Children with special needs Flashcards
features of normal development
a constant pattern sequential acquisition of skills median age vs limit age genetic factors environmental influences
presentation
routine health surveillance
childen with identified risk factors
parental concern
professional contact
assessment of development
video recordings of child
observation in clinic
Primary care assessment tools
ASQ (ages and stages questionaire)
Secondary care assessment tools
bayley scales of infant development
Common syndromes
down syndrome
fragile X
william’s syndrome
red flag signs
\+ve Loss of developmental skills Concerns re vision Concerns re hearing Floppiness No speech by 18-24 months Asymmetry of movement Persistent toe walking Head circumference >99.6th C or < 0.4th C
-ve Sit unsupported by 12 months Walk by 18months (boys) or 2 years (girls): Check creatinine kinase Walk other than on tiptoes Run by 2.5 years Hold objects in hand by 5 months Reach for objects by 6 months Points to objects to share interest by 2 years
investigation
Based on clinical abnormalities Diagnostic yield of specific tests Timing Genetic testing: chromosomal analysis, Fragile X, FISH, array CGH Creatine kinase Thyroid screening Metabolic testing: amino and organic acids,NH4,Lactate. Ophthalmological examination Audiology assessment Consider congenital infection Neuroimaging
why investigate
The family gains understanding of the condition, including prognostic information
Lessens parental blame
Ameliorates or prevents co-morbidity by identifying factors likely to cause secondary disability that are potentially preventable
Appropriate genetic counselling
Accessing more support
Address concerns about possible causes e.g. events during pregnancy or delivery
Potential treatment for a few conditions
effects on family
Emotional Social isolation Financial implications Implication for siblings Wider family
