Delayed Speech, Hearing, Walking Flashcards
Harry is an 18-month-old boy whose mother is concerned about his speech and understanding. In particular, he often points to what he wants rather than naming it, and his 3 year old sister will tell mother what he wants. In addition, he often doesn’t come when he is called. She is concerned that he only has about 7 words that she recognises, mostly for family and pets.
What is your impression about Harry’s language development based on this short history?
Question 1Select one:
a.
Autistic spectrum disorder
b.
Conductive hearing loss
c.
Normal language development
d.
Auditory processing disorder
Normal language development
7 words is normal
A mother brings her 3-year-old girl Ella to see you, as she is concerned about Ella’s speech and poor social skills. Ella cannot yet put two words together although she has about 20 recognisable words and she is gradually acquiring new words. She prefers to play by herself than with other children and has poor eye contact with you and her parents. She gets quite distressed if she is cuddled and doesn’t tolerate a change of routine at home. She has no dysmorphic features. She is active, mobile, and dexterous and has a normal examination but is not interested in any interaction with you. An audiogram is performed and is normal.
What is your assessment about Ella’s language and communication skills?
Question 2Select one:
a.
Sensorineural hearing loss
b.
Conductive hearing loss
c.
Normal language for age
d.
Autistic spectrum disorder
Autism
Bart is an 18 month old boy whose mother is concerned that he is not walking. He sat alone at 7 months of age, was able to pull himself to standing at furniture at 11 months of age. He gets around by shuffling on his bottom. He was able to use a pincer grasp at 10 months. He smiles, laughs and babbles. His examination is normal.
What is your assessment of the most likely reason for his delayed walking?
Question 3Select one:
a.
Spina bifida minima occulta
b.
Environmental deprivation
c.
Developmental dysplasia hips
d.
Normal variant late walker
Normal variant late walker
Camilla is a 2 year old girl whose mother is concerned because she has only just started to walk independently and she tends to walk on her tip-toes.
Camilla seems to have been well and developing normally up until now. She sat alone at 7 months of age, was able to pull herself to standing at furniture at 15 months of age. She was cruising around furniture at around 18 months, but on tip-toe and with her legs slightly bent. Camilla was able to use a pincer grasp at 10 months. She smiles, laughs and uses at least 6 words with meaning.
When you observe her gait you notice that besides walking on her toes, she turns her knees inward when walking so that she appears to walk each leg around the other. Her ankle jerks are brisk and she has upgoing plantar responses. Her buttock folds are symmetrical, and there is no leg length disparity.
What is the likely diagnosis?
Question 4Select one:
a.
Duchenne’s muscular dystrophy
b.
Normal variant tiptoe walking
c.
Spastic diplegia cerebral palsy
d.
Developmental dysplasia of hips
Spastic diplegia cerebral palsy
late walking, tiptoe, scissoring, reflexes brisk
A 21-month old boy is brought to the family doctor because he is only saying three single words. He is able to run, climb stairs, feed himself, scribble, and throw a ball. He smiles and laughs and is interactive with his family members.
What assessment is indicated at this stage?
Question 5Select one:
a.
Speech therapy assessment
b.
Assessment of hearing
c.
Assessment of intelligence
d.
Assessment for autism
Assessment of hearing
