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Paediatrics > Developmental > Flashcards

Developmental Flashcards

1
Q

Difference between ADD and ADHD

A

less of the hyperactive component in ADD

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2
Q

% of children that suffer ADHD?

A

3-5%

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3
Q

Co-morbidities assocaited with ADHD?

A

learning difficulties, autism , communication issues, behavioural disorders like oCD, tourettes, mood disorders, sleep disorders, developmental coordination disorder, sensory processing disorder

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4
Q

How do you diagnose ADHD?

A

diagnosed by someone with expertise in ADHD, psychological and cognitive full assessment, developmental and psychiatric history, mental state

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5
Q

How long must patient have ADHD to be diagnosed and what age must they be?

A

Under 7 suffering for atleast 6 months

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6
Q

Scoring system used to diagnose ADHD?

A

Connors score

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7
Q

Pre-school management of ADHD?

A

Parent training and education programme

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8
Q

3 medications used to treat severe ADHD in school age and above?

A

methylphenidate, atomoxetine, dexemefetamine

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9
Q

2 examples of short acting methylphenidates? How long do they last?

A

Ratalin (methylphenidate), medikinet - 2 to 4 hours

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10
Q

2 examples of long acting methylphenidate? how long do they last?

A

concerta, medikinet XL - 6 to 8 hours

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11
Q

SE of using methylphenidate to control ADHD?

A

Seizures, tics, psychotic symptoms, anxiety, drug abuse

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12
Q

What class of drugs is atomoxetine?

A

SNRI

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13
Q

SE of using atomoxetine for ADHD management?

A

Seizures, agitation, TLNWL, sexual dysfunction, liver dysfunction

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14
Q

SE of using dexemefetamine as ADHD management?

A

Seizures, tics, psychotic symptoms, anxiety, misuse

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15
Q

4 unlicensed drugs used for ADHD?

A

bupropion, modafinil, clonidine, imipramine

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16
Q

In ADHD drug monitoring, what needs to be checked every 3 months (2 things), 6 months (2 things) and yearly?

A

3 months - BP/HR
6 months - weight/BMI
yearly - drug review

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17
Q

What 2 basic criteria must ADHD fill to be diagnostic with ICD10

A

fulfill icd10, be pervasive in more than 1 settings and be affecting progress of social/emotional/development needs

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18
Q

what 4 areas does ASD effect?

A

Social interactions, communication, interests and behvaiours

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19
Q

4 genetic disorders associated with ASD?

A

Down’s syndrome, angelmans, fragile X, williams

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20
Q

What does CHAT screen for?

A

Checklist for autism in toddlers

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21
Q

How is the diagnosis of autism made in toddlers?

A

Health visitor, gp, paediatrician, screening tools (CHAT), MDT, multisource reports (home/school/clinic), assessment tools (DISCO)

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22
Q

What does DISCO stand for?

A

diagnostic interview for social and communication disorders

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23
Q

ICD 10 requires one of which 3 criteria to be present for ASD diagnosis?

A

Impaired development in social play, selective social attachments, delay in receptive or expressive language

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24
Q

What 4 impairments of social interaction are listed as criteria on ICD10?

A

eye contact, making friends for their age, seeking shared enjoyment, impaired emotional response

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25
Q

What 4 impairments of communication are listed as criteria on ICD10?

A

lack of initiating or maintaining conversation, delay in speech development, lack of imagination, repetitive use of language

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26
Q

what 4 repetitive/sterotyped behaviours are listed as criteria on ICD10?

A

strict non-functional routines, obsession with a certain interest, motor mannerisms, interested in non-functional aspects of play materials

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27
Q

How are autistic children initially assessed?

A

MDT - autistic specific service, child development team, CAMHS, ADOS, school, parents

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28
Q

What does ADOS stand for and who is invovled?

A

autistic diagnostic observation schedule, SLT/psychologist/paediatrician/2 observers

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29
Q

How does medical management of autism play a role?

A

Monitor their sleep, feeding, epilepsy and medicate accordingly

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30
Q

What management areas of autism are needed to think about?

A

Behavioural, medical, educational, SLT, OT

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31
Q

What sign language can autistic children use?

A

Makaton

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32
Q

What are the 4 domains of development for a child?

A

Gross motor, fine motor, speech, social/emotional/behavioural

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33
Q

Gross motor skills shown at 6 weeks?

A

Head control in supine

34
Q

Fine motor control shown at 6 weeks?

A

Eyes fix and follow

35
Q

Speech and language developments shown at 6 weeks?

A

Quietens to voices, vocalising

36
Q

Social skills developed at 6 weeks?

A

Smiles

37
Q

Gross motor skills developed at 3 months?

A

Head control and can partly lift torso when prone

38
Q

Speech and language skills developed at 3 months?

A

Turns head to sound

39
Q

Gross motor skills developed at 6 months?

A

Sit with a round back, rolls, begins to weight bare

40
Q

Fine motor skills developed at 6 months?

A

palmar grasp, can transfer hand to hand

41
Q

Speech and language developed at 6 months?

A

Babbles, turns to mothers voice

42
Q

Social development at 6 months?

A

Stranger awareness

43
Q

Gross motor developments at 9 months?

A

Sits unsupported

44
Q

Fine motor development at 9 months?

A

pincer grip

45
Q

Speech and language developed at 9 months?

A

two syllables, responds to name

46
Q

Social skills developed at 9 months?

A

peek a boo, clapping

47
Q

gross motor skills developed by 1 year?

A

walking

48
Q

Speech and language developed by 1 year?

A

1st word,

49
Q

Social development by 1 year?

A

waves bye bye

50
Q

Fine motor skills developed by 15 months?

A

Scribble

51
Q

Speech and language developed at 2 years?

A

Put two words together

52
Q

Gross motor skills developed by 18 months?

A

Run, bend over, climb onto chair

53
Q

Fine motor skills developed by 18 months?

A

Three bricks stacked

54
Q

Gross motor skills developed at 2 years?

A

climbs stairs

55
Q

Fine motor skills developed at 2 years?

A

Stack 7 blocks

56
Q

Social skills developed at 2.5 years?

A

Dry in the daytime, spoon and fork

57
Q

How do you assess gross motor development in a baby?

A

Top down, posture, movements, tone, fix and follow (6 weeks), head lag as you pull them up, straightness of spine, ventral suspension (truncal tone? head lifting?), put them down and assess ability to lift head, reflexes

58
Q

What do you need to assess in fine motor skills in a baby?

A

Fix and follow, grasp, passing object, pincer grip, object permenance, pointing

59
Q

what do you assess for speech and language in a baby?

A

Vocalisation, parents have any concerns, startles to loud noise, babbling

60
Q

What do you ask an older child to do in order to assess gross motor development?

A

Walk, gait, run, jump, stand on one foot, kick a ball, bounce and catch ball, climb stairs

61
Q

How do you assess fine motor skills in an older child?

A

picture book (any pointing? turning pages? vocab and speech), drawing (scribble, grasp, imitate or copy) building blocks (tower, can they imitate shapes selected)

62
Q

How do you assess speech and language in an older child?

A

Point to body parts, name/age/gender/birthday, following instructions

63
Q

How do you assess social, emotional and behavioural development of older children?

A

Ask if they can use the toilet, eating, drinking

64
Q

What age would you expect a child to walk unaided?

A

18 months

65
Q

What age does a child develop hand dominance?

A

18 months

66
Q

at 30 months old how many blocks would you expect a child to be able to stack as a tower?

A

6-10

67
Q

What age would you expect a child to copy to drawing of a circle?

A

30-36 months

68
Q

What age would you expect a child to point out body parts?

A

18 months

69
Q

What conditions can cause tip toe walking to develop?

A

Cerebral palsy, autism

70
Q

What examination needs to be performed on a child who is tip toe walking?

A

Full neuro exam

71
Q

If you are suspicious of cerebral palsy in a child what is first line investigation you perform?

A

CT/MRI of brain, neuroimaging

72
Q

List 9 things that an individual with cerebral palsy is more likely to suffer from?

A

Epilepsy, learning difficulties, hearing problems, visual issues, joint contractures, scoliosis, behavioural problems, speech and language problems, feeding problems

73
Q

What does cerebral palsy appear like on CT/MRI and how does it differ depending on if insult occurs in early or late 3rd trimester?

A

Early 3rd trimester sees white mater injury with loss of volume and enlarged lateral ventricles, late 3rd trimester sees grey mater injury with basal ganglia and thalamic lesions

74
Q

Sensory issues experiencing by autistic children?

A

Dislike of loud noises, interest in certain aspects of play, dont like bright lights, certain textures, certain smells and food fascinate them or dislike them

75
Q

What questions can you ask a mother to determine whether her child has ASD?

A

are they sensitive to touch? do they over-react to loud noises and bright lights? do they like or hate certain foods? When playing do they focus on certain aspects of play? play with other children? speech and language progression? eye contact? nappies?

76
Q

What age does a child indicate their toilet needs?

A

18-24 months

77
Q

What age does cooperative play begin?

A

24-36 months

78
Q

When you suspect ASD what test should be organised?

A

Hearing test

79
Q

Recognised assessment tool for autism?

A

ASOD

80
Q

Once a diagnosis of autism is made who are the patients referred to? if they are struggling with their education who are they then referred to?

A

Autism intervention team, educational psychology input

Paediatrics (20 decks)

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