Child Development

Question 1

What does the rubrospinal tract do?

Answer 1

Automatic movements of arm in response to posture/balance changes

Question 2

What does the reticulospinal tract do?

Answer 2

Coordinates automated movements of locomotion and posture

Question 3

What does the vestibulospinal tract do?

Answer 3

Regulates balance

Question 4

What does the olivospinal tract do?

Answer 4

Transmission of unconscious proprioception and balance

Question 5

What are the four domains of development?

Answer 5

Gross motor skills
Fine motor skills
Social skills
Speech & language skills

Question 6

Give examples of gross motor skills

Answer 6

Head lag
Sitting
Walking
Running
Position

Question 7

Give examples of fine motor skills

Answer 7

Use of hands
Grasp
Fine pincer

Question 8

Give examples of speech and language skills

Answer 8

Vocalisation
Words
Understanding
Imaginative player

Question 9

Give examples of social skills

Answer 9

Social interaction
Stranger reaction
Eating skills
Dressing

Question 10

What is the moro reflex?

Answer 10

When you quickly drop a baby’s head and they abduct and quickly adduct their arms

Question 11

What types of patterns of development would be abnormal?

Answer 11

Slow but steady
Plateau
Regression

Question 12

List some common problems in the development of children

Answer 12

Delayed walker
Clumsy child
Delayed speech and language 
Odd social interaction 
Hyperactivity

Question 13

Which part of the brain is implicated in ADHD

Answer 13

Prefrontal cortex - low levels of dopamine -> lack of concentration

Question 14

Give some features of autism

Answer 14

Impaired social interaction (solitary play)
Impaired communication (avoidance of gaze)
Restricted interests
Repetitive behaviours
Self stimulation

Question 15

What is cerebral palsy?

Answer 15

Impaired corticospinal pathway -> motor deficits
Imbalance of flexors and extensors
Increased tone in legs due to lack of inhibition from corticospinal pathway

Question 16

What are the two types of developmental delay?

Answer 16

Global vs specific

Question 17

List some general causes of global delay

Answer 17

Chromosomal abnormalities
Metabolic disorders
Antenatal and perinatal factors
Environmental-social issues
Chronic illness

Question 18

Which factors lead to developmental delay?

Answer 18

Lack of physical/psychological stimuli
Sensory/motor impairment
Ill health
Reduced inherent potential

Question 19

List some metabolic causes of global delay

Answer 19

Hypothyroidism

Inborn errors of metabolism

Question 20

List some antenatal/perinatal factors causing global delay

Answer 20

Infections 
Drugs
Toxins
Anoxia 
Trauma
Folate deficiency

Question 21

List some causes of motor delay

Answer 21

Cerebral palsy
Down's 
Congenital hip dislocation 
Social deprivation 
Muscular dystrophy (Duchenne's)
Neural tube defects
Hydrocephalus

Question 22

List some causes of language delay

Answer 22

Hearing loss
Learning disability
ASD
Lack of stimulation
Impaired comprehension of language (development dysphasia)
Impaired speech production (stammer, dysarthria)

Question 23

How would you assess the child’s development?

Answer 23

Ask about milestones
Observe the child
Get the child to do task

Question 24

What history would you ask the parents?

Answer 24

Birth history
Family history
Developmental history
Parental anxiety

Question 25

List some commonly used assessment tools

Answer 25

Schedule of growing skills Griffiths developmental scale Bailey developmental scale Denver developmental screening tests

Question 26

What would you look for during the focussed physical examination?

Answer 26

The general look of the child Growth - height, weight, occipitofrontal circumference Hearing and vision Neurological examination Skin Systems examination to identify syndromes Genitalia

Question 27

Which bloods would you request?

Answer 27

``` FBC Ferritin Metabolic screen (TFTs, U&Es, LFT, bone profile) Lead Organic ions Amino acids Creatine kinase Ammonia Lactate ```

Question 28

What imaging/other things would you arrange?

Answer 28

``` US CT/MRI EEG Cytogenetic studies e.g. chromosomes Nerve and muscle biopsy! ```

Question 29

What are the objectives of management?

Answer 29

Maximise mobility Minimise discomfort Promote speech and language Promote social and emotional health

Question 30

List members of the MDT involved in child developmental services

Answer 30

``` Speech and language therapist OT Paediatrician Physiotherapist Dietician Social work Psychologist Specialist health advisor ```

Question 31

Give some common signs which suggest that a child's development is delayed

Answer 31

``` Delayed walking Clumsy child Delayed speech and language Odd social interaction Hyperactivity ```

Question 32

What birth history would be significant?

Answer 32

Prematurity | Prolonged or complicated labour

Question 33

What antenatal history would be significant?

Answer 33

``` Illness Infections Medications Drugs Environmental exposures ```

Question 34

What postnatal history would be significant?

Answer 34

Trauma Illness Infections

Question 35

What would you ask about the parents?

Answer 35

Consanguinity