Development and developmental delay

Question 1

What are the four areas of development?

Answer 1

Gross motor
Fine motor
Language and hearing
Social behaviour and play

Question 2

Define developmental delay.

Answer 2

Failure to achieve appropriate developmental milestones for a given chronological age, corrected for prematurity.

Question 3

Other than delay, what are the two other major patterns of developmental disorder?

Answer 3

Deviation (e.g. ASD) or regression (Rett’s)

Question 4

What are the red flags for developmental in terms of:

a) movement
b) reaching for objects
c) sitting unsupported
d) walking
e) speech

Answer 4

a) asymmetry of movement
b) not reaching by 6 months
c) not achieved by 12 months
d) no walking by 18 months
e) no speech by 18 months

Question 5

What is global developmental delay and what accounts for around 25% of these?

Answer 5

Significant delay in two of the four categories. Genetic causes e.g. Down’s syndrome

Question 6

Give examples of specific developmental delays:

a) motor
b) language
c) sensory

Answer 6

a) Duchenne muscular dystrophy, cerebral palsy
b) specific language impairment
c) Treacher-Collins syndrome (conductive hearing loss)

Question 7

What is the triad of ASD?

Answer 7

Impaired communication, social interaction and flexibility of thought

Question 8

In the history, what specific aspects is it important to ask about?

Answer 8

Perinatal and birth history; development history; play and behaviour; school/nursery

Question 9

What particular features should be looked for in examination?

Answer 9

Dysmorphism, head circumference, CNS exam, vision, hearing

Question 10

What genetic investigations can be carried out?

Answer 10

Karyotype, fragile X, array CGH

Question 11

What are the main principles of intervention in developmental delay?

Answer 11

Early intervention and family/educational support

Therapy- physio, OT

Question 12

What other studies may be carried out in assessing a developmental delay?

Answer 12

MRI brain; EEG; PKU testing, thyroid studies; metabolic studies

Question 13

When should a baby develop a social smile?

Answer 13

6 weeks

Question 14

For 18 months of age, outline the milestones which should be attained.

Answer 14

Gross motor- runs
Fine motor and vision- builds a tower of 3/4 blocks, develops hand preference
Language and hearing- 5-20 words, points to body parts
Social- feeds with spoon, imitates adult activities

Question 15

When should a child be able to climb stairs with alternating feet?

Answer 15

3 years

Question 16

When do children typically begin to crawl?

Answer 16

Around 9 months

Question 17

When do children typically develop the fine motor control required to pick up a small object (e.g. a raisin) between forefinger and thumb?

Answer 17

About 9 months

Question 18

Gross motor developmental milestones:

a) sits without support
b) crawls
c) walks unsupported
d) runs
e) rides a tricycle with pedals

Answer 18

a) 7-8 months
b) 9 months
c) 13-15 months
d) 2 years
e) 3 years

Question 19

Social developmental milestones:

a) smiles
b) laughs
c) plays peek-a-boo
d) plays near others
e) plays with other children

Answer 19

a) 6 weeks
b) 3 months
c) 6 months
d) 9 months
d) 2 years
e) 4 years