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Y3 paediatrics > child development and special needs > Flashcards

child development and special needs Flashcards

(37 cards)

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1
Q

what is developmental delay

A

present when functional aspects of the child’s development in one or more domains are significantly delayed compared to the expected level for age

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2
Q

what is global developmental delay

A

performance below 2SD below mean of age appropriate, norm referenced testing

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3
Q

what is a learning disability

A

significant impairment in intellectual functioning and affects the person’s ability to learn and problem solve in their daily life

has nearly always been present since childhood

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4
Q

how common is GDD

A

1-3% of children
? potentially up to 16%

1% have an autism spectrum disorder

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5
Q

when is GDD identified

A

only 1/3 identified before school entrance

careful evaluation and investigation can reveal a cause in 50-70% of cases

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6
Q

presentation of GDD - when is it picked up

A

routine health surveillance

children w/ identified risk factors

parental concern

professional contact - nursery/daycare

opportunistic health contact

UK healthy child programme

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7
Q

assessment of development in children

A
  • hx and examination
    • prenatal, perinatal and postnatal events
    • developmental milestones
    • red book
    • environmental, SHx, FHx
  • video recordings of child
  • observation
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8
Q

1y care assessment tools for development

A

ASQ - ages and stages questionnaire

PEDS - parents evaluation of developmental status

M-CHAT - checklist for autism in toddlers

SOGS-2 - schedule of growing skills

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9
Q

quantification of developmental abilities

A

areas of development are age appropriate?

  • delay: global (2 or more domains) vs isolated
  • disorder: abnormal progression and presentation e.g. autism
  • regression: loss of milestones
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10
Q

schedule of growing skills

A

information of child’s development across a range of areas

0-5yrs

9 key areas

separate cognitive score can be derived

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11
Q

2y care assessment tools

A

Griffiths mental development scales

Bayley scales of infant development

Wechsler preschool and 1y scale of intelligence

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12
Q

things to remeber to include in hx

A

comprehensive

  • FHx neurodevelopmental/genetic disorder
  • hx miscarriages
  • prenatal, perinatal, neonatal
  • drug and alcohol use in pregnancy
  • developmental, behavioural, social, educational hx
  • medications
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13
Q

hx - further investigatinos

A
  • results of prev metabolic/thyroid testing
  • neuroimaging
  • lead and iron screening
  • growth records
  • vision and hearing surveillance
  • high index of suspicion for abuse and neglect
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14
Q

examination - what do we include

A

head circumference

dysmorphic features

skin abnormalities - neuro-cutaneous markers

movement quality

ability to sit and stand from supine

eye movements and eye examination

general examination: CVS, resp, abdo

observation of behaviour

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15
Q

sensory screening - how common are disorders

A

vision - 13-50%

hearing impairment - 18%

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16
Q

red flag signs - positive

Study These Flashcards
A

loss of developmental skills

concerns re vision/hearing

floppiness

no speech by 18-24mths

asymmetry of movement

persistent toe walking

head circumference >99.6th C or <0.4th C

17
Q

red flag signs - negative

Study These Flashcards
A

sit unsupported by 12mths

walk by 18mths (M) or 24mths (F) - check CK

walk other than on tiptoes

run by 2.5yrs

hold objects in hand by 5mths

reach for objects by 6mths

points to objects to share interest by 2yrs

18
Q

investigations - 3 important things to remember

Study These Flashcards
A

based on clinical abnormalities

diagnostic yield of specific tests

timing

19
Q

types of investigations

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A
  • genetic testing - chromosomal analysis, fragile X, FISH, array CGH
  • CK
  • thyroid screening
  • metabolic testing: aa and organic acids, ammonia, lactate
  • ophthalmological examination
  • audiology assessment
  • consider congenital infection e.g. toxoplasmosis, CMV
  • neuroimaging
20
Q

1st line investigations for GDD

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A

following thorough hx and exam:

  • chromosomes
  • fragile X
  • U+E
  • CK
  • lead
  • TFT
  • urate
  • FBC
  • ferritin
  • biotinidase
21
Q

2nd line investigations for GDD and when are they considered

Study These Flashcards
A

metabolic: bloods (lactate, aa, ammonia, VLCFA, carnitine, homocysteine, disialotransferrin)

  • FHx
  • consanguinity
  • regression
  • organomegaly
  • coarse features

neuroimaging: MRI, CT (bones, calcification)

  • abnormal head size
  • seizures
  • focal neurology

EEG:

  • speech regression, seizures, neurodegenerative disorder

genetics:

  • dysmorphism
  • abnormal growth
  • sensory impairment
  • odd behaviour
  • FHx
22
Q

common motor problems

Study These Flashcards
A

delayed maturation

cerebral palsy

developmental coordination disorder

23
Q

common sensory problems

Study These Flashcards
A

deafness

visual impairment

multisensory impairment

24
Q

common language/cognitive disorders

Study These Flashcards
A

specific language impairment

learning disability

25
common social/communication problems
autism asperger syndrome elective mutism
26
why is it important to investigate
* family understanding of condition and prognosis * lessens parental blame and address concerns re causes * prevents co-morbidity by identify preventable factors * genetic counselling * support * potential treatment
27
MDT approach
developmental paediatrician SLT OT/PT psychologist social worker geneticist
28
what are additional support needs
when a child needs additional support with their education can mean any kind of educational provision that is more than/very different from the education that is normally provided in mainstream schools
29
why might a child required additional support
may be multiple different reasons: * difficulties w/ mainstream approaches to learning * disabiility/health needs e.g. motor/sensory impairment, learning difficulties, ASD * family circumstances e.g. young people who are parents/carers
30
what is personal learning planning
a way of thinking about, talking about and planning what and how a child learns also a way of assessing their progress and acting on the results of that assessment
31
what is an individualised educational plan (IEP)
* detailed plan for the child's learning * specific, short-term learning targets for the child and will set out how the targets will be reached * targets are: **specific, measurable, achievable, relevant, timed** * aka additional support plans, individual support plans * not a legal document
32
what is a co-ordinated support plan (CSP)
* detailed plan of how child's support will be provided * **legal document** - aims to ensure all professionals helping the child work together * helps ensure everyone (incl parents and child) if fully involved in the support
33
when is a CSP put in place
* **for children in local authority school education and needing significant additional support** * complex/multiple needs, needs likely to continue \>1yr * support required by \>1 agency
34
what is GIRFEC
getting it right for every child * many children will now have a child's plan
35
when is a child's plan created
if a child/young person needs some extra support to meet their wellbeing needs e.g. access to mental health services, respite care, help from a range of different agencies
36
what does the child's plan contain information about
* why a child/young person needs support * the type of support they will need * how long they will need support and who should provide it * all professionals working with the child would use the plan, which may include an IEP or CSP
37
what does the long term outlook of a developmental condition depend on
nature of the problem acquisition of skills social and emotional needs personal attributes, family, social surroundings and level of care recieved

Y3 paediatrics (45 decks)

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