Developmental Delay Flashcards
How is developmental delay defined?
Children don’t attain appropriate developmental milestones for their correct chronological age
What are the 3 main categories of abnormal development?
Delay
Deviation
Regression
Give an example of a condition which would be considered a deviation development
Autism Spectrum Disorder
Give an example of a condition which would be considered a regression development
Rett’s syndrome
Metabolic Disorder
What is meant by deviation development and can skills be developed?
children may never develop a certain skill or may develop it differently from others
In regression syndromes the skill is never developed. TRUE/FALSE?
FALSE
they may have acquired the skill and then proceed to lose the skill again
Compare a normal IQ to that which would indicate a learning disability
Normal IQ = 90-110
Low Average = 70-90
Learning Disability = 50-70
What are the main RED FLAGS for development?
- Asymmetry of movement
- Not reaching for objects by 6 months
- Unable to sit unsupported by 12 months
- Unable to walk by 18 months
- No speech by 18 months
If a child is unable to walk by 18 months what investigation should be carried out and why?
→ check CK for evidence of muscular dystrophy
Normal CK 200-250, in MD it can be in the thousands
Give examples of activities of daily living
Washing themself
Dressing themself
What complications can Down’s syndrome cause in children
- Cardiac
- Vision (cant assess far and near objects)
- Hearing
- Thyroid function (underactive)
- Sleep apnoea (due to abnormal anatomy)
- Short height but put weight on easily
At what chronological age do children with Down’s syndrome achieve their peak mental age? (regardless of the delay between CA and MA)
around 16
=> their mental age could be 8yrs at the CA of 16 and this is the most developed they will become
Give 2 examples of coordination disorders caused by motor delay?
Duchenne Muscular Dystrophy
Cerebral Palsy
Why is an excessive lumbar lordosis usually found in Duchenne Muscular dystrophy?
to counteract an unstable pelvis
What is Gower’s manoeuvre?
Child walks hand in and up to stand due to proximal muscle weakness
What are the 3 main types of cerebral palsy based on the area of the body which is affected?
Hemiplegic - one side of body affected
Diplegic - both legs affected
Quadraplegic - all 4 limbs affected
How is hemiplegic cerebral palsy usually acquired?
If there is an interruption in blood flow preterm
aka during pregnancy
Why is physio an important part of cerebral palsy management?
Some muscles develop more than others (e.g. biceps more than triceps) therefore can create contractures which need stretched out in physio
What other problems are often associated with cerebral palsy?
Mobility /spasticity problems Learning difficulties Epilepsy Visual/Hearing impairment Feeding difficulties Sleep problems Behaviour problems
Why do many children with cerebral palsy develop behaviour problems?
they see other children completing tasks that they themselves cannot do
What symptoms present with cerebral visual impairment?
Photosensitivity
Nystagmus (abnormal eye movements)
What is the Autistic Triad?
Communication
Social interaction
Flexibility of thought/ Imagination
Why are objects of reference used in patients with autism?
They rely on their vision more than speech
e.g. car keys could signal they are going in the car
Why do children with autism struggle with frustration when they want something from someone?
They don’t always verbally ask for what they want, they expect others to know what they want
Why is turn taking a difficult social interaction for patients with autism?
What another child will do on their turn (e.g. of a toy) is unpredictable
Patient wants routine and predictability
Describe an example of unusual ritualistic behaviour common in children with autism
Taking an unusual inanimate object to bed
Children with autism respond better to firm touch than to light touch from others. TRUE/FALSE
TRUE
What sensory issues may a child with autism face?
- Fussy eater/ not want to take medication
- Textures of clothes
- Sleep
- Toilet training
- Hair washing / cutting
- Nail cutting
What different periods of a child’s life must be covered in past medical history in order to diagnose developmental delay?
Perinatal and Birth (Hx of mother as well as child)
Family and Social
School/Nursery
What different parts of an examination should be covered when assessing for developmental delay?
Dysmorphism (e.g. abnormally small/large head?) Head Circumference Assess CNS Vision Hearing
What healthcare professionals are involved in the early intervention of a child with a developmental delay?
Physiotherapist
Speech and Language Therapist
Occupational Therapist
What parts of the body are affected in oculocutaneous albinism?
Decreased iris, hair and skin pigmentation
