The Child with Developmental Delay

Question 1

What are some of the causes of cerebral palsy?

Answer 1

• Most (80%) are due to antenatal events
  
  • Stroke, TORCH infection, cortical migration disorder, genetics
• 10% intrapartum (HIE e.g. cord prolapse, shoulder dystocia)
• 10% postnatal (meningitis, trauma, hypoglycaemia, kernicterus)

Question 2

Outline some of the ongoing management considerations for a person with cerebral palsy

Answer 2

• Management of associated disability if present
  
  • Hearing/vision, epilepsy, cognition, communication
• Monitoring and treatment of associated health problems
  
  • Growth failure, GORD, constipation, chronic lung problems, hydrocephalus, osteopaenia, mental health
• Monitoring and treatment of motor disorder consequences
  
  • Drooling, incontinence, undescended testes, orthopaedic problems, spasticity
• Multidisciplinary team management

Question 3

With other health conditions are associated with Down’s syndrome?

Answer 3

• Vision (cataracts, strabismus), leukaemia, hypothyroidism, obesity, OSA, infections, dental problems, atlantoaxial instability

Question 4

Describe some of the features possible in a person with Fragile X syndrome

Answer 4

• Intellectual disability, features of autism
• Dysmorphism - macrocephaly, high forehead, long face, large jaw, big ears, large testes (post-puberty), soft skin, joint laxity

Question 5

Describe some of the clinical features possible in a patient with autism

Answer 5

• Lack of: pretend play, pointing out objects, social interest, joint attention, social play, response to name when called, emotion recognition
• Stereotyped behaviours (ordering, aligning), literality, sensory dysregulation, pain insensitivity, imbalance