Developmental delay

Question 1

what varies in development the sequence or the rate

Answer 1

rate

Question 2

define developmental delay

Answer 2

failure to attain appropriate developmental milestones for child’s corrected chronological age

Question 3

what is global developmental delay

Answer 3

when 2 or more areas of development are delayed

Question 4

give an example of a cause of global developmental delay

Answer 4

downs syndrome

Question 5

what is specific developmental delay

Answer 5

when one area of development affected

Question 6

name a cause of specific developmental delay

Answer 6

duchennes muscular dystrophy

Question 7

what are the patterns of abnormal development

Answer 7

delay (global and specific)
deviation (e.g. autism)
regression (loose abilities previously acquired)

Question 8

what can cause developmental regression

Answer 8

retts syndrome, metabolic disorders (genetic conditions causing biochem pathways to go wrong)

Question 9

what is the average IQ

Answer 9

100

Question 10

how many kids have autism

Answer 10

1%

Question 11

give examples of specific learning disabilities

Answer 11

dyslexia, dyspraxia

Question 12

an IQ less than what classifies as a severe learning difficulty

Answer 12

less than 50

Question 13

what are the red flags for development

Answer 13

asymmetry of movement (power on one side, toppling over on one side)
not reaching for objects by 6 months
unable to sit unsupported by 12 months
unable to walk by 18 months (check CK for MD)
no speech by 18 months
concerns re vision or hearing
loss of skills- regression

Question 14

when should you reach for things

Answer 14

3-4 months

Question 15

what might cause no speech by 18 months

Answer 15

autism, hearing, understanding, problems forming words

Question 16

what is ADL

Answer 16

activities of daily living

Question 17

what is involved in medical screening in downs syndrome

Answer 17

cardiac
vision
hearing (Brachycephaly can impinge on tubes)
thyroid function (prone to underactive thyroid)
sleep related breathing disorders (sleep apnoea)
growth charts (short, more prone to obesity)
development

Question 18

does developmental delay catch up?

Answer 18

no gap widens as get older, delay more like a percentage, reach peak at 16

Question 19

what can cause motor delays

Answer 19

duchennes MD, cerebral palsy, co-ordination disorders

Question 20

what can cause language delays

Answer 20

specific language impairment

Question 21

what can cause sensory deficits and associates delay

Answer 21

oculocutaneous albinism, treacher collins

Question 22

what can cerebral palsy cause a delay in

Answer 22

speech and cognition, motor

Question 23

what is the inheritance of duchennes MD

Answer 23

X linked

Question 24

how can you test for duchennes MD

Answer 24

high CK

Question 25

why do you get an arched back in duchennes MD

Answer 25

weakness in pelvic girdle

Question 26

why do some muscles appear very strong in duchennes

Answer 26

pseudohypertrophy- muscles replaced by fibrous tissue

Question 27

what manoeuvre is seen in duchennes

Answer 27

gowers

Question 28

what conditions are associated with cerebral palsy

Answer 28

``` mobility problems spasticity orthopaedic problems learning difficulties epilepsy visual/hearing difficulties communication difficulties feeding problems sleep problems behaviour problems ```

Question 29

what type of hearing loss is seen in treacher collins

Answer 29

conductive- bones not formed properly

Question 30

what is the autistic triad

Answer 30

communication social interaction flexibility of thought/imagination

Question 31

what types of behaviours are seen in autism

Answer 31

restrictive or repetitive

Question 32

what language signs can be seen in autism

Answer 32

``` finding abstract language difficult visually more able echoes odd intonation/pitch can repeat chunks of video speak ```

Question 33

what non verbal language can autistic kids struggle with

Answer 33

facial expression, eye contact, recognising intentions of others

Question 34

how can autistic people struggle with the use of language

Answer 34

initiating and substaining conversation restricted interests lack of awareness of reciprocal nature of conversation

Question 35

how can autism affect social interaction

Answer 35

``` joint attention and referencing difficult turn taking hard unable to share pleasure no motivated by social approval social rules empathy relationships others point of view/ feelings ```

Question 36

what is flexibility of thought like in autism

Answer 36

``` concrete and literal ideas concept of time routines change in environment hard to cope with ritualistic behaviour ```

Question 37

what are the sensory issues in autism

Answer 37

``` fussy eater/ medications textures of clothes sleep toilet training hair washing/ cutting nail cutting noise ```

Question 38

what should be included in a history about the pregnancy

Answer 38

preterm? alcohol, smoking, postnatal depression

Question 39

what should be included in an exam in developmental delay

Answer 39

observation, dysmorphism, head circumference, systems, CNS including neurocutaneous, vision, hearing

Question 40

what type of hearing loss in glue ear

Answer 40

conductive

Question 41

what investigations of developmental delay

Answer 41

chromosomes fragile X oligoarray CGH neonate PKU (metabolism disorder) thryoid studies CK ``` if indicated: brain MRI EEG (seizures) metabolic studies genetic consultation ```

Question 42

what is the typical pattern for cerebral palsy

Answer 42

C pattern- spastic diplegia

Question 43

what is the key to developmental delay

Answer 43

early intervention: special to each child- therapy (physio, SLT, OT), family support, education, referral

Question 44

what type of hearing loss does sensorineural produce

Answer 44

worst at high frequencies

Question 45

what type of hearing loss does conductive produce

Answer 45

worst at all frequencies

Question 46

what is the most common cause of conductive hearing loss

Answer 46

glue ear

Question 47

what condition is freckling of the axilla and cafe au lait spots seen in

Answer 47

neurofibromatosis type 1