Developmental Flashcards
Difference between ADD and ADHD
less of the hyperactive component in ADD
% of children that suffer ADHD?
3-5%
Co-morbidities assocaited with ADHD?
learning difficulties, autism , communication issues, behavioural disorders like oCD, tourettes, mood disorders, sleep disorders, developmental coordination disorder, sensory processing disorder
How do you diagnose ADHD?
diagnosed by someone with expertise in ADHD, psychological and cognitive full assessment, developmental and psychiatric history, mental state
How long must patient have ADHD to be diagnosed and what age must they be?
Under 7 suffering for atleast 6 months
Scoring system used to diagnose ADHD?
Connors score
Pre-school management of ADHD?
Parent training and education programme
3 medications used to treat severe ADHD in school age and above?
methylphenidate, atomoxetine, dexemefetamine
2 examples of short acting methylphenidates? How long do they last?
Ratalin (methylphenidate), medikinet - 2 to 4 hours
2 examples of long acting methylphenidate? how long do they last?
concerta, medikinet XL - 6 to 8 hours
SE of using methylphenidate to control ADHD?
Seizures, tics, psychotic symptoms, anxiety, drug abuse
What class of drugs is atomoxetine?
SNRI
SE of using atomoxetine for ADHD management?
Seizures, agitation, TLNWL, sexual dysfunction, liver dysfunction
SE of using dexemefetamine as ADHD management?
Seizures, tics, psychotic symptoms, anxiety, misuse
4 unlicensed drugs used for ADHD?
bupropion, modafinil, clonidine, imipramine
In ADHD drug monitoring, what needs to be checked every 3 months (2 things), 6 months (2 things) and yearly?
3 months - BP/HR
6 months - weight/BMI
yearly - drug review
What 2 basic criteria must ADHD fill to be diagnostic with ICD10
fulfill icd10, be pervasive in more than 1 settings and be affecting progress of social/emotional/development needs
what 4 areas does ASD effect?
Social interactions, communication, interests and behvaiours
4 genetic disorders associated with ASD?
Down’s syndrome, angelmans, fragile X, williams
What does CHAT screen for?
Checklist for autism in toddlers
How is the diagnosis of autism made in toddlers?
Health visitor, gp, paediatrician, screening tools (CHAT), MDT, multisource reports (home/school/clinic), assessment tools (DISCO)
What does DISCO stand for?
diagnostic interview for social and communication disorders
ICD 10 requires one of which 3 criteria to be present for ASD diagnosis?
Impaired development in social play, selective social attachments, delay in receptive or expressive language
What 4 impairments of social interaction are listed as criteria on ICD10?
eye contact, making friends for their age, seeking shared enjoyment, impaired emotional response
What 4 impairments of communication are listed as criteria on ICD10?
lack of initiating or maintaining conversation, delay in speech development, lack of imagination, repetitive use of language
what 4 repetitive/sterotyped behaviours are listed as criteria on ICD10?
strict non-functional routines, obsession with a certain interest, motor mannerisms, interested in non-functional aspects of play materials
How are autistic children initially assessed?
MDT - autistic specific service, child development team, CAMHS, ADOS, school, parents
What does ADOS stand for and who is invovled?
autistic diagnostic observation schedule, SLT/psychologist/paediatrician/2 observers
How does medical management of autism play a role?
Monitor their sleep, feeding, epilepsy and medicate accordingly
What management areas of autism are needed to think about?
Behavioural, medical, educational, SLT, OT
What sign language can autistic children use?
Makaton
What are the 4 domains of development for a child?
Gross motor, fine motor, speech, social/emotional/behavioural
Gross motor skills shown at 6 weeks?
Head control in supine
Fine motor control shown at 6 weeks?
Eyes fix and follow
Speech and language developments shown at 6 weeks?
Quietens to voices, vocalising
Social skills developed at 6 weeks?
Smiles
Gross motor skills developed at 3 months?
Head control and can partly lift torso when prone
Speech and language skills developed at 3 months?
Turns head to sound
Gross motor skills developed at 6 months?
Sit with a round back, rolls, begins to weight bare
Fine motor skills developed at 6 months?
palmar grasp, can transfer hand to hand
Speech and language developed at 6 months?
Babbles, turns to mothers voice
Social development at 6 months?
Stranger awareness
Gross motor developments at 9 months?
Sits unsupported
Fine motor development at 9 months?
pincer grip
Speech and language developed at 9 months?
two syllables, responds to name
Social skills developed at 9 months?
peek a boo, clapping
gross motor skills developed by 1 year?
walking
Speech and language developed by 1 year?
1st word,
Social development by 1 year?
waves bye bye
Fine motor skills developed by 15 months?
Scribble
Speech and language developed at 2 years?
Put two words together
Gross motor skills developed by 18 months?
Run, bend over, climb onto chair
Fine motor skills developed by 18 months?
Three bricks stacked
Gross motor skills developed at 2 years?
climbs stairs
Fine motor skills developed at 2 years?
Stack 7 blocks
Social skills developed at 2.5 years?
Dry in the daytime, spoon and fork
How do you assess gross motor development in a baby?
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
What do you need to assess in fine motor skills in a baby?
Fix and follow, grasp, passing object, pincer grip, object permenance, pointing
what do you assess for speech and language in a baby?
Vocalisation, parents have any concerns, startles to loud noise, babbling
What do you ask an older child to do in order to assess gross motor development?
Walk, gait, run, jump, stand on one foot, kick a ball, bounce and catch ball, climb stairs
How do you assess fine motor skills in an older child?
picture book (any pointing? turning pages? vocab and speech), drawing (scribble, grasp, imitate or copy) building blocks (tower, can they imitate shapes selected)
How do you assess speech and language in an older child?
Point to body parts, name/age/gender/birthday, following instructions
How do you assess social, emotional and behavioural development of older children?
Ask if they can use the toilet, eating, drinking
What age would you expect a child to walk unaided?
18 months
What age does a child develop hand dominance?
18 months
at 30 months old how many blocks would you expect a child to be able to stack as a tower?
6-10
What age would you expect a child to copy to drawing of a circle?
30-36 months
What age would you expect a child to point out body parts?
18 months
What conditions can cause tip toe walking to develop?
Cerebral palsy, autism
What examination needs to be performed on a child who is tip toe walking?
Full neuro exam
If you are suspicious of cerebral palsy in a child what is first line investigation you perform?
CT/MRI of brain, neuroimaging
List 9 things that an individual with cerebral palsy is more likely to suffer from?
Epilepsy, learning difficulties, hearing problems, visual issues, joint contractures, scoliosis, behavioural problems, speech and language problems, feeding problems
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?
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
Sensory issues experiencing by autistic children?
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
What questions can you ask a mother to determine whether her child has ASD?
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?
What age does a child indicate their toilet needs?
18-24 months
What age does cooperative play begin?
24-36 months
When you suspect ASD what test should be organised?
Hearing test
Recognised assessment tool for autism?
ASOD
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?
Autism intervention team, educational psychology input