- genetic, epigenetic, environment - males - sibling /w autism - advanced paternal age - downs, NFT, tuberous sclerosis, fragile X, angelman, rett syndrome - prematurity, low BW

Child Development Flashcards by Erica S

Red Flag - can’t sit at___

9 mo

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Red Flag - can’t walk by ____

18 mo

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Red Flag - no pincer grasp by ____

12 mo

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Red Flag - hand dominance at

<18mo

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Red Flag - no response to name by ____

12 mo

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Red flag - <15 words by ___

18 mo

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Red Flag - no two word sentences at

2 years

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Red Flag - no pretend play by

3 years

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Red flag – does not point to desired object by ___

15 mo

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Other general red flag

regression at any age

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Developmental Hx

med hx, prenatal
diet
sleep
hearing, vision
seizures
milestones
famhx
soc hx
corroboration - teachers, etc

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Developmental physical exam

growth (HC, wt, ht)
full exam
esp: neuro, dysmorphic features, neurocutaneous signs
developmental observation

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Developmental Disorder - DDx / categories

motor: CNS (e.g. CP), PNS (e.g. MD), developmetnal coordination disorder
language: oromotor anatomy, hearing impairment, language disorder, ASD
emotional/social: ASD, neglect, social communication disorder
if 2+ areas: global developmental delay (language, social, cognitive, motor (fine, gross))

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Developmental disorder w/u

hearing, vision
genetic syndromes potentially
MRI head (if neuro findings, seizures, macro/microcephaly)
metabolic testing
EEG if ?seizures
lead + iron studies possibly
TSH

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Autism Spectrum Disorder - diagnostic criteria

A criteria (persistent + multiple contexts):

deficit in social-emotional reciprocity, affect, fail to initiate/respond
deficit in non-verbal communication
deficit in relationships

B restrictive behaviours

repetitive motions / speech
insistence on routine
restricted + fixed interests
hyper or hypo-reactivity to sensory input

Present early in development, cause impairment, not explained by ID or GDD

If co-occur with ID, ASD social communication is below expected for IQ

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ASD risk factors

genetic, epigenetic, environment
males
sibling /w autism
advanced paternal age
downs, NFT, tuberous sclerosis, fragile X, angelman, rett syndrome
prematurity, low BW

ASD w/u and diagnosis

screen: 18-24mo
M-CHAT-R, ADOS-2
DSM5 to dx
speech, OT, maybe psych assessments
chromosome microarray + fragile X testing
hearing test if speech delay
+/- genetic test, MRI, EEG, metabolic test, CBC, TSH, lead
psychoeducational testing for school

ASD management

early multi-D intervention
applied behavioural analysis therapy
SLP, OT, behaviour support
meds if refractory aggression
social skills + vocational training

Cerebral Palsy Description / types

non-progressive movement disorder from peri-natal brain injury. Hypertonia.

types:
- spastic (uni or bilat)
- ataxic
- dyskinetic (dystonic or choreoathetosis - kernicterus)

investigations for CP

MRI
**vision + hearing **
EEG if seizures
coagulopathy profile if hemiplegic
metabolic + genetic testing NOT routine

CP management

physio, OT, speech therapy

hypertonia: botox, diazepam, dantrolene, baclofen, tizanidine

intrathecal baclofen pump

surgery: contractures, neuro (dorsal rhizotomy)

CP possible associations

speech delay
ID
LD
hearing + vision issues
seizures
feeding/swallowing
constipation

Global developmental delay definition

delay in 2 domains (motor, speech/language, cognition, social, ADLs)

only for kids <5, may become ID when older

Global Dev Delay w/u

chromosome microarray + fragile X
basic metabolic testing
hearing + vision
others based on physical: EEG, lead, iron, genetics consult
MRI if neuro, seizures, abnormal HC

Intellectual Disability criteria

3 criteria (meets all) - deficit in intellectual functioning (reasoning, problem solving, planning, etc) by clinically + testing - deficit in adaptive functioning (independence, ADLs, social role) - onset during developmental period mild, mod, severe, profound levels (based on adaptive function) diagnosed by psychologist

FASD criteria

Can be either with sentinel features - (all 3) smooth philtrum, thin lip, short palpebral fissures - prenatal EtoH confirmed or unknown AND - evidence of impairment in 2+ neurodev domains OR microcephaly if infant without sentinel features - impaired in 3+ neurodev domains AND - confirmed prenatal EtOH associated defects: CHD, cleft palate, hearing loss, renal, eye high risk of mental illness, criminality, peer issues

Learning Disabilities - diagnostic criteria

4 criteria - learning difficulty in 1+ area (word reading, comprehension, writing, numbers, math reasoning) - academics below grade level - begin in school years - not explained by ID, hearing/vision, psychosocial, psych Co-occurs: ADHD, ASD, anxiety, dev coordination

2 months

- raises chin briefly when prone - coos / sounds - social smile - follows movement with eyes

3 months

- head control | - hand regard

4 months

- rolls to supine - hold object briefly if put in hand - reach for midline objects - turn head to sound - excited reaction to people

6 months

- sits tripod / briefly - transfer objects hand to hand - babbles - stranger anxiety

9 months

- sits well - crawl/shuffle - pull to stand - stand /w support - pincer grasp - points - raises arms to be picked up - object permanence - social games (peek a boo) - separation anxiety - seeks joint attention

12 months

- stands with support - walks while holding on - holds cup to drink - cubes into cup / release - first word, up to 3 words - follows simple command - responds to name

15 months

- walks without support - self feed finger foods - imitates, scribbles

18 months

- runs stiffly - stoop + recover - eat /w spoon - 10+ words - three body parts - eye contact, affection

2 years

- upstairs 1 at a time - draws lines, circular stroke - 50% intelligble - 2 step directions - says 50+ words - temper tantrums - parallel + pretend play

3 years

- tricycle - copy circle - 3-4 word sentence - 75% intelligble - recognizes colours - toilet training - make-believe / role play

4 years

- stairs alternating feet - hop on 1 foot - buttons / zippers - dresses with help - copies a cross - sings nursery rhymes - 100% intelligible - toilet trained at day

5 years

- ride bike - copies square / triangle - full sentences - counts to 10, tell story - group play - separate easily