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Royal Super 4th Year Brain > Development > Flashcards

Development Flashcards

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1
Q

DDx/mimics for ADHD

A
  • Organic: Neuro (CN injury/infection, mass lesion, epilepsy, FASD), genetic, sensory (hearing, vision), med conditions (iron def, thyroid disease, DM, sleep d/o, malnutrition)
  • Meds/toxins: lead, AEDs, steroids, substances
  • Dev/behaviour: autism, learning disorder, ODD
  • MH: Stress, personality d/o, mood/anxiety
  • Enviro/psychosocial: poverty, family dysfunction
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2
Q

2 month milestones

A
  • GM: neck control, head up to 45 deg when prone
  • FM: hands open 1/2 the time, bats at objects
  • Language: turns to voice, coo-ing
  • Social: prefers usual caregiver, social smile
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3
Q

4 month milestones

A
  • GM: sits with support, head up to 90 deg when prone, roll from front to back
  • FM: palmar grasp, bring objects to midline
  • Language: laughs, razz, “ga”, squeal
  • Social: explores environment/faces
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4
Q

9 month milestones

A
  • GM: pulls to stand, starting to cruise
  • FM: pincher grasp
  • Language: specific mama/dada, says “bye”
  • Social: separation anxiety, object permanence
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5
Q

15 month milestones

A
  • GM: walks well
  • FM: using spoon, stacks 2 blocks
  • Language: 1 step command, 5 words, 1 body part
  • Social: experiment with toys, shared attention
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6
Q

18 month milestones

A
  • GM: running
  • FM: undress, carries toys when walking, fisted pencil grasp
  • Lang: 25 words, follow 1-2 step commands, point to object, name x3 body parts
  • Social: parallel play, symbolic play
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7
Q

4 year old milestones

A
  • GM: alternating down stairs, one foot jump
  • FM: buttons, draw square
  • Lang: sentences, 100% intelligible, tells story, past tense
  • Social: fantasy play, preferred friend
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8
Q

Handedness - when does it normally develop + when is it a concern?

A
  • 18-24 months

- Red flag if before 1 year

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9
Q

x2 risk factors for DCD?

A
  • Preterm

- Male

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10
Q

x5 co-morbidities associated with DCD?

A
  • ASD
  • ADHD
  • Language impairments
  • Specific learning disabilities
  • Mental health
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11
Q

Diagnostic criteria for DCD

A

A: Acquisition + execution of coordinated motor skills are substantially below expectations for child’s age + opportunities for motor skill learning.
B: Motor skills deficit significantly/persistently interferes with activities of daily living + impacts school/activities.
C: Onset of symptoms in the early developmental period.
D: Deficit is not better explained by another disorder.

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12
Q

Examples of “soft” neuro findings on exam associated with DCD?

A
  • Overflow movements
  • Mirror movements
  • Finger agnosia
  • Coordination difficulties
  • Behaviour -avoidance/excuses
  • Hyper-mobility
  • Low normal tone
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13
Q

When should you no longer have fists and raises concern for CP?

A

Past 4 months

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14
Q

Up to what point do you expect normal development in Rett Syndrome?

A

Until 6-9 months

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15
Q

For the pincer grasp, when do you develop (a) inferior grasp (with straight fingers) vs (b) true grasp?

A

(a) 9 months

(b) 12 months

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16
Q

Shapes that children can draw from 2-7 yeras

A 
2 = straight line
3 = circle
4 = cross
5 = square
6 = triangle
7 = diamond
17
Q

x5 genetic syndromes associated with Autism Spectrum Disorder

A
  • TSC
  • NF
  • T21
  • Rett Syndrome
  • Angelman
  • Fragile X
18
Q

Diagnostic criteria for Autism Spectrum Disorder

A

A = impairments in social communication (3/3)

1) Socio-emotional reciprocity
2) Deficits in developing/understanding/maintaining friendships
3) Deficits in non-verbal communication

B = Behaviours (2/4)

1) Stereotyped/repetitive behaviours
2) Strict adherence/rigidity to routine
3) Intense, fixated, restricted interests
4) Atypical sensory reactivity

*Must occur in the early developmental period

19
Q

Investigations for new dx of Autism

A
  • Audiology
  • Vision
  • Microarray
  • MECP2
  • Fragile X
20
Q

Risk factors for Autism

A
  • Genetic: Male, genetic syndromes, family history
  • Prenatal: older maternal age (>35), maternal obesity/DM/HTN, in-utero exposure to VPA/pesticide/air pollution, maternal infection, close spacing of pregnancies
  • Post-natal: low BM, extreme prematurity
21
Q

x3 components of a psychoeducational assessment

A
  • Cognitive
  • Academic achievement
  • Adaptive/behavioural
22
Q

What is a normal score for a psychoeducational test/IQ? And what would equate to 2 SD’s?

A

100 +/-15

2SD = +/- 30

23
Q

Criteria for specific learning disorder

A
  • Neurodevelopmental disorder with learning difficulty + problems acquiring academic skills
  • Selective impairment with average intelligence
  • Ongoing for 6 months
  • Not attributed by another disorder or intellectual disability
24
Q

Investigations to do/consider in GDD?

A
  • Microarray, fragile X, MECP2
  • Thyroid
  • Lead
  • Ferritin + iron studies
  • Audiology + vision
  • Metabolic screen
  • Neuroimaging
  • EEG
25
Q

Definition/criteria for GDD

A
  • Significant delay (by at least x2 SD below the mean) in 2 or more developmental areas
  • For children <5 years old who cannot undergo assessment yet
26
Q

x3 criteria for intellectual disability

A
  • Cognitive deficits (low IQ)
  • Adaptive dysfunction
  • Onset before 18 years old (dx at >5 years old)
27
Q

When must childhood-onset fluency disorder + stuttering resolve before you get worried?

A

7 years old

28
Q

What types of dysfluency are okay?

A
  • Interjection (“um”)
  • Multi-syllabic repetitions (“I want to I want to”)
  • Revised/abandoned utterances (“I want / hey look at that”)
29
Q

When to refer a dysfluency case?

A
  • Parental or child concern
  • Impacts functioning
  • Worsening in frequency/severity
  • Has remained for 12 months or more or >7 years of age
  • Presence of secondary behaviours (blinking, jaw jerks)
30
Q

Criteria for ADHD

A
  • Must have 6 symptoms from 1 or both categories for 6 months
  • Functional impairment
  • Symptoms present in at least 2 settings
  1. Inattention:
    - Careless mistakes
    - Trouble holding attention
    - Does not listen
    - Does not follow through
    - Trouble being organized
    - Avoids mental effort
    - Loses things
    - Easily distracted
    - Forgetful
  2. Hyperactivity + impulsivity:
    - Fidgets + squirms
    - Leaves seat
    - Runs about
    - Cannot be quiet
    - Always on the go
    - Talks excessively
    - Blurts out answers
    - Cannot wait for turn
    - Interrupts
31
Q

x5 early warning signs for CP

A
  • Hand preference development <12 months of age
  • Fisting beyond 4 months of age
  • Delays or asymmetry in development of movement/posture
  • Tightness of legs before 12 months of age
  • Delay in sitting by 9 months of age
32
Q

When will breath holding spells typically disappear by?

A

5 years old

33
Q

What are the two types of breath holding spells and what is the mechanism for both?

A
  1. Cyanotic = hyperventilation + apnea = typically when angry
  2. Pallid = vagal mediated bradycardia = typically following mild injury
34
Q

Mimics of seizures

A
  • Breath holding spells
  • Tics
  • Sandifer syndrome
  • Self gratification
  • Benign sleep myoclonus of infancy
  • Benign myoclonus of infancy
  • PNES
  • Syncope
  • Migraine
  • Dystonia
35
Q

When do children develop a secure gender identity?

A

4 years old

36
Q

What are the different characteristic reactions to parental divorce in (a) <3 years old, (b) 4-5 year olds, (c) school-aged, and (d) adolescent?

A

(a) development regression, irritable, separation anxiety, appetite/sleep disturbance
(b) blame themselves, externalizing behaviours
(c) take sides
(d) try to please everyone

37
Q

At what age are you able to self-soothe yourself to bed?

A

8-10 months

Royal Super 4th Year Brain (25 decks)

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