Childhood Disability and Development

Question 1

What is the definition of childhood disability?

Answer 1

Child with mental/physical impairment that results in marked, pervasive limit on activity e.g. C Palsy, Down’s

Question 2

What are the 3 factors to affect childhood disability?

Answer 2

1) Impairment
2) Environment
3) Childhood social background

Question 3

What are the main signs of Down’s?

Answer 3

1) Brushfield spots
2) CHD
3) Short stature
4) Hypotonia
5) Learning/development delay

Question 4

Define cerebral palsy?

Answer 4

1) Non-prog development disorder of movement and posture
2) Permanent, non-prog cerebral pathology leading to handicap/disability in children

Question 5

What are the 3 causes of CP?

Answer 5

1) Antenatal: Hypoxia, Haemorrhage, Ischaemia, infection (80%)
2) Peri-natal: Hypoxia, haemorrhage or infection (10%)
3) Post-natal: hypoxia, infection e.g. meningitis, haemorrhage, encephalopathy, trauma.

Question 6

What support is provided for someone/family with CP?

Answer 6

1) SALT
2) Feeding support
3) Sleeping support
4) Physiotherapists for hand function/mobility
Holistic, child focussed and MDT

Question 7

What is child development?

Answer 7

The biological, psychological and emotional changes that occur between birth and adolescence as the individual progresses from dependency to increasing autonomy. It is a continuous process with a predictable sequence however each child’s development is unique.

Question 8

What are the main influences on a child’s development?

Answer 8

Genetic factors.
Stimulating environment.
Pregnancy factors e.g. premature? Mums health?
Healthy attachment.
Medical conditions.
Abuse/neglect/domestic violence.
Healthy peer relationships.
Education.
Nutrition.
Parenting style

Question 9

What are the 4 domains of childhood development?

Answer 9

1) Gross motor skills
2) Fine motor/vision
3) Speech, Language, Hearing
4) Social interaction and self care skills

Question 10

Gross Motor Function: What are the developmental milestones?

Answer 10

3m: lifts head on tummy.
6m: chest up with arm support, can sit unsupported.
8m: crawling.
9m: pulls to stand.
12m: walking.
2 years: walking up stairs.
3 years: jumping.
4 years: hopping.
5 years: rides a bike.

Question 11

Gross Motor function: When would the child walk, jump, crawl and climb stairs?

Answer 11

1) Walk: 12 months
2) Jump: 3 years
3) Crawl: 8 months
4) Climb stairs: 2 years

Question 12

Fine Motor/Vis: What are the developmental milestones?

Answer 12

4m: grabs an object using both hands.
8m: takes objects in each hand.
12m: scribbles with crayons e.g. circle, cross, square.
18m: builds a tower of 2 cubes.
3 years: builds a tower of 8 cubes.

Question 13

FM/V: When would you expect a child to draw w/ crayons, tower of 8 blocks, object in both hands, tower of 2 blocks

Answer 13

1) Draw with crayons: 12m
2) Tower of 8 blocks: 3 years
3) Object in each hand: 8 months
4) Tower of 2 blocks: 18 months

Question 14

Speech, Language, Hearing: What are the developmental milestones?

Answer 14

3m: laughs and squeals.
9m: can make sounds such as ‘dada’ and ‘mama’.
12m: can say one word.
2 years: can form short sentences and name body parts.
3 years: speech is mainly understandable.
4 years: knows colours and can count.
5 years: knows the meaning of words.

Question 15

SLH: When would they form short sentences/name body parts, knows colours/can count, laughs/ squeals, mainly understandable speech.

Answer 15

1) SS/Body parts: 2 years
2) Colours/count: 4 years
3) Laugh/squeal: 3 months
4) Mostly understandable: 3 years

Question 16

Social Interaction/Selfcare: What are the developmental milestones?

Answer 16

6 weeks: smiles.
6 months: finger feeds.
9m: waves bye-bye.
12m: uses cutlery.
2 years: undresses, feeds toys.
3 years: plays with others, names a friend.
4 years: dresses with no help, plays a board game.

Question 17

SI/SC: When would you expect them to uses cutlery, plays with others/names a friend, smiles, waves bye-bye.

Answer 17

1) Cutlery: 12 months
2) Play/name: 3 years
3) Smiles: 6 weeks
4) Waves bye/bye: 9 months

Question 18

What does the “Healthy Child programme” encourage?

Answer 18

• Encourages care to keep children healthy and safe.
• Promotes healthy eating and activity.
• Identifies problems in children’s development.
• Identifies ‘at risk’ families for more support.
• Ensures children are prepared for school.

Question 19

What are concerns for each type of development domain?

Answer 19

1) GM: Not sitting by 12 months, not walking by 18 months
2) FM: Hand preference before 18 months
3) SLH: Not smiling by 3 months, no clear words by 18 months
4) SCD: No play by 3 yo, no response to care interactions by 3 months

Question 20

What are main causes of developmental delay?

Answer 20

1) Genetics
2) Pregnancy
3) Factors around birth
4) Factors in childhood
5) Environmental

Question 21

What investigations would you do in a child where you thought there was a problem?

Answer 21

Thorough hx and exam, tailor towards a child:
- Boys not walking by 18m check creatinine kinase for Duchenne.
- Focal neurological signs -> MRI brain.
Genetic testing.
- Unwell, failure to thrive -> metabolic investigations.

Question 22

What are the main problems in each category of developmental delay?

Answer 22

1) Genetic: Chromosomal abnormality, micro del/dup, polygenic, single gene disorder
2) Pregnancy: MCA infarct, congenital infection, exposure to drug/alcohol
3) Birth: Birth asphyxia, prematurity
4) Medical: Chronic illness, infections, acquired brain injury, hearing/visual impairment
5) Environment: Chronic abuse/neglect, low stimulation