Child Development Flashcards
What does the rubrospinal tract do?
Automatic movements of arm in response to posture/balance changes
What does the reticulospinal tract do?
Coordinates automated movements of locomotion and posture
What does the vestibulospinal tract do?
Regulates balance
What does the olivospinal tract do?
Transmission of unconscious proprioception and balance
What are the four domains of development?
Gross motor skills
Fine motor skills
Social skills
Speech & language skills
Give examples of gross motor skills
Head lag Sitting Walking Running Position
Give examples of fine motor skills
Use of hands
Grasp
Fine pincer
Give examples of speech and language skills
Vocalisation
Words
Understanding
Imaginative player
Give examples of social skills
Social interaction
Stranger reaction
Eating skills
Dressing
What is the moro reflex?
When you quickly drop a baby’s head and they abduct and quickly adduct their arms
What types of patterns of development would be abnormal?
Slow but steady
Plateau
Regression
List some common problems in the development of children
Delayed walker Clumsy child Delayed speech and language Odd social interaction Hyperactivity
Which part of the brain is implicated in ADHD
Prefrontal cortex - low levels of dopamine -> lack of concentration
Give some features of autism
Impaired social interaction (solitary play)
Impaired communication (avoidance of gaze)
Restricted interests
Repetitive behaviours
Self stimulation
What is cerebral palsy?
Impaired corticospinal pathway -> motor deficits
Imbalance of flexors and extensors
Increased tone in legs due to lack of inhibition from corticospinal pathway
What are the two types of developmental delay?
Global vs specific
List some general causes of global delay
Chromosomal abnormalities Metabolic disorders Antenatal and perinatal factors Environmental-social issues Chronic illness
Which factors lead to developmental delay?
Lack of physical/psychological stimuli
Sensory/motor impairment
Ill health
Reduced inherent potential
List some metabolic causes of global delay
Hypothyroidism
Inborn errors of metabolism
List some antenatal/perinatal factors causing global delay
Infections Drugs Toxins Anoxia Trauma Folate deficiency
List some causes of motor delay
Cerebral palsy Down's Congenital hip dislocation Social deprivation Muscular dystrophy (Duchenne's) Neural tube defects Hydrocephalus
List some causes of language delay
Hearing loss
Learning disability
ASD
Lack of stimulation
Impaired comprehension of language (development dysphasia)
Impaired speech production (stammer, dysarthria)
How would you assess the child’s development?
Ask about milestones
Observe the child
Get the child to do task
What history would you ask the parents?
Birth history
Family history
Developmental history
Parental anxiety
List some commonly used assessment tools
Schedule of growing skills
Griffiths developmental scale
Bailey developmental scale
Denver developmental screening tests
What would you look for during the focussed physical examination?
The general look of the child
Growth - height, weight, occipitofrontal circumference
Hearing and vision
Neurological examination
Skin
Systems examination to identify syndromes
Genitalia
Which bloods would you request?
FBC Ferritin Metabolic screen (TFTs, U&Es, LFT, bone profile) Lead Organic ions Amino acids Creatine kinase Ammonia Lactate
What imaging/other things would you arrange?
US CT/MRI EEG Cytogenetic studies e.g. chromosomes Nerve and muscle biopsy!
What are the objectives of management?
Maximise mobility
Minimise discomfort
Promote speech and language
Promote social and emotional health
List members of the MDT involved in child developmental services
Speech and language therapist OT Paediatrician Physiotherapist Dietician Social work Psychologist Specialist health advisor
Give some common signs which suggest that a child’s development is delayed
Delayed walking Clumsy child Delayed speech and language Odd social interaction Hyperactivity
What birth history would be significant?
Prematurity
Prolonged or complicated labour
What antenatal history would be significant?
Illness Infections Medications Drugs Environmental exposures
What postnatal history would be significant?
Trauma
Illness
Infections
What would you ask about the parents?
Consanguinity
