Development and Disability Flashcards
1
Q
What is cerebral palsy? What are some things you should consider in these patients?
A
- Not a specific disease
- refers to a group of conditions of variable severity with certain developmental features in common
- describes a phenotype
- 40,000 people
- a motor disability occuring following injury to developing CNS
- activity limitation
- non-progressive disturbances occured in fetal or infant brain
- disturbances of sensation, perception, cognition, communication and behaviour.
- Causes:
- prematurity
- encephalopathy
- ABI <2 years
- deformity/contracture/hip dislocation
- need for equipment to support/orthoses/wheelchair
- tone and or movement disorder, spasticity, dystonia, choreoathetosis
- common complications:
- epilepsy (Mg)
- musculoskeletal problems
- PEG (impaired feeding)
- ID
- nature and extent of brain injury (PVL vs deep grey matter)
2
Q
What is Intellectual Disability?
A
- IQ<70 - construct (71 you don’t have one)
- population changes, not hard and fast diagnosis
- Associated with
- down’s syndrome
- tuberous sclerosis
- Fragile X
- ASD
- in common?
- difficulty managing independent tasks
- can’t manage money
- adaptability
3
Q
What is Autism and how do you diagnosis it?
A
- typically appears in first 3 years of life
- developmental disability
- impacting social interaction and communication
- verbal and non-verbal communication
- social interaction
- leisure and play activities
- communicaiton difficulties
- social difficulties
- repetivie sterotyped behaviours
Associated comorbidities:
- epilepsy
- psychiatric
- medical diagnosis underlying
4
Q
What can you do for a disabled child?
A
- Who is the child?
- what the child and family really need
- Diagnosis (review overtime)
- Coordination
- seeing the whole child
- Practical Support
- letters
- forms
- links to EIP
- continence
- Ongoing care
- alternative or complementary treatment
5
Q
What can be used to assess children for syndromes?
A
CBCL - child behaviour checklist
- Internalizing problems sums the:
- Anxious/depressed,
- Withdrawn-depressed, and
- Somatic complaints scores;
- Externalizing problems combines
- Rule-breaking and
- Aggressive behavior.
- breaks into normal, borderline and clinical behaviour.
6
Q
What are the domains you include in a development history?
A
Common Disability categories include:
- motor functioning (e.g. cerebral palsy)
- cognitive functioning (e.g. ID)
- social functioning (e.g. ASD)
- sensory functioning (vision or hearing impairments)
frequently more than one area of functioning is affected.
7
Q
What are some developmental milestones for 6 months of age?
A
- social:
- alert and responsive
- smile and laugh appropriately and become fearful of strangers
- sensory
- responds to sound by turning towards the source and vocalising using a variety of sounds
- visually fix on an object and follow it through 180 degrees
- motor
- pick up objects with a palmar grasp and self-feed finger foods
- sit momentarily with a straight back and hold the head steady
- cognitive -
8
Q
What are some developmental milestons for 12 months?
A
- Cognitive:
- indicate their wants through sound and gesture
- say at least two words with meaning and imitate a range of sounds
- Motor:
- pick up small objects with thumb-finger graps and transfer toys from hand to hand
- crawl and pull themselves up - sit independently
- Social
- enjoy cause and effect of play
- Sensory:
9
Q
What are some developmental milestones for 2 year olds?
A
- Motor
- walk well, run and manage steps
- Cognitive
- scribble and build a tower of 2.5cm cubes
- speech includes two-word phrases
- eats with a spoon
- Sensory
- Social
- start to develop make-believe play and imitate parents activities
- enjoy playing alongside other children
10
Q
What are some developmental milestons of a 3 + 1/2 year old child?
A
- motor
- kick and throw a ball
- cognitive
- increasingly independent in their personal care (clothing, teeth)
- speak in short sentences and point to pictures and name them
- social
- sociable and can name a friend
- interact with children during play
- mimic adult activities, play imaginary
- sensory
11
Q
What are some developmental milestones for a 5 year old?
A
- motor
- can run, climb, hop, pedal a tricycle
- cognitive
- dress and undress independently
- speaks in clear sentences with some prepositions and name colours
- copy a circle and draw a primitive person
- social
- simple board game/card games
- good conversational skills in play
- well-developed imaginary games
- sensory
12
Q
Disability vs Impairment vs Handicap
A
Impairment
- any loss or abnormality of physiological, psychological or anatomical structure. Refers to a specific task.
Disability:
- any restriction in the ability to perform an activity within the range considered normal for a human being. Specific to a task.
Handicap:
- disadvantage that limits or prevents fulfillment of a role that is normal. Relative to a peer group.
13
Q
What are 3 DDx for a child throwing tantrum at age 2. He has difficulty relating to peers.
A
- ASD
- language delay/regression
- 24 months no single words
- 3 years no phrasing
- echolalia or stereotyped speech
- communication impairment
- facial expression, demeanour
- social impairment
- imaginative play
- social interest
- repetitive/rigid/stereotyped behaviours
- language delay/regression
- ADHD
- impulsivity that interferes with function/development (inattention, hyperactivity) (diagnosis less reliable before school age)
- ODD (oppositional defiant disorder)
- pattern of hostile behaviour >6mths with >4 of:
- temper, argues, defies rules, annoys, blames others, angry, spiteful
- pattern of hostile behaviour >6mths with >4 of:
14
Q
What are some recommendations you can make to manage ASD?
A
-
Communication:
- communication aids - PECS (picture exchange communication system), book/board, Apps.
- referral to speech pathology
-
Routines - plan ahead of time for procedures
- accomodate leisure period activities, what is their intense interest.
- try not to change plans
-
Sensory sensitivities - low stimulus environment
- light/colour/textures/volume/unexpected noises
- hyper or hyposensitive
- Variations between home, school and respite care. Different strategies?
- Referrals to Educational Play Therapy (for procedural support) and Speech pathology (for communication assistance)
-
psychotropic meds to preempt behaviour.
- clonazepam
- lorazepam
- risperidone
15
Q
What are further questions you can ask of the carer for ASD?
A
- what is the best way to comfort your child?
- does your child avoid eye contact or being in close proximity to oyhers?
- What are your child’s favourite food/beverages?
- Does your child respond to visual cues? A video or picture example?
- What types of toys or activities does your child prefer?
