Down syndrome Flashcards
Other name for down syndrome
trisomy 21
Brain changes in DS kiddos (3)
1) smooth (less ridges)
2) decreased myelination
3) decreased brain volume
Kids with DS have a gap in skill level when comparing their motor skills to those of normally developing kids. Will this gap increase or decrease as they get older?
Increase - they have decreased coordination and balance with becomes more obvious as they get older and have to perform higher level skills
You are working with a 10 year old child who has DS to improve overall core strength and balance. The child recently got new Surestep SMOs. You have been noticing that the child appears to be walking with a limp. You mention this to the mother who tells you that this has been happening on and off over the last few weeks. Mom also notes that the child will sometimes rub his hip after playing awhile, but notes they have been playing a lot on their new climbing structure in the backyard. You assess the child’s ROM and note decreased hip abduction range on one side. What would be a possible differential diagnosis?
1) Legg-Calve-Perthes
2) Rheumatoid Arthritis
3) Slipped Capital Femoral Epiphysis
4) Ill-fitting SMOs
5) A and D
6) A and C
A and C
Legg Calve Perthes - repeated episodes of transient synovitis in children 3-12 yoa (mostly boys). synovitis increases blood pressure which cuts off blood flow to femoral neck. S/S: pain, decreased hip ABD and IR, atypical gait (limp) and (+) Trendelenburg sign
SCFE - growth plate of proximal femoral physis is weak which leads to displacement from normal position. S/S antalgic gait, pain in groin, decreased hip ABD ROM
30% kids with DS can develop SCFE, LCP, or hip sublux
Red Flags for Atlantoaxial Instability (7)
Significant neck pain Radicular pain Weakness: especially new onset or change Spasticity or change in muscle tone Change in gait or use of arms and legs Hyperreflexia (normal is HYPOreflexive) Change in bowel or bladder function
**AA occurs in 15% of kids with DS
Sternal precautions for post-op thoracic surgery
Limitations for tummy time and weight bearing through
upper extremities, usually four to six weeks post-op
Palisiano study on motor skill acquisition (does not take into account comorbidities, quality of movement, hospitalizations)
1) Sitting for 3 sec: 99% by __ months
2) Crawling on knees 6ft: 99% by __ months
3) Walking 10 steps w no support: 99% __ months
4) Running 15ft, stop, return: 67% by __ months
5) Walk up 2 stairs alternating feet and no hand/handrail hold: 77% by __ months
6) Jumping forward 2 inches: 84% at __ months
1) 18
2) 60
3) 48
4) 72
5) 72
6) 72
In a pilot study that observed 10 minutes of play in children with DS, what percent of play was spent in passive positions?
90%
Name level of support for following orthotics (FO, SMO, AFO)
1) Pattibob
2) Surestep
3) Cascade
4) Jump start Leapfrog
5) Hotdog
1) FO
2-4) SMO
5) FO
What is the Valmassy criteria?
7 - child’s age = normal calcaneal valgus in standing (plus or minus two to three degrees)
You are seeing a 2 year old child with DS through IDEA part C services. The mother has concerns about the child’s flat foot when walking and asks if you think her child would benefit from SMOs (she had been reading on some online blogs that they could be helpful. You note that the child has a fixed, moderate pronation deformity. What would be the most appropriate recommendation?
1) Refer to orthotist for AFO
2) Refer to orthotist for SMO
3) Refer to orthotist for FO
4) Refer to orthopedic doctor
4) due to FIXED pronation
What other 2 diagnoses may benefit from treadmill training?
CP and SCI
Treadmill training parameters
8 min supported walking on treadmill 5 days a week
You are working with a child who has DS via IDEA part C services. The child had thoracic surgery 2 weeks ago and mom reports that she has noticed her child experience episodes of rapid breathing, fatigue, vomiting, poor feeding. They are scheduled to follow up with the surgeon in a week but mom was wondering if you could recommend anything to make the child more comfortable or eat better. What would be the best course of action?
1) Assess child for edema and have the family call the surgeon to follow up sooner
2) Recommend the child sit in a semi reclined position to reduce strain on core muscles needed to perform upright eating
3) Tell the mother that these are normal occurrences after open heart surgery and they will resolve with time
4) Tell her to increase amount of time spent on tummy to increase blood flow to the abdomen
1) Assess for edema and have family call surgeon
**S/S CHF: rapid breathing, changes in behavior, edema, excessive sweating, fatigue, vomiting, poor feeding
You are working with a child who has DS via IDEA part C services. The child had thoracic surgery 2 weeks ago. What is most likely heart defect to occur in this child?
Ventricular and atrial septal wall defects
