Approach to the child with developmental delay Flashcards
What is developmental delay?
Failure to attain appropriate developmental milestones for child’s corrected chronological age
What is an example of a global abnormal development?
Down’s syndrome
What is a global delay?
Significant delay in more than 2 of:
Gross/fine motor, speech/language
Cognition, social/personL
What is an example of a specific abnormal development?
Duchenne’s muscular dystrophy
What is an example of a deviation of abnormal development?
ASD
What is an example of a regression of abnormal development?
Rett’s syndrome
Metabolic disorder
What IQ is considered a mild learning disability?
IQ between 50 and 70
What IQ is considered a severe learning difficulty?
Less than 50
What are red flags for development?
Asymmetry of movement Not reaching for objects b 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
What should be checked in a child that cannot walk by 18 months?
CK
What medical screening should children with down’s syndrome undergo?
Cardiac Vision Hearing Thyroid function Sleep related breathing disorders Growth charts Development
What are examples of specific motor developmental delay?
Duchenne muscular dystrophy
Cerebral palsy
Co-ordination disorders
What are examples of specific language developmental delays?
Specific language impairement
What are examples of specific sensory deficits and associated delays?
Oculocutaneous albinism
Treacher-collins
What is an example of a specific developmental deviation?
Autism spectrum disorder
What is the common manoeuvre seen in duchenne MD?
Gower’s
What are the 3 different types of CP?
Hemiplegic
Diplegic
Quadraplegic
What can cause a diplegic pattern?
Insult between the 24-32nd week of pregnancy
Injury to lateral ventricles
What conditions are associated with cerebral palsy?
Mobility, spasticity and orthopaedic Learning difficulties Epilepsy Visual or hearing impairment Communication difficulties Feeding difficulties Sleep problems Behaviour problems
What is the autistic triad?
Communication Social interaction - eye contact etc Flexibility of thought/ imagination Restricted, repetitive behaviors Sensory difficulties
What non verbal language do ASD children struggle with?
Facial expression
Eye contact
Recognising intention of others
What language use to ASD children suffer with?
Initiating and sustaining conversation
Restricted interests
Lack of awareness of reciprocal nature of conversation
What social interactions do children with ASD struggle with?
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
What limits of flexibility of thought/imagination do ASD children suffer from?
Theory of mind Concrete and literal Concept of time Routines Changes in environment Ritualistic behaviour
What sensory issues do ASD children suffer from?
Fussy eaters Textures of clothes Sleep Toilet training Hair washing Nail cutting Noise
What should be assessed in the examination of a developmentally delayed child?
Observation Dysmorphism Head circumference Systems CNS inc neurocutaneous Vision Hearing
What investigations should/can be done for a developmentally delayed child?
Chromosomes, FRAX and oligoarray CGH Neonatal PKU, thyroid studies, CK MRI brain EEG Metabolic studies Genetic consultation
What assessment tools can be used in developmental assessment?
Griffiths (0-8yrs)
Bayleys (0-3yrs)
Schedule of growing skills (0-5yrs)
ADOS (ASD)
What type of hearing loss does sensorineural produce?
Worst hearing at high frequencies
What type of hearing loss does conductive hearing loss produce?
Lower at all frequencies than sensorineural but small dip at higher frequencies
What is the most common type of conductive hearing loss?
Glue ear
How is glue ear treated?
Grommet
What can commonly cause sensorineural hearing loss?
Viral, measles, mumps, meningitis
