Fatigue
Fatigue or tiredness can have an important affect on how well people think, learn, move and act. In particular, behaviour can be much worse when children are tired. For some children fatigue can be a real problem, not only for them, but also for other members of their family.
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Why children with disabilities may suffer fatigue
Children with disabilities sometimes learn different ways to manage activities, which they might not otherwise be able to do. While doing things in a different way allows them to join in, it also comes at a cost. To achieve the same result as others it can take more:
- effort
- persistence
- muscle control
- concentration.
This extra load often results in the child with disabilities (and adults who care for them!) tiring more quickly than other children. Tiredness, such as this, sometimes incorrectly gets called 'laziness’. Other signs of fatigue, in addition to feeling tired may include:
- muscle aches
- muscle cramps
- problems with concentration
- sleepiness
- behaviour problems or becoming irritable.
Sometimes a medical check or a physiotherapy assessment can provide information about what is causing tiredness.
Other reasons for tiredness may include:
- disturbed sleep due to physical problems, such as not being able to change position in bed
- disturbed sleep due to behaviour problems such as needing to get attention from parents or others
- higher level of muscle activity when ‘at rest’ (often a problem for children with athetoid cerebral palsy)
- poor positioning during the day, requiring increased muscle activity
- muscle weakness and limited endurance
- barriers in the child's surroundings that make it more difficult to get around
- changes in circumstances (such as starting school) that put more demands on the child
- recent surgery
- too much physical activity on one day
- increased energy requirements - children with disabilities generally use more energy to walk or run than other children
- seizure activity in some children
- reduced functioning of the lungs (with or without dysphagia) leading to reduced levels of oxygen in the blood - this in turn limits the supply of 'fuel' to the body
- not enough intake of food and drink to meet energy needs - this can often be more of a problem as children grow and need energy (sometimes all the energy of the child can be taken up just in eating and drinking).
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What can be done about fatigue?
If it is known that a child's tiredness is caused by their disability and the reasons for it are understood, it is important that things be made a little easier for the child. This can happen by:
- providing the child with more breaks at school, preschool or work
- providing a short time for relaxation after lunch
- encouraging the child to watch others as part of the day, rather than needing to be actively involved all day
- including some tasks in the day that don’t need as much effort and concentration
The physiotherapist and occupational therapist can:
- advise on positioning and posture to limit fatigue
- provide advice on changes to the child's surroundings to make 'getting around' easier
- suggest special equipment to make activity easier and lessen fatigue.
The physiotherapist can:
- provide advice about fitness and exercise choices to improve overall muscle strength and endurance
- provide ideas, where appropriate, about different choices for getting around.
The occupational therapist can suggest changes to the way tasks are carried out to keep effort to a minimum.
The psychologist can talk to families about other things that might be causing fatigue, such as how the child feels, thinks, behaves and gets on with others - sometimes they might point you in the direction of other people or agencies that can help.
For more information
- Read the book: Read, C (1992). Doctor, I'm tired: causes and treatments of fatigue, sleep disorders, depression, chronic fatigue syndrome. Gore & Osment, Rushcutters Bay, New South Wales.
The above book can be borrowed via the Novita Toy & Resource Centre if you are registered with the Centre. Send a loan request by completing the on-line request form.
Disclaimer Detail: The above information on is of a general nature only and does not constitute advice. Novita Children's Services makes no representations, express or implied, as to the accuracy, usefulness, suitability or application of the information to a child's particular circumstances. Use of the information above is at your sole risk, and you should seek professional advice before acting or relying on the information. Novita Children's Services accepts no liability for any damages or loss that may arise from the use of, or any omission from, the information provided.
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