Beyond the Scar
A recent newsletter discussed the considerations of pre- and post-surgical considerations which often leave a lasting imprint of pain, discomfort, and insomnia. When procedures are for a child there is more to consider.
The impact of medical procedures upon a child’s development is personal — my son had 38 lumbar punctures and four surgical procedures during his three years of leukemia treatment. The biggest impacts, which doctors had no answers for, were in the cognitive, emotional, and social domains. I was left to figure it out on my own. Nine years later he is now thriving.
What about when the surgery is for an infant or young child?
In addition to the obvious signs of discomfort and pain, young children are also impacted in their development by medical procedures.
As adults we expect to be sidelined for the usual recovery period of 6-10 weeks. This is the amount of time spent healing and then rebuilding strength. For an infant these are precious formative weeks. For children, depending upon age, the disruption to development of a month or two is cataclysmic. Why, you ask?
Let’s consider an infant born with an abdominal hernia (third most common pediatric surgery) who has surgery before six months of age. This baby will not be on its stomach on a floor playing, thus missing critical Tummy Time development in these formative first six months.
These are some of the foundational skills an infant with medical interventions will not completely master:
- Hold their head up (essential for visual development)
- Push-up on arms (key to crawling and later fine-motor control)
- Roll-over (core control and strength needed to sit and stand)
- Learning to reach out for toys (which is a key stage to visual-motor skills)
- Reciprocally sleep/wake, calm/excite (self-regulation for social-emotional growth)
ALL of these developmental skills are impacted in some way when a young child is hospitalized, not just if they are having surgery.
ALL of these developmental skills are the foundation to playing, reading, writing, and socially engaging. Youth who have good executive function and behavioral regulation skills have a well-established underlying movement and development foundation.
Yes, the developmental foundation is impacted in some way, although some of the impact won’t be noticed until more advanced transitions are challenged. Challenges typically surface at the transitional ages of 4-5, 7-8, 11-13 when fine motor, reading, and social-emotional skills should pivot from learning to mastery. The frustration often plays out in the behavioral realm as anxiety, anger, and lack of effort or cooperation.
Why can hospitalization impact developmental foundations?
We see many children with mystery behavioral, growth, cognitive, and social-emotional challenges. A common theme amongst the children is early-in-life medical intervention (which was often life-saving).
Here are some aspects of common medical procedures and how we find they affect development.
- Lumbar puncture for high fevers. (The location of the puncture is where the diaphragm and hip flexor meet. We find respiratory implications and/or subsequent challenges to movement transitions for crawling and walking.)
- Respiratory support which can include intubation. (We find motor-control for the head and arms is impacted by the insertion process, leaving bilateral visual-motor development asymmetric.)
- Abdominal surgery (Appendix and hernia are most common). (We find movement symmetry impacted–skewed to the side of the body where internal scarring restricts movement.)
- IVs and monitoring (Restricted limb movement affects push and pull movements. The arms and legs need to push and pull to establish the rich core interactions required for postural control used in play and learning.)
More common than you’d expect
As rare as hospitalization and surgery are for young children, the numbers are still large.
In the most current data (2009) available there were 216,081 pediatric surgical procedures, The three most common:
- Trauma management (surgical intervention to stabilize traumatic injury)
- Inguinal hernia under age 6 months
Hospital admission rates tell an even more interesting story. In 2016 some of the most common US admits of ages 0-17 were:
- 171,855 Bronchitis and Asthma
- 116,442 Full term babies w/ major problem
- 97,317 Pneumonia
- 86,026 Digestive and enteric
- 60,716 Neonates w/ extreme issues or respiratory distress
- 37,801 Cellulitis
Why this matters to us, and to you
At Kinetic Konnections we find that adults and children who have mystery performance or pain issues very often have had an early age hospitalization or surgical procedure.
Addressing the disconnect right after a surgery, can eliminate the years of pain, performance, or delayed development in your child.
Did your child or a loved one have medical procedures as a child? We can help solve many unseen or mystery challenges.
How do I get started?
You can call 847-390-8348 or schedule online for a session.