6: Approach to the child with developmental delay Flashcards Preview

Child Health Week 1 2017/18 > 6: Approach to the child with developmental delay > Flashcards

Flashcards in 6: Approach to the child with developmental delay Deck (38)
Loading flashcards...
1

What is the definition of developmental delay?

Failure to achieve developmental milestones for child's chronological age

2

What are the two subtypes of developmental delay?

Global

Specific

3

Apart from developmental delay, what are two other types of developmental disorder?

Deviation or total lack of skills

Regression of skills

4

How is developmental delay discovered in children?

By health visitors / GP during screening

OR

By parents

By nursery staff

 

5

What is an example of a developmental

a) delay

b) deviation

c) regression?

a) Learning disabilities (global or specific e.g dyslexia and dysgraphia)

Down syndrome

b) Autism spectrum disorders

c) Rett's syndrome (caused progressive regression of eye movement among other things)

6

What are some developmental red flags?

Asymmetry of movement (i.e hand dominance in the very young)

Not reaching for objects by 6 months

Unable to sit unsupported by 12 months

Unable to walk by 18 months

No speech by 18 months

Vision or hearing problems

LOSS of skills

7

Failure to achieve developmental milestones is a red flag for developmental disorders. By which age should infants be able to:

a) walk

b) reach for objects

c) sit up properly

d) talk?

a) Walking - 18 months (median is 12)

b) Reaching for objects - 6 months

c) Sit up properly - 6 months (median is 3)

d) Talk - 24 months (median is 18)

8

Why is asymmetrical movement at a young age an example of a developmental red flag?

Children shouldn't have dominant hands / sides until later on in development

9

What should be checked in children who cannot walk by 18 months?

Why?

 

CK

Screen for muscle-wasting diseases like Duchenne muscular dystrophy

10

What is global developmental delay?

Delay in two or more of

Gross / fine motor skills

Speech and language

Cognition

Social personal skills

ADL

11

What is global developmental delay called in children of school age?

Learning disability

12

Do children with global developmental delay eventually catch up with others?

No, so "delay" is a misnomer

As age increases the gap between affected and unaffected widens

13

Global developmental delay commonly has a ___ cause.

genetic

14

What are two genetic diseases which cause global developmental delay?

Down syndrome

Fragile X syndrome

15

Which genetic defect causes Down syndrome?

Trisomy 21

16

Apart from a global developmental delay, what is the physical presentation of Down syndrome?

Short stature

Slanted eyes

Excess skin at back of neck

Flat nose

Small mouth and protruding tongue

17

What are important systemic complications of Down syndrome?

C1/C2 instability

Congenital heart disease (AVSD, VSD, valve disease, Tetralogy of Fallot)

Hypothyroidism

18

Which genetic disease, characterised by a long face, causes global developmental delay?

Fragile X syndrome

19

What are some specific motor delays?

Duchenne muscular dystrophy

Cerebral palsy

Coordination disorders e.g dyspraxia

20

What is the Gower maneouvre?

What causes it?

What specific motor developmental delay is it associated with?

When child stands up, they need to walk their legs together from a crawling position

Pelvic instability

Duchenne muscular dystrophy

21

What is the mode of inheritance of Duchenne muscular dystrophy?

X-linked recessive

so most commonly affects boys

22

Apart from the Gower manoeuvre, what is another MSK sign of DMD?

Increased lumbar lordosis

again due to pelvic instability

23

What is a neurological cause of specific motor developmental delay?

What specific type of the disease causes stiffness and spasticity in the lower limbs?

Cerebral palsy

Spastic diplagia

24

What type of gait is associated with spastic diplagia?

Intoeing gait

25

Which primitive motor reflex persists in some types of cerebral palsy?

When is it normally lost?

ATNR / "Fencing reflex"

6 months

26

Apart from motor issues, what problems are seen in cerebral palsy?

Epilepsy

Hearing / vision problems

Sleep problems

27

If a child with cerebral palsy is having particular difficulty moving, what may accompany their disorder?

Visual impairment

28

What is a pigmentation disorder which causes visual impairment?

Oculocutaneous albinism

29

Which syndrome causes facial deformity and hearing impairment?

Treacher-Collins syndrome

30

What is a disorder which causes developmental deviation?

Autism spectrum disorders