Developmental delay Flashcards
what are the 2 types of delay
global - 2 or more areas of development effected
specific - 1 area of development effected
what is developmental delay
failure to attain appropriate developmental milestones for child’s chronological age
what are 3 abnormal development patterns
Delay
Deviation
Regression
example of deviation
autism spectrum - not just a delay but they may not acquire a skill, or do things differently
example of regression
Loss of skills that were previously acquired
examples: Rett’s syndrome (genetic condition when they acquire milestones up to 18 months then start to loose them again)
what is the IQ of someone with a severe learning disability
Norm - 100
severe learning disability - 50
what are some red flags for development
- Asymmetry of movement
- Not reaching out for objects by 6 months (could be vision or motor skill or lack of interest)
- Unable to sit unsupported by 12 months
- Unable to walk by 18 months (check CK for muscular dystrophy)
- No speech by 18 months
- Concerns re vision/hearing
- Loss of skills (regression)
what is screened for in Down’s syndrome patients (common complications)
- cardiac problems
- vision
- hearing
- thyroid function
- sleep related breathing disorders
- growth charts (smaller, put on more weight)
- development
what happens do children with a developmental delay, do they eventually catch up?
no, for example if a 2 year old is 6 months delayed then thats 1/4. They will most likely always been 1/4 delayed for their age eg. a 12 year old will act more like a 9 year old
what is Duchenne muscular dystrophy
presents with a motor delay, hearing/speech problems- weakness in pelvic girdle which is seen by a compensatory back lordosis.
GOWERS manoeuvre is associated due to weakness in legs (pushing body up with arms on thighs instead of legs)
what is hemiplegic cerebral palsy
when 1 side is effected
what is biologic cerebral palsy
when 2 limbs are effected - most commonly related to an insult to pregnant women interrupting blood flow to foetus
what is quadriplegic cerebral palsy
when all 4 limbs are involved
most common cause of cerebral palsy
antenatal issues
conditions associated with cerebral palsy
- mobility problems, spasticity and orthopaedic problems
- learning difficulties
- epilepsy
- visual/hearing impairment
- communication difficulties
- feeding difficulties
- sleep problems
- behaviour problems
- co-ordination disorders
what are some causes of sensory defects and associated delay
Oculocutaneous albinism
- effects pigmentation of hair skin and eyes
- problems with eye movements, light sensitivity
‘Glue ear’ - ears blocked temporarily causing it to sound like you’re underwater - 3 months to clear
what is the triad of autism impairments
communication
social interaction
flexibility of though/imagination
what is the difference between receptive and expressive language in autism
receptive language is often less than expressive language meaning they use words and say things they don’t understand
some signs of autism in expressive language
Echoes- repeating back what they’ve heard without understanding it
off intonation/pitch - either v monotone or sometimes high
Chunks of video speak- learn chunks of dialogue from tv ect and repeats it
what non-verbal communication difficulties are seen in autism
facial expressions and gestures can be hard to read
eye contact can be difficult
struggle to recognise the intentions of others
what difficulties with the use of language are seen in autism
initiating and sustaining conversation
restricted interests eg. child being obsessed with trains
lack of awareness of reciprocal nature of conversation - don’t stop talking at you
Difficulties seen during social interaction in people with autism
joint attention and referencing - can’t get them interested in something you’re also interested in
taking turns - cant predict what will happen if they let someone else play with their toy
unable to share pleasure
dont follow social rules
lack empathy
relationships
other points of view/feelings
difficulties in thought/imagination seen in autism
-theory of mind
-concrete and literal - don’t understand figures of speech
-no concept of time
dont like changes in
environment - can memorise entire environments an know of any changes to them
-ritualistic behaviour
sensory issues associated with autism
fussy eater/medications textures of clothes sleep - prefer heavy blankets and heavy touch toilet training hair washing/cutting nail cutting noise
what to ask about in the history for developmental delay
Presenting complaint PMH Perinatal and birth Family and Social Developmental Play and Behaviour School/nursery
examination for developmental delay
Observation Dysmorphism (abnormal body structure) Head circumference Systems CNS Vision Hearing
Investigations for developmental delay
Chromosomes FRAX - not that common (fragile x) Oligoarray CGH Neonatal PKU, thyroid studies, CK
If indicated: MRI EEG Metabolic studies Genetic consultation Others
