Children with Special Needs Flashcards
What are some features of normal development?
- Constant pattern
- Sequential acquisition of skills
- Median age vs limit age
- Genetic factors
- Environmental influences
What are the 5 aspects of child development?
- Gross motor skills
- Fine motor skills
- Speech and language
- Social, personal and activities of daily living
- Performance and cognition
What is developmental delay?
Is when functional aspects of child’s development in one or more domain (motor, language, cognitive, social, emotional) are significantly delayed compared to expected level for age:
- 2SD below mean of age-appropriate, norm-referenced testing
How is learning disability different from developmental delay?
- Significant impairment in intellectual functioning and affects the persons ability to learn and problem solve in daily life
- Nearly always been present since childhood
What does developmental delay present through?
- Routine health surveillance
- Parental concern
- Professional contact – nursery/daycare
- Opportunistic health contact
- UK Healthy Child Programme (HCP)
What are different ways of assessing development?
- History and examination
- Prenatal, perinatal and postnatal events
- Developmental milestones
- The ‘red book’
- Environmental, social and family history
- Video recordings of child
- Observations in clinic
What are some primary care assessment tools used for development monitoring?
- ASQ (ages and stages questionnaire)
- PEDS (parents evaluation of developmental status)
- M-CHAT (checklist for autism in toddlers)
-
SOGS-2 (schedule of growing skills)
- Most commonly used
- Assessed children from 0-5 years
- Assessed 9 key areas
What are some secondary care assessment tool for development delay?
- Griffiths mental development scales
- Bayley scales of infant development
- Wechsler preschool and primary scales of intelligence
What are the 3 different ways to quantify developmental ability?
- Delay
- Global or isolated
- Disorder
- Abnormal progression and presentation such as autism
- Regression
- Loss of milestones
What parts of the history are particularly important for developmental delay?
- FH of neurodevelopmental/genetic disorders
- History of miscarriages
- Prenatal, perinatal and neonatal course
- Drugs and alcohol use in pregnancy
- Developmental, behavioural, social and educational history
- Record of medications
- Past investigations
- Metabolic/thyroid testing
- Neuroimaging
- Lead and iron screening
- Growth records
- Vision and hearing surveillance
What parts of the examination are important for developmental delay?
- Head circumference
- Dysmorphic features
- Skin abnormalities
- Movement quality
- Ability to sit and stand from supine
- Eye movements and eye examination
- General examination
- CVS, resp
- Abdominal examination
- Observation of behaviour
What are examples of common syndromes?
- Down syndrome
- Fragile X syndrome
- Williams syndrome
What are some positive and negative red flag signs in terms of developmental delay?
- Positive
- Loss of developmental skills
- Concerns regarding vision or hearing
- Floppiness
- No speech by 18-24 months
- Asymmetry of movement
- Persistent toe walking
- Negative
- Sit unsupported by 12 months
- Walk by 18 months (boys) or 2 years (girls)
- Check creatine kinase)
- Run by 2.5 years
- Hold objects in hand by 5 months
- Reach for objects by 6 months
- Points to objects to share interest by 2 years
When does absence of the following become a red flag sign:
- speech
- sitting unsupported
- run
- hold objects by hand
- reach for objects
- point to objects to share interest
- Speech
- 18 to 24 months
- Sit unsupported
- 12 months
- Run
- 2.5 years
- Hold objects in hand
- 5 months
- Reach for objects
- 6 months
- Point to objects to share interest
- 2 years
What are some common investigations for developmental delay?
- Genetic testing
- Chromosomal analysis (karyotype)
- Fragile X, FISH, array
- Creatine kinase
- Thyroid screening
- Metabolic testing
- Amino and organic acids, ammonia, lactate
- Ophthalmological examination
- Audiology assessment
- Consider congenital infection
- Neuroimaging
