Special needs

Question 1

What is a developmental delay?

Answer 1

Present when functional aspects of the child’s development in one or more domains (motor, language, cognitive, social, emotional) are significantly delayed compared to the expected level for age

Question 2

What is GDD?

Answer 2

Global developmental delay

Question 3

How is GDD measured?

Answer 3

Performance below 2SD below mean of age-appropriate, norm-referenced testing

Question 4

What is a learning disability?

Answer 4

A significant impairment in intellectual functioning and affects the person’s ability to learn and problem solve in their daily life

Question 5

How can a developmental delay present?

Answer 5

Routine health surveillance
Children with identified risk factors
Parental concern
Professional contact: nursery
Opportunistic health contact
UK Healthy Child Programme (HCP)

Question 6

How can you assess development?

Answer 6

History and exam
Prenatal, perinatal and postnatal events
Developmental milestones
‘Red Book’
Environmental, social and family history
Video recordings
Observation in clinic

Question 7

What are primary care assessment tools for developement?

Answer 7

ASQ = ages and stages questionnaire
PEDS = parents evaluation of developmental status
M-CHAT = checklist of autism in toddlers
SOGS-2 = schedule of growing skills

Question 8

What are the two types of delay?

Answer 8

Global or isolated

Question 9

What is regression?

Answer 9

Loss of milestones

Question 10

What are secondary care assessment tools?

Answer 10

Griffiths mental development scales
Bayley scales of infant development
Wechscler preschool and primary scales of intelligence

Question 11

What should you ask in a history?

Answer 11

FHx neurodevelopmental/genetic disorder
Hx miscarriages
Prenatal, perinatal, neonatal course
Drugs and alcohol during pregnancy
Developmental, behavioural, social, educational Hx
Record of medications

Question 12

What investigations should you do?

Answer 12

Metabolic/thyroid testing
Neuroimaging
Lead and iron screening
Growth records
Vision and hearing
Abuse and neglect?

Question 13

What should you exam?

Answer 13

Head circumference
Dysmorphic features
Skin abnormalities
Movement quality Ability to sit and stand from supine
Eye exam
General, CVS, resp, abdo
Observe behaviour

Question 14

What are positive red flag signs?

Answer 14

Loss of developmental skills
Concerns re vision and hearing
Floppiness
No speech by 18-24 months
Asymmetry of movement
Persistent toe walking
Head circumference >99.6th C

Question 15

What are negative red flag signs?

Answer 15

Sit unsupported by 12mo
Walk by 18mo boys, 2yr girls
Walk other than on tiptoes
Run by 2.5yrs
Hold objects in hand 5mo
Reach for objects 6mo
Points to object to share interest 2yrs

Question 16

What investigations can you do based on clinical abnormalities?

Answer 16

Chromosomal analysis
Fragile X
FISH
Array CGH
Creatinine kinase
Thyroid screening
Metabolic testing

Question 17

What are common motor problems?

Answer 17

Delayed maturation
Cerebral palsy
Developmental coordination disorder

Question 18

What are common language/cognitive problems?

Answer 18

Specific language impairment

Learning disability

Question 19

What are common sensory problems?

Answer 19

Deafness
Visual impairment
Multisensory impairment

Question 20

What are common social/communication problems?

Answer 20

Autism
Asperger syndrome
Elective mutism

Question 21

What are local services for developmental problems?

Answer 21

Community paediatric clinics
Child development teams
MDT assessment
Therapy services

Question 22

When does a child need additional support needs?

Answer 22

If they need additional support with their education

Question 23

What is PLP?

Answer 23

Personal learning planning

Question 24

What is IEP?

Answer 24

Individualised educational plane

Detailed plan for child’s learning

Question 25

What is CSP?

Answer 25

Coordinated support plan (CSP)

Legal document, aims to ensure professionals work together. Plan of how child’s support will be provided.

Question 26

What is a child’s plan?

Answer 26

Created if a child or young person needs some extra support to meet their needs

Question 27

What will the Child’s plan continue information about?

Answer 27

Why a child or young person needs support
The type of support they will need
How long they will need support and who should provide it