Management of People with Special Needs 2024 PDF
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2024
Dr. Lamiaa Amin
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Summary
This document provides an overview of the management of individuals with special needs, outlining definitions, characteristics, common challenges facing these individuals, and principles for effective care coordination. The document also covers disability prevention strategies, primary health care roles in managing special needs, nursing care strategies, and emphasizes the importance of a holistic approach to care.
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1 Management of UNDER SUPERVISION: DR. LAMIAA AMIN people with special needs 2 -11ﻋﺒﺪاﻟﻌﺰﻳﺰ ﻣﺴﺎﻋﺪ -1إﻳﻤﺎن ﻋﺒﺪاﻟ...
1 Management of UNDER SUPERVISION: DR. LAMIAA AMIN people with special needs 2 -11ﻋﺒﺪاﻟﻌﺰﻳﺰ ﻣﺴﺎﻋﺪ -1إﻳﻤﺎن ﻋﺒﺪاﻟﻌﻈﻴﻢ -21ﻣﻬﻨﺪ ﺣﺴﻴﻦ ال ﺗﻮﻓﻴﻖ ﻋﻠﻲ اﻟﺰﺑﻮن ﻟﻌﺠﻢ -12ﺻﺎﻟﺢ ﺳﺎﻟﻢ ﺻﺎﻟﺢ -2أﺳﻤﺎء ﺻﻼح اﻟﻌﺰب -22ﻋﺠﻴﻢ ﻫﺎدي ﻋﺒﺪاﻟﺤﻤﻴﺪ ال ﺳﻌﺪ -3ﻳﺎرا ﻳﺎﺳﺮ -13ﻣﺤﻤﺪ ﻋﺒﺪا -23ﻋﺒﺪاﻟﺮﺣﻤﻦ ﺳﻌﺪ ﻋﺒﺪاﻟﺘﻮاب ﻣﻘﻠﺪ ﻧﺎﺻﺮ اﻟﺴﻬﻠﻲ ﻋﻠﻲ اﻟﻤﺤﻤﺪي -14ﻋﺒﺪاﻟﻠﻄﻴﻒ ﻫﺪﻳﺎن -4ﻣﺮﺟﻲ ﻣﺮزوق -24اﻟﺤﺴﻴﻦ ﻣﻬﺪي Prepared By: اﻟﻌﺘﻴﺒﻲ اﻟﺬوﻳﺒﻲ ﺻﺎﻟﺢ ال ﻣﺴﻌﺪ -5ﻣﺤﻤﺪ ﻋﺒﻴﺪا -15ﻓﻬﺪ ﻋﺎﻳﺪ ﻋﺒﺪا -25ﻋﺒﺪاﻟﺮﺣﻤﻦ ﻣﺤﻤﺪ اﻟﺤﺮﺑﻲ اﻟﺸﻤﺮي اﻻﻧﺼﺎري -6اﻟﻮﻟﻴﺪ ﻓﻬﻴﺪ ﻋﺒﺪا -16ﻋﺒﺪا ﻣﺤﻤﺪ -26ﻳﻮﺳﻒ اﺣﻤﺪ اﻟﻘﺼﻴﺮ ﺣﺴﻴﻦ اﻟﻌﺘﻴﺒﻲ اﻟﻤﺎﻟﻜﻲ -7ﻋﺒﺪاﻟﻌﺰﻳﺰ ﺳﺒﻴﻞ -17ﻣﺎﺟﺪ ﻋﺒﺪا -27أﺳﻤﺎء ﻋﺒﺪا اﻟﻤﻄﻴﺮي ﻣﺰﻳﺪ اﻟﻤﻄﻴﺮي اﻟﻌﺘﻴﺒﻲ Outlines: 3 Introduction Definitions of special needs, Disability and vulnerability Characteristics of people with special needs Types of disability Causes of disability Common challenges faced by people with special needs Principles of management for people with special needs Disability prevention measures and rehabilitation Role and benefits of Primary Health Care Nursing care strategies for people with special needs. References Outcomes: 4 By the end of this presentation the student will be able to: Understand the definition and characteristics of people with special needs. Recognize the types and causes of disability. Discuss the Common challenges faced by people with special needs. Outline the Principles of management and prevention measures for people with special needs. Describe the role and benefits of Primary Health Care in management of people with special needs. Develop nursing management plan for people with special needs. 5 Introduction: Special needs encompass a diverse range of conditions, including physical, intellectual, developmental, sensory, and mental health challenges. These individuals often require tailored care and support to address their unique healthcare needs and promote their overall well-being. In this context, primary healthcare providers play a vital role in the management of people with special needs. By adopting a person-centered approach, healthcare providers can ensure that care is individualized, respectful, and responsive to the specific needs and preferences of each person. Additionally, promoting accessibility, cultural competence, and collaboration across healthcare teams are essential principles in delivering effective care for this population. 6 Definitions: Special Needs: Special needs refer to specific requirements or conditions that individuals may have due to physical, developmental, cognitive, emotional, or behavioral challenges. These needs may require additional support, accommodations, or specialized services to ensure that individuals can fully participate in activities and access opportunities available to others. Disability: Disability is a broad term that encompasses impairments, activity limitations, and participation restrictions experienced by individuals in various aspects of life due to physical, cognitive, sensory, or mental health conditions. Disabilities can affect a person's mobility, communication, learning, and daily living activities, and may vary in severity and impact from person to person. 7 Definitions: Vulnerability: Vulnerability refers to the susceptibility or increased risk of harm, disadvantage, or adverse outcomes experienced by individuals or groups due to various factors such as social, economic, environmental, or health-related circumstances. Vulnerability can result from factors such as poverty, discrimination, lack of access to resources or support, and underlying health conditions, and may intersect with disability or special needs in complex ways. Characteristics of people with special needs: 8 1. Diverse Range of Conditions: People with special needs may have a wide range of conditions, including physical disabilities, intellectual or developmental disabilities, sensory impairments (such as vision or hearing loss), mental health disorders, chronic illnesses, and behavioral challenges. 2. Functional Limitations: Individuals with special needs may experience limitations in their ability to perform daily activities, participate in social interactions, communicate effectively, or access educational and employment opportunities. 3. Varied Levels of Independence: The degree of independence among individuals with special needs can vary significantly. Some individuals may require substantial support and assistance with daily tasks, while others may be more independent but still benefit from accommodations or modifications. Characteristics of people with special needs: 9 4. Unique Strengths and Abilities: Despite their challenges, people with special needs often possess unique strengths, talents, and abilities. These strengths may include resilience, creativity, determination, problem-solving skills, and a unique perspective on the world. 5. Need for Support and Accommodations: Individuals with special needs often require specialized support and accommodations to help them overcome barriers, access services, and participate fully in society. This may include assistive devices, therapy services, educational accommodations, accessible environments, and caregiver support. 6. Diversity Within the Population: It's important to recognize that people with special needs are a diverse group with individual characteristics, preferences, and experiences. Factors such as age, gender, cultural background, and socioeconomic status can influence how special needs are expressed and experienced. Characteristics of people with special needs: 10 7. Increased Vulnerability: People with special needs may be at increased risk of experiencing discrimination, social isolation, stigma, abuse, neglect, and barriers to accessing healthcare, education, employment, and other services. Addressing these vulnerabilities requires a holistic and inclusive approach that prioritizes dignity, respect, and equity. 8. Potential for Growth and Development: With appropriate support, interventions, and opportunities, individuals with special needs have the potential to learn, grow, and thrive. Access to inclusive education, vocational training, community resources, and supportive environments can help individuals with special needs reach their full potential and lead fulfilling lives. Types of disability: 11 1. Physical Disabilities: involve impairments that affect mobility, dexterity, or physical functioning include: Mobility impairments (e.g., paralysis, limb loss, spinal cord injury) Musculoskeletal disorders (e.g., arthritis, osteoporosis) Neuromuscular disorders (e.g., cerebral palsy, muscular dystrophy) Sensory impairments (e.g., blindness, deafness, hearing loss) 2. Intellectual or Developmental Disabilities: characterized by limitations in intellectual functioning and adaptive behavior, which often manifest during childhood and impact cognitive, social, and practical skills include: Intellectual disability (formerly known as mental retardation) Autism spectrum disorder Down syndrome Fetal alcohol spectrum disorders Types of disability: 12 3. Sensory Disabilities: involve impairments in one or more sensory systems, including vision, hearing, and balance include: Visual impairment (e.g., blindness, low vision) Hearing impairment (e.g., deafness, hearing loss) Vestibular disorders affecting balance and spatial orientation 4. Psychiatric or Mental Health Disabilities: involve conditions that affect mood, thought processes, behavior, and emotional well-being include: Depression Anxiety disorders Bipolar disorder Schizophrenia Post-traumatic stress disorder (PTSD) Types of disability 13 5. Neurodevelopmental Disabilities: characterized by impairments in the growth and development of the nervous system, leading to difficulties in motor control, cognition, communication, and social interaction include: Attention-deficit/hyperactivity disorder (ADHD) Learning disabilities (e.g., dyslexia, dyscalculia) Communication disorders (e.g., speech-language impairment) Tic disorders (e.g., Tourette syndrome) Types of disability: 14 6. Chronic Health Conditions: involve long-term medical conditions that can impact daily functioning, quality of life, and overall health include: Diabetes Asthma Chronic obstructive pulmonary disease (COPD) Epilepsy Cardiovascular diseases Autoimmune disorders 7. Acquired Disabilities: result from injury, illness, or medical conditions acquired later in life include: Traumatic brain injury (TBI) Spinal cord injury Stroke (cerebrovascular accident) Amputation Chronic pain conditions Causes of disability: 15 1. Congenital Conditions: Genetic factors: Inherited genetic mutations or abnormalities can result in congenital disabilities, such as Down syndrome, cystic fibrosis, or muscular dystrophy. Prenatal exposure: Exposure to teratogenic substances (e.g., drugs, alcohol, tobacco) or infections during pregnancy can lead to developmental disabilities or birth defects. Complications during childbirth: Birth injuries, such as oxygen deprivation or trauma during delivery, can cause neurological damage or physical impairments. Causes of disability: 16 2. Acquired Injuries or Trauma: Traumatic injuries: Accidents, falls, sports injuries, or violence can result in traumatic brain injuries, spinal cord injuries, amputations, fractures, or other disabling conditions. Medical procedures or surgeries: Complications from medical interventions, surgeries, or treatments can sometimes lead to disability, such as nerve damage or loss of function. Occupational hazards: Exposure to workplace hazards, such as chemical toxins, machinery accidents, or repetitive stress injuries, can cause disabling conditions over time. Causes of disability: 17 3. Chronic Illnesses or Health Conditions: Degenerative diseases: Progressive conditions, such as multiple sclerosis, Parkinson's disease, Alzheimer's disease, or amyotrophic lateral sclerosis (ALS), can lead to increasing disability over time. Autoimmune disorders: Conditions like rheumatoid arthritis, lupus, or Crohn's disease can cause inflammation and damage to tissues and organs, resulting in disability. Infectious diseases: Serious infections, such as meningitis, encephalitis, or HIV/AIDS, can cause neurological damage, cognitive impairment, or physical disabilities. Cardiovascular diseases: Heart conditions, stroke, or vascular diseases can lead to mobility limitations, cognitive impairments, or other disabling complications. 18 Causes of disability: 4. Environmental or Social Factors: Poverty: Lack of access to healthcare, nutrition, sanitation, and education can contribute to disability through malnutrition, preventable diseases, or inadequate medical care. Environmental toxins: Exposure to environmental pollutants, hazardous substances, or unsafe living conditions can increase the risk of developmental disabilities, respiratory conditions, or other health problems. War or conflict: Armed conflict, violence, or humanitarian crises can result in physical injuries, trauma, displacement, and psychosocial disabilities among affected populations. Discrimination and stigma: Social exclusion, discrimination, and lack of accommodations can exacerbate the impact of disability and limit opportunities for participation in society. Common challenges faced by people with special 19 needs: People with special needs face a variety of challenges that can impact their daily lives, well-being, and ability to fully participate in society. These challenges may vary depending on the type and severity of the disability, as well as environmental, social, and cultural factors. Some common challenges faced by people with special needs include: 1. Accessibility Barriers: Physical barriers: Inaccessible buildings, lack of ramps, elevators, or accessible restrooms can limit mobility and independence for individuals with physical disabilities. Communication barriers: Limited access to sign language interpreters, captioning, or assistive communication devices can hinder communication for individuals with hearing or speech impairments. Digital barriers: Inaccessible websites, software, or electronic devices can restrict access to information, communication, and online services for individuals with visual or cognitive impairments. Common challenges faced by people with special 20 needs: 2. Discrimination and Stigma: Social stigma: Negative attitudes, stereotypes, and misconceptions about disability can lead to discrimination, social exclusion, and marginalization in various settings, including education, employment, and community life. Bullying and harassment: People with special needs may face bullying, teasing, or harassment based on their disability, which can affect their self-esteem, mental health, and sense of safety. Employment discrimination: Limited job opportunities, lack of accommodations, and employer biases can contribute to unemployment or underemployment among individuals with disabilities. Common challenges faced by people with special 21 needs: 3. Healthcare Disparities: Limited access to healthcare: Physical barriers, lack of transportation, financial constraints, or inaccessible healthcare facilities can hinder access to medical care, preventive services, and specialized treatments for individuals with special needs. Healthcare provider biases: Negative attitudes, stereotypes, or lack of disability competence among healthcare providers can lead to disparities in healthcare quality, communication, and treatment outcomes for people with special needs. Common challenges faced by people with special 22 needs: 4. Education and Learning: Inclusive education: Lack of access to inclusive classrooms, specialized instruction, or support services can impede learning opportunities and academic achievement for students with disabilities. Bullying and exclusion: Bullying, teasing, or social exclusion in school settings can create barriers to learning, socialization, and emotional well-being for students with special needs. Transition planning: Inadequate transition planning and support for students with disabilities as they transition from school to post-secondary education, employment, or independent living can hinder their successful transition and long-term outcomes. Common challenges faced by people with special 23 needs: 5. Economic and Financial Challenges: Financial insecurity: Limited employment opportunities, low wages, and lack of financial assistance programs can contribute to economic hardship and poverty among individuals with disabilities. Healthcare costs: High healthcare costs, including expenses for medical equipment, assistive devices, therapies, and medications, can pose financial burdens for individuals with special needs and their families. Common challenges faced by people with special 24 needs: 6. Access to Support Services: Limited access to support services: Shortages of support services, including personal care attendants, therapists, counselors, and community-based programs, can affect individuals' ability to access necessary support and resources for daily living, socialization, and community participation. Long waiting lists: Lengthy waiting lists for support services, such as home-based services, residential placements, or vocational training programs, can delay access to needed services and supports for individuals with disabilities. Principles of management for people with special 25 needs: The management of people with special needs requires a comprehensive and person-centered approach that prioritizes dignity, respect, and individualized care. Here are some key principles of management for people with special needs: 1. Person-Centered Care: Tailor care plans to the individual's unique needs, preferences, strengths, and goals. Involve individuals with special needs in decision-making regarding their care, treatment options, and goals. Respect the autonomy, choices, and rights of individuals with special needs, including their right to privacy and confidentiality. Principles of management for people with special 26 needs: 2. Accessibility and Inclusivity: Ensure physical, communication, and programmatic accessibility in healthcare facilities, educational institutions, workplaces, and community settings. Provide accommodations, modifications, and assistive technologies to support full participation and equal access to services and opportunities. Promote inclusive practices and environments that welcome and embrace diversity, including individuals with special needs. Principles of management for people with special 27 needs: 3. Cultural Competence and Sensitivity: Recognize and respect the diversity of cultural, linguistic, and religious backgrounds among individuals with special needs. Engage with individuals and families from diverse backgrounds in culturally competent and respectful ways, considering their beliefs, values, and preferences. Provide language interpretation services, culturally appropriate materials, and community resources to support effective communication and understanding. Principles of management for people with special 28 needs: 4. Collaboration and Coordination: Foster collaboration among multidisciplinary teams, including healthcare providers, educators, therapists, social workers, and support staff, to address the holistic needs of individuals with special needs. Coordinate care and services across different settings and providers to ensure continuity, consistency, and seamless transitions for individuals with special needs. Engage with family members, caregivers, and other stakeholders as partners in care, providing education, support, and resources to promote the well-being of individuals with special needs. Principles of management for people with special 29 needs: 5. Empowerment and Advocacy: Empower individuals with special needs to advocate for themselves, express their needs and preferences, and participate actively in decisions affecting their lives. Advocate for the rights, needs, and inclusion of individuals with special needs in policies, programs, and society at large. Promote self-determination, independence, and empowerment through skill-building, education, and access to resources and opportunities. Principles of management for people with special 30 needs: 6. Evidence-Based Practice: Base care decisions and interventions on the best available evidence, including clinical guidelines, research findings, and individualized assessments. Continuously evaluate and monitor the effectiveness of interventions, adjusting care plans as needed to achieve optimal outcomes for individuals with special needs. Stay informed about advances in research, technology, and best practices in the field of special needs management, incorporating new knowledge and innovations into practice. Disability prevention measures and rehabilitation: 31 1. Prevention Measures: Health Promotion: Promote healthy lifestyles, including regular physical activity, balanced nutrition, tobacco cessation, and preventive healthcare screenings, to reduce the risk of chronic conditions and disabilities. Prenatal Care: Provide comprehensive prenatal care to pregnant individuals to promote maternal health, prevent birth complications, and reduce the risk of congenital disabilities in newborns. Immunization Programs: Implement vaccination programs to prevent infectious diseases that can cause disabilities, such as polio, measles, rubella, and meningitis. Injury Prevention: Implement injury prevention programs targeting common causes of traumatic injuries, such as falls, motor vehicle accidents, sports injuries, workplace hazards, and violence. e. Environmental Modifications: Create accessible and safe environments through urban planning, building codes, transportation systems, and community design to prevent accidents and promote accessibility for individuals with disabilities. Disability prevention measures and rehabilitation: 32 2. Early Intervention: ► Early Identification: Screen for developmental delays, disabilities, and health conditions in infancy and early childhood to facilitate early diagnosis and intervention. ► Early Intervention Services: Provide early intervention services, including therapies, educational programs, and family support services, to promote optimal development, learning, and functioning in children with disabilities. ► Parent Education and Support: Offer education, guidance, and support to parents and caregivers of children with disabilities to enhance their caregiving skills, coping strategies, and ability to advocate for their child's needs. Disability prevention measures and rehabilitation: 33 3. Rehabilitation Services: Multidisciplinary Approach: Provide comprehensive rehabilitation services delivered by multidisciplinary teams, including physicians, therapists, social workers, psychologists, and vocational counselors, to address the physical, cognitive, emotional, and social aspects of disability. Physical Rehabilitation: Offer physical therapy, occupational therapy, and speech-language therapy to improve mobility, motor skills, communication, and activities of daily living for individuals with physical and developmental disabilities. Cognitive Rehabilitation: Provide cognitive rehabilitation programs to address cognitive impairments, memory deficits, executive function difficulties, and learning challenges in individuals with acquired brain injuries or neurodevelopmental disorders. Psychosocial Support: Offer counseling, mental health services, and peer support programs to address the emotional, social, and psychological needs of individuals with disabilities and their families, promoting coping skills, resilience, and social integration. Assistive Technology: Provide access to assistive devices, adaptive equipment, and assistive technologies to enhance independence, communication, mobility, and participation for individuals with disabilities in home, school, work, and community settings. Role and benefits of Primary Health Care: 34 Primary health care plays a crucial role in the management of people with special needs by providing comprehensive, accessible, and person-centered care that addresses their unique health needs and promotes their overall well-being. Here are some key roles and benefits of primary health care in the management of people with special needs: 1. Accessibility and Coordination: Primary health care services are typically the first point of contact for individuals with special needs, providing accessible and convenient access to healthcare professionals, including physicians, nurses, and allied health professionals. Primary care providers serve as the central coordinators of care for individuals with special needs, facilitating referrals to specialists, diagnostic services, rehabilitation programs, and community-based support services as needed. Role and benefits of Primary Health Care: 35 2. Comprehensive Assessment and Diagnosis: Primary care providers conduct comprehensive assessments and screenings to identify and diagnose health conditions, disabilities, and developmental delays in individuals with special needs. Through regular health check-ups, primary care providers monitor the health status, growth, and development of individuals with special needs, identifying emerging health concerns and implementing timely interventions to address them. 3. Person-Centered Care: Primary care providers adopt a person-centered approach to care that respects the dignity, autonomy, and preferences of individuals with special needs, involving them in decision-making regarding their care, treatment options, and goals. By building trust, rapport, and continuity of care, primary care providers establish strong therapeutic relationships with individuals with special needs, promoting communication, engagement, and collaboration in their care. Role and benefits of Primary Health Care: 36 4. Chronic Disease Management: Primary care providers manage chronic health conditions commonly experienced by individuals with special needs, such as diabetes, asthma, epilepsy, cardiovascular diseases, and mental health disorders. Through comprehensive care plans, medication management, lifestyle counseling, and preventive interventions, primary care providers help individuals with special needs achieve optimal health outcomes and quality of life. 5. Preventive Care and Health Promotion: Primary care providers deliver preventive care services, including immunizations, screenings, and health education, to reduce the risk of common health conditions, complications, and disabilities in individuals with special needs. By promoting healthy behaviors, self-management skills, and adherence to treatment regimens, primary care providers empower individuals with special needs to take control of their health and prevent secondary complications. Role and benefits of Primary Health Care: 37 6. Rehabilitation and Support Services: Primary care providers collaborate with rehabilitation specialists, therapists, social workers, and community resources to coordinate rehabilitative services, support programs, and assistive technologies for individuals with special needs. Through ongoing monitoring, assessment, and advocacy, primary care providers address the physical, cognitive, emotional, and social needs of individuals with special needs, promoting their functional independence, social integration, and quality of life. Nursing care strategies for people with special needs: 38 encompass a holistic approach that addresses their physical, emotional, social, and developmental needs. Nurses play a crucial role in providing individualized care, promoting health and well-being, and advocating for the rights and dignity of individuals with special needs. Here are some nursing care strategies for people with special needs: 1. Comprehensive Assessment: Conduct thorough assessments of individuals with special needs, including physical, developmental, cognitive, and psychosocial dimensions. Assess the individual's functional abilities, strengths, limitations, and preferences to tailor care plans to their unique needs and goals. Use appropriate assessment tools and communication techniques to accommodate sensory, cognitive, or communication impairments. Nursing care strategies for people with special needs: 39 2. Person-Centered Care: Adopt a person-centered approach to care that respects the individual's autonomy, dignity, and rights. Involve individuals with special needs in care planning, decision-making, and goal-setting, empowering them to actively participate in their care. Establish therapeutic relationships built on trust, respect, empathy, and effective communication. Nursing care strategies for people with special needs: 40 3. Health Promotion and Education: Provide health education and promotion activities tailored to the individual's needs, preferences, and developmental level. Offer guidance on healthy lifestyle behaviors, preventive healthcare measures, medication management, and self-care skills. Educate individuals with special needs, caregivers, and families on managing chronic conditions, recognizing signs of illness, and accessing healthcare services. Nursing care strategies for people with special needs: 41 4. Supportive Care: Provide emotional support, reassurance, and encouragement to individuals with special needs and their families, particularly during times of transition, crisis, or adjustment. Offer counseling, coping strategies, and stress management techniques to address emotional and psychological challenges associated with disability. Facilitate peer support groups, support networks, and community resources to promote social connectedness and resilience. Nursing care strategies for people with special needs: 42 5. Functional and Adaptive Care: Assist individuals with special needs in performing activities of daily living (ADLs), such as bathing, dressing, grooming, toileting, and eating, as needed. Implement adaptive techniques, assistive devices, and environmental modifications to promote independence, safety, and accessibility. Collaborate with occupational therapists, physical therapists, and other rehabilitation specialists to develop personalized mobility and rehabilitation plans. Nursing care strategies for people with special needs: 43 6. Advocacy and Empowerment: Advocate for the rights, needs, and preferences of individuals with special needs within healthcare settings, educational institutions, workplaces, and community organizations. Empower individuals with special needs to self-advocate, assert their rights, and access resources, services, and opportunities in their communities. Advocate for inclusive policies, environments, and programs that promote accessibility, equality, and social inclusion for individuals with special needs. Nursing care strategies for people with special needs: 44 7. Collaboration and Coordination: Collaborate with interdisciplinary teams, including physicians, therapists, social workers, educators, and community resources, to coordinate comprehensive care for individuals with special needs. Communicate effectively and share relevant information with healthcare providers, caregivers, and other stakeholders involved in the individual's care. Facilitate smooth transitions between healthcare settings, educational programs, and community services to ensure continuity of care and support. References : 45 Louyse Schuertz, A., de Azevedo Mazza, V., Seidel, B., Trevisan Nóbrega Martins Ruthes, V. B., & Macedo, L. C. (2020). Primary Health Care to meet families of children with special needs. Rev Rene, 21(1). Palma, D. D., & Tafuri, D. (2016). 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