Childhood Disability Lecture

Question 1

What are the overall aims of the Childhood disability lecture

Answer 1

The overall aim of this lecture is to identify common causes for delay in the different domains examined as part of a developmental assessment

Question 2

Hi Dr I am one of the fourth year medical students I am currently looking at disabilities in children and I know that disability can be broken down into the four domains of the motor disabilities problems with communication problems with sensory such as Vision and hearing. There are many different domains but I was wondering which domain of disability is more common to see in the general UK population

Answer 2

In the general UK population the highest prevalence which is the word used to describe how common it is within the population the highest prevalence tends to be seen in language delay and if you want to specific conditions dyslexia

Question 3

Hi Dr I am one of the fourth year medical students I know that problems with development in children can be broken down into the gross motor and fine motor the social the hearing and Vision and language. I know that within the general UK population language delay is high prevalence but generally low severity and example condition being dyslexia but I was wondering what is an example of a condition that is highest severity but doesn’t crop up as commonly as say dyslexia

Answer 3

So conditions that appear commonly are termed low prevalence and if you’re asking specifically about low prevalence high severity conditions then the first condition that should come to mind is cerebral palsy

Question 4

Hi Dr I have just seen a child who I believe has cerebral palsy which I know can come in four different forms athetoid ataxia spastic and mixed. I know that this is an example of a low prevalence but high severity condition I was wondering if you knew of any of the low prevalence that high severity conditions

Answer 4

So cerebral palsy is the most common low prevalence high severity condition and the rarest high severity low prevalence condition would be a muscular condition such as Beckers or duchenne muscular dystrophy

Question 5

Hi Dr
I just wanted to get a feel for the general ranking of the severe conditions in terms of their prevalence or in simple terms how commonly you see them.
I know that in general high severity conditions are cerebral palsy severe speech and language disorders severe learning difficulties autistic spectrum disorder and muscular dystrophy

Answer 5

Haha funnily enough you have given the ranking in the correct border first is cerebral palsy second is severe speech and language delay III are learning difficulties IV comes autistic spectrum disorder and V are the muscular dystrophy such as Becker’s and duchenne

Question 6

Hi Dr
I have just finished seeing parents and their child unfortunately there five year old child has cerebral palsy the mum is currently 35 weeks into her second pregnancy and she was wondering how common is cerebral palsy is within the general population of the UK

Answer 6

The prevalence of cerebral palsy in the UK is 2 per every thousand

Question 7

Hi Dr
I have just done a developmental assessment of a 7 year old boy who is showing signs of ritualistic behaviour according to his mum’s history and also is showing problems in his social developmental milestone. I am clearing the diagnosis of severe autistic spectrum disorder. The mum also had an idea that this is what it could be and she was wondering how prevalent severe autistic spectrum disorder is within the general population of the UK

Answer 7

So you can tell her that severe autistic spectrum disorder the rarest of the low prevalence high severity developmental impairments occurs thrice in every 10000

Question 8

Hi Dr

I have been seeing a 9 year old child over a period of about 5 years in order to monitor his development as his mum was concerned he was not reaching his language milestones on time. When this child was one year old he was behind his peers that after a couple of years he caught up and is now within two standard deviations of the mean of his peers so his developmental progress is now beings to be normal what is the specific term given to describe this kind of delay to reach normal milestones

Answer 8

Transient developmental delay

Question 9

Hi Dr I am one of the medical students
I was speaking to the consultant earlier today and he was telling me about a child who he saw originally when the child was about 2 months old. The child is now currently 6 and during that time the consultant has noticed a consistent delay globally across all his milestones. The consultants used to specific phrase to describe a failure to consistently reach the milestones and I was wondering if you could tell me what that was

Answer 9

Persistent developmental delay

Question 10

You are the general practitioner
Mother has come in to see you in regards to her 2 year old daughter who’s she is worried has started showing signs of regression. What is the specific term used to describe a regression when initially the child was on track with their milestones think along the lines of transient developmental delay persistent developmental delay and discontinuous developmental delay

Answer 10

Developmental deviation

Question 11

Hi Dr I am one of the medical students I was doing some reading into causes of developmental delay specifically looking at gross motor and I was wondering if you could give me two general classifications to try and help me group The multitude of causes

Answer 11

No problem there are the social problems such as upper motor neurone and disturbances and then there are the peripheral problems such as lower motor neurone disturbances

Question 12

Hi Dr
I am one of the fourth year medical students and I was wondering if you could tell me which upper motor neurone problems may result in a delay in gross motor

Answer 12

Cerebral palsy

Question 13

Hi Dr I am one of the third year medical students I was doing some research into the general causes of gross motor delay and was wondering if you know a specific lower motor neurone condition that I could research for my ssc that results in a delay to reach gross motor milestones at the normal times

Answer 13

Yes spina bifida is a lower motor neurone condition that would be great

Question 14

You are the 4th year medical student in an OSCE situation. You have been tasked with doing the developmental assessment of a 4 year old child who has one particular pathology on examination. When you go to see the child he is originally in a seated position.
In order to assess his ability to walk which you are expecting him to do confidently by age 4 you ask him to stand up.
As you watch him get up from the floor you notice that he uses his hands and his arms to pull his upper body up off the floor. What is the specific name of this sign or manoeuvre which may indicate a low prevalence high severity condition such as Beckers or Duchennes muscular dystrophy

Answer 14

Gower’s manoeuvre

Question 15

You are the fourth year medical students tasked with assessing whether or not a 5 year old girl has an abnormal delay in her speech and language. You expect that by 5 years old the child should be able to talk in full sentences and if not that at least be able to tell a story. You ask about the history of the presenting complaint but are not able to elucidate anything abnormal. When you are doing the systems review you ask specific questions about the child’s hearing. At this point the mum tells you that actually the child didn’t receive any of the hearing tests it was supposed to such as the acoustic emission test. Based on this information what is the most likely cause of this 5 year old girls delay in speech and language

Answer 15

A hearing problem

Question 16

You are a third year medical student on the ward with a paediatric consultant who’s testing your knowledge. The consultant asks you when you think of a delay to reach social milestones at the expected time what should be a common differential that you think of although technically it’s a low prevalence high severity condition

Answer 16

Autistic spectrum disorder

Question 17

You are a 4th year medical student with a paediatric consultant you have seen an obese child and the diagnosis behind this is Prader-Willi syndrome the consultant ask you to explain the physiology underlying why Prader-Willi syndrome may result in some children becoming obese.

Answer 17

With Prader-Willi syndrome this is a genetic defect that result in a child having poor muscles and poor feeding. The poor feeding leads to a constant hunger which the child tries to satiate. This results in obesity if not controlled and problems with insulin

Question 18

You have just finished assessing a 5 year old boy who you determine has a global delay. After genetic test come back it is revealed that are actually this five year old had angelman syndrome. You have been asked to explain what this congenital disorder is.

Answer 18

Angelman syndrome is a congenital disorder characterized by a problem with the childs inherited copy of chromosome 15 from the mother. The typical presentation of this condition apart from the physical manifestation of jerky movements is typically picked up through a developmental assessment of a child where it will be revealed that a child has a global delay

Question 19

Hi Dr apart from Down Syndrome what are the other two conditions that may result in a global delay in a child mentioned in the Childhood disability lecture

Answer 19

Angelman syndrome and Prader-Willi syndrome

Question 20

Hi medical students
My 3 year old daughter is just I’m really worried about her. When I go to pick her up from nursery I noticed that the other girls are walking playing drawing and and putting phrases together where is my daughter isn’t doing any of that can you tell me what might possibly be going on.

Answer 20

There are lots of things that could be going on in this situation but remember that there’s a condition although there are a single Gene disorder rett syndrome which almost exclusively affects girls and presents as a global delay
Other differentials include down syndrome angelman syndrome and Prader-Willi syndrome

Question 21

Hi Dr we have been investigating a 3 year old child his mum is worried that he is not reaching the milestones at the appropriate times. We want to make sure that he didn’t have genetic problems so we did some genetic tests we also decided to do bloods as well. When we did the Bloods we checked urea and electrolytes liver function test only. Is there anything important that we missed that may explain this global developmental delay

Answer 21

Thyroid function test may indicate problems with the thyroid gland. This is important as hypothyroidism may result in a global developmental delay

Question 22

Hi Dr my name is Millie I am the mum of Sophie a 4 year old girl one of my friends had a lot of alcohol to drink during her pregnancy and didn’t have any problems and so I was wondering does that mean that I can drink for my current pregnancy. Explain the risk

Answer 22

There is a condition called foetal alcohol spectrum disorder which essentially refers to the series of problems that your child may have when it’s born due to the alcohol that you’ve consumed these may result in physical impairment that prevent your child from walking at the right time and may also include intellectual impairments that may prevent your child from achieving academically