Assessment of Developmental Disorders - Palat and ASD - Hepburn

Question 1

1. Describe normal development and how you evaluate and assess it.
2. Describe abnormal development.
3. Compare and contrast developmental disabilities, intellectual disabilities, cerebral palsy, and autism, including how you diagnose and the cause of each.

Answer 1

x

Question 2

How is the developmental quotient calculated, and what are the ranges?

Answer 2

Developmental age/chronological age.
Greater than 85 reassurance
70-84 - close monitoring
Less than 70 refer

Question 3

How is normal development evaluated and assessed?

Answer 3

“An individual who grows and matures on an expected path and achieves developmental milestones appropriately”

Assess with ASQ (Ages and Stages Questionnaire), physical exam, history

Question 4

How is delayed development quantified?

Answer 4

Less than 2 SD below the mean is considered a developmental delay.

Question 5

In what 5 domains can a developmental delay manifest?

Answer 5

Social
Cognition
Fine motor
Gross motor
Language

Question 6

What is the clinical approach to assessing development?

Answer 6

History–>ASQ (Ages and Stages questionnaire)–>Physical Exam–>Formal evaluation by specialist team

Question 7

Which category includes the other: intellectual disability or developmental delay

**Developmental disability is an umbrella term that includes intellectual disability

Answer 7

All people with intellectual disability have developmental delay, but not all people with developmental delay have intellectual disability

Question 8

What is the IQ threshold for intellectual disability?

Answer 8

2SD, or below 70.

Question 9

Cerebral Palsy

Answer 9

70% have intellectual disability, 30% have normal cognition

Question 10

Above what age can IQ be measured reliably?

Answer 10

5 years.

Question 11

Angelman Syndrome

Answer 11

15q11-13 imprinting disorder. non-PC “Happy puppet” symptoms: hand flapping, smiling, ataxia, seizures, nonverbal, microcephaly

Question 12

Rett syndrome

Answer 12

Girls only MECP2 gene (x-linked). Symptoms include microcephaly, autistic features, hand-wringing, seizures

Question 13

10% of children with DD and risk factors will have elevated ____ levels

Answer 13

lead

Question 14

x

Answer 14

x

Question 15

1. Discuss the signs and symptoms associated with autism spectrum disorders (ASD) at different ages, including basic facts about prevalence, etiology and outcome.
2. Discuss shared symptomology and individual differences in individuals presenting with autism spectrum disorders (ASD).
3. Identify available resources and support services to assist in the provision of quality health care to patients with developmental disabilities, such as autism spectrum disorders ASD.

Answer 15

x

Question 16

x

Answer 16

Impairment in 2 areas

1) social communication or interaction that is thought to be reciprocal.
2) and the ability to communicate socially

As physicians we look for physical signs that are indicators (joint attention - point at something and look at parent).

Question 17

What is the treatment goal for patients with autism?

Answer 17

Optimal functioning. (2/10 people with autism will have undetectable symptoms by adulthood.)

Question 18

MCHAT (Modified Checklist for Autism in Toddlers) 10 min office screen for autism

Answer 18

x

Question 19

Regression of skills in 15-30% of kids between 16-24 months (eg loss of words)

Answer 19

x

Question 20

Absence of nonverbal communication is the most notable finding at a young age. Unusual behaviors don’t appear until older ages.

Answer 20

x

Question 21

Symptom severity often occurs around age 4-5, and improves during the school years

Answer 21

x