Children With Special Needs Flashcards
What is developmental delay?
When functional aspects of a child’s development in one or more domains are significantly delayed compared to the expected level for their age
What is global delay?
A significant delay in 2 or more of the developmental domains
What is a learning difficulty?
A significant impairment in intellectual functioning and affects the person’s ability to learn and problem solve in their daily life (present since childhood)
How can developmental delay be identified?
- Routine health surveillance
- Children with identified risk factors
- Parental concern
- Professional contact: nursery/childcare
- Opportunistic health contact
- Healthy Child Programme
How can the child’s development be assessed?
- History and exam
- Prenatal, perinatal and post natal events
- Developmental milestones
- Red book
- Environmental, social and family history
- Video recordings of the child
- Observation in clinic/ other settings
Which questionnaires can be used in primary care to asses a child’s development
- ASQ: ages and stages questionnaire
- PEDS: parents evaluation of developmental status
- M-CHAT: checklist for autism in toddlers
- SOGS-2: schedule of growing skills
Name the secondary care assessment tools
- Griffiths mental development scales
- Bayley scales of infant development
- Weschler preschool and primary scales of intelligence
What should be asked about in the history of a child with suspected special needs?
- FH of neuro-developmental or genetic disorder
- Miscarriages
- Prenatal, perinatal and neonatal course
- Drugs and alcohol use in pregnancy
- Developmental, behavioural, social and educational history
- Record of medications
What other information about the child’s do you want to find out (child with special needs)?
- Results of previous metabolic/thyroid testing
- Neuroimaging
- Lead and iron screening
- Growth records
- Vision and hearing surveillance
- Suspicion for abuse and neglect
What would you include in an examination of a child who you suspect has special needs?
- Head circumference
- Dysmorphic features
- Skin abnormalities
- Movement quality
- Ability to sit and stand
- Eye movements and eye exam
- General exam/CVS/ resp/abdo
- Observation of behaviour
Name the red flag signs for development
- Loss of developmental skills
- Concerns re vision or hearing
- Floppiness
- No speech by 18-24 months
- Asymmetry of movement
- Persistent toe walking
- Head circumference >99.6th or <0.4th C
- Not sitting unsupported by 12 months
- Not walking by 18 months for boys or 2yrs for girls
- Not walking other than on tiptoes
- Not holding objects by 5 months and not reaching for them by six months
- Not sharing interest in objects by pointing by 2yrs
How can a developmental delay be investigated?
- Based on clinical abnormalities, test results and timing
- Genetic testing:chromosomal analysis, fragile X, FISH and array CGH
- Creatine kinase
- TFTs
- Metabolic testing: amino and organic acids, NH4 and lactate
- Vision and hearing tests
- ?congenital infection
- Neuroimaging
Name some common motor problems
- Delayed maturation
- Cerebral palsy
- Developmental coordination disorder
Name some common language/cognition problems
- Specific language impairment
- Learning disability
Name some common sensory problems
- Deafness
- Visual impairment
- Multisensory impairment
