Development SAQ Flashcards
- Four features of dyslexia (reading impairment).
- Difficulty reading due to poor word recognition
- Poor spelling and decoding abilities
- Normal cognition and comprehension when read to aloud
- Strong FHx
2 Child with ODD (they give you this).
a) What management would you suggest (2 marks)
b) What 3 comorbidities are associated (3 marks)
A)
- Parent training classes
- CBT + social emotional skill training for child
- Medications to treat comorbidities
B)
- ADHD
- Anxiety
- Conduct disorder
- 6 or 7 m.o. Boy that her mother is concerned about his development. He rolls both sides, is unable to sit without support, he babbles and her mother thinks he is right handed because he crosses midline to grab with his right hand when objects are on the left.
a) Of those findings what one thing is the MOST worrisome on history?
b) Explain why?
a) Early handedness
b) Handedness before 18mo is a red flag and is suggestive of CP
Spastic hemiplegia
- decreased spontaneous movment on affected side, arms > legs
- early hand preference
- Name 5 characteristics of Rett syndrome (5).
- Females. MEC2P mutations
- Normal development until ~1yo then regression of motor + language. Plateaus after
- Acquired microcephaly
- Repetitive handwringing. Loss of spontaneous movement of the hands
- Autistic behaviour
- Gait abnormalities
- Sighing respirations with intermittent apenas +/ cyanosis
- GTC Sz
- Arrhythmias
5) A 7 year old boy fights when going to bed and takes an hour to fall asleep. What are five pieces of advice you would give the parents for improving sleep hygiene?
30 ) Teenage boy with trouble sleeping. List 5 things to improve his sleep hygiene.
- Set bedtime and routine
- Sleep and wake hours should be same on school and non-school nights (<1H difference)
- Shared quiet time 1H before bed without screens
- Light snack before bed
- Avoid caffeinated products for several hours before bed
- Keep bedroom at appropriate temperature
- Keep bedroom dark and quiet. Can use night light
- Don’t use bedroom for punishment
- No TV in bedroom
- Ensure adequate exercise. Go outside (for sun)
For teenagers
- Don’t use weekends to catch up on sleep
- Limit naps to <1H in afternoons
- Use bed only for sleep
- No smoking or alcohol
- No sleep meds unless prescribed
6) A 9 year old girl has a short temper, is argumentative, and disrespects her parents. What are 5 key features of a parenting plan for this child?
Parent management training
- Develop warm, supportive relationship with child
- Encourage child-directed interaction + play
- Provide predictable, structured household environment
- Set clear + simple househodl rules
- Consistently praise + reward positive behaviour
- Consistently ignore annoying behaviour (then praise when it ceases)
- Consistently give consequences for dangerous or destructive behaviour (time out or loss of privileges)
7) A 6 year old boy is referred to you for school difficulties. He is previously healthy and was born at term. What information on history would help confirm your suspicion of reading disability (dyslexia)? (They had 5 lines but did not specify how many points they wanted.)
- Difficulty with reading due to difficulties with fluency or accuracy of word recognition
- Poor spelling and decoding abilities
- Normal language comprehension when read to aloud
- Normal cognitive ability
- Family history
8) Name 5 safe sleeping advice
- Back to sleep
- No extra bedding
- Crib in same room as parents
- No cosleeping
- No bottle propping
9) You noticed that the community has a high rate of dental caries, what 5 things can you do at the community level to decrease dental caries
- Advocate for fluoride supplementation in water
- Dental assessment for infants wtihin 6mo fo their first tooth. No later than 1yo for all children
- Develop ongoing surveillence system to monitor state of pediatric oral health
- Create leadership positions to represent specific interests of children + youth on oral health issues in the community
- Child health care providers should get appropraite training + continuing education in oral health. Provide anticipatory guidance for parents so that disease can be prevented.
10) A 28 week prem is now 10 months old. He is able to sit alone for 5 min, is commando crawling, can transfer objects from hand to hand and can stand if supported. He does not have a pincer grasp.
a. What is his developmental level?
b. How should you advise parents?
A. 6mo (CGA 7mo)
- 6mo: sit momentarily propped on hands, 7mo: sits without support steadily, 8 mo: commando crawls
- 6mo: transfers hand to hand
- 6mo: palmar grasp, 9mo: inferior pincer grasp, 12mo: mature pincer grasp
B.
- Reassure that he is developing appropriately for CGA
- Anticipatory guidance: safety for furniture in preparation for walking, work on pincer grasp + utensils, work on drinking from cup, should have babbling + imitating sounds, shake head for no, read to baby
- Counsel families about using correct GA for development + growth parameters until 2yo
11) Name 4 biological factors that influence a child’s development.
- Intrauterine exposures (teratogens, drugs, alcohols) + TORCH infections
- Prematurity + low BW
- Underlying genetic/metabolic condition
- Postnatal illness, disease, injury
- FHx of developmental delay
13) Teacher concerned about 4 yr old child who can’t use scissors, can’t copy a square… she wonders about developmental coordination disorder. List 2 diagnostic criteria for developmental coordination disorder.
- Acquisition and execution of coordinated motor skills below expected level for age and opportunity to learn
- Interferes wtih ADLS/play/school
- Began in early developmental period
- Impairment in motor skills not better explained by another condition
15) School refusal: what three recommendations would you make?
- Early return to school - longer child stays out of school, more difficult it is to return
- Address comorbid psychiatric problems, family dysfunction + other contributing problems
- Positive reinforcements for going to school. No positive reinforcements for staying at home (TV)
16) Table of 5 different developmental milestones for an 18 month old. Mark as normal or abnormal:
a. Walked at 14 months, not yet doing stairs
b. Speaks a 2 word vocabulary
c. Follows one step commands
d. Cries for wants but does not point to needs
e. Points to face but doesn’t know any other body parts
a. Walked at 14 months, not yet doing stairs: ?normal
* 15mo: creep up stairs, 18mo: creep down, 2yo: up/down stairs 2 feet/step + rail
b. Speaks a 2 word vocabulary - not normal
* 18mo: should have 10-25 words
c. Follows one step commands - normal
- 12mo: 1 step with gesture
- 15mo: 1 step without gesture
d. Cries for wants but does not point to needs - not normal
- 12mo: protoimperative pointing
- 15mo: protodeclarative pointing
e. Points to face but doesn’t know any other body parts - not normal
* 18mo: 3 body parts
17) Mom brings in her 6 month old child. Noted to not be using the left hand, and left arm and leg appear stiff. Babbling, smiling, but unable to sit even with support. Otherwise looks well. What is your first management step?
CK + MRI brain