4 - Paeds - Community Paeds + Psych - Specific LDs

Question 1

Dyslexia - what is it? mgmt? involve who?

Answer 1

disorder of reading disproportionate to IQ - when reading age >2y behind actual age

assess vision and hearing and involve educational psychologist

Question 2

Dyscalculia/Dysgraphia - what is this?

Answer 2

disorder in development of calculation and writing skills

Question 3

Dyspraxia/Dev coordination disorder - LD of? no findings when? disorder characterised by 4 things? may impact on what?

Answer 3

motor planning/execution with no findings on neuro exam

higher cortical processes, associated problems of perception, use of language, and putting thoughts together

education and self esteem

Question 4

Dyspraxia/Dev coordination disorder - clinical features

Answer 4

awkward messy handwriting, poor dressing, poor literality, poor copying/drawing, messy eating/dribbling

Question 5

Dyspraxia/Dev coordination disorder - mgmt? therapy ?

Answer 5

assessment/advice from OT or SALT
visual assessment
therapy - sensory integration , sequencing, executive planning

Question 6

Disorder of Executive Function - what is EF responsible for?

Answer 6

planning and organisation, self-regulation, cognitive flexibility, problem solving, abstract reasoning

Question 7

Disorder of EF - cause of deficits? manifests as..?

Answer 7

consequence of acquired brain injury - infection, trauma, stroke

forgetful, poor focus, volatile mood, overeating, poor social skills

Question 8

Associated comorbidities seen with LDs

Answer 8

ADD, ADHD, poor sensory integration skills (touch/balance), depression, conduct disorder

Question 9

MGMT principles for specific LDs

Answer 9

assessment - > vision and hearing by OT, Physio, SALT, and educational psychologist
ID comorbidities
trt aimed at improving skill acquisition with educational and IT support as appropriate

Question 10

LD IQ banding?

Answer 10

70-80 = mild
50-70 = moderate
35-50 = severe
<35 = profound

Question 11

When do LD present normally, corresponding to how severe they are?

Answer 11

mild - later on
mod - emerge as delay in S+L
severe and profound - from infancy as dev delay

Question 12

LDs mostly have organic cause - 3 types?

Answer 12

prenatal, perinatal, postnatal

Question 13

prenatal causes (6)

Answer 13

genetic (downs, fragile X, microcephaly, hydrocephalus)
vascular (occlusion, haemorrhage)
metabolic (hypothy, PKU) teratogenic (alcohol, drugs)
congenital infection (rubella, CMV, HIV, Toxo)
neurocutaneous syndromes (tuberous sclerosis, NFT)

Question 14

Perinatal causes

Answer 14

extreme prematurity
birth asphyxia
metabolic (hypo, hyperbilirubinemia)

Question 15

postnatal causes

Answer 15

infection (meningitis/encephalitis) 
anoxia (drowning, suffocation, seizures)
trauma (head injury)
metabolic (hypo)
vascular (stroke)