Abnormal Development

Question 1

define developmental delay

Answer 1

this is a failure to attain developmental milestones for chronological age

Question 2

red flags for development

Answer 2

asymmetry of movement
not reaching for objects by 6 months
unable to sit unsupported by 12 months
unable to walk by 18 months (check CK)
no speech by 18 months
concerns with vision or hearing
loss of skills

Question 3

three patterns of abnormal development

Answer 3

1. delay
2. deviation
3. regression

Question 4

two types of delay

Answer 4

1. global

2. specific

Question 5

define global delay

Answer 5

significant delay in 2 or more of gross/fine motor, speech/language, cognition, social/personal and ADL

Question 6

example of global delay

Answer 6

Down’s syndrome

Question 7

what is Down’s syndrome associated with

Answer 7

cardiac
vision
hearing
hypothyroidism
sleep apnoea
growth chart- weight gain screening

Question 8

four types of specific delay

Answer 8

motor
language (specific language impairment)
sensory deficits
developmental deviations

Question 9

examples of motor specific delay

Answer 9

Duchenne’s (Gower’s manoeuvre sign of hip girdle weakness)
cerebral palsy
co-oridination disorders e.g. dyspraxia

Question 10

examples of sensory deficits in specific delay

Answer 10

oculocutaneous albinism

Treacher-Collins

Question 11

example of developmental deviaion

Answer 11

autism

Question 12

triad of presentation in autism

Answer 12

1. communication= delayed, abstract language difficulty, odd pitch, video speak, eye contact, restricted interest, lack of interests
2. social interaction= turn-taking, joint attention, not motivated by social approval, empathy, others feelings
3. flexibility of thought/imagination= routine, concept of time, ritualistic behaviour

Question 13

sensory difficulties in autism

Answer 13

fussy eater
texture of clothing
sleep 
toilet training
hair/nail cutting
noise

Question 14

example of regression

Answer 14

Rett’s syndrome

metabolic disorders

Question 15

history questions in developmental delay

Answer 15

PMH
birth 
family
play
behaviour

Question 16

examination in developmental delay

Answer 16

dysmorphism
head circumference
systems
CNS include neurocutaneous
vision and hearing

Question 17

investigations in developmental delay

Answer 17

chromosomes
FRAX
oligoarray CGH
neonatal PKU
thyroid studies
CK
others e.g. MRI brain, EEG, metabolic studies, genetics, etc.

Question 18

intervention in developmental delay

Answer 18

therapy e.g. physio, SLT, OT
family support
education placement
referral to other agencies