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Lucy Knox - Year 2 > 222 - CP + Autism > Flashcards

222 - CP + Autism Flashcards

1
Q

What is a learning disability?

A

IQ

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2
Q

What can cause a learning disability?

A

Genetic (fragile X, down’s. Prader willi)
Antenatal (infections, intoxication, endocrine - hypothyroid)
Perinatal (birth asphyxia, kernicterus, haemorrhage)
Post-natal (injury, infection, intoxication, malnutrition, epilepsy

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3
Q

What is kernicterus?

A

Bilirubin toxcitiy

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4
Q

How common are associated symptoms with learning difficulties?

A 
40% - sight issues
25% - hearing issues
20% - dental issues
12% - psychiatric
20% - epilepsy
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5
Q

When do you asses child development?

A

Oppertunistically
Whenever concerns expressed
At routine child health surveillance appointments
When well known factors exist (down’s, neglect..)

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6
Q

How to we judge child develpment?

A

Milestones - when an average child does X
Monitored over time
Correct for due date

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7
Q

What factors determine child development?

A

Genetic
Antenatal exposure (alcohol)
Diseases (meningitis, trauma)
Chronic health problems (congenital heart probs - put all energy into them)
Parenting (home structure and relationships important
Socioeconomic circumstances (need opportunities to learn and play)

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8
Q

What are the 4 domains child development is split into?

A

Gross motor
Social, emotional, behavioural
Speech and hearing
Fine motor + vision

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9
Q

What are some common milestones a child should meet in gross motor areas?

A 
Sit - 6months
Crawl - 8 months
Walk - 12 months
Kick - 2 years
Steps - 2-3 years
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10
Q

What are some common milestones a child should meet in the social, emotional and behavioural area?

A

Social smile - 6 weeks
Waves - 10 months
Symbolic play - 18months
Play socially - 3 years

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11
Q

What are some common milestones a child should meet in speech and hearing areas?

A

‘aa aa’ - 3 months
Turns to sound - 3 months
Words - 12 months
Sentences - 3 years

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12
Q

What are some common milestones a child should meet in fine motor and vision areas?

A

Fix eyes on object - 6 weeks
Hold object - 3 months
Pincer grip - 9 months
Draw - 3 years

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13
Q

What are some red flags of child development?

A 
Regression
Special sense issues
Discordance between domains
Abnormal head growth 
Not meeting milestones 
Hand dominance under 1year
No words by 18 months
Only tip-toe walking at 2 years
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14
Q

what is cerebral palsy?

A

A disorder of movement and posture, or motor function.
Permanent but not unchanging
Due to a non-progressive lesion of the developing brain

Often accompanied by disturbances in sensation, cognition, communication, perception and behaviour

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15
Q

How common is cerebral palsy?

A

2/1000 live births
M:F, 1.33:1
20% of people with CP have profound disability

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16
Q

What types of motor impairment may someone with CP have?

A

Ataxia - abnormality in smooth approach to an object
Athetosis - slow writhing movements, usually distal
Chorea - rapid, high amplitude sudden + involuntary

Tone:

  • Spasticity: velocity dependant, increase in resistance to passive stretch + hyperreflexia
  • Dystonia: abnormal sustained contraction of agonists and antagonists resulting in abnormal posture
17
Q

What are some common subtypes that CP is classified into?

A

Spastic CP - bilateral or unilateral
Dyskinetic CP - dystonic or choreo-athetotic
Ataxic CP

18
Q

What associated impairments are seen in someone with CP?

A

Cognitive - 30% have global learning disability
Visual - 11% severe impairment, many have myopia, cortical VI, squint, field deficit, visuo-perceptual difficulties

Hearing 20-30% have impairment
Epilepsy - 20%
Sleep disturbances
Behavioural, attentional, communicative issues too.

19
Q

Will you find abnormalities in radiological investigations in someone with CP?

A

83% have abnormal imaging

10% have maformations

20
Q

When does CP occur / when is the cause?

A

80% pre-natal

10% peri-natal

21
Q

How does a child with CP often present?

A 
Delayed motor milestones
Abnormal gait
Early hand dominance
Reduced movements
Persistant of primitive reflexes
Tone and posture abnormalities
22
Q

How is CP managed?

A

Aim to maximise QoL, improve everyday function and increase independence and participation.

MDT key

need good respiratory care, ? gastrostomy feeding, epilepsy control, immunisations….

23
Q

What is the 20yr survival expectation of someone with CP?

A

If 1 severe disability - 90%
if 2: 85%
if 3: 50%

24
Q

What is autism?

A

A neurodevelopmental disorder
Characterised by difficulties in - social aspects, communication and restricted repetitive behaviour + interests.
Lifelong, typically noticed around 3 years old.

At any level of intellegance

25
Q

What are the 2 key criteria for autism spectrum disorder in the DSM-5?

A

Difficulties in social communication and interaction

Restricted + repetitive behaviour, interests and activities

26
Q

What is the prevelance for autism?

A

1% of children
M:f, 4:1
Increasing - ? better recognition

27
Q

What other medical conditions is autism associated with?

A 
8-30% epilepsy
up to 70% have GI issues
40% immune dysregulation
50-80% sleep disorders
Anxiety, OCD and depression common

Also linked with learning disabilities - 45% have, 30% have regression, 80% have some motor abnormality

28
Q

What risk factors are there for autism?

A

Increasing maternal or paternal age
Genetic predisposition
Syndromal link - down’s

29
Q

What are some very early signs useful to try spot autism?

A 
Language delay/regression
Set words
Poor response to name
Poor eye contact or social smiling
Lack of imaginative play
Sterotyped movements, fixations, flapping
30
Q

What signs of autism can be seen in a primary school aged child?

A 
PICA - eating non-food
Learned speech - monotonous
Reduced awareness of personal space
Limited facial expression
Likes routines, rituals, agenda
Stereotyped movements
31
Q

What signs of autism are seen in a seconday school ages child?

A

(often show as loose the close support of primary school)

Odd intonation
Take things literally
Social situation issues
Lack common sense
Unusual skill profile + interests
Bullying
Can become aggressive or cause self injury
32
Q

What is the management of autism?

A

Aim to maximise functioning independence, tailored to the child, behavioural and educational needs.

Medication - nothing for the -ve symptoms.

  • melatonin to help with sleep
  • SSRIs if anxiety a problem
  • Sodium valoprate to stabalise mood

Lucy Knox - Year 2 (17 decks)

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