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Paediatrics > 1: Neurology: Assessment Development and Developmental Delay > Flashcards

1: Neurology: Assessment Development and Developmental Delay Flashcards

1
Q

What is a developmental disorder

A

Group of conditions resulting in impairment of one or more functional areas

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2
Q

What are primitive reflexes

A

Reflexes that arise from the brainstem

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3
Q

What happens with age

A

Frontal lobe can suppress brainstem reflexes

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4
Q

What are 5 primitive reflexes

A
  1. Stepping
  2. Moro
  3. Grasp
  4. Rooting
  5. Asymmetric neck reflex
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5
Q

What is the stepping reflex

A

When placed on a surface infant will step

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6
Q

When does stepping reflex disappear

A

2-months

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7
Q

What is the moro reflex

A

When head is extended infant will abduct then adduct arms

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8
Q

When does the moro reflex dissapear

A

4 months

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9
Q

What is the grasp reflex

A

Object placed in palm, infant will grasp

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10
Q

When does the grasp reflex disappear

A

4-5 months

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11
Q

What is the rooting reflex

A

Object placed near infants mouth - will cause suckling

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12
Q

When does rooting reflex occur

A

4 months

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13
Q

What is asymmetric neck reflex

A

If lying supine, if head turned arm will extend giving a ‘fencing’ posture

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14
Q

What are the 4 developmental domains

A
  1. Gross Motor
  2. Fine Motor
  3. Speech (Language and Hearing)
  4. Social (Emotional and Behavioural)
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15
Q

What can an infant do gross-motor domain at 6W

A

Raised head 45’

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16
Q

What can infant do gross-motor at 6 months

A

Pulls to sit
Roll back to front
Lie on abdomen and extend arms

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17
Q

What can infant do gross-motor at 7-8 months

A

Sits without support

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18
Q

When can an infant sit without support

A

7-8 months

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19
Q

When should you refer an infant who can’t sit without support

A

12 months

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20
Q

What can an infant do at 9-months

A

Crawls

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21
Q

When an an infant crawl

A

9-months

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22
Q

What can an infant do at 12 months

A

Cruises

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23
Q

What can an infant do at 13-15 months

A

Walks unsupported

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24
Q

When can an infant walk unsupported

A

13- 15 months

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25
Q

When should you refer an infant if they cannot walk unsupported

A

18 - months

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26
Q

When can a child run

A

2- years

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27
Q

When can a child walk up and downstairs whilst holding on to hand rail

A

2-years

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28
Q

When can a child ride a tricycle

A

3-years

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29
Q

When can a child walk up and down stairs without holding hand rail

A

3-years

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30
Q

When does an infant have good head control

A

3-months

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31
Q

What can an infant do in fine-motor at 6W

A

Track objects

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32
Q

What can an infant do in fine-motor at 3 months

A

Reaches

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33
Q

What can an infant do at 6 months

A

Palmar grasp

Point to objects

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34
Q

When does an infant acquire a palmar grasp

A

6-months

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35
Q

When does early pincer grip occur

A

9-months

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36
Q

What can an infant do at 9-months

A
  • Early pincer grip

- Points to objects

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37
Q

When does an infant have a neat pincer grip

A

12-months

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38
Q

What is abnormal before 12-months in fine-motor and what can it indicate

A

Hand preference. Can indicate cerebral palsy

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39
Q

What can infant do at 13-15m in fine-motor

A

Tower 2-bricks

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40
Q

What can infant do at 18m in fine-motor

A

Tower 3-bricks

Scribble

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41
Q

What can infant do at 2-years in fine-motor

A

Tower 6-bricks

Copy line

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42
Q

What can infant do at 3-years in fine-motor

A

Tower 9-bricks

Copy circle

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43
Q

What can infant do at 4-years in fine-motor

A

Copy cross

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44
Q

What can infant do at 5-years in fine-motor

A

Copy square and triangle

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45
Q

What age can an infant turn to sound

A

3-months

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46
Q

What can an infant do at 3-months in language

A
  • Turn to sound
  • Quieten to parents voice
  • Squeals
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47
Q

When does an infant use double syllables

A
  • 6-months
48
Q

When does an infant say ‘mumma’ and ‘dadda’

A

9-months

49
Q

What can an infant do at 9-months

A

Say mumma and dadda

Understand NO

50
Q

When does an infant known and respond to its own name

A

12-months

51
Q

What can an infant do at 13-15 months in language domain

A

Vocabulary 2-6 words

52
Q

If an infant does not know 2-6 words by what age should you refer

A

18-months

53
Q

When can an infant combine two words

A

2-years

54
Q

How many words would you expect a 2.5-year old to know

A

200-words

55
Q

What age may a child be able to talk in short sentences

A

3-years

56
Q

What can a child of 3-years do in language domain

A
  • Short sentences
  • Asks questions
  • Counts to 10
  • Identifies colours
57
Q

what age does a child smile

A

6W

58
Q

if a child has not smiled by what time frame should they be referred

A

10W

59
Q

when does a baby laugh by

A

3-months

60
Q

when is a baby not shy

A

6-months

61
Q

what can an infant do at 9-months in social domain

A
  • Shy
  • Takes objects by mouth
  • Peek-a-boo
62
Q

what can infant do at 12-months in social domain

A

Waves bye-bye

Patty cake

63
Q

what can infant do at 13-15 months in social domain

A
  • Drinks from cup
  • Uses spoon
  • Help getting dressed and undressed
64
Q

what can infant do at 18-months in social domain

A
  • Takes shoes off

- Plays alone

65
Q

what can infant do at 2-years in social domain

A
  • Plays near others, not with them
66
Q

what can child do at 3-years in social domain

A
  • Uses spoon and fork
67
Q

what can child do at 4-years in social domain

A
  • Dresses independently

- Plays with others

68
Q

what is bottom-shuffling

A

normal variant: child may bottom shuffle, opposed to crawl, prior to walking

69
Q

when should individual be referred if not smiling

A

10-weeks

70
Q

when should children be referred if poor head control

A

6-months

71
Q

when should children be referred if not sitting without support

A

12-months

72
Q

when should children be referred if not walking

A

18-months

73
Q

when should children be referred for not known 2-6Words

A

18-months

74
Q

what is considered a red-flag for development

A

Regression in previously learnt skill

75
Q

what are other red flags for development

A
  • Parental concern
  • Abnormal tone: difference between R and L
  • Poort interaction
76
Q

When is the new baby review

A

1-2W

77
Q

Who performs the new baby review

A

Health visitor

78
Q

When is a developmental review performed

A

9 months - 1-year

79
Q

What is completed at the developmental review

A

ASQ3 questionnaire by the parents

80
Q

When is the second health-development review

A

2-2.5 years

81
Q

Who completes second health-review

A

ASQ3 questionnaire - done by parents

Visit by health visitor

82
Q

What is developmental screening

A

Brief assessment where a screening tool is used to identify children who need further assessment and investigations

83
Q

How is developmental screening performed

A

Using developmental screening tool

84
Q

What Developmental screening test is used in the UK

A

Ages and Stages Questionnaire (ASQ)

85
Q

What age-range is the ages and stages questionnaire suitable

A

1 month - 5.5 years

86
Q

Define developmental delay

A

Slow acquisition of skills across all developmental domains or in one-specific developmental domain

87
Q

What are the two types of developmental delay

A

Global DD = delay in two or more domains

Specific DD = delay in one domain

88
Q

When is developmental delay often detected

A

When development for that skill is expected at that greatest

89
Q

What are the 3 patterns of developmental delay

A
  1. Slow but steady
  2. Plateau
  3. Regression
90
Q

What is slow-but-steady

A

Individuals are below where expected for they gestation but gradually improving

91
Q

What is plateau effect

A

Individuals initially improved and now are not

92
Q

What is regression

A

Individuals improved and then regressed

93
Q

When should individuals be referred due to abnormal motor development

A

18m if unable to walk

94
Q

What are 5 causes abnormal motor development

A
  • Cerebral palsy
  • Duchenne muscular dystrophy
  • Global developmental delay
  • Idiopathic
  • Spina bifida
95
Q

What does hand preference before 12-months indicate

A

CP

96
Q

Explain late-walking in normal variants

A

Bottom-shufflers and commando crawlers are late variants associated with later-onset of walking

97
Q

What can hypertonia indicate

A

CP

98
Q

What is a sign of DMD

A

Gower’s sign = using arms to push up legs to stand-up

99
Q

What do NICE recommend if child is at risk of cerebral palsy

A

General movement assessment at 0-3 months

100
Q

If only motor developmental delay what may be ordered

A

creatinine phosphate kinase - to exclude DMD

101
Q

what is language delay

A

delay in understanding or expressing speech

102
Q

what are causes of language delay in children

A
  • Familial
  • Hearing: chronic otitis media
  • Physical: tongue-tie, cleft palate
  • Neuropsych: neglect, autism
103
Q

how can language delay be divided

A 
Receptive = understanding 
Expressive = communicating
104
Q

when should child turn head to sound

A

3-months

105
Q

when should infant be referred if not turning head to sound

A

9-months

106
Q

when should infant babble

A

6-months

107
Q

when should infant be referred if not babbling

A

12-months

108
Q

when should child be referred if it has no clear words

A

18-months

109
Q

when should child have 2-6 words

A

12-months

110
Q

why may a child be referred at 2.5-years

A

if vocabulary is less than 50-words

111
Q

how many words should a child have at 2.5 years

A

200 words

112
Q

if child has language delay who should they be referred to

A

SALT

Audiology assessment

113
Q

what is global developmental delay

A

delay in two or more domains

114
Q

when does global developmental delay tend to appear

A

2-years

115
Q

in which domains is global developmental delay more common

A

fine motor
social
speech

(less apparent in gross motor)

Paediatrics (61 decks)

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