Children with Special Needs Flashcards
What is child development?
The process by which each child evolves from infancy to adulthood
- Gross motor skills
- Fine motor skills
- Speech and language
- Social, personal, activities of daily living
- Performance and cognition
What are the features of normal development?
- A constant pattern
- Sequential acquisition of skills
What is normal development influenced by?
- Genetic factors
- Environmental factors
What is median age?
The age at which half the population of children acquire that skill.
What is limit age?
The skill should have been acquired by this and is 2SD from the mean
What do genetic factors determine?
The fundamental developmental potential
What is developmental delay?
Developmental delay is present when functional aspects of the child’s development in one or more domains (motor, language, cognitive, social, emotional) are significantly delayed compared to the expected level for age
What is global developmental delay?
- Performance below 2SD below mean of age-appropriate, norm-referenced testing
- A significant delay in 2 or more of the developmental domains
What is a learning disability?
A learning disability is a significant impairment in intellectual functioning and affects the person’s ability to learn and problem-solve in their daily life. It has nearly always been present since childhood.
What is the scope of special needs?
- GDD: 1-3% of children
- 1% have an autistic spectrum disorder
- Only 1/3 identified before school entrance
- Careful evaluation and investigation can reveal a cause in 50-70% of cases.
- Early intervention has long term benefits
How can a present with a learning difficulty of developmental delay?
- Routine health surveillance
- Children with identified risk factors
- Parental concern
- Professional contact: nursery/ daycare
- Opportunistic health contact
- The UK Healthy Child programme (HCP)
How is development assessed?
- History and examination
- Prenatal, perinatal, postnatal events
- Developmental milestones
- The ‘Red Book’
- Environmental, social and family history
- Video recordings of child
- Observation in clinic / other settings
What primary care tools are used in the assessment of children?
- ASQ (ages and stages questionnaire)
- PEDS (Parents evaluation of developmental status)
- M-CHAT (Checklist for autism in toddlers)
- SOGS-2 (Schedule of Growing Skills)
How can developmental abilities by quantified?
- All areas of development are age appropriate
- Delay: Global or isolated
- Disorder: Abnormal progression and presentation eg Autism
- Regression: loss of milestones
What is SOGS?
Schedule of growing skills
- Information of child’s development across a range of areas
- 0-5 years
- 9 key areas
- Separate cognitive score can be derived
What secondary care assessment tools are used in the assessment of children?
- Griffiths mental development scales
- Bayley scales of infant development
- Wechsler preschool and primary scales of intelligence
What history should be obtained?
- Family h/o neurodevelopmental/ genetic disorder
- H/O miscarriages
- Prenatal, perinatal, neonatal course
- Drugs and alcohol use in pregnancy
- Developmental, behavioural, social and educational history
- Record of medications
- Results of previous metabolic/ thyroid testing
- Neuroimaging
- Lead and iron screening
- Growth records
- Vision and hearing surveillance
- High index of suspicion for abuse and neglect
What examination should be carried out?
- Head circumference
- Dysmorphic features
- Skin abnormalities
- Movement quality
- Ability to sit and stand from supine
- Eye movements and eye examination
- General examination: CVS, Respiratory
- Abdominal examination
- Observation of behaviour