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Pediatric PT > Environment disorders and Developmental coordination disorder > Flashcards

Environment disorders and Developmental coordination disorder Flashcards

1
Q

definition: A group of conditions that can occur in a person whose mother drank alcohol during pregnancy. These effects can include physical problems and problems with behavior and learning.

A

Fetal alcohol spectrum Disorders

FASD

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2
Q

What do those with FAS have problems with?

A

Learning, memory, abnormal facial features, growth problems, CNS problems

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3
Q

(true/false) There is a safe amount of alcohol to drink during pregnancy

A

FALSE

Dose dependent relationship between maternal alcohol intake and the occurrence of features of FAS

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4
Q

(true/false) Alcohol rapidly crosses the placenta and BBB of the fetus

A

true

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5
Q

FAS, ARND, and ARBD affects (less/more) newborns per year than Down syndrome, CF, spina bifida, and SIDS combined

A

More

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6
Q

What are the types of FASDs?

A
  1. FAS
  2. Alcohol-related Neurodevelopmental Disorder (ARND)
  3. Alcohol-related birth defects (ARBD)
  4. Neurobehavioral Disorder associated with prenatal alcohol exposure (ND-PAE)
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7
Q

What population(s) have the highest prevalence of alcohol use?

A

College students and single individuals

35-44 y/o

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8
Q

What are the diagnostic criteria for FAS?

A
  1. confirmed materal alcohol exposure
  2. characteristic pattern of facial abnormalities
  3. evidence of CNS abnormalities
  4. Evidence of growth retardation

Signs of growth retardation:
- Low birth weight
- deceleration of weight over time not due to nutrition
- disproportional low weight to height ratio

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9
Q

Characteristics:
- Short stature
- Slight build
- small head
- short eye openings
- upturned nose
- smooth area between nose and mouth
- thin upper lip
- elongated face

A

FAS

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10
Q

How do those with FAS behave?

A
  1. outgoing and socially engaging
  2. lack social skills
  3. intrusive and overly talkative
  4. unaware of social cues
  5. desire for attention
  6. short attention span and poor memory
  7. impulsive
  8. harder to learn from experiences
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11
Q

What percent of those with FAS are able to live on their own?

A

10%

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12
Q

What educational limitations do children with FAS have?

A
  1. language delays
  2. hyperactive
  3. irritable and distractible
  4. assistance with basic life skills
  5. vocational training
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13
Q

What are signs of overstimulation?

A
  • gaze aversion
  • yawning
  • sneezing
  • hiccups
  • spitting up
  • crying
  • increased motor activity
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14
Q

What is neonatal abstinence syndrome?

NAS

A

A multisystem disorder that is a result of abrupt discontinuation of chronic exposure to substances abused during pregnancy

withdrawal may be severe/intense

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15
Q

(true/false) Neonatal abstinence syndrome does not increase illness and hospital stays.

A

FALSE

longer hospital stays and leads to illnesses

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16
Q

(true/false) NAS is fatal

A

FALSE

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17
Q

What are nonpharmacological care items used to treat NAS?

A
  • demand feeding
  • avoidance of waking sleeping infant
  • swaddling
  • gentle handling
  • dim light and low noise
  • kangaroo care
  • pacifiers
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18
Q

What are pharmacological interventions used for NAS? What is the preferred medication?

A
  1. Morphine
  2. methadone
  3. phenobarbital

Morphine is preferred medication - decreases incidence of Sz

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19
Q

What medication is an alternative to morphine?

A

Methadone

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20
Q

What medication can be used for polydrug withdrawal?

A

Phenobarbital

used for non-opioid NAS

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21
Q

How often is morphine administered?

A

every 2 hours due to short half life

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22
Q

How often is methadone administered if the patient cannot use morphine?

A

2x/day due to a longer half life

23
Q

What warrants a d/c from the hospital in those with NAS?

A
  • no major signs of withdrawal
  • sleeping well
  • gaining weight
24
Q

Those with NAS are 6x more likely to develop ___.

A

torticollis

25
Q

Those with NAS have lower scores on motor skills at the age of ___.

A

3 y/o

26
Q

What are the outcomes of NAS?

A
  • torticollis
  • impact of vision and postural control
  • behavioral and cognitive issues

Higher cognitive skills have been identified with adoptive families compared to living with relatives

27
Q

What are some sources of lead?

A
  • turf
  • candy
  • fold medicines
  • toy jewelry
  • toys
  • water
  • peeling paint
  • dust
  • old furniture
  • old, ceramic dishes
  • Water from lead pipes
28
Q

1 in _ children under the age of 3 have concerning blood levels.

A

1 in 9 children

1 in 6 children under the age of 6 have enough blood lead to be of concern

29
Q

What does the body mistake lead as?

A

calcium

30
Q

What happens with lead in the body?

A
  1. Mistaken as calcium
  2. distrupts essential enzyme functioning in the brain and other cells
  3. not decomposed by the body
31
Q

What type of drugs can remove lead from the bloodstream?

A

Chelator drugs

Lead absorbed into the brain remains for the whole lifetime

32
Q

(true/false) Lead can be passed to an unborn fetus

A

True

33
Q

Symptoms:
- HA
- irritability
- abdominal pain
- Vomiting
- anemia
- weight loss
- slowed speech development
- hyperactivity
- loss of interest in play
- learning difficulties

A

Lead poisoning

34
Q

What can lead cause?

A
  • learning disabilities
  • speech and language disorders
  • neuro deficits
  • behavioral problems
  • intellectual disabilities
  • kidney failure
  • stroke
  • death
35
Q

When should you screen for lead blood levels?

A

between 9-12 months and then at 2 years of age

36
Q

What is the common age range of infants that experience shaken baby syndrome?

A

newborn to 4 y/o

Avg age is between 3-8 months

37
Q

When do the MAJORITY of shaken baby syndrome cases occur?

A

before the infant’s first birthday

38
Q

What happens during shaken baby syndrome?

A
  1. hands are under the arms or around the chest and are shaken violently for approx. 5-20 seconds.
  2. the infant stops crying due to not being able to breathe = decreased O2 to the brain

Triggers: uncontrollale crying and frustration

39
Q

What are the results of shaken baby syndrome?

A
  • decreased oxygen to the brain
  • veins that are bridging to the brain and the dura mater are overstretched
  • axons are sheared off
  • immediate brain swelling leading to increased ICP
  • direct trauma to brain substance
  • Fx (skull, long bones, and/or posterior ribs)
  • Retinal hemorrhages
  • Bruising

overstretched dura and bridging veins can cause subdural hematomas and/or subarachnoid hemorrhage

40
Q

Clinical presentation:
- variable findings
- decreased responsiveness
- irritability
- lethargy
- limpness
- convulsions
- vomiting
- decreased HR
- decreased temperature
- increased RR

A

Shaken baby syndrome

41
Q

What are immediate consequences of shaken baby syndrome?

A
  • respiratory arrest
  • seizures
  • cardiac arrest
  • death
42
Q

What are long term consequences of shaken baby syndrome?

A
  • learning disabilities
  • physical disabilities
  • visual disabilities
  • seizures
  • death
43
Q

definition: movement skill disorder that significantly affects a child’s everyday functioning

A

developmental coordination disorder where motor coordination is below expected levels

Impairments in gross/fine motor skills and postural control

Severely interferes with academics and ADLs

Other names: developmental clumsiness, clumsy child, developmental apraxia

44
Q

(true/false) DCD meets criteria for other medical conditions

A

FALSE

45
Q

What is the common population to experience DCD?

A
  • boys
  • children who were born preterm and/or had low birth weight
46
Q

What percent of children with a learning disability have motor coordination and/or visuomotor problems?

A

90%

47
Q

What are common comorbidities for DCD?

A
  • ADHD
  • dyslexia
  • ASD
48
Q

What it the etiology/causes of DCD?

A

unknown

  • Damage to CNS may occur during the 3rd trimester
  • some areas of the brain may be affected
  • anoxia
  • low birth weight
  • IVH
  • prenatal, perinatal, or neonatal risk factors
49
Q

What areas may be affected to cause DCD?

A
  • thalamus
  • cerebellum
  • basal ganglia
50
Q

Early signs of condition:
- messy eating
- late walker
- awkward
- late talker
- excessive frustration
- demands adult attention

A

DCD

51
Q

DCD is typically not identified until what age?

A

School age

52
Q

What are some examination findings of those with DCD?

A
  • soft neuro signs
  • immature movement patterns (choreiform)
  • inconsistent motor responses and gait pattern
  • impaired static balance and postural control
  • difficulty with 2 and 3 step commands
  • delayed motor milestones
  • weakness
  • joint laxity
  • poor vision/spatial organization
  • poor memory, language, and written communication
  • depression and decreased interaction with peers
  • dependent with ADLs/self-help skills
53
Q

What are appropriate interventions for children with DCD?

A
  • activity task-oriented interventions
  • functional
  • relevant to daily living
  • active computer games
  • group setting activities

1:1 actvities show some improvement

54
Q

What is the MATCH strategy for teachers who have students with DCD?

A

Modify the task
Alter expectations
Teach strategies
Change the environment
Help for understanding

Emphasis should be on fun, effort, and participation

Pediatric PT (14 decks)

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