CEREBRAL PALSY AND MENTAL RETARDATION AUTISM Flashcards
Cerebral Palsy
• A disorder of ________ and ________ resulting from a (temporary or permanent?) (progressive or non-progressive?) defect or lesion of the
(Mature or immature?) brain.
• The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, cognition, communication, perception, and/or behaviour, and/or by a seizure disorder’.
movement ; posture
permanent ; non-progressive
immature
Aetiology of CP
Pre-natal, Perinatal, Postnatal –
• Commonest Causes
Nigeria and Developing Countries
– Severe ______________
– ______________
– Infections (Intrauterine and Perinatal)
– Metabolic (______________)
Developed Countries
– Extreme ______________
– Inborn Errors of Metabolism
Severe Perinatal Asphyxia
Kernicterus
(Hypoglycaemia
prematurity
Classification (CP)
• _________
• _________
• The _______________ Classification System (GMFCS)
Clinical
Anatomical
The Gross Motor Function Classification System (GMFCS)
Classification (CP)
• Clinical (_________ , __________ , extra-pyramidal [__________, __________ , __________] and __________).
• Anatomical (__________plegia, __________plegia, _____plegia and
_________plegia)
spastic, flaccid, extra-pyramidal [dystonic, ataxic, choreo-athetoid] and mixed).
monoplegia, hemiplegia, triplegia and
quadriplegia)
The Gross Motor Function Classification System (GMFCS) is a recently developed system which classifies children with CP by their age specific motor activity.
– It is based on the assessment of severity of CP in children 0-____
years of age based on their ______________ rather than their
___________ .
– The GMFCS describes the functional characteristics in five levels, from I to V, level I being the mildest.
12
functional abilities
limitations
Aetiology (MR) 1
Before or At Conception
• Inherited disorders (such as ___________, ________ disease, neurofibromatosis, hypo__________, and _________ syndrome)
• Chromosome abnormalities (such as _______________)
phenylketonuria
Tay-Sachs disease
hypothyroidism
Fragile X syndrome)
Down syndrome
Aetiology (MR) 1
During Pregnancy
• Severe maternal ____________
• Infections with HIV, cytomegalovirus, herpes simplex, toxoplasmosis, rubella virus
• Toxins (such as _______ and _______ )
• Drugs (such as phenytoin, valproate, isotretinoin, and cancer chemotherapy)
• Abnormal brain development (such as poro-encephalic cyst, _______________, and ___________)
• Pre-eclampsia and ________ births
malnutrition
alcohol ; lead
Grey matter heterotopia ; encephalocoele
multiple births
Aetiology (MR) 2
During Birth
• Insufficient ________ (_______)
• Extreme __________
oxygen (hypoxia)
prematurity
Aetiology (MR) 2
After Birth
• Brain _________ (such as meningitis and encephalitis)
• Severe _________
• _________ of the child
• Severe emotional neglect or abuse
• Toxins (such as lead and _________)
• Brain tumors and their treatments
infections ; head injury
Malnutrition ; mercury
A specific cause can only be identified in only about _______ third of
people with mild MR/ID and in _______ thirds of people with moderate to
profound MR/ID.
one
two
Classification (MR)
• In general an IQ of ______ or below indicates mental retardation.
70
The Developing Brain
• Critical Periods of Brain growth
– ________ – neural tube
– _______ – All the lobes and major divisions complete
– _______ post-natal – 2/3 adult size
– _________ age – 75% adult size
– _________ – 90% adult size
1 month
4th month
1 year post-natal
2 years age
5 years
Potential for Neurogenesis (peaks in _________) and Synaptogenesis (peaks by ________) continues throughout life.
utero
5 years
Normal Development
Maturation of the nervous system
underlies development and it progresses _____________ (head downward). It is also a smooth continuous process.
cephalo-caudally
Motor
• Primitive reflexes (disappear by 3-4 months)
• Neck control _______ months (earlier in African children)
• Sitting _______ months
• Rolls _______ months
• Crawls _______ months
• Stands with support _______ months
• Walks _______ months
• Climbs up and down stairs _______ months
• Sitting 5-6 months
• Rolls 7 months
• Crawls 7-8 months
• Stands with support 10 months
• Walks 12 months
• Climbs up and down stairs 20 months
Social
• Smiles _______ (reflex smiles from birth)
• Follows person with the eyes ____ months
• Turns head to person talking _____ months
• Shows toy ____ months
• Waves bye-bye ______ months
• Knows 2 body parts ______
Social
• Smiles 6 weeks (reflex smiles from birth)
• Follows person with the eyes 3 months
• Turns head to person talking 6 months
• Shows toy 8 months
• Waves bye-bye 10 months
• Knows 2 body parts 2 years
Language
• Babbles ______ months
• Says mama/dada ______ months
• Understands “No” ______ months
• Babbled conversation ______ months
• Understands 6-20 words ______ months
• 2 word sentences ______ months
Language
• Babbles 6 months
• Says mama/dada 9-12 months
• Understands “No” 12 months
• Babbled conversation 18 months
• Understands 6-20 words 20 months
• 2 word sentences 24 months
Intelligence is the ability to _________ and _______ to the _____________ of everyday life. It involves verbal ability and problem solving skills.
learn ; adapt
experience
IQ = _____/_____ x 100
• Score of _____ is considered average.
IQ = MA/CA x 100
100
Common intelligence tests used:
• ____________ Test
• ____________ Scales
• ____________ Developmental Scales
• ____________ Scales
• Griffiths Scales
• Raven’s Progressive Matrices
Stanford-Binet Test
• Weschler Scales
• Denver Developmental Scales
• Bayley Scales
Quantification of milestone achievement can yield three types of abnormalities: _______,___________, and __________.
delay
dissociation
deviance.
Delay means a significant __________ rate of development. It can be global or affect one stream of development. It is the commonest reason for referral.
sub-average
• Dissociation is a state that exists when ????????.
one phase of development is out synchrony with the others
Deviance refers to _________________
e.g. a child who walks without crawling.
non-sequential development
