Childhood Disability and Development Flashcards
What is the definition of childhood disability?
Child with mental/physical impairment that results in marked, pervasive limit on activity e.g. C Palsy, Down’s
What are the 3 factors to affect childhood disability?
1) Impairment
2) Environment
3) Childhood social background
What are the main signs of Down’s?
1) Brushfield spots
2) CHD
3) Short stature
4) Hypotonia
5) Learning/development delay
Define cerebral palsy?
1) Non-prog development disorder of movement and posture
2) Permanent, non-prog cerebral pathology leading to handicap/disability in children
What are the 3 causes of CP?
1) Antenatal: Hypoxia, Haemorrhage, Ischaemia, infection (80%)
2) Peri-natal: Hypoxia, haemorrhage or infection (10%)
3) Post-natal: hypoxia, infection e.g. meningitis, haemorrhage, encephalopathy, trauma.
What support is provided for someone/family with CP?
1) SALT
2) Feeding support
3) Sleeping support
4) Physiotherapists for hand function/mobility
Holistic, child focussed and MDT
What is child development?
The biological, psychological and emotional changes that occur between birth and adolescence as the individual progresses from dependency to increasing autonomy. It is a continuous process with a predictable sequence however each child’s development is unique.
What are the main influences on a child’s development?
Genetic factors.
Stimulating environment.
Pregnancy factors e.g. premature? Mums health?
Healthy attachment.
Medical conditions.
Abuse/neglect/domestic violence.
Healthy peer relationships.
Education.
Nutrition.
Parenting style
What are the 4 domains of childhood development?
1) Gross motor skills
2) Fine motor/vision
3) Speech, Language, Hearing
4) Social interaction and self care skills
Gross Motor Function: What are the developmental milestones?
3m: lifts head on tummy.
6m: chest up with arm support, can sit unsupported.
8m: crawling.
9m: pulls to stand.
12m: walking.
2 years: walking up stairs.
3 years: jumping.
4 years: hopping.
5 years: rides a bike.
Gross Motor function: When would the child walk, jump, crawl and climb stairs?
1) Walk: 12 months
2) Jump: 3 years
3) Crawl: 8 months
4) Climb stairs: 2 years
Fine Motor/Vis: What are the developmental milestones?
4m: grabs an object using both hands.
8m: takes objects in each hand.
12m: scribbles with crayons e.g. circle, cross, square.
18m: builds a tower of 2 cubes.
3 years: builds a tower of 8 cubes.
FM/V: When would you expect a child to draw w/ crayons, tower of 8 blocks, object in both hands, tower of 2 blocks
1) Draw with crayons: 12m
2) Tower of 8 blocks: 3 years
3) Object in each hand: 8 months
4) Tower of 2 blocks: 18 months
Speech, Language, Hearing: What are the developmental milestones?
3m: laughs and squeals.
9m: can make sounds such as ‘dada’ and ‘mama’.
12m: can say one word.
2 years: can form short sentences and name body parts.
3 years: speech is mainly understandable.
4 years: knows colours and can count.
5 years: knows the meaning of words.
SLH: When would they form short sentences/name body parts, knows colours/can count, laughs/ squeals, mainly understandable speech.
1) SS/Body parts: 2 years
2) Colours/count: 4 years
3) Laugh/squeal: 3 months
4) Mostly understandable: 3 years
Social Interaction/Selfcare: What are the developmental milestones?
6 weeks: smiles.
6 months: finger feeds.
9m: waves bye-bye.
12m: uses cutlery.
2 years: undresses, feeds toys.
3 years: plays with others, names a friend.
4 years: dresses with no help, plays a board game.
SI/SC: When would you expect them to uses cutlery, plays with others/names a friend, smiles, waves bye-bye.
1) Cutlery: 12 months
2) Play/name: 3 years
3) Smiles: 6 weeks
4) Waves bye/bye: 9 months
What does the “Healthy Child programme” encourage?
- Encourages care to keep children healthy and safe.
- Promotes healthy eating and activity.
- Identifies problems in children’s development.
- Identifies ‘at risk’ families for more support.
- Ensures children are prepared for school.
What are concerns for each type of development domain?
1) GM: Not sitting by 12 months, not walking by 18 months
2) FM: Hand preference before 18 months
3) SLH: Not smiling by 3 months, no clear words by 18 months
4) SCD: No play by 3 yo, no response to care interactions by 3 months
What are main causes of developmental delay?
1) Genetics
2) Pregnancy
3) Factors around birth
4) Factors in childhood
5) Environmental
What investigations would you do in a child where you thought there was a problem?
Thorough hx and exam, tailor towards a child:
- Boys not walking by 18m check creatinine kinase for Duchenne.
- Focal neurological signs -> MRI brain.
Genetic testing.
- Unwell, failure to thrive -> metabolic investigations.
What are the main problems in each category of developmental delay?
1) Genetic: Chromosomal abnormality, micro del/dup, polygenic, single gene disorder
2) Pregnancy: MCA infarct, congenital infection, exposure to drug/alcohol
3) Birth: Birth asphyxia, prematurity
4) Medical: Chronic illness, infections, acquired brain injury, hearing/visual impairment
5) Environment: Chronic abuse/neglect, low stimulation
