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Paediatrics > Children with Special Needs COPY > Flashcards

Children with Special Needs COPY Flashcards

1
Q

What is child development?

A

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

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2
Q

what are the Features of normal development?

A

A constant pattern

Sequential acquisition of skills

Median age vs limit age

Genetic factors

Environmental influences

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3
Q

what is developmental delay?

A

‘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’

Global developmental delay when 2 or more domains are affected

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4
Q

what is classed as a Global developmental delay (GDD)?

A

Performance below 2SD below mean of age-appropriate, norm-referenced testing

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5
Q

what is alerning disability?

A

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.

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6
Q

how do they present?

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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7
Q

how is a Assessment of development done?

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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8
Q

what are Primary care assessment tools?

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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9
Q

what is Quantification of Developmental abilities?

A

All areas of development are age appropriate

Delay: Global (across 2 or more domains) or isolated

Disorder: Abnormal progression and presentation eg Autism

Regression: loss of milestones

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10
Q

what is Schedule of growing skills (SOGS)?

A

Information of child’s development across a range of areas

0-5 years

9 key areas

Separate cognitive score can be derived

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11
Q

what information should be gathered in a history?

A

Comprehensive

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 (can cause developmental delay)

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12
Q

what do you want to do 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 behaviour

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13
Q

what are some common syndromes?

A

William: elfin facies, supravalvular AS, MR. The dysmorphic facial features consist of 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

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14
Q

what are some Red flag signs: Positive

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

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15
Q

what are some 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

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16
Q

how is investigaiton done?

A

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,Ammonia,Lactate

Ophthalmological examination

Audiology assessment

Consider congenital infection

Neuroimaging

17
Q

what are Common problems affecting motor, sensory, lamguage/cognition and social/communication

A
18
Q

why investigate?

A

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

19
Q

The multidisciplinary approach - who should be involved?

A

Developmental paediatrician

Speech and Language therapist

OT/ PT: functional impairments and strengths

Psychologist

Social worker

Geneticist

20
Q

what are some possible effects on a family?

A

Emotional

Social isolation

Financial implications

Implication for siblings

Wider family

21
Q

what are the possible signs of cerebal palsy in a child

A

delays in reaching development milestones – for example, not sitting by 8 months or not walking by 18 months

seeming too stiff or too floppy (hypotonia)

weak arms or legs

fidgety, jerky or clumsy movements

random, uncontrolled movements

muscle spasms

shaking hands (tremors)

walking on tiptoes

The severity of symptoms varies significantly from child to child.

The parts of the body affected can also vary. Sometimes only one side of the body is affected, sometimes the whole body is affected, and sometimes mainly the legs are affected.

22
Q

what is the Evaluation of developmental problems?

A

Is there a problem?

Global or single field?

Delay, Disorder or Regression

Aetiology

Co-ordination of care and support

Problem based approach

23
Q

what Local services for developmental problems is there?

A

Community paediatric clinics

Child development teams

Multidisciplinary assessment

Therapy services

24
Q

what is Additional Support Needs?

A

A child or young person is said to have ‘additional support needs’ if they need additional support with their education

Additional support can mean any kind of educational provision that is more than, or very different from, the education that is normally provided in mainstream schools

25
Q

Why ASL? Additional Support for Learning

A

“To ensure the development of the personality, talents and mental and physical abilities of that child or young person to their fullest potential.”

26
Q

A child or young person may need additional support for a number of different reasons, for example what?

A

Difficulties with mainstream approaches to learning

Disability or health needs, such as motor or sensory impairment, learning difficulties or autistic spectrum disorder

Family circumstances e.g. young people who are carers or parents

27
Q

what is Personal learning planning (PLP)?

A

a way of thinking about, talking about and planning what and how a child learns. It’s also a way of assessing their progress and acting on the results of that assessment

28
Q

what is a Individualised Educational Plan (IEP)

A

IEP is a detailed plan for a child’s learning. It contains some specific, short-term learning targets for the child and will set out how those targets will be reached. Targets are:

Specific, Measurable, Achievable, Relevant, Timed

In some areas these plans are called additional support plans or individual support plans

Not a legal document

29
Q

what is a Co-ordinated Support Plan (CSP)?

A

A CSP is a detailed plan of how child’s support will be provided. It is a legal document and aims to ensure all the professionals who are helping the child, work together. It also helps ensure that everyone, including parents and the child, is fully involved in that support

For children in local authority school education and needing significant additional support

Complex or multiple needs

Needs likely to continue > 1 year

Support required by > 1 agency

30
Q

GIRFEC appraoch, Childs Plan - what is it?

A

In line with the ‘Getting it right for every child’ (GIRFEC) approach, many children will now have a Child’s Plan. This is part of the Children and Young People Act that applies from Autumn 2016. 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

The Child’s Plan will 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

All professionals working with the child would use the plan, which may include an IEP or a CSP

31
Q

What does the Long term outlook depend on?

A

Depends on nature of the problem

Acquisition of skills

Social and emotional needs

Personal attributes, family, social surroundings and level of care received

Paediatrics (142 decks)

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