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Paediatrics > Children with special needs > Flashcards

Children with special needs Flashcards

1
Q

what are the most consistent milestones?

A

social smile, sitting

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2
Q

Negative developmental factors

A

maternal infections, toxins, drugs, postnatal infections malnutrition, maternal mental health disorders.

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3
Q

what is median age

A

is the age at which half the population of children acquire that skill.

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4
Q

when is developmental delay present?

A

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’

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5
Q

Global development delay means?

A

Performance below 2SD below mean of age-appropriate, norm-referenced testing
GDD vs Learning disability

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6
Q

what is a learning disability

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.

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7
Q

Presentation of learning disabilities

A 
Routine health surveillance
Children with identified risk factors
Parental concern
Professional contact: nursery/ daycare
Opportunistic health contact
The UK Healthy Child programme (HCP)
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8
Q

Assessment of development

A 
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
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9
Q

Examples of Primary care assessment tools (4)

A

ASQ (ages and stages questionnaire)
PEDS (Parents evaluation of developmental status)
M-CHAT (Checklist for autism in toddlers)
SOGS-2 (Schedule of Growing Skills)

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10
Q

Disorder of abnormal progression?

A

autism

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11
Q

regression means

A

loss of milestones

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12
Q

Most common used assessment tool in infant development

A

SOGS
9 key areas
ages 0-5

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13
Q

other scales of infant development (3)

A

Griffiths mental development scales
Bayley scales of infant development
Wechsler preschool and primary scales of intelligence

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14
Q

features of Down syndrome

A

small chin
small pointed nose
abducted thumb
Trisomy 21

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15
Q

things to look for on examination

A 
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
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16
Q

some common syndromes

A

Downs
Fragile X syndrome
William’s syndrome

17
Q

features of Fragile X syndrome?

A

small pointer nose
prominent ears
long face
large testicles

18
Q

features of William’s syndrome?

A

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
19
Q

Positive red flag signs in infant development ?

A 
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
20
Q

Red flag signs - NEGATIVE

A

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

21
Q

Investigations and screening tests for developmental delays

A

Genetic testing: chromosomal analysis, Fragile X, FISH, array CGH
Creatine kinase
Thyroid screening
Metabolic testing: amino and organic acids,Ammonia,Lactate.

22
Q

Further investigations and screening tests for developmental delays

A

Ophthalmological examination
Audiology assessment
Consider congenital infection - toxoplasmosis
Neuroimaging

23
Q

Common problems - motor

A

Delayed maturation
Cerebral palsy
Developmental coordination disorder

24
Q

Common problems - sensory

A

Deafness
Visual impairment
Multisensory impairment

25
Q

common problems - Language/Cognitive

A

Specific Language Impairment

Learning Disability

26
Q

Common problems - Social/Communication

A

Autism
Asperger syndrome
Elective mutism

27
Q

breaking bad news - follow?

A

TACT

28
Q

The multidisciplinary approach to explaining bad news

A 
Developmental paediatrician
Speech and Language therapist
OT/ PT: functional impairments and strengths
Psychologist
Social worker
Geneticist
29
Q

Features of spastic diplegia cerebal palsy

A

unable to sit and crawl but can roll over
increased tone
exaggerated reflexes

30
Q

features of austism

A 
No eye contact 
language is delayed
social interaction is reduced
- tip toe walking
- hand flapping
31
Q

Diagnosis of Autism - what are the next steps/support

A
  • 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
32
Q

Important tests for girls with autism

A

Microarray,Fragile X and Rhett’s syndrome

33
Q

What is an IEP

A

a detailed plan for a child’s learning. It contains some specific, short-term learning targets

Specific ● Measurable ● Achievable ● Relevant ● Timed.

34
Q

what is a co-ordinated support plan?

A

legal document

- ensure all the professionals who are helping the child, work together

35
Q

GIRFEC - Childs plan - what is it?

A

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.

36
Q

what will a child’s plan contain information about?

A
  • 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.

Paediatrics (49 decks)

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