Developmental delay

Question 1

define developmental delay

Answer 1

failure to attain appropriate developmental milestones for the child’s corrected chronological age

Question 2

what are the 7 red flags for development

Answer 2

• asymmetry of movement
• not reaching our for objects by 6 months
• unable to sit up unsupported by 12 months
• unable to walk by 18 months
• no speech by 18 months
• vision/hearing concerns by parents
• regression / loss of skills

Question 3

give patterns of abnormal development

Answer 3

Delay
Deviation
Regression

Question 4

list subgroups of delay as a pattern of abnormal development and their definitions

Answer 4

global - significant delay in >=2 domains

specific - 1 domain

Question 5

give an example of global developmental delay

Answer 5

Down’s syndrome

Question 6

give examples of specific developmental delay

Answer 6

Cerebral palsy
Duchenne Muscular Dystrophy
Treacher Collins

Question 7

give an example of deviation as a pattern of abnormal development

Answer 7

Autism Spectrum Disorder

Question 8

Give examples for regression of development

Answer 8

Rett’s syndrome

Metabolic disorders - Hunter’s syndrome

Question 9

list features of Down’s syndrome

Answer 9

cardiac anomalies - AVSD 
GI anomalies - duodenal atresia 
Visual - cataracts 
Hearing - recurrent AOM 
MSK - atlantoaxial instability 
Hypothyroidism 
dysmorphic features 
OSA

Question 10

inheritance pattern of DMD

Answer 10

X linked recessive

Question 11

features and progression of DMD

Answer 11

delay in gross motor skills 
unable to walk by 18 months 
raised CK 
weakness in pelvic girdle muscles 
Gower's sign 
Excessive lumbar lordosis 
calf pseudohypertrophy 
wheelchair bound by teens 
die in 20s due to cardiorespiratory muscle failure

Question 12

list the subtypes of CP

Answer 12

hemiplegic - one side affected
diplegic - both legs affected
quadriplegic - all limbs affected

Question 13

Why do those with CP require physiotherapy

Answer 13

muscle groups get tighter than others so need PT to prevent spasms

Question 14

list conditions associated with CP

Answer 14

epilepsy 
mobility and ortho 
learning disabilities 
communication difficulties 
feeding difficulties 
hip dislocations 
behavioural problems 
dental decay 
silent reflux

Question 15

What is the inheritance pattern of Treacher Collins and what type of hearing loss does it cause

Answer 15

Autosomal dominant

CHL

Question 16

What is the autistic triad

Answer 16

impaired:
communication - receptive or expressive delay
social interaction - no empathy, doesnt follow social rules
flexibility of thought - no imagination, concrete and literal, routine is favoured
PLUS
sensory issues
restricted and repetitive behaviours

Question 17

the term global developmental delay applies to all ages, true or false

Answer 17

false
applies to <5yo
school age children = learning disability ?difficulty