Studying Normal Development ✅

Question 1

What aspects of brain function can be measured?

Answer 1

• Electrical activity
• Metabolic activity
• Changes in blood oxygenation and flow to different parts of the brain

Question 2

How can electrical activity in the brain be measured?

Answer 2

• EEG

- Brainstem evoked responses

Question 3

How can metabolic activity of the brain be measured?

Answer 3

Using radiolablled molecules such as glucose, e.g. with PET

Question 4

How can changes in blood oxygenation and flow to parts of the brain be measured?

Answer 4

Functional MRI

Question 5

Which methods of measuring brain activity are well established in paediatrics?

Answer 5

• EEG

- Brainstem evoked potentials

Question 6

What is EEG used for in paediatrics?

Answer 6

Looking for abnormal discharges suggesting epileptic activity

Question 7

In what investigation are brainstem evoked potentials used in paediatrics?

Answer 7

Automated auditory brainstem response (AABR)

Question 8

What happens in automated auditory brainstem response testing in paediatrics?

Answer 8

Look for brainstem evoked potentials in response to auditory clicks

Question 9

When is AABR used in paediatrics?

Answer 9

As part of the newborn hearing screen

Question 10

What are the difficulties of accurate developmental assessment?

Answer 10

• 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

Question 11

What are the problems with the inclusivity of assessment tools?

Answer 11

• Geared towards specific populations

- Assume a shared first language between assessor and child

Question 12

What are the problems with the application of developmental assessment tools?

Answer 12

Utility of any assessment tool closely linked to appropriate tool being selected and the familiartiy of the assessor with using the tool correctly

Question 13

Give an example of when one domain of development can impact on another?

Answer 13

Language problems can impact on the development of social skills

Question 14

What are the commonly used developmental domains?

Answer 14

• Gross motor/locomotive
• Fine motor/hand-eye coordination
• Language/speech and hearing
• Social/personal
• Cognition/reasoning

Question 15

What does the gross motor/locomotive developmental domain consider?

Answer 15

Large motor function and movement

Question 16

What is assessed in the gross motor/locomotive developmental domain?

Answer 16

• Neuromuscular assessments of tone and power
• Ability to perform tasks
• Measures of coordination and function

Question 17

What does the fine motor/hand-eye coordination developmental domain consider?

Answer 17

Skills involving the small muscles of the hands and manipulation of objects, and the integration of visual input and motor function

Question 18

What is the fine motor/hand-eye coordination developmental demain reliant on?

Answer 18

• Visual function

- Neuromuscular function

Question 19

What does the language/speech and hearing developmental domain consider?

Answer 19

• Produced speech
• Ability to understand and comprehend
• Ability to produce verbal and non-verbal communication
• Use of symbols
• Understanding of pragmatic (social) language

Question 20

What aspects of produced speech can be assessed in the language/speech and hearing domain?

Answer 20

• Quality

- Higher content

Question 21

What does the social/personal developmental domain consider?

Answer 21

• 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

Question 22

What does the cognitive/reasoning developmental domain consider?

Answer 22

Higher cognitive functions and ability to problem solve

Question 23

What are tools used to assist in developmental assessment based on?

Answer 23

Observations of large numbers of children using standardised assessment methods

Question 24

What sources of information are used in developmental assessment?

Answer 24

• Direct observation of a child
• Parental report
• Completion of a set of tasks by the child

Question 25

What are the most widely used developmental assessment methods in the UK?

Answer 25

• Denver II
• Griffiths
• Ages and Stages Questionnaire

Question 26

How is the fact that children vary in age when they acquire skills mitigated against in developmental assessment tools?

Answer 26

Milestones are often quoted as range of ages at which skills are achieved rather than a set time point

Question 27

How does the Denver II address variation in the age children achieve milestones?

Answer 27

• Shaded boxes

- Limit ages

Question 28

What do the shaded boxes in the Denver II indicate?

Answer 28

The age at which a milestone was achieved by 25%, 50%, 75%, and 90% of children in the reference population

Question 29

What are the limit ages in the Denver II?

Answer 29

The age it would be expected a child would have reached a milestone

Question 30

How are limit ages determined in the Denver II?

Answer 30

Usually 2 standard deviations from the mean