased endurance, breathing difficulty related to posture
Urinary System: problems with bowel and bladder continence due to muscle control

# data[].attributes.body
Group of symptoms and neurological disorders that appear in early childhood and infancy
Cerebral= brain
Palsy= muscle problems or weakness
Due to non-progressive damage to areas of the brain that control movement and and coordination, such as the cerebellum and basal ganglia
Damage to these areas also affect muscle tone, endurance, strength and speech
4 Types:
- Static: muscles are stiff and can be permanently contracted, muscles are tight and tone is increased
- Athetoid or Dyskinetic CP: slow, uncontrolled movements usually in extremities and face, low muscle tone, frequently dysarthria, intelligence is rarely affected
Mixed: combination of any type above, many have combination of high and low tone or stiffness and involuntary movements

# data[].attributes.body
According to the information found on Duchenne.com, "Duchenne is a rare genetic disease. It primarily affects males, but, in rare cases, can also affect females. Duchenne causes the muscles in the body to become weak and damaged over time, and is eventually fatal. The genetic change that causes Duchenne — a mutation in the DMD gene — happens before birth and can be inherited, or new mutations in the gene can occur spontaneously"

# data[].attributes.body
Hearing Loss
- Depends on setting and primary problem
- Small group or individual interventions
- Community resources: Recreation or communication support, National Association of the Deaf and the Hearing Loss Association of America
- Focus on enhancing adaptations for communication in various settings might use role-play, outings, or family sessions to accomplish short- and long-term goals
- Compensatory strategies, coping techniques, social skills training, community integration programs, or lifelong leisure and recreation skill development

Visual Impairments:
- Orientation and mobility: to safely and purposely and independently travel in and through divers environments
- Self-Care: adaptation to performing everyday tasks without vision
- Communication: effective social skills to engage with others and recognize and utilize socially normative behaviors such as shaking hands, making eye contact, and interpreting gestures
- Reading: alternative format including large print, braille, audio, and/or digital formats
- Leisure skills: leisure skill development and participation, community resource development, and healthy leisure development
- Facilitators and barriers: environmental (products and technology), physical environment support and relationships, attitudes, and services, systems, or policies.

# data[].attributes.body
Ocular visual impairments: disease or conditions affecting the eye
Cortical visual impairment: injury or structural difference in the brain
Diagnosed when:
- an eye exam that is either normal or cannot explain the degree of diminished functional vision
- a history of a significant congenital or acquired brain injury or neurologic disorder
- the presence of the unique visual behaviors associated with CVI (attraction to specific colors, difficulties with visual fields, difficulties with visually attend to novel targets, and difficulties viewing targets at a distance)

Refractive errors
Age-related macular degeneration (AMD)
Cataract
Diabetic retinopathy
Glaucoma
Amblyopia
Strabismus
Diplopia
Visual

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20/20- Can see small details at 20 feet away
20/50- Would see same detail at 20 feet away that a person with normal eyesight would see at 50 feet away

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Types
1. Conductive: caused by something that stops sounds from getting through the outer or middle ear (medicine or surgery)
2. Sensorineural: occurs when there is a problem in the way of the inner ear or hearing nerve works
3. Mixed: includes both conductive and sensorineural
4. Auditory Neuropathy Spectrum Disorder: when sound enters the ear normally but because of damage to the inner ear or the hearing nerve, sound ins't organized in a way that the brain can understand
Degrees
1. Mild hearing loss: may hear some speech sounds but soft sounds are hard to hear
2. Moderate hearing loss: may hear almost no speech when another person is talking at a normal level
3. Severe hearing loss: will hear no speech when a person is talking at a normal volume and only some loud sounds
4. Profound hearing loss: will not hear any speech sound and only very loud noises.

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- Noise
- Aging
- Disease
- Heredity
- Illness and certain medications
- For babies, 25% is unknown, 25% is due to maternal infections during pregnancy, complications after birth, and head trauma, 50% is due to genetics

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According to the Texas School for the Blind and Visually impaired, they say, "Much of the sensory information that is vital to children's development comes through the senses of vision and hearing. During the first three years of a child's life major neural networks are being formed in the brain. Much of this development comes from distance senses, i.e., vision and hearing, which allows us to know about things and people in the world even when we are not in physical contact with them. After the first three years, development of these neural networks becomes slower. Skills that may be gained in early intervention cannot be made as quickly when the child is older."

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Effective Recreational Therapy interventions for Intellectual Disability

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Effective Recreational Therapy interventions for Intellectual Disability

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Mild and moderate intellectual disability:
- training opportunities to develop self-determining behaviors and decision making skills
- Critical independence in the individuals ability to make personal choices and preferences based on education decision-making
- Leisure education training-skill development, knowledge and access to community resources, family involvement and the development of friendships or peer relationships,
- Passive and active activities with a goal of developing home-based and community-based leisure skills.
Severe and profound intellectual disability:
- Services that promote physical growth and development, enhance cognitive and social skills, and develop leisure-activity skills through the support of staff or caregivers.