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RDA - reproduction, development and aging > child developmenty > Flashcards

child developmenty Flashcards

1
Q

what is the role of the frontal lobe

A

concentrating

executive function

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2
Q

what is the role of the temporal lobe

A

speech and language development

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3
Q

what is mediated through the reticulospinal tract

A

coordination - the cerebellum

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4
Q

importance of the vestibulospinal tract *

A

balance

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5
Q

importance of educational needs *

A

20% children have special educational needs

2% have severe disability

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6
Q

what are the developmental domains *

A

speech and language skills - vocalisation, words, understanding, imaginitive play

gross motor skills - position, head lag, sitting, walking, running

fine motor skills - use of hands, grasp and fine pincer, bricks, crayon, puzzles

social skills - social interaction, eating, stranger reaction, dressing

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7
Q

developmental domains at 2 and a half months *

A

uncoordinated and crude movements - gross motor only

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8
Q

developmental domains at 8 months *

A

gross motor - Hold self up – sitting and in prone position, Limbs more coordinated

fine motor - hold bricks, fine motor grasp

social - check for affirmation from mum, awareness of strangers

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9
Q

developmental domains at 2yrs *

A

gross - can stand

fine - do puzzles

language - 50words, pointing to things, wanting to show what is happening in their life, listen carefully and respond

social - follow instructions, eating skills

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10
Q

developmental domain at 4.5 yrs *

A

gross - catch and through

fine - hold pen, copy shapes

social - know colours

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11
Q

describe the mororeflex *

A

when you extend babies head quickly they extend their arms and then grasp

this is primitive and a protectve reflex

should disappear at 3-4months

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12
Q

what are the patterns of abnormal development *

A

there is a large normal range

abnormal if

  • slow but steady
  • plateu
  • regression (lose skills)
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13
Q

what are common developmental problems *

A

delayed walking

clumsy

delayed speech and language

odd social interaction - ASD/Aspergers

hyperactivity

problems with sleep onset/frequent night waking

problems eating

problems toilet training

specific learning difficulties eg dyscalculia (cant use numbers well), dyslexia

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14
Q

area of the brain involved in speech and language *

A

wernick’s - collect information

broca’s - language

motor componenets

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15
Q

area of the brain involved in hyperactivity *

A

frontal lobe ie the prefrontal cortex

dopamine is low = ill attention, hyperactivity and impulsivity

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16
Q

describe autism *

A

distinguished by a pattern of symptoms rather than a single problem

effect boys more than girls

impairments in social interaction, communication, restricted interests and repetitive behaviour

solitary play - impaired social interaction

avoid gaze

preoccupation

self stimulating

line toys up in unusual way

speech and language disorder

routines and repetitive behaviour

learning and attention difficulties

epilepsy

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17
Q

describe cerebral palsy *

A

damage to the corticospinal pathway

have motor deficit/posture problem

it is a persistant disorder

from non-progressive lesion acquired before 2yrs, most acses antenatal

range in severity

brain abnormal development because of genetics, or an effect of infection/trauma

people walk on tip toes because of increased flexor contraction relative to extensor contraction - there is increased tone - the inhibitory pathways are effected

presentation may evolve and vary with age

epilepsy

hearing loss

feeding difficulties

poor growth

resp problems

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18
Q

what are the causes opf developmental impairments *

A

prenatal

perinatal

postnatal

eg folic acid deficiency, teratogens (eg alcohol)

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19
Q

what are the factors that influence developmental delay *

A

laco of physical/psychological stimuli

sensory/motor impairment

reduced inherent potential

ill health

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20
Q

what are the types of developmental delay *

A

global - ie in all domains

specific - language/motor/sensory/cognitive

21
Q

what are the causes of global delay *

A

chromosomal abnormalities - Down’s/fragile X

metabolic - hypothyroidism, inborn errors of metabolism

antenatal and perinatal factors - Infections, drugs, toxins, anoxia, trauma, folate def

environmental/social issues

chronic illness

22
Q

causes of motor delay *

A
  • Cerebral palsy
  • Global delay eg Down’s syndrome
  • Congenital dislocation hip
  • Social deprivation
  • Muscular dystrophy-Duchenne’s
  • Neural tube defects: spina bifida
  • Hydrocephalus
23
Q

causes of language delay *

A
  • Hearing loss
  • Learning disability
  • Autistic spectrum disorder
  • Lack of stimulation
  • Impaired comprehension of language -Developmental dysphasia
  • Impaired speech production -stammer, dysarthria
24
Q

how do you assess child development *

A

parents know something is wrong before professionals do

therefore ask first, then observe and set tasks

need to assess the milestones preceding their age adn the expected milestones for age

take history - prenatal, birth and FH

PMH - developmental history and current skills

examination - developmental assessment and general and neuro examination

investigations as appropriate

25
Q

what are the tools that can be used to assess developpment I

A

standardised tests

schedule of growing skills

griffiths developmental scale

bailey developmental scale

denver developmental screening tests

26
Q

things involved in the physical examination of development *

A

look of child - can pick up syndromes

growth

OFC - occipitofrontal circumference - give idea of brain development

skin

genitalia

neurological examination

systems examination to identify associations or syndromes

growth parameters

dysmorphic features

27
Q

blood and imaging used to assess development *

A

FBC and ferritin

TSH

Chromosomes, cytogenic studies

Lead

US

CT/MRI, EEG

blood ammonia/lactate

nerve/muscle biopsy

bone profile

urine and blood organic or amino acid

28
Q

what are the objectives of managing development *

A

maximise mobility

minimise discomfort

promote speech and language

promote social and emotional health

29
Q

who is involved in MDTs for development *

A

specialist health visitor

paediatrician

OT

psychologist

physio

social worder and social services

dietician

speech and language therapist

30
Q

role of MDT *

A

assessment

diagnosis and disclosure

management program

social support

31
Q

role of specialist health visitor *

A

helps coordinate multidisiplinary and multiagency care

advice on development of play or local authority schemes

32
Q

role of psychologist *

A

cognitive testing

behavioural management

educational advice

33
Q

role of social worker/services *

A
  • Advice on benefits: disability, mobility, housing, respite care, voluntary support agencies
  • Day nursery placements
  • Advocate for child and family
  • Register of children with special needs
34
Q

role of dietician *

A

advice on feeding and nutrition

35
Q

role of SALT *

A
  • Feeding
  • Language development
  • Speech development
  • AAC (augmentative and alternative communication aids) e.g. Makaton sign language, Bliss symbol boards, voice synthesisers
36
Q

role of physio *

A
  • Balance and mobility
  • Postural maintenance
  • Prevention of joint contractures, spinal deformity

Mobility aids, orthoses

37
Q

role of OT *

A
  • Eye-hand coordination
  • ADL (activities of daily living) – feeding, washing, toileting, dressing, writing
  • Seating

House adaptations

38
Q

role of paediatrician *

A
  • Assessment, investigation and diagnosis
  • Continuing medical management
  • Coordination of input from therapists and other agencies – health, social services, education
39
Q

things included in a history *

A

Antenatal – illnesses/infections; medications; drugs; environmental exposures

Birth –Prematurity, Prolonged/complicated labour

Postnatal – illnesses/infections; Trauma

Consanguinity – increases chances of chromosomal or autosomal recessive conditions

Developmental milestones from parent

40
Q

management of cerebral palsy

A

minimise spasticity and associated problems

41
Q

management for autism *

A

intensive support for child and family

42
Q

describe attention defiit hyperactivity disorder *

A

diagnostic criteria - inattention, hyperactivity, impulsivity, lasting >6months, commencing <7yrs and inconsistent with the child’s developmental level

features should present in >1 setting and cause significant school/social impairment

increased risk of CD, anxiety disorder, ad aggression

risk factors: boys, learning difficulties, developmental delay

Neurological disorder, e.g. epilepsy, cerebral palsy; first-degree relative with ADHD; family member with depression, learning disability, antisocial personality or substance abuse

large proportion become adults with antisocial personality, increased incidence of criminal behaviour and substance misuse

43
Q

management of ADHD *

A

psychotherapy - behavioural therapies

family therapy

drugs - if behavioural therapy alone is insufficient give stimulants - methylphenidate (Ritalin), amphetamines (dexamphetamine)

diet - some benefit from exclusion of certain foods eg red food colouring

44
Q

describe learning disability

A

1/4 people with severe learning disability have no identifyable cause

causes can be - chromosome disorders, syndromes, post-natal cerebral insults, metabolic or degenerative disease

lassified as mild, moderate, severe, profound

may present with reduced interlectual functioning, delay in early milestones, dysmorphic features and associated problmes (epilepsy, sensory impairment, ADHD)

45
Q

management of learning difficulties

A

establishing a diagnosis and input from the multidisciplinary team with long term follow up.

46
Q

define child development *

A

the global impression of a child which encompasses growth, increase in understanding, acquisition of new skills and more sophisticated responses and behaviour.

It serves to endow the child with increasingly complex skills in order to function in society.

47
Q

what are limit ages *

A

the ages by which things should be achieved

if more than 2 SD from mean - could be major concern

48
Q

effect of folate deficiency *

A

neural tube defects

limb paralysis

neurogenic bladder and bowel

intellectual impairment

49
Q

identify child milestones *

A

RDA - reproduction, development and aging (10 decks)

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