peds: learning disorder&disability Flashcards
what three things should an evaluation of a developmental delay include?
Evaluation should define developmental deficits, determine reason if possible, and plan for a treatment program
5 types of developmental delays
- Intellectual Disability
- Specific Learning Disorder
- Communication Disorders
- Motor Disorders
- Autism Spectrum Disorder
what are the 3 areas that a “specific learning disorder: could be in?
Written expression
Reading
Math
4 types of communication disorders
Language Disorder
Speech Sound Disorder
Childhood Onset Fluency Disorder (Stuttering)
Social (Pragmatic) Communication Disorder
3 types of motor disorders
Developmental Coordination Disorder
Stereotypic Movement Disorder
Tic Disorders
intellectual developmental disorder (intell. disbality): an Impairment in development of _______ and ______ functioning, dx by what three things?
cognitive and adaptive fxning
a. Deficits in intellectual functioning (low scores on formal IQ tests, <70)
b. Impaired functioning in adaptive functioning
(1+ activities of daily life, across multiple environments)
c. Onset during the developmental period
normal IQ is ____ with a standard deviation of about ___
100, 10-15
Intellectual disability is diagnosed based on…
a. IQ Score
b. Deficits in adaptive functioning
c. Both IQ score and deficits in adaptive functioning
C. BOTH
etiology of ID, if its more severe are you more or less likely to find that cause?
more likely!
etiology of ID: prenatal
genetic syndromes, brain malformations, maternal disease, environmental (alcohol, drugs, toxins)
etiology of ID: perinatal
labor and delivery-related events leading to neonatal encephalopathy
etiology of ID: postnatal
hypoxic ischemic injury, traumatic brain injury, infections, demyelinating disorders, seizure disorders, severe and chronic social deprivation, toxic metabolic syndromes (lead, mercury)
Down syndrome: what is the cause? IQ range? what increases the risk of this occuring?
extra chromosome on 21st pair.
Broad IQ range – mean 47-50
high maternal age increases risk
down syndrome, what are they more susceptible to? life expectancy?
Susceptible to infections, particularly respiratory
Few reach 50 years old; many die in childhood
what is Fragile X ?
Small section of genetic code repeated on X chromosome
Severe to mild ID (intellectual disability)
fragile X: what type of delays? physical features? (kinda weeds)
Delay in crawling, walking, or twisting; hand clapping or hand biting; hyperactive or impulsive behavior; speech and language delay; tendency to avoid eye contact
Physical : flat feet, flexible joints and low muscle tone, large body size, large forehead or ears with prominent jaw, long face, soft skin
trisomy 18: what is the cause? what is one major key feature?
Third copy of genetic material from chromosome 18, instead of the usual two copies
- rocker-bottom feet
what is prader-willi syndrome
disease that involves obesity, (strong craving for food) decreased muscle tone, decreased mental capacity, and sex glands that produce little or no hormones.
two types of single gene defects (no family history)
prader- willi and wilson’s disease
what is wilson’s disease?
disorder in which there is too much copper in the body’s
tissues. The excess copper damages the liver and nervous system
most common preventable cause of ID?
fetal alcohol syndrome
3 signs of fetal alcohol syndrome
- CNS deficits (low IQ), ADHD symptoms
- Faces with broad set eyes, narrow eye
slits, flat cheeks, short nose, thin upper
lip & nose, flat philtrum - Growth retardation
4 signs in pregnancy of a possible ID
- loss of fetal growth, minimal fetal movement
- abnormal weight gain by mother
- maternal drug or alcohol use
- illness during pregnancy (rubella, syphilis, HIV especially)
signs during birth of possible ID
not looking normal at birth, small
3 signs in infancy of possible ID
- head size abnormal
- delay in developmental milestones
- abnormal muscle tone, reflexes, postures, movements
If a child has a selective delay in only one area (such as math or reading), it is not ID but rather what?
a learning disorder
what could maybe cause or mimic a developmental delay
hearing or visual impairment
*hearing loss often not detected till 2yo
pharm txt for ID: agression/impulse
Anticonvulsants
Lithium
pharm txt for ID: anxious/OCD, self-injury
Clomipramine
SSRIs
Buspirone
Naltrexone – repetitive harmful behaviors
“school performance isnt actually reflecting his intelligence level” what is this?
learning disorder
DSM V Dx criteria (4)
- Difficulties learning and using academic skills
- academic skills substantially and quantifiably below those expected for age; interference with functioning
- Began during school-age years
- Not better accounted for by ID, other disorders
specific learning disorder is coded and categorized by what three things?
Coded:
With impairment in reading
With impairment in written expression
With impairment in mathematics
Severity: Mild, Moderate, Severe
SLDs are often not recognized until when?
2nd grade (maybe 3rd for math)
failure to name and count numbers or to use or understand numbers in simple, everyday activities
specific learning disorder w/ impairment in math
SLD with impairment in written expression
spelling, grammar, punctuation
dyslexia is an alternative term for what?
SLD w/ impairment in reading
dyslexia more common in boys or girls?
boys
referral for SLD
Refer to child neuropsychologist or educational psychologist for assessment
With early identification and intervention, prognosis is good
for who is the risk for an SLD higher?
if they have a 1st degree relative with one (genetics + enviornment)
Learning disorders are suspected when…
A child’s achievement is below what would be expected given his/her age, IQ, and education
communication disorder: language
Difficulties in acquisition and use of language, both receptive and expressive
communication disorder: speech sound disorder
Articulation disorder – problem with speech, not communication or understanding
-Pronunciation problems, omissions of sounds, substitutions of sounds
communication disorder: childhood onset fluency disorder (stuttering)
Sounds are made accurately, but fluency and time patterning are disrupted
what is the “split-off from what asberger’s used to be? “
communication disorder: social (pragmatic)
communication disorder: social (pragmatic) - difficulties in what 4 things
- communication for social purposes
- ability to change communication to match context or needs of listener
- following rules for conversation and storytelling
- understanding hidden/ambiguous meanings of language (sarcasm)
development coordination d/o: what is it? what age kids?
delay in gross and fine motor skills
- kids 5-11.
Head banging, body rocking, self-biting, etc - example of what?
stereotaxic movement d/o
tourette’s d/o
Tourette’s Disorder
Motor and vocal tics- BOTH
Persistent Motor or Vocal Tic Disorder
Motor or vocal, but not both
Dx for both tourettes and persistent motor/vocal : what is the time period?
For both, tics present for at least 1 year, onset before 18;
Daniel is 9 years old. He is of above average intelligence and his academic achievement is normal for a child his age. However, when he talks, he is very hard to understand due to his sounds not being very clearly articulated. Daniel probably has…
speech sound d/o
Dx criteria for autism: part b: restricticted, repetative patterns of ____, _____ or ______ with at least 2 of the following (4)
behavior, interests, or activities (at least 2 of the following)
- Stereotyped or repetitive motor movements, speech
- Insistence on sameness; adherence to routines
- Highly restricted, fixated interests
- Hyper- or hyporeactivity to sensory input
Dx criteria for autism part a: communication + social interation deficits across what 3 contexts?
- social-emotional reciprocity
- nonverbal communicative behaviors
- developing, maintaining, and understanding relationships
when must symptoms start for Dx of autism?
present in early childhood (but may not become fully manifest until social demands exceed limited capacities)
asberger syndrome is now known as what?
now Autism Spectrum Disorder (or Social Communication Disorder)
childhood disintegrated d/o is now known as what?
nothing- its been deleted
rett syndrome is now known as what?
“Autism spectrum disorder associated with Rett Syndrome” if meet criteria
- gene abnormality on X chromosome, only in girls
- normal for months then have movement + communication d/o
what does IDEA stand for?
Individuals with Disabilities Education Act
what is developmental surveillance?
scheduling of screenings
5 components of developmental surveillance (AAP) (maybe weeds)
- eliciting and attending to the parents’ concerns about their child’s development;
- maintaining a developmental history;
- accurate observations of the child;
- identifying risk and protective factors;
- maintaining an accurate record of documenting the process and findings.
developmental screening does not result in either a diagnosis or treatment plan but rather …
identifies areas in which a child’s development differs from same-age norms
