developmental disorders Flashcards

1
Q

what are the 3 patterns of delay

A

slow and steady
plateau
regressing

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2
Q

causes of abnormal motor development

A

central motor deficit (CP)
spinal cord problem
congenital myopathy
global delay

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3
Q

How does cerebral palsy present

A

abnormal motor development characterised by NON-PROGRESSION
only visible after a couple of years of life
accompanied by visual/sensory/auditory/behavioural problems

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4
Q

What is the diagnostic difference between CP and acquired brain injury

A

motor development delay becomes attributed to acquired brain injury if it happens after 2 years

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5
Q

causes of CP

A

80% antenatal (from cerebral haemorrhage, failure of cortical migration etc.)
10% at birth from HIE
10% postnatal (meningitis, sepsis, hypoglycaemia)

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6
Q

how does CP present

A
a lot dx antenatally
don't meet motor milestones
abnormal posture
abnormal gait
primitive reflexes persist/become obligatory
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7
Q

what are the 4 classes of CP

A

spastic (80%)
dyskinetic
ataxic
other

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8
Q

Hallmarks of spastic CP

A

UMN/ corticospinal tract damage
spasticity which is velocity dependent (more you stretch muscle stiffer it is - dynamic catch)
brisk tendon reflexes

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9
Q

3 types of spastic CP

A

unilateral:
arm>leg
presents at 4-12 months with fisted hand and asymmetrical reach
associated with tip toe walking

bilateral quadriplegia:
affects all limbs equally and may present in trunk with opsithotonos
associated with HIE

bilateral diplegia:
legs>arms
get abnormal gait
associated with preterm birth (periventricular white matter damage)

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10
Q

features of dyskinetic CP

A

dyskinesias are abnormal stereotyped movements
primitive movements predominate:
choreas
athetosis - slow writhing movements (fanning of fingers)
dystonia - simultaneous contration of agonist and antagonist

present with floppiness and strange movements in infancy
linked with HIE

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11
Q

features of ataxic CP

A

also known as hypotonic

presents with limb floppiness and poor balance

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12
Q

RF for CP

A

antenatal: chorioamnionitis, maternal resp or GU infection
perinatal: preterm birth, LBW, neonatal sepsis + encephalopathy
post natal: meningitis, head trauma before age of 3

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13
Q

Mx CP

A

Physio
SALT assessment
speech and communication therapy

medical:
baclofen for stiffness
mx saliva - anticholinergics
lone bone mineral density cause non-ambulant - check vit d
mx sleep disturbances w/ sleep hygiene (can use melatonin)
referral for visual + hearing impairment

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14
Q

what medical conditions are associated with CP

A

gastro-oesophageal reflux
constipation (3/5)
epilepsy (1/3)

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15
Q

what two tests can you do for language development

A

toy test

Reynell test for expressive and receptive aphasia

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16
Q

causes of speech + language delay

A

hearing loss, anatomical defects meaning you can’t make sound, lack of social interaction

17
Q

causes of speech + language disorder

A

problems with language comprehension and expression, stammer, dysarthria (where muscles used to make sound don’t work)

18
Q

what is the ASD triad

A

problems with social interaction (avoids direct gazes)
speech and language disorder (takes stuff literally, doesn’t use hand gestures)
imposition of routines

19
Q

what conditions are associated with ASD

A

learning + attention deficits, seizures (in adolescence), affective disorders (anxiety), ADHD

20
Q

Mx ASD

A
psychocial help for social situations and communication
SALT for speech problems
medications if necessary 
special school
help to carer
21
Q

what is dyslexia

A

disorder of reading

child is 2 years behind when compared to IQ

22
Q

what are disorders of executive function

A

Problems with planning or organisation

children: poor concentration, overeat, forgetful, volatile

23
Q

mx of specific learning disorder

A

OT
physio
SALT
Educational psychologist

24
Q

hallmarks of ADHD

A
child is legitimately overactive
socially disinhibited
can't take turns
distracted
fidgety (can't regulate activity given certain situation)
tend to do poorly at school
25
Mx ADHD
refer to CAMHS if adversely impacting education or development: 10 week watch and wait period 1. ADHD group parent training session (can liaise with school etc.) 2. 6-week trial of meds (methylphenidate) 3. CBT
26
S/E of ADHD meds
loss of appetite, tics, mood changes palpitations (meds are cardiotoxic so need to do ECG)
27
RF for conductive hearing loss
down's syndrome, cleft palate, atopy (otitis media)
28
Ix for conductive hearing loss
impedance audiometry to assess if middle ear is working
29
what is a squint
misalignement of visual axes common up to 3 months after 3 months most likely due to refractive error eg. cataracts and retinoblastoma
30
what are the two types of squint
concomitant non-paralytic - refractive error, easily corrected with glasses paralytic - depends on gaze direction as it's a motor nerve problem
31
4 types of refractive errors
hypermetropia - long sighted myopic - short sighted astigmatism - abnormal curvature of cornea amblyopia - eye fails to achieve acuity even with corrective lenses. causes include: squint or obstructions to visual pathway (cataracts)
32
causes of visual impairment
``` congenital: cataracts albinism retinoblastoma retinal dystrophy ``` Ante and post natal: HIE infections optic nerve hypoplasia paediatric trauma infection jaundice