milestones and development

Question 1

5 key areas of development

Answer 1

gross motor skills, for example crawling, jumping or running
fine motor skills, such as writing and drawing
speech and language
cognitive and intellectual, such as coutning or identifying shapes
social and emotional skills, such as playing with other children

Question 2

primary speech and language problems

Answer 2

developmental speech and language delay
expressive language disorder
receptive language disorder

Question 3

developmental speech and language delay

Answer 3

where speech is delayed but children have normal comprehension, intelligence, hearing, emotional relationships. speech language therapy is effective
good prognosis

Question 4

expressive language disorder

Answer 4

speech is delayed
difficult to distinguish from developmental
active intervention is necessary, this is not self correcting

Question 5

receptive language disorder

Answer 5

speech is delayed and sparse, agrammatic and indistinct in articulation. there is a deficit in comprehension but normal responses to non-verbal auditory stimuli.
rare for these children to develop normal oral language capacity

Question 6

secondary speech and language problems

Answer 6

autism spectrum disorder
cerebral palsy
childhood apraxia of speech
dysarthria
hearing loss after spoken language established
hearing loss before onset of speech
intellectual disability
selective mutism

Question 7

autism spectrum disorder

Answer 7

speech delay with concurrent intellectual disability
echolalia (repeating phrases)
difficulty initiating and sustaining conversations
impaired communication and social interaction
children benefit from intense, early intervention

Question 8

cerebral palsy

Answer 8

speech delay may be due to difficulty with coordination or spasticity of tongue muscles, hearing loss, coexisting intellectual disability, or a defect in cerebral cortex

Question 9

childhood apraxia of speech

Answer 9

physical problem in which children have difficulty making sounds in the right order
children mostly communicate with gestures

Question 10

dysarthria

Answer 10

physical problem in which children can have speech difficulties ranging from mild, with slightly slurred articulation to profound with inability to produce any recognisable sounds

Question 11

hearing loss after spoken language established

Answer 11

speech and language gradually affected, with a decline in the precision of speech articulation and a lack in progess of vocabulary acquision
refer to an audiologist

Question 12

hearing loss before onset of speech

Answer 12

speech is delayed
may not look at or point to objects named by parents
normal visual communication skills

Question 13

intellectual disability

Answer 13

speech, use of gestures and comprehension is delayed.
refer to tertiary level child development centre and geneticist

Question 14

selective mutism

Answer 14

consistant failure to speak in social situations in which there is an expectaation for speaking despite speaking in other situations
speech languge and CBT therapy

Question 15

red flags at 12 months

Answer 15

does not babble, point or gesture

Question 16

red flags at 18 motnhs

Answer 16

does not follow one step instructions
does not say mama dada or other names

Question 17

red flags at 2 years

Answer 17

does not point to pictures or body parts when named

Question 18

red flags at 3 years

Answer 18

does not understand preposition or action words
does not follow two-step directions

Question 19

reassuring signs in gross motor achievements

Answer 19

Question 20

reassuring signs in fine motor achievements

Answer 20

Question 21

speech and language achievements

Answer 21

Question 22

social achievements

Answer 22

Question 23

important points on family history

Answer 23

parents’ relationship, family size aand blend, socioeconomic circumstance
if learning difficulties have been experienced by other family members
post natal depression and other mental health problems in the family can interfere with secure attachement

Question 24

important points on physical examination

Answer 24

height
weight
head circumference
dysmorphic features
fundus
skin search

Question 25

the landau reflex

Answer 25

in ventral suspension, the baby will extend their head and lower extremeties
appears at 4-5 months of age

Question 26

management of developmental delay

Answer 26

identify and treat underlying medical comorbidity eg. hearing loss
behavioural issues: behavioural therapy
emotional/cognitive issues: psychology
gross motor delay: physical therapy
fine motor delay: occupational therapy
speech delay: speech therapy