Studying Normal Development ✅ Flashcards
What aspects of brain function can be measured?
- Electrical activity
- Metabolic activity
- Changes in blood oxygenation and flow to different parts of the brain
How can electrical activity in the brain be measured?
- EEG
- Brainstem evoked responses
How can metabolic activity of the brain be measured?
Using radiolablled molecules such as glucose, e.g. with PET
How can changes in blood oxygenation and flow to parts of the brain be measured?
Functional MRI
Which methods of measuring brain activity are well established in paediatrics?
- EEG
- Brainstem evoked potentials
What is EEG used for in paediatrics?
Looking for abnormal discharges suggesting epileptic activity
In what investigation are brainstem evoked potentials used in paediatrics?
Automated auditory brainstem response (AABR)
What happens in automated auditory brainstem response testing in paediatrics?
Look for brainstem evoked potentials in response to auditory clicks
When is AABR used in paediatrics?
As part of the newborn hearing screen
What are the difficulties of accurate developmental assessment?
- Development is a continuum, not a set of ‘pass-fail’ cut offs
- Children vary widely, large spectrum of normal
- Performance at a task may be more related to mood than skill level
- Delay in one domain can impact on another
- Problems with inclusivity of assessment tools
- Problems with application of assessment tools
What are the problems with the inclusivity of assessment tools?
- Geared towards specific populations
- Assume a shared first language between assessor and child
What are the problems with the application of developmental assessment tools?
Utility of any assessment tool closely linked to appropriate tool being selected and the familiartiy of the assessor with using the tool correctly
Give an example of when one domain of development can impact on another?
Language problems can impact on the development of social skills
What are the commonly used developmental domains?
- Gross motor/locomotive
- Fine motor/hand-eye coordination
- Language/speech and hearing
- Social/personal
- Cognition/reasoning
What does the gross motor/locomotive developmental domain consider?
Large motor function and movement
What is assessed in the gross motor/locomotive developmental domain?
- Neuromuscular assessments of tone and power
- Ability to perform tasks
- Measures of coordination and function
What does the fine motor/hand-eye coordination developmental domain consider?
Skills involving the small muscles of the hands and manipulation of objects, and the integration of visual input and motor function
What is the fine motor/hand-eye coordination developmental demain reliant on?
- Visual function
- Neuromuscular function
What does the language/speech and hearing developmental domain consider?
- Produced speech
- Ability to understand and comprehend
- Ability to produce verbal and non-verbal communication
- Use of symbols
- Understanding of pragmatic (social) language
What aspects of produced speech can be assessed in the language/speech and hearing domain?
- Quality
- Higher content
What does the social/personal developmental domain consider?
- Interaction with the environment and other people
- Understanding of self vs non-self
- Awareness of social rules and conventions
- Ability to self-care and be independent
What does the cognitive/reasoning developmental domain consider?
Higher cognitive functions and ability to problem solve
What are tools used to assist in developmental assessment based on?
Observations of large numbers of children using standardised assessment methods
What sources of information are used in developmental assessment?
- Direct observation of a child
- Parental report
- Completion of a set of tasks by the child
What are the most widely used developmental assessment methods in the UK?
- Denver II
- Griffiths
- Ages and Stages Questionnaire
How is the fact that children vary in age when they acquire skills mitigated against in developmental assessment tools?
Milestones are often quoted as range of ages at which skills are achieved rather than a set time point
How does the Denver II address variation in the age children achieve milestones?
- Shaded boxes
- Limit ages
What do the shaded boxes in the Denver II indicate?
The age at which a milestone was achieved by 25%, 50%, 75%, and 90% of children in the reference population
What are the limit ages in the Denver II?
The age it would be expected a child would have reached a milestone
How are limit ages determined in the Denver II?
Usually 2 standard deviations from the mean
