Case 10: Down Syndrome (exam 2 - kaylee) Flashcards
What is down syndrome?
Most common chromosomal abnormality characterized by three copies of the 21st chromosome
- causes intellectual disability
What is HYPOTHYROIDISM?
Condition in which the thyroid gland does not produce enough thyroid hormone
What is IDEA Part C?
Individuals with Disabilities Education Improvement Act Part C
- Federal law that provides financial aid to state for early intervention programs to meet developmental needs of children with disabilities
What is thyroxine?
Synthetic thyroid hormone replacement use to treat hypothyroidism
What is Ranitidine?
Histamine H2-receptor antagonist that inhibits stomach acid production and is commonly used to treat GERD.
ventricular Septal defect
hole in wall that separates the lower chambers of the heart
Precautions during PT for children with down syndrome
- protect joints form extreme ROM (d/t hypotonia and ligamentous laxity)
- observe for S&S of AA instability
- observe for signs of inadequate mgmt of thyroid & cardiopulmonary comorbidities
Complications during PT
- behavioral challenges d/t young age and intellectual disability
- OA instability (potentially devastating if not identified and treated
PT POC and goals
- improve motor control to achieve motor milestones
- focus on pulling to stand -> standing -> Independent ambulation
- caregiver education to facilitate motor development at home
- monitor LE alignment and need for orthoses
PT interventions
- Caregiver education to create environment for ind. exploration and gross motor play
- strengthening in the form of play
- assisted ambulation
- evaluation for orthoses
Down syndrome AKA
Trisomy 21
t/f: incident of DS increases with increasing maternal age.
TRUE
(20 y.o. women - incidence is 1/2000 but
40 y.o. women - incidence is 1/100)
t/f: the diagnosis of DS can be made prenatally as early as the first trimester.
True
Children with DS show delayed development of postural control that is most affected by:
a. hydrocephalus
b. smaller than normal cerebellum
c. visual impairment
d. tendency toward obesity
smaller than normal cerebellum
Which of the following has been shown to help a young child with DS learn to walk independently earlier?
a. supramalleolar orthoses
b. early intervention programming
c. treadmill training
d. aquatic therapy
treadmill training
Poor activity tolerance, as evidenced by the child’s refusal to participate in active play for more than a few minutes, could be a symptom of inadequate management of:
a. hypothyroidism
b. visual deficits
c. gastroesophageal reflux
d. postural control deficits
hypothyroidism
What standardized developmental assessment tool has been specifically validated for children with DS?
GROSS MOTOR FUNCTION MEASURE (GMFM)
What are other standardized tests are appropriate for this population?
- Peabody Developmental Motor Scales 2 ed. (PDMS-2)
- Bayley Scales of Infant Development (this is the gold standard for this population)
What orthoses helps children with DS to improve gait, balance, and gross motor skills?
supramalleolar orthoses
what are some possible comorbidities that can occur with DS?
- MSK impairments (hypotonia and ligamentous laxity)
- neurological impairments (reduced brain volume, smaller frontal & temporal areas, smaller cerebellum and smaller hippocampus)
- hypothyroidism
- Congenital heart defects (septal defect)
- Gastrointestinal tract abnormalities
- Skin disorders (eczema, seborrheic dermatitis, hyperkeratosis, and more)
- Seizures
- obstructive sleep apnea
- Behavioral/Mental health disorders (ADHD, autism, oppositional disorder, aggressive behavior
- hearing and/ or visual impairments
_______ instability is present in approximately 15% of this population.
ATLANTOAXIAL INSTABILITY
