Developmental Neuro Flashcards
What is the diagnostic criteria for DCD
learning and coordinated movement is difficult
early onset of development
all other neuro issue been ruled out
difficulty with motor that intefere with ADLs
What is a specific test and measure for DCD partication?
CAPE (childrens assessment of participation and enjoyment)
goal attainment scale
canadian occupational performance measure
What are DCD diagnosis specific tests?
DCD’Q’07 age 5-15
movement assessment battery for children-2 = gold standard
<5th % on MABC2– probable DCD
What activity limitation test and measure for DCD?
motor development – BOT 2
What age should you do individual PT for children with DCD?
<5-6
WHat is the CO-OP
cognitive orientation to daily performance (CO_OP)
7 key features =
guided discovery,
client chosen goals,
dynamic performance analysis (DPA)
parent involvement
structured interventional formal 10-12 sessions.
What age do you focus on group therapy sessions
> 6 years old
What intervention specific to DCD?
CO-OP
neuromotor task training
motor imagery
Is there a medical management for DCD
no medications, but can treat co-morbidities
What is the diagnostic criteria for autism?
DSM-V
impairment in social communication/interaction
restricted/repetitive behavior
What is the classification of level of support
level 1= support
level 2= mod support
level 3= substantial support
What is the pathophysiology of autism?
synapses do not undergo normal pruning during childhood and adolescense
cerebral morphology differences in volume and geometry
brains of indiviudals with autism are large
overgrowth in temporal lobe
What are common co morbid conditions of autism
ADHD, OCD, DCD, anxiety/ mood, psychosis
What are predictive factors for autism?
geriatric pregnancy, medications during pregnancy, air pollution, genetics
What is the medical management for autism?
no specific, but can managed other medical conditions
What is autism diagnostic observation schedule (ADOS)?
gold standard– completed by psychologists, along with clinial observation
semi structured assessment of communication, social interaction and play for individuals
4 modules– child to adult
What is the screening for autism
M-CHAT-R used for 6- 30 months
What are interventions for autsim?
focus on meaningful interventions
short duration
ICF components
accomodate environment
integrate interventions with daily routines
What is a common impaitment or deviation for children with autsim?
idiopathic toe walking
What is idiopathic toe walking?
condition in which children ambulate with bilateral toe-toe pattern without known etiology
What are interventions for idiopathic toe walking?
behavioral strategies (flippers, heels, squeakers)
followed by serial casting followed by orthotic
What is spina bifida
type of neural tube defect
When does the caudal neural tube close?
day 28
When does the rostral neural tube close?
day 24
What is the double hit theory
maldevelopment of the neural tube + exposure to amniotic fluid= damage to normal spinal cord tissue
What are risk factors for spina bifida?
polycentric inheritance
envirnmental
follic acid deficeincy
How do you diagnose spina bifida?
lab alpha- fetoproteint at 13-15
fetal ultrasound 16-24 wks
amniocentesis at 16-18
Which diagnostic test is 100% accurate?
amniocentesis
What is a banana sign?
cerebellum appears banana like because it is wrapped around the posterior brainstem due to downward traction of the spinal cord
indicative of Chiari II
What is a lemon sign?
is the shape of the skull
What are the different types of spina bidfia
myelomeniongecele
meninogecele
myocele
spina occulta
Describe myelomeningocele
most common
nerves outside spinal tract– open defect
motor, sensory, bowel and bladder impairments
majority 75% lumbar-lumbosacral
Decribe meningocele
incomplete skin coverage= CSF leak
neuro signs may normal
pocket but no nerve elements
Describe myelocele spina bifida
cystic cavity anterior to the spinal cord
majority 75% lumbar-lumbosacral
Describe occulta spina bifida
L5-S1 is most common
no neurological deficits
rarely associated with tehtered cord or lipoma
what is hydrocephalus?
CSF build up in the ventricles
what is tethered cord?
spinal cord gets stuck to the base of spine
w/ growth SC can’t move
What is syringomyelia
pockets of fluid throughout the spinal cord
What is Arnold Chiarir Type II Malformation ?
downward displacement of medulla, brainstem and cerebellar tonsil through fooramen mangnum
What are the symtpoms of arnold chiari type II?
sleep apnea
palpitations/arrhythmis
diploplia
dysphagia
impaired fine motor coodination and ataxia
What are the symptoms of hydrocephalus?
HA
nausea
altered mental status
lethargy
personality change
swallow issues
hoarse cry
vision changes
What are the symptoms syringomyelia?
motor changes (fine motor)
sensory changes (temperature)
reflex changes
neck pain
What are symptoms of a tethered cord?
motor, sensory, reflex change
back pain
progressive scoliois
bowel or bladder/ sexual changes
change in function
What is the sign or gaze palsy associated with severe hydrocephalus?
sunset gaze
upward gaze palsy
what is the most frequent shunt complication
infection
When do children with thoracic level SB roll?
18 months
What are the predictors of ambulation?
lower motor level
no histroy of shunt
no hx of hiip or knee contracture surgery
what are the cuntional abilities for thoracic level?
standing at 12-18 months
gait with HKAFO
wheelchair training as early 12 months
Functional abilities of lower thoracic and lumbar
RGO after age 3
if L3 spared – child may use AFO
Functional abilities of low lumbar aand sacral
bracing may not be required but might benefit from AFO or GRAFO if PF are non-functional
What is common impairment in the feet for T6-T12
club foot
What is a common gait pattern you might see with a patient with an L4 myelomeningocele?
trendelenburg
What are common orthopedic conditions for spina bifida
scoliosis
clubfoot
hip subluxation and dislocation
What is neurogenic bowel?
surgery required for patient with difficulty with independence and maintaining continenence
80% of kids have it
what is a neurogenic bladder?
present in >90% patients with MMC
hypertonic bladder= thoracic lesions
hypotonic= sacral lesions
need annual renal ultrasouns and renal function testings
What is the management for neurogenic bladder?
management= normal renal function and maximize continende
independent catheteization as early as 5/6 years old
UTI ver common
urologic cause 40% deaths between 5-30 years old
What are common considerations for skin care for spina bifida?
allergy to latex
high risk for pressure injuries
