Children with special needs Flashcards
what are the most consistent milestones?
social smile, sitting
Negative developmental factors
maternal infections, toxins, drugs, postnatal infections malnutrition, maternal mental health disorders.
what is median age
is the age at which half the population of children acquire that skill.
when is developmental delay 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’
Global development delay means?
Performance below 2SD below mean of age-appropriate, norm-referenced testing
GDD vs Learning disability
what is a learning disability
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.
Presentation of learning disabilities
Routine health surveillance Children with identified risk factors Parental concern Professional contact: nursery/ daycare Opportunistic health contact The UK Healthy Child programme (HCP)
Assessment of development
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
Examples of Primary care assessment tools (4)
ASQ (ages and stages questionnaire)
PEDS (Parents evaluation of developmental status)
M-CHAT (Checklist for autism in toddlers)
SOGS-2 (Schedule of Growing Skills)
Disorder of abnormal progression?
autism
regression means
loss of milestones
Most common used assessment tool in infant development
SOGS
9 key areas
ages 0-5
other scales of infant development (3)
Griffiths mental development scales
Bayley scales of infant development
Wechsler preschool and primary scales of intelligence
features of Down syndrome
small chin
small pointed nose
abducted thumb
Trisomy 21
things to look for on examination
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 behaviourHead 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
some common syndromes
Downs
Fragile X syndrome
William’s syndrome
features of Fragile X syndrome?
small pointer nose
prominent ears
long face
large testicles
features of William’s syndrome?
broad forehead, medial eyebrow flare, strabismus, flat nasal bridge, malar flattening, a short nose with a long filtrum, full lips, and a wide mouth
- high calcium in the blood and urine
Positive red flag signs in infant development ?
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
Red flag signs - NEGATIVE
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
Investigations and screening tests for developmental delays
Genetic testing: chromosomal analysis, Fragile X, FISH, array CGH
Creatine kinase
Thyroid screening
Metabolic testing: amino and organic acids,Ammonia,Lactate.
Further investigations and screening tests for developmental delays
Ophthalmological examination
Audiology assessment
Consider congenital infection - toxoplasmosis
Neuroimaging
Common problems - motor
Delayed maturation
Cerebral palsy
Developmental coordination disorder
Common problems - sensory
Deafness
Visual impairment
Multisensory impairment
common problems - Language/Cognitive
Specific Language Impairment
Learning Disability
Common problems - Social/Communication
Autism
Asperger syndrome
Elective mutism
breaking bad news - follow?
TACT
The multidisciplinary approach to explaining bad news
Developmental paediatrician Speech and Language therapist OT/ PT: functional impairments and strengths Psychologist Social worker Geneticist
Features of spastic diplegia cerebal palsy
unable to sit and crawl but can roll over
increased tone
exaggerated reflexes
features of austism
No eye contact language is delayed social interaction is reduced - tip toe walking - hand flapping
Diagnosis of Autism - what are the next steps/support
- School advised via Educational psychologist
- DLA
- In-house training for parents
- Referal to clinical genetics
- Microarray,Fragile X and Rhett’s syndrome - All Negative. FBC,TFT,CK,U/E all Normal
Important tests for girls with autism
Microarray,Fragile X and Rhett’s syndrome
What is an IEP
a detailed plan for a child’s learning. It contains some specific, short-term learning targets
Specific ● Measurable ● Achievable ● Relevant ● Timed.
what is a co-ordinated support plan?
legal document
- ensure all the professionals who are helping the child, work together
GIRFEC - Childs plan - what is it?
Child’s Plans are created if a child or young person needs some extra support to meet their wellbeing needs such as access to mental health services or respite care, or help from a range of different agencies.
what will a child’s plan contain information about?
- why a child or young person needs support
- the type of support they will need
- how long they will need support and who should provide it.
