Developmental Delay Flashcards
What is global developmental delay? Which diagnoses might this suggest?
Refers to a child displaying slow development in all developmental domains.
Could indicate-
- down’s syndrome
- fragile X syndrome
- fetal alcohol syndrome
- rett syndrome
- metabolic syndrome
What is gross motor delay and what might this indicate?
A delay that is specific to the gross motor domain may indicate underlying:
Cerebral palsy Ataxia Myopathy Spina bifida Visual impairment
What is fine motor delay and what might this indicate?
A delay that is specific to the fine motor domain may indicate underlying:
Dyspraxia Cerebral palsy Muscular dystrophy Visual impairment Congenital ataxia (rare)
What is language delay and what might this indicate?
A delay that is specific to the speech and language domain may indicate underlying:
Specific social circumstances, for example exposure to multiple languages or siblings that do all the talking
Hearing impairment
Learning disability
Neglect
Autism
Cerebral palsy
Management of language delay involves a referral to speech and language, audiology and the health visitor. Referral to safeguarding is required if neglect is a concern.
What is personal and social delay? What might this indicate?
A delay that is specific to the personal and social domain may indicate underlying:
Emotional and social neglect
Parenting issues
Autism
What is a learning disability?
Learning disability is an umbrella term encompassing a range of different conditions that affect the ability of the child to develop new skills. The amount they are affected varies from mild to severe. In mild cases the child may need extra time and help learning new skills. In severe cases there is significant intellectual impairment and they may need help with all activities of daily living.
What types of learning disability are there?
Dyslexia refers to a specific difficulty in reading, writing and spelling.
Dysgraphia refers to a specific difficulty in writing.
Dyspraxia, also known as developmental co-ordination disorder, refers to a specific type of difficulty in physical co-ordination. It is more common in boys. It presents with delayed gross and fine motor skills and a child that appears clumsy.
Auditory processing disorder refers to a specific difficulty in processing auditory information.
Non-verbal learning disability refers to a specific difficulty in processing non-verbal information, such as body language and facial expressions.
Profound and multiple learning disability refers to severe difficulties across multiple areas, often requiring help with all aspects of daily life.
How is the severity of the learning disability classified?
It is based on the intelligence quotient (IQ)-
- 55-70- mild
- 40-55- moderate
- 25-40- severe
- under 25- profound
What are the causes of a learning disability?
Often there is no clear cause for the learning disability. A family history of learning disability increases the risk. Environmental factors such as abuse, neglect, psychological trauma and toxins can all increase the risk.
Certain conditions are strongly associated with learning disability:
Genetic disorders such as Downs syndrome
Antenatal problems, such as fetal alcohol syndrome and maternal chickenpox
Problems at birth, such as prematurity and hypoxic ischaemic encephalopathy
Problems in early childhood, such as meningitis
Autism
Epilepsy
How is a learning disability managed?
The key to managing learning disability is with a multidisciplinary approach to support the parents and child. This involves:
Health visitors Social workers Schools Educational psychologists Paediatricians, GPs and nurses Occupational therapists Speech and language therapists
What is important when assessing capacity in someone with a learning disability?
It is important to remember that capacity is decision specific, and having learning disability does not prevent patients from being able to make decisions. They may require more time, effort and decision aids to be able to fulfil the criteria. It may take several attempts on different days or at different times of day to be able to make a decision. Capacity becomes more important as they approach adulthood, as most decisions about a child will be made by their parent or guardian.
To have capacity a patient must demonstrate the ability to:
Understand the decision that needs to be made
Retain the information long enough to make the decision
Weight up the options and the implications of choosing each option
Communicate their decision
