Development

Question 1

Risk factors for CP in preterm

Answer 1

— Periventricular Leukomalacia
— IVH/Hydrocephalus
— Intraparenchymal hemorrhage — Infection
— Bilateral but asymmetric in severity

Question 2

Etiology of CP for Term Infants

Answer 2

◦ 50% related to prenatal factors:
Malformations,prenatalstrokes,congenitalTORCH
infections
◦— 6% due to asphyxia during birth: HIE
◦ Low APGAR scores, respiratory compromise,
abnormal reflexes & seizures
◦ Risk factors: maternal thyroid disease, fever during labor, treatment of infertility

Question 3

Sleep disorders counselling

Answer 3

—Parent Education
—Establish a bedtime routine —Consistent bedtime and schedule —Remove maladaptive sleep associations —Teach child to fall asleep on own —Extinction/Graduated Extinction

Question 4

Sleep counselling for teenager

Answer 4

Reasonable and consistent bedtime
—Sleep in only one hour later on weekends
—Eliminate caffeinated beverages after 12noon — Have breakfast each morning
—No late night or evening exercise
—No television in room

Question 5

Characteristics of Night terrors

Answer 5

—Occur 1-3 hours after falling asleep —Deep slow-wave, non-REM sleep —Child does NOT wake during episode —Does NOT recall episode in morning —Confused after episode
family history

Question 6

Work up for GDD or intellectual disability

Answer 6

Chromosomal Microarray (10-15%)
—Fragile X (2.5% of males, 1.5% of females)
—MECP2 (1.5% of females mod-severe ID)
—Thyroid (4% or nearly 0% with normal newborn screen) —
Lead and Ferritin (only if mouthing/PICA)
Metabolic testing (1-5%)
— Neuroimaging (MRI 10-55%)
—EEG (only if seizures suspected) (<1%)
—Ophthalmology Consult (Visual impairment 10-50%) —
Audiology (Hearing impairment 20%)

Question 7

Developmental disfluency

Answer 7

—-Occasional (once every 10 sentences)

• Brief (0.5 seconds or less)
• Repetition of sounds, syllables or words (no prolongations; at start of word)
• Worse when tired, excited, complex language, questions, anxious
• No tension in the facial muscles

Question 8

Changes to ADHD diagnosis

Answer 8

Key changes in DSM-5
◦ Criterion for age of onset (several symptoms present by
age 12 years, rather than by age 7)
◦ Several symptoms must be present in more than one
setting.
◦ Presentations, rather than Subtypes (Combined, Predominantly Inattentive, Predominantly Hyperactive- Impulsive)
◦ASD not an exclusion (can diagnose with ADHD and ASD)

Question 9

ADHD management

Answer 9

— Preschool (Ages 4-5)
◦ Evidence-based Behaviour Therapy ◦ Methylphenidate if you need to
— School-aged (6-11)
◦ Start with Meds and/or Behaviour Therapy
◦ Preferably both
— Adolescents (12-18)
◦ Start with Meds, maybe Behaviour Therapy
◦ Preferably both

Question 10

Common issues with fetal alcohol spectrum disorder

Answer 10

• Cognitive and learning disorders
• ADHD (severe and refractory)
• Poor judgement, poor sense of cause and effect