Developmental delay and disability Flashcards
What is impairment
any loss or abnormality of psychological, physiological or anatomical structure or function. ( e.g. paralysis of the legs)
What is disability
any restriction or lack (resulting from impairment) of ability to perform an activity in the manner or within the range considered normal for a human being. (e.g. Inability to walk)
What is handicap
the impact of the impairment or disability on the person’s pursuit or achievement of the goals which are desired by him/her or expected of him/her by society. (e.g. unable to work in a job that requires mobility)
- not used anymore
what can disability lead to
- lifetime consequences
- increased poverty
- increased exclusion
what does the international classification of functioning disability and health aim to do
- provide a unified and standard language in order to describe heath and heath related states
- allows new terms and positive experiences to be described
What is the definition of international classification of functioning, disability and health
• Disability = not purely biological/social but result between health conditions environment/personal.
iN the international classification of functioning disability and health (ICF) what are the three levels of it
- Impairment in body function/structure.
- A limitation in activity. - such as the inability to read or move around
- A restriction in participation such as exclusion from school
What are the ICF main factors
- Functioning and Disability (health)
a. Impairments of body functions and structures
b. Activities and participation. - Contextual Factors (health related).
a. Environmental factors
b. Personal factors
what is the definition of disability under the equality act of 2010
. You’re disabled under the Equality Act 2010 if you have a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities
how do people with disability usually present
- problems are often complex and multiple
screening programmes
- new born hearing - if they fail this then they have repeat tests
- Down syndrome = antenatal triplet test - this is a blood test on the pregnant mother
- routine reviews
- e.g. 6 week baby check at GP - vision if not fixing following = baby should be able to look at you and follow you by 6 weeks, if they don’t do this at 6 weeks then this could mean there are vision problems
- 2 year check with health visitor and no words produced - this check is called the ASQ (age and stage questionnaire)
- parental concerns
- concerns of others e.g. friends, nursery, school
what system is used for diagnosis of disability
ICD10
List the different types of developmental trajectories
- progressive disorder
- plateau
- episodic
- delay
describe the different types of developmental trajectories
Progressive disorder - normal development and then rapidly declines
Plateau
- this is when normal development happens and then between 1 and 2 for example your development of speech plateaus and then after a while it carries on progressing (can be a sign for autism)
Episodic
- this is a metabolism disorder when you get unwell the body cannot clear out the toxins and this can effect your neurology
Delay
- this is when you are progressing normally but just at a slower rate than your peers
How do you assess disabilities in an examination
Neurology – tone power reflexes observe
Visual behaviour
Hearing behaviour
Interaction, speech, play
list 4 development screening/assessment questionarreis
ASQ - ages and stages questionnaire
SGS - schedule of growing skills
Griffiths
Bayley
describe the 4 development screening/assessment questionnaires
ASQ ages and stages questionnaire – at 9 months and 2 years, parents complete, paper based, and health visitor/community nurse
SGS – schedule of growing skills - simple toys, crayons etc up to 5 years, screening tool relay
Griffiths.- formal assessment up to 6 years – takes 1 hour
Baylye – up to 2 years often used for ex premature
what is the negative with the ASQ
parent done so if the parents don’t bother nobody chases them up but does pick up a lot of children
what does ASQ stand for
ages and stages questionnaire
What is SGS stand for
schedule of growing skills
what are the implications of disability on the family
- grief
- stigma
- financial
- fear
- use of the terms slow/delayed may suggest that children will catch up
- understanding/use of the term disability
- affects all rest of the family
there is lots to learn
what are the 5 stages of grief
- denial
- anger
- bargaining
- depression
- acceptance
How can you diagnose down syndrome
- Fluorescence in situ hybridization (FISH) may be used for rapid diagnosis of trisomy 21 (prenatal diagnosis and postnatal confirmation).
- Does not provide information about whether trisomy 21 is secondary to a translocation. Therefore, a FISH test must be confirmed by a complete karyotype analysis
what chromosome is affected in down syndrome
trisomy 21
What complications can be experienced in down syndrome
- cardiac defects
- hearing problems such as glue ear
- cataracts congenital can be a problem therefore test for ophthalmology
- ensure feeding is established and no vomitting
- hypothyroidism can be effected
- gastrointestinal tract
what are the intial tests that are done on a down syndrome child
- cardiac assessment - echocardiogram = 40-60% have congenital heart defects and oft these 30-40% are complete AVSD
- hearing test - sensorineural hearing loss idenftiied at new born hearing test
- refer to ophthalmology
- ensure regular feeding as there can be malformation of their gastrointestinal tract
- newborn sport screening test should be performed on day 5-7 as hypothyroidism can be a congenial condition in downs syndrome
- physio sometimes as they are late to walk
What is portage
portage is a home-visiting educational service for pre-school children with additional support needs and their families.
what does portage aim to do
- equip parents with the skill and confidence they need to help their child
- practical help and ideas to encourage a Childs interests and make learning fun for all the family
what is the early support programme
- government mechanism for improving the quality, consistency and coordination of family focused services for young disabled children and their families
what does the early support programme aim to do
aims to raise expectations about the way agencies and services work together, to encourage change, and provide practical tools to support multi-agency service development at local level
what does the key worker do
acts as a single point of contact for them
supports them in making choices about the help they need
ensures that they receive the right help at the right time, delivered by the most appropriate practitioners,
makes sure that professional duplication and inconsistency are avoided.
what is the education health plan
- idea that extra funding should be given to support disabled people in school
what is autism spectrum disorder
A developmental condition affecting the way the brain processes information
How many people have autism
Approx 1: 100 and increasing
what can cause autism
- epigenetic
- may be a genetic cause for some children with ASD
- likely to have mutable genes rather than a single gene
what does fetal alcohol spectrum disorder look like
- small head
- flat face
- small eye opening
- short nose
- low nasal bridge
- underdeveloped jaw
- thin upper lip
- smooth philtrum
what is fetal alcohol spectrum disorder a cause of
The commonest non genetic cause of disability (1% babies born per year)
how does fetal alcohol spectrum disorder affect children
Affected children can look very ‘normal’
They can be very verbal with a normal IQ
However their brains are unable to process information
They have executive function deficits
what is executive function
An ability to organize and plan
An ability to focus and maintain attention
An ability to store and retrieve memories
An ability to inhibit inappropriate actions
An ability to prevent emotions from getting out of control
An ability to understand social situations and social behaviour
How does fetal alcohol spectrum disorder present
- Sleep disturbances, poor wake/sleep cycle
- Poor sucking responses/feeding problems
- Failure to thrive
- Hyper/hypo sensitivity to light cold pain
- Delays in walking and talking
- Delayed toilet training
- Difficulty in following directions
- Temper tantrums and disobedience
- Distractibility
What are children with fetal alcohol spectrum disorder present
Children are often diagnosed with ADHD or ASD
what can you do for children with fetal alcohol spectrum disorder
- chromosomal analysis to exclude other diagnosis
- diagnosis before the age of 6 mitigates subsequent secondary disabilities such as unemployment, social, and sexual exploitation’s, sucidie and future alcohol problems
- may prevent future children born to the same mother with FASD
- give adopters advice
what is cerebral palsy
‘Disorder of movement and posture due to a non-progressive lesion of the motor pathways in the developing brain
what is the commonest cause of motor impairment
cerebral palsy
- Commonest cause of motor impairment in chldren: 2/1000 live births, static over last 40 years. 40% born prem
what is the presentation of cerebral palsy
Abnormal tone and posturing in early infancy
Feeding difficulties: incoordination
Delayed motor milestones
Abnormal gait
Developmental delay
what can assess cerebral palsy
- GMFCS levels
describe the 5 GMFCS levels
Level 1
- children walk indoors and outdoors without limitation
- can perform gross motor skills including running, jumping, speed and balance
Level 2
- children walk indoors and outdoors and climb starts holding onto a railing but experience limitations walking on uneven surfaces and inclines and walking in crowds
Level 3
- children can walk indoors or outdoors on a level surface with an assertive mobility device
- can climb stairs holding onto a railing
- may propel a wheelchair manually or transported while travelling long distances
Level 4
- children continue to walk for short distances on a walker or rely more or wheeled mobility at home and school
Level 5
- physical impairment restricts voluntary control of movement and the ability to maintain antigravity head and trunk postures
- all areas of motor function are limited
- have no means of independent motility
