Development and developmental disorders Flashcards
Gross motor red flags:
- Head control
- Sitting unsupported
- Standing unsupported
- Walking
Head control
- 4 months
Sitting unsupported
- 9 months
Standing unsupported
- 12 months
Walking
- 18 months/ 2 years
Fine motor red flags:
- Reaching for objects
- Transferring object from hand to hand
- Pincer grip
- Drawing
Reaching for objects
- 6 months
Transfer objects hand-to-hand
- 9 months
Pincer grip
- 12 months
Drawing
- 2.5 years
Social development red flags
- Smiling
- Fear of strangers
- Feeding self
- Symbolic play
- Interactive play
Smiling
- 8 weeks
Fear of strangers
- 10 months
Feeding self
- 18 months
Symbolic play
- 2-2.5
Interactive play
- 3-3.5
Speech development, red flags:
- Polysyllabic babbling
- Consonant babbling
- Knowledge of 6 words
- Joining words to phrases
- 3-word sentence
Polysyllabic babbling
- 7 months
Consonant babbling
- 10 months
6 words
- 18 months
Words to phrases
- 2 years
3-word sentence
- 2.5 years
Cerebral palsy definition
- Non-progressive
- Postural and movement disorder
- Caused by an acquired insult to the brain before the age of 3.
Cerebral palsy causes
- Maternal factors
- Foetal factors
Maternal
- Infection
- Smoking/ alcohol/ drugs
- Pre-eclampsia/ eclampsia
- Vascular ischaemia
- Multiple gestation
Cerebral palsy causes
- Foetal factors (prenatal, perinatal)
Pre-natal
- Genetic mutation
- Metabolic disorders
- Congenital brain malformations
Perinatal
- pre-term
- hypoxia
- head insult
- infection
- traumatic birth, hypoglycaemia, raised bilirubin
Cerebral palsy prevalence
2-3.5 in 1000.
Cerebral palsy types [4]
Spastic
- Hypertonia
- Brisk reflexes
- Muscle atrophy and low power
Ataxia (cerebellar disease)
- DANISH
Dyskinetic
- Slow reflexes
- Low muscle power
- Changes in muscle tone
Mixed
Investigations for cerebral palsy
Brain MRI
Muscle function
Genetic screens
Differential for cerebral palsy
Muscular dystrophy
Spinal muscular atrophy
Brain tumour
Causes of global developmental delay
Genetic syndromes
- Down’s syndrome
- Fragile X syndrome
- Fetal-alcohol syndrome
- Rett syndrome
- Metabolic disorders
Cerebral palsy
Causes of gross motor delay
- Cerebral palsy
- Myopathy
- Spina bifida
- Visual impairment
- Ataxia
Causes of fine motor delay
- Cerebral palsy
- Muscular dystrophy
- Dyspraxia
- Visual impairment
Causes of Language delay
- Hearing impairment
- Social circumstances: multiple languages, siblings
- Autism
- Cerebral palsy
- Neglect.
- Learning disability
Causes of social delay
- Autism
- Emotional and social neglect
- Parenting problems.
Risk factors for learning disabilities
- Family history
- Environmental: abuse, neglect, psychological trauma
Associations with learning disabilities
- Epilepsy
- Autism
- Genetic syndromes: Down’s syndrome
- Perinatal complications: prematurity, hypoxic ischaemic encephalopathy.
- Childhood infections: i.e. meningitis
- Antenatal syndrome: fetal-alcohol syndrome, maternal chickenpox.
Assessment of learning disability
IQ test
- 55-70 = mild
- 40-55 = moderate
- 25- 40= severe
- < 25= profound.
Posterior fontanelles close _____ after birth
2-3 months
The anterior fontanelle closes around _______ after birth
18 months
The moro reflex disappears ____ after birth
3-6 months
The babinski reflex disappears roughly ______ after birth
12 months (when corticospinal tract is myelinated)
Gross motor features in a 6-week old baby
Can lift head 45 degrees when on tummy
Can stabilise head when seated supported.
Fine motor features in a 6-week old baby
Track objects/ face
Speech/language motor features in a 6-week old baby
Startles to loud noise
Social features in a 6-week old baby
Social smiling
Gross motor features in a 6-month old baby
Sitting unsupported, rounded back
Rolls from tummy to back
Fine motor features in a 6-month old baby
Palmar grasp (5m)
Transfer objects from hand to hand
Speech/ language features in a 6-month old baby
Turns head to loud noise
Understands bye/bye, no (7m)
Monosyllabic babbling
Social features in a 6-month old baby
Puts objects to mouth
Shakes rattle
Reaches for bottle/ breast
Gross motor features in a 9-month old baby
Sits unsupported, straight back (7.5m)
Stands when holding
Fine motor features in a 9-month old baby
Inferior pincer grip (10m)
Object permanence (peek-a-boo)
Speech/ language features in a 9-month old baby
Responds to own name
Imitates adult sounds
Social features in a 9-month old baby
Stranger fear (6-9 months to 2 years)
Holds and bites food
Gross motor features in a 1-year old baby
Walking
Causes of delayed walking
Duchenne’s MD
Hip abnormalities (dysplasia)
Cerebral palsy
Fine motor features in a 1-year-old child
Neat pincer grip (10 m)
Throwing bricks (stop by 18 months).
Bricks- tower of 2
Speech/language features in a 1-year child
Understand nouns
3 words
Points to own body parts (13m)
Social features in a 1-year old child
Waves bye bye
Hand clapping
Plays alone near familiar person
Drinks from beaker with lid
Gross-motor features in a 18-month-old child
Runs (16m)
Jumps
Fine-motor features in a 18-month-old child
Draws line to-and-fro
Brick tower of 4
Speech/language features in a 18-month-old child
6 different words
Social features in a 18-month-old child
Imitates everyday activities
Gross-motor features in a 2-year-old, 2.5 years child
Runs, tiptoes
Walks upstairs using both feet
Throws ball at shoulder level
- 5
- Kicks ball
Fine-motor features in a 2-year-old, 2.5 years child
Draws vertical line
- Horizontal line (2.5)
Brick tower of 8
Puzzles
Turns several pages of book
Speech/language features in a 2-year-old, 2.5 years child
Understands verbs
- Understand prepositions (2.5)
2-words join together
- 3-4 (2.5 years)
Vocab for 50+ words
Social features in a 2-2.5 year old child
Eats with a spoon (2.5 yrs)
Gross-motor features in a 3-3.5 year-old child
Hops on one foot for 3 steps
Walks upstairs, one foot per step
- Downstairs two feet per step
Fine-motor features in a 3-3.5 year-old child
Draws circle
Brick: bridge/ train
Cut using scissors–> single cut
- Into pieces (3.5)
Griffith beads
Turns one page of book at a time
Speech/language features in a 3-3.5 year-old child
Understands negatives and adjectives
- Understands comparatives (3.5)
Social features in a 3-3.5 year-old child
Share toys with friends
Plays without parents
Eats with fork, spoon
Bowel control
Gross-motor features in a 4 year-old child
Walks up and downstairs in adult manner
Fine-motor features in a 4-5 year-old child
Drawing
- Cross
- Square (4.5)
- Triangle (5)
Brick
- 12 block tower
- Steps
- Big steps (5 years)
Cutting + beads
- Cuts paper in half
- Small beads
Speech/ language features in a 4 year-old child
Understands complex instructions (2-step)
Uses complex narrative/ sequences
Scoial features in a 4 year-old child
Sympathy/ concern for others if hurt
Has best friend
Dressing and undressing
Eating without little help
- Handles knife (5)
Bladder control (4.5)
Imaginative play (4.5-5)
Red flag for saying clear words
18 months
Red flag for running
4 years
Red flag for hand dominance
If <1
Red flag for point/ showing interest
By 1 year.
Features of fetal alcohol syndrome
Small eye opening (palpebral fissure)
Absent philtrum (flat nose)
Thin upper lip
Features of down syndrome
Hypotonia
Facial: epicanthal folds
Co-morbidites: thyroid, congenital heart defect, hearing
Single palmar crease, sandal gap between toes
Fragile X features
Macroencephaly
