4. Special Needs Flashcards
What are the features of normal development?
Constant pattern Sequential acquisition of skills Median age vs maximum age Genetic factors Environmental factors
What is a learning disability?
A significant impairtent in intellectual function, affects the persons ability to learn and problem solve in early life. It has been present since childhood.
How do children present with disabilities?
Routine health surveillance Children with identified risks (premature, problems during birth/spent time in neonatal) Parental concern Professional contact Uk healthy child program
What is involved on history and examination in clinic?
Parental, perinatal, postnatal events Developmental milestones The red book Environmental, social and family history Video recording of child Observation in clinic
What are some of the primary care assessment tools?
ASQ
PEDS
M-CHAT
SOGs-2
What are the secondary care assess,ent tools?
Griffiths mental development scales
Bayley scales of infant development
Wechsler preschool and primary scales of intelligence
What are key things to assess on history and examination when looking at a childs growth?
Family history of genetic disorders Miscarriages Gestational history Alcohol and drug use in pregnancy Record medications Lead and iron Growth records Neuroimaging Vision and hearing surveillance
What aspects do you look for on the examination?
Head circumference Dysmprohic feathers Skin abnormalities Movement qualities Ability to sit and stand from saline Eye movements and eye examination CVS,RESP Abdo exam Obervation of behaviour
What are some common syndromes picked up?
Down syndrome
Fragile X- broad forehead, prominent ears,chin. Delayed, hyper mobile
Williams syndrome- elephant lime features low set ears
What are some red flag signs of child development?
Child is losing skills Vision/hearing Too floppy No speech by 18-24 months Asymmetry Head circumference on the extreme upper or lower ranges
What are some green flags
Sit unsupported by 12 months Walk by 18 months-2 years Walk Run by 2.5 years Hold objects in hand by 5 months Reach by 6 months Points to objects to share interest by share 2 years
What are the primary investigations you would do
Streamline by differential!
Chromosomal analysis, fragile X, array CGH
Creatinine kinase
Thyroid screening
Metabolic testing: amino and organic acid, NH4, lactate
Hearing/vision tests
Neuroimaging (after 2)
What are the common motor problems?
Delayed maturation
Cerebral palsy
Developmental co-ordination disorder
What are the common sensory problems?
Deafness
Visual impairment
Multi sensory impairment
What are the common language problems?
Specific language impairment
Learning disability
What are the common social/communication problems
Autism, aspergers, elective mutism
Who is involved in dealing with children with special needs?
Developmental paediatrician Speech and language therapist OT/PT: functional impairment and strengths Psychologist Social worker Geneticist
How do assess a child with suspected cerebral palsy?
Motor development Posture Tone Primitive reflexes Diagnosis Prognostic factors
What do you do with an autistic kid
School advised via educational psychologist DLA In house training for parents Refer to clinical genetics Fragile X and Rhet’s syndrome FBC, TFT, CK,U&E
What services can help support a diabled child?
Community paediatric clinic
Child development teams
MDT
Therapy services
What is meant by additional support needs
Additional support with their education
Why would a child require Advanced support learning?
Difficulties with mainstream approaches to learning
Disability or health needs, such as motor or sensory
impairment, learning difficulties or autistic
spectrum disorder.
Family circumstances e.g. young people who are
carers or parents.
What is an individualised education plans (IEP)
Non legal document that outlines a detailed plan for a child’s learning
It sets out SMART goals and how they will be achieved
Not a legal document
What is a co-ordinated support plan?
Legal requirement that details what a child’s support needs are and who would provide them.
What is GIRFEC?
Getting it right for every child
Contains information about:
why a child or young person needs support
the type of support they will need
how long they will need support and who should provide it.
What are the long term prognostic factors?
Depends on nature of problem
Acquisition of skill
Social and emotional needs
Personal attributes, family, social surroundings and level of care received
