Developmental Delay

Question 1

How is developmental delay defined?

Answer 1

Children don’t attain appropriate developmental milestones for their correct chronological age

Question 2

What are the 3 main categories of abnormal development?

Answer 2

Delay
Deviation
Regression

Question 3

Give an example of a condition which would be considered a deviation development

Answer 3

Autism Spectrum Disorder

Question 4

Give an example of a condition which would be considered a regression development

Answer 4

Rett’s syndrome

Metabolic Disorder

Question 5

What is meant by deviation development and can skills be developed?

Answer 5

children may never develop a certain skill or may develop it differently from others

Question 6

In regression syndromes the skill is never developed. TRUE/FALSE?

Answer 6

FALSE

they may have acquired the skill and then proceed to lose the skill again

Question 7

Compare a normal IQ to that which would indicate a learning disability

Answer 7

Normal IQ = 90-110
Low Average = 70-90
Learning Disability = 50-70

Question 8

What are the main RED FLAGS for development?

Answer 8

• Asymmetry of movement
• Not reaching for objects by 6 months
• Unable to sit unsupported by 12 months
• Unable to walk by 18 months
• No speech by 18 months

Question 9

If a child is unable to walk by 18 months what investigation should be carried out and why?

Answer 9

→ check CK for evidence of muscular dystrophy

Normal CK 200-250, in MD it can be in the thousands

Question 10

Give examples of activities of daily living

Answer 10

Washing themself

Dressing themself

Question 11

What complications can Down’s syndrome cause in children

Answer 11

• Cardiac
• Vision (cant assess far and near objects)
• Hearing
• Thyroid function (underactive)
• Sleep apnoea (due to abnormal anatomy)
• Short height but put weight on easily

Question 12

At what chronological age do children with Down’s syndrome achieve their peak mental age? (regardless of the delay between CA and MA)

Answer 12

around 16

=> their mental age could be 8yrs at the CA of 16 and this is the most developed they will become

Question 13

Give 2 examples of coordination disorders caused by motor delay?

Answer 13

Duchenne Muscular Dystrophy

Cerebral Palsy

Question 14

Why is an excessive lumbar lordosis usually found in Duchenne Muscular dystrophy?

Answer 14

to counteract an unstable pelvis

Question 15

What is Gower’s manoeuvre?

Answer 15

Child walks hand in and up to stand due to proximal muscle weakness

Question 16

What are the 3 main types of cerebral palsy based on the area of the body which is affected?

Answer 16

Hemiplegic - one side of body affected
Diplegic - both legs affected
Quadraplegic - all 4 limbs affected

Question 17

How is hemiplegic cerebral palsy usually acquired?

Answer 17

If there is an interruption in blood flow preterm

aka during pregnancy

Question 18

Why is physio an important part of cerebral palsy management?

Answer 18

Some muscles develop more than others (e.g. biceps more than triceps) therefore can create contractures which need stretched out in physio

Question 19

What other problems are often associated with cerebral palsy?

Answer 19

Mobility /spasticity problems
Learning difficulties
Epilepsy
Visual/Hearing impairment
Feeding difficulties
Sleep problems
Behaviour problems

Question 20

Why do many children with cerebral palsy develop behaviour problems?

Answer 20

they see other children completing tasks that they themselves cannot do

Question 21

What symptoms present with cerebral visual impairment?

Answer 21

Photosensitivity

Nystagmus (abnormal eye movements)

Question 22

What is the Autistic Triad?

Answer 22

Communication
Social interaction
Flexibility of thought/ Imagination

Question 23

Why are objects of reference used in patients with autism?

Answer 23

They rely on their vision more than speech

e.g. car keys could signal they are going in the car

Question 24

Why do children with autism struggle with frustration when they want something from someone?

Answer 24

They don’t always verbally ask for what they want, they expect others to know what they want

Question 25

Why is turn taking a difficult social interaction for patients with autism?

Answer 25

What another child will do on their turn (e.g. of a toy) is unpredictable
Patient wants routine and predictability

Question 26

Describe an example of unusual ritualistic behaviour common in children with autism

Answer 26

Taking an unusual inanimate object to bed

Question 27

Children with autism respond better to firm touch than to light touch from others. TRUE/FALSE

Answer 27

TRUE

Question 28

What sensory issues may a child with autism face?

Answer 28

• Fussy eater/ not want to take medication
• Textures of clothes
• Sleep
• Toilet training
• Hair washing / cutting
• Nail cutting

Question 29

What different periods of a child’s life must be covered in past medical history in order to diagnose developmental delay?

Answer 29

Perinatal and Birth (Hx of mother as well as child)
Family and Social
School/Nursery

Question 30

What different parts of an examination should be covered when assessing for developmental delay?

Answer 30

Dysmorphism (e.g.  abnormally small/large head?)
Head Circumference
Assess CNS 
Vision
Hearing

Question 31

What healthcare professionals are involved in the early intervention of a child with a developmental delay?

Answer 31

Physiotherapist
Speech and Language Therapist
Occupational Therapist

Question 32

What parts of the body are affected in oculocutaneous albinism?

Answer 32

Decreased iris, hair and skin pigmentation