1: Neurology: Assessment Development and Developmental Delay Flashcards
1
Q
What is a developmental disorder
A
Group of conditions resulting in impairment of one or more functional areas
2
Q
What are primitive reflexes
A
Reflexes that arise from the brainstem
3
Q
What happens with age
A
Frontal lobe can suppress brainstem reflexes
4
Q
What are 5 primitive reflexes
A
- Stepping
- Moro
- Grasp
- Rooting
- Asymmetric neck reflex
5
Q
What is the stepping reflex
A
When placed on a surface infant will step
6
Q
When does stepping reflex disappear
A
2-months
7
Q
What is the moro reflex
A
When head is extended infant will abduct then adduct arms
8
Q
When does the moro reflex dissapear
A
4 months
9
Q
What is the grasp reflex
A
Object placed in palm, infant will grasp
10
Q
When does the grasp reflex disappear
A
4-5 months
11
Q
What is the rooting reflex
A
Object placed near infants mouth - will cause suckling
12
Q
When does rooting reflex occur
A
4 months
13
Q
What is asymmetric neck reflex
A
If lying supine, if head turned arm will extend giving a ‘fencing’ posture
14
Q
What are the 4 developmental domains
A
- Gross Motor
- Fine Motor
- Speech (Language and Hearing)
- Social (Emotional and Behavioural)
15
Q
What can an infant do gross-motor domain at 6W
A
Raised head 45’
16
Q
What can infant do gross-motor at 6 months
A
Pulls to sit
Roll back to front
Lie on abdomen and extend arms
17
Q
What can infant do gross-motor at 7-8 months
A
Sits without support
18
Q
When can an infant sit without support
A
7-8 months
19
Q
When should you refer an infant who can’t sit without support
A
12 months
20
Q
What can an infant do at 9-months
A
Crawls
21
Q
When an an infant crawl
A
9-months
22
Q
What can an infant do at 12 months
A
Cruises
23
Q
What can an infant do at 13-15 months
A
Walks unsupported
24
Q
When can an infant walk unsupported
A
13- 15 months
25
When should you refer an infant if they cannot walk unsupported
18 - months
26
When can a child run
2- years
27
When can a child walk up and downstairs whilst holding on to hand rail
2-years
28
When can a child ride a tricycle
3-years
29
When can a child walk up and down stairs without holding hand rail
3-years
30
When does an infant have good head control
3-months
31
What can an infant do in fine-motor at 6W
Track objects
32
What can an infant do in fine-motor at 3 months
Reaches
33
What can an infant do at 6 months
Palmar grasp
| Point to objects
34
When does an infant acquire a palmar grasp
6-months
35
When does early pincer grip occur
9-months
36
What can an infant do at 9-months
- Early pincer grip
| - Points to objects
37
When does an infant have a neat pincer grip
12-months
38
What is abnormal before 12-months in fine-motor and what can it indicate
Hand preference. Can indicate cerebral palsy
39
What can infant do at 13-15m in fine-motor
Tower 2-bricks
40
What can infant do at 18m in fine-motor
Tower 3-bricks
| Scribble
41
What can infant do at 2-years in fine-motor
Tower 6-bricks
| Copy line
42
What can infant do at 3-years in fine-motor
Tower 9-bricks
| Copy circle
43
What can infant do at 4-years in fine-motor
Copy cross
44
What can infant do at 5-years in fine-motor
Copy square and triangle
45
What age can an infant turn to sound
3-months
46
What can an infant do at 3-months in language
- Turn to sound
- Quieten to parents voice
- Squeals
47
When does an infant use double syllables
- 6-months
48
When does an infant say 'mumma' and 'dadda'
9-months
49
What can an infant do at 9-months
Say mumma and dadda
| Understand NO
50
When does an infant known and respond to its own name
12-months
51
What can an infant do at 13-15 months in language domain
Vocabulary 2-6 words
52
If an infant does not know 2-6 words by what age should you refer
18-months
53
When can an infant combine two words
2-years
54
How many words would you expect a 2.5-year old to know
200-words
55
What age may a child be able to talk in short sentences
3-years
56
What can a child of 3-years do in language domain
- Short sentences
- Asks questions
- Counts to 10
- Identifies colours
57
what age does a child smile
6W
58
if a child has not smiled by what time frame should they be referred
10W
59
when does a baby laugh by
3-months
60
when is a baby not shy
6-months
61
what can an infant do at 9-months in social domain
- Shy
- Takes objects by mouth
- Peek-a-boo
62
what can infant do at 12-months in social domain
Waves bye-bye
| Patty cake
63
what can infant do at 13-15 months in social domain
- Drinks from cup
- Uses spoon
- Help getting dressed and undressed
64
what can infant do at 18-months in social domain
- Takes shoes off
| - Plays alone
65
what can infant do at 2-years in social domain
- Plays near others, not with them
66
what can child do at 3-years in social domain
- Uses spoon and fork
67
what can child do at 4-years in social domain
- Dresses independently
| - Plays with others
68
what is bottom-shuffling
normal variant: child may bottom shuffle, opposed to crawl, prior to walking
69
when should individual be referred if not smiling
10-weeks
70
when should children be referred if poor head control
6-months
71
when should children be referred if not sitting without support
12-months
72
when should children be referred if not walking
18-months
73
when should children be referred for not known 2-6Words
18-months
74
what is considered a red-flag for development
Regression in previously learnt skill
75
what are other red flags for development
- Parental concern
- Abnormal tone: difference between R and L
- Poort interaction
76
When is the new baby review
1-2W
77
Who performs the new baby review
Health visitor
78
When is a developmental review performed
9 months - 1-year
79
What is completed at the developmental review
ASQ3 questionnaire by the parents
80
When is the second health-development review
2-2.5 years
81
Who completes second health-review
ASQ3 questionnaire - done by parents
| Visit by health visitor
82
What is developmental screening
Brief assessment where a screening tool is used to identify children who need further assessment and investigations
83
How is developmental screening performed
Using developmental screening tool
84
What Developmental screening test is used in the UK
Ages and Stages Questionnaire (ASQ)
85
What age-range is the ages and stages questionnaire suitable
1 month - 5.5 years
86
Define developmental delay
Slow acquisition of skills across all developmental domains or in one-specific developmental domain
87
What are the two types of developmental delay
Global DD = delay in two or more domains
Specific DD = delay in one domain
88
When is developmental delay often detected
When development for that skill is expected at that greatest
89
What are the 3 patterns of developmental delay
1. Slow but steady
2. Plateau
3. Regression
90
What is slow-but-steady
Individuals are below where expected for they gestation but gradually improving
91
What is plateau effect
Individuals initially improved and now are not
92
What is regression
Individuals improved and then regressed
93
When should individuals be referred due to abnormal motor development
18m if unable to walk
94
What are 5 causes abnormal motor development
- Cerebral palsy
- Duchenne muscular dystrophy
- Global developmental delay
- Idiopathic
- Spina bifida
95
What does hand preference before 12-months indicate
CP
96
Explain late-walking in normal variants
Bottom-shufflers and commando crawlers are late variants associated with later-onset of walking
97
What can hypertonia indicate
CP
98
What is a sign of DMD
Gower's sign = using arms to push up legs to stand-up
99
What do NICE recommend if child is at risk of cerebral palsy
General movement assessment at 0-3 months
100
If only motor developmental delay what may be ordered
creatinine phosphate kinase - to exclude DMD
101
what is language delay
delay in understanding or expressing speech
102
what are causes of language delay in children
- Familial
- Hearing: chronic otitis media
- Physical: tongue-tie, cleft palate
- Neuropsych: neglect, autism
103
how can language delay be divided
```
Receptive = understanding
Expressive = communicating
```
104
when should child turn head to sound
3-months
105
when should infant be referred if not turning head to sound
9-months
106
when should infant babble
6-months
107
when should infant be referred if not babbling
12-months
108
when should child be referred if it has no clear words
18-months
109
when should child have 2-6 words
12-months
110
why may a child be referred at 2.5-years
if vocabulary is less than 50-words
111
how many words should a child have at 2.5 years
200 words
112
if child has language delay who should they be referred to
SALT
| Audiology assessment
113
what is global developmental delay
delay in two or more domains
114
when does global developmental delay tend to appear
2-years
115
in which domains is global developmental delay more common
fine motor
social
speech
(less apparent in gross motor)
