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children and complex needs Flashcards

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1
Q

what is difference between mild LD and severe LD?

A

LD: general umbrella for range of conditions that affect from mild to severe
- Mild: child may need extra time and help with learning new skills
- Severe: significant intellectual impairment and they may need help with ADLs

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2
Q

what is dyslexia?

A

Dyslexia: specific difficulty in reading, writing and spelling

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3
Q

what is dysgraphia?

A

Dysgraphia: specific difficulty in writing

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4
Q

what is dyspraxia?

A

Dyspraxia: developmental co-ordinator disorder
- Specific type in physical co-ordination
- Presents with delayed gross and fine motor skills and child that appears clumsy

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5
Q

who is dyspraxia more common in?

A

boys

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6
Q

what is auditory processing disorder?

A

Auditory processing disorder: specific disability in processing auditory info

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7
Q

what is non-verbal LD?

A

Non-verbal learning disability: difficulty in processing non-verbal information such as body language and facial expression

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8
Q

how is LD classified?

A

based on IQ

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9
Q

what are the classifications of LD based on IQ?

A
  • Mild: 55-70
  • Moderate: 40-55
  • Severe: 25-40
  • Profound: <25
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10
Q

which is the most common IQ bracket for children with LD to be within?

A

mild - 55 to 70
children may be borderline

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11
Q

what can cause LDs?

A
  • May have underlying family Hx
  • Environmental factors:
    genetics
    antenatal probelms
    labour problems
    problems in early childhood
    autism
    epilepsy
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12
Q

what environmental factors can cause LD?

A
  • Environmental factors: abuse, neglect, psychological trauma and toxins (alcohol in-utero) can increase risk
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13
Q

what antenatal problems may cause LD?

A

fetal alcohol, maternal chickenpos

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14
Q

name some labour problems that may cause LDs?

A

preemie, hypoxic ischaemia encephalopathy

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15
Q

what childhood conditions can cause LD?

A

meningitis

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16
Q

who is in MDT to manage childhood LDs?

A

MDT approach to support parents/ child
- Paediatrician
- Social workers
- Health visitors – all under 5 have one
- Schools
- Educational psychologists
- GPs/ nurses
- Ots
- SALT

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17
Q

what is developmental delay?

A

There is flexibility within milestones  children that are slow to achieve all milestone sor lags behind in certain areas  pathological

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18
Q

what is global developmental delay?

A

Global developmental delay: child is displacing slow development in all developmental domains

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19
Q

what conditions can cause global developmental delay?

A
  • Down’s syndrome
  • Fragile X syndrome
  • Fetal alcohol
  • Rett syndrome
  • Metabolic disorders
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20
Q

what conditions can cause gross motor delay?

A

Cerebral palsy
Ataxia
Myopathy
Spina bifida
Visual impairments

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21
Q

what can cause fine motor delay?

A

Dyspraxia
Cerebral palsy
Muscular dystrophy
Visual impairment
Congenital ataxia (rare)

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22
Q

what can cause language delay?

A

specific social - many siblings or multiple languages

Hearing impairment
LD
Neglect
Autism
Cerebral palsy

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23
Q

who should you refer to with language delay?

Study These Flashcards
A

Need referral to SALT, audiology, health visitor and safeguarding?

24
Q

what can cause personal and social delay?

Study These Flashcards
A

Emotional and social neglect

Parenting issues
Autism

25
what is HIE?
Hypoxic ischaemic encephalopathy: HIE: occurs in neonates as a result of hypoxia during birth
26
what is the pathophys of HIE?
- Lack of oxygen causing restriction of blood flow to brain causing encephalopathy (malfunctioning of the brain)
27
what can HIE lead to?
cerebral palsy
28
what events can cause hypoxia in neonates?
- Acidosis on umbilical artery blood gas - Poor apgar - Features of mild/ moderate, severe HIE - Multi organ failure
29
what is asphyxia?
anything leading to asphyxia (deprivation of oxygen) to brian can cause HIE
30
what can cause asphyxia which can lead to HIE?
- Maternal shock - Intrapartum haemorrhage - Prolapsed cord - nuchal cord
31
what is prolapsed cord?
compression of cord during birth
32
what is nuchal cord?
cord wrapped around neck of baby
33
what grading system is used for HIE?
Sarnat staging
34
what are the three stages within HIE staging
Sarnat mild moderate severe
35
how would mild HIE present?
Poor feeding, general irritability and hyper-alert Resolves within 24hrs Normal prognosis
36
how would moderate HIE present?
Poor feeding, lethargic,, hypotonic, seizures Can take weeks to resolve Up to 40% go on to develop cerebral palsy
37
how would severe HIE present?
Reduced consciousness, apneoas, flaccid, reduced/ absent reflexes 50% mortality 90% develop cerebral palsy
38
how do you manage HIE?
need specialist in neonatology - Supportive care: therapeutic hypothermia MDT throughout childhood
39
what is supportive care within HIE?
neonatal resus, ongoing optimal ventilation, circulatory support, nutrition, acid-base balance, manage seizures
40
what is therapeutic hypothermia within HIE and why?
- Need therapeutic hypothermia  cooling baby core to 33-34 in NICU for 72hrs and then gradually increased temp back up, can help reduce inflammation, neurone loss, reduced risk of cerebral palsy, developmental delay, blindness and death
41
what is ASD?
Autism spectrum disorder: ASD ASD: refers to full range of people affect by deficit in social interaction, communication and flexible behaviour - Groups autistic disorder and Aspergers
42
what components make up ASD?
social interaction communication behaviour
43
what features within social interaction would indicate ASD?
Social interaction: lack of eye contact, delay in smiling, avoids physical contact, unabale to read on non-verbal cues, difficulty in establishing cues, difficulty in establishing friendships, not wanting to share attention (no playing with others)
44
what communications skills would indicate ASD?
Comms: delay/ regression in language development - Lack of appropriate non-verbal comms eg smiling, eye contact, responding to others with shared interest - Difficulty with imaginative/ imitative behaviour - Repetitive use of words
45
what behavioural attributes would indicate ASD?
Behaviour: greater interest in objects, numbers, patterns than people - Stereotypical behaviour eg self stimulating to comfrot themselves egg hand-flapping/ rocking - Intensive and deep interests that are persistent and rigid - Repetitive behaviours + fixed routine - Anxiety and distress with outside of routine - Extremely restricted food preferences
46
who can diagnose autism?
: made by specialist  paeds psych or peads specialist with interest in developmental and behaviour
47
does an autism diagnosis have to be at school age?
no can be before 3yrs
48
who is within MDT of autism management?
Management: MDT to provide best environment and support for child and parent - CAMHS - SALT - Dietician - DR - Social worker - Specially trained educators and special school environments - Charities such as national autistic society
49
what is ADHD?
There is a normal spectrum among children and adults in their level of activity throughout day and night and ability to concentrate on a single task for an extended period ADHD: is extreme end of hyperactivity + inability to concentrate
50
how should ADHA affect child in order for diagnoses?
- Affecting person’s ability to carry out everyday tasks, develop normal skills and perform well in school - Should be consistent across various setting  eg only doing this at school but well and behaved at home: environmental problem
51
what are features of ADHD?
ADHD is pat of normal spectrum  when it adversely affecting child - Very short attention span - Quickly moving from one activity to another - Quickly losing interest and not being able to persist with challenging tasks - Constantly moving/ fidgeting - Impulsive behaviour - Disruptive / rule breaking
52
how do you manage ADHD?
coordination from specialist - Parental strategies to manage behaviour - Establishing healthy food and exercise can have significant improvement in symptoms - Keeping a food diary alongside behaviour eg food colourings Medications: specialist only
53
what is the moa of ADHD meds?
- Central nervous system stimulants
54
name some examples of medications used in ADHD management?
- Methylphenidate (Ritalin) - Dexamphetamine - Atomoxetine
55

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