Child with Developmental Delay - Approach Flashcards
What is the definition of “developmental delay”?
Failure to attain apporpriate developmental milestones for child;s corrected chronological age
What are the three main types of abnormal development seen in children?
Delay (Globl or specific)
Deviation (e.g. autism)
Regression (e.g. Rett’s Syndrome)
What percentage of UK child population has Autistic Spectrum Disorder?
1%
What percentage of UK child population has Mild Learning Disability?
1-2%
What percentage of UK child population has Severe Learning Disability?
0.3-0.5%
What percentage of UK child population has a Specific Learning Disability?
5-10%
What are the RED FLAGS to look out for in Development? (7)
Asymmetry of movement
Not reaching for objects by 6 months
Unable to sit unsupported by 12 months
Unable to walk by 18 months –> check CK
No speech by 18 months
Concerns re vision or hearing
Loss of skills
What is Global Developmental Delay?
Significant delay in 2+ of:
Gross/Fine motor skills, speech language, cognition, social/personal, activities of daily living (ADL)
(termed learning disability in school age)
What is screened medically in Down’s Syndrome?
Cardiac Vision Hearing Thyroid function Sleep related breathing disorders Growth- charts Development
Name the (4) SPECIFIC developmental delays.
Motor delays (e.g. Duchenne Muscular Dystrophy, Cerebral Palsy, Co-ordination disorders)
Language delays (e.g. Specific language Impairment)
Sensory Deficits and Associated Delay
(e.g. Oculocutaneous Albinism, Treacher-Collins Syndrome)
Developmental deviations
(e.g. Autism Spectrum Disorders)
What conditions are associated with Cerebral Palsy? (8)
Mobility problems, spasticity and orthopaedic problems
Learning Difficulties
Epilepsy
Visual/Hearing impairment
Communication difficulties
Feeding Difficulties
Sleep problems
Behaviour problems
What is in the Autistic Triad of impairments? (3)
Communication
Social Interaction
Flexibility of thought/imagination
What do people with ASD show with communication in terms of: Receptive Language (4)
Receptive Language: Delayed Expressive>Receptive Abstract Language Difficult Visually more able
What do people with ASD show with communication in terms of: Expressive Language (4)
Expressive Language: Delayed Echoes Off intonation/pitch Chunks of video speak
What do people with ASD show with communication in terms of:
Non-verbal Language (3)
Facial expressions, gesture
Eye contact
Recognising intention of others
What do people with ASD show with communication in terms of:
Use of Language (3)
Initiating and sustaining conversation
Restricted interests
Lack of awareness of reciprocal nature of conversation
What do people with ASD show problems with in social interaction?
(8)
Problems with Joint Attention and Referencing
Difficulty with Turn-taking
Unable to share pleasure
Not motivated by need for social approval
Issues with social rules
Problems with Empathy
Problems with relationships
Struggle to understand others point of view/feelings
What do people with ASD show in terms of Flexibility of Thought/Imagination?
(6)
Theory of mind Concrete and literal Concept of time Routines Changes in environment Riualistic behaviour
What SENSORY issues do people with ASD have? (7)
Fussy with eating/taking medications Issues with texture of clothes Sleep issues Toilet training issues Problems with hair washing/cutting Problems with nail cutting Issues with noise
What is the structure of a history of a child with suspected developmental delay?(7)
Concerns - presenting complaint Past Medical History Perinatal and birth Family and social Developmental Play and behaviour School/Nursery
What is the structure of an examination of a child with suspected developmental delay?(7)
Observation Dysmorphism Head Circumference Systems CNS, including neurocutaneous Vision Hearing
What investogations are done for a patient with suspected developmental delay?
Chromosomes, FRAX & Oligoarray CGH
Neonatal PKU, thyroid studies, CK
If indicated: MRI brain EEG Metabolic studies Genetic consultation Others
What assessment tools are used in the assessment of people with suspected developmental delay?
Griffiths (0-8years)
Bayleys (0-3 years)
Schedule of Growing Skills (0-5years)
ADOS (ASD)
What assessment tool is used for people with suspected ASD?
ADOS
