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Child and Family > Approach to the child with developmental delay > Flashcards

Approach to the child with developmental delay Flashcards

1
Q

What is the definition of developmental delay?

A

Failure to attain appropriate developmental milestones for a child’s corrected chronological age

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2
Q

Why may a chronological age be corrected?

A

If a baby is premature then the growth to normal must be accounted for

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3
Q

What are the three patterns of abnormal development?

A

Delay
Deviation
Regression

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4
Q

What are the 2 branches of delayed development?

A

Global

Specific

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5
Q

What is an example of a global delay?

A

Down syndrome

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6
Q

What is an example of specific delay?

A

Duchenne’s muscular dystrophy

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7
Q

What is an example of a deviation development problem?

A

Autism spectrum disorder (ASD)

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8
Q

What are 2 examples of regression development?

A

Loss of skills
Rett’s syndrome
Metabolic disorders

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9
Q

What % of the UK child population have ASD?

A

1%

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10
Q

What is a mild learning disability and what % of children have one?

A

IQ 50-70

1-2%

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11
Q

What is a severe learning difficulty and what % have one?

A

IQ<50

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12
Q

What are 3 examples of a specific learning difficulty and what % of children have one?

A

Dyslexia
Dyscalcuria
Dyspraxia

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13
Q

What are 7 red flags for development?

A 
Asymmetry of movement
Not reaching for objects by 6 months
Unable to sit unsupported by 12 months
Unable to walk by 18 months
No speech by 18 months
Concerns re vision or hearing
Loss of skills
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14
Q

What may be a concern when a child isn’t walking by 18 months and what should be checked?

A

Muscular Dystrophy
Check CK
(10x in DMD)

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15
Q

How is a global development delay characterised?

A

Significant delay in 2+ of:

  • Gross/fine motor
  • Speech/language
  • Cognition
  • Social/personal
  • Activities of daily living
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16
Q

What accounts for 5-25% of global development delays?

A

Genetic causes

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17
Q

What % of under 5s have a global developmental delay?

A

1-3%

18
Q

What 7 things are screened for in down syndrome?

A 
Cardiac
Vision
Hearing
Thyroid function
Sleep related breathing disorders
Growth-charts
Development
19
Q

What are 3 examples of motor delays?

A

Duchenne MD
Cerebral palsy
Co-ordination disorders

20
Q

What are 2 examples of sensory deficits and associated delay?

A

Oculocutaneous albinism

Treacher-collins

21
Q

What are three variants of cerebral palsy?

A

Hemiplegic
Diplegic
Quadriplegic

22
Q

What does hemiplegic mean and what does this present with?

A

Only one side affected
Arm bent, hand spastic or floppy
Walks on tiptoe of foot

23
Q

What does diplegic mean and what does this present with?

A

Both legs affected only
Normal upper body
May develop contractures of the ankles or feet

24
Q

What does quadriplegic mean and what does this present with?

A 
Both arms and legs
Arms head and mouth may twist strangely
Severe brain damage
Knees press together
legs and feet turned inwards
25
Q

What are 10 conditions associated with cerebral palsy?

A 
Mobility problems
Spasticity 
Orthopaedic problems
Learning difficulties
Epilepsy
Visual/Hearing impairment
Communication difficulties
Feeding difficulties 
Sleep probelms
Behaviour problems
26
Q

What is the autism triad?

A

Communication
Social interaction
Flexibility of thought/imagination

27
Q

How is receptive language affected in ASD?

A

Delayed
Expressive>Receptive
Abstract language difficult
Visually more able

28
Q

How is expressive language affected in ASD?

A

Delayed
Echoes
Odd/intonation/pitch
Chunks of video speak

29
Q

How is non-verbal language affected in ASD?

A

Facial expressions
Gestures
Eye contact
Recognising intention of others

30
Q

How is use of language affected in ASD?

A

Initiating and sustaining conversation
Restricted interests
Lack of awareness of reciprocal nature of conversation

31
Q

How is social interaction affected in ASD?

A 
Joint attention and referencing
Turn taking
Unable to share pleasure
Not motivated by need for social approval
Social rules
Empathy
Relationships
Others point of view/feelings
32
Q

How is flexibility of thought/imagination affected in ASD?

A 
Theory of mind
Concrete and literal
Concept of time
Routines
Changes in environment
Ritualistic behaviour
33
Q

What are some sensory difficulties of ASD?

A 
Fussy eater/medication
texture of clothes
Sleep
Toilet training
Hair washing/cutting
Nail cutting
Noise
34
Q

What are the 5 main points in the approach to developmental delay?

A 
History
Examination
Investigations
Assessments
Intervention
35
Q

What are important aspects of the history?

A 
Concerns
PMH
Perinatal and birth
Family and social
Developmental
Play and behaviour
School/nursey
36
Q

What are important aspects of the examination?

A 
Observation
Dysmorphism
Head circumference
Systems
CNS (including neurocutaneous)
Vision
Hearing
37
Q

What are important investigations in developmental delay?

A 
Chromosomes
Fragile X
Oligoarray CGH
Neonatal PKU
Thyroid studies
CK
38
Q

What investigations can be done if indicated?

A

MRI brain
EEG
Metabolic studies
Genetic consultation

39
Q

What are 4 assessment tools for assessing development?

A

griffiths (0-8yrs)
Bayleys (0-3 yrs)
Schedule of growing skills (0-5yrs)
ADOS (ASD)

40
Q

What interventions can help a child with a developmental delay?

A 
Early intervention
Therapy
-Physio
-SLT
-OT
Family supprt
Educational placemtn
Referral to agencies

Child and Family (13 decks)

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