What are the four domains of childhood develoment?
- Speech and Language
- Gross motor skills
- Fine Motor skills
- Social skills
What are the possible patterns of abnormal development
- Slow but steady
- Plateau (no further development)
- Or regression
What does developmental progress depend on?
Combiation of biological and environmental influecnes
When are developmental abnormalities in children normally picked up?
(i) identification of antenatal or postnatal risk factors; (ii) developmental screening; or (iii) concerns raised by parents or other healthcare professionals. Thus, these children may present at any age.
Which factors influece a developmental delay?
What are the different types of developmental delay?
They can be
- Global
- affectinv every domain of development or
- Specific
- affecting only one/several domains of development
- language
- motor
- social/cognitive
- sensual
- affecting only one/several domains of development
What are possible causes of global developmental delays?
- Chromosomal abnormalities
- e.g. Down’s syndrome, Fragile X
- Metabolic
- e.g. hypothyroidism, inborn errors of metabolism
- Antenatal and perinatal factors
- Infections, drugs, toxins, anoxia, trauma, folate def
- Environmental-social issues
- Chronic illness
Explain the approact to assess develpmental delays
- History taking
- family history
- birth history
- parental anxiety
- PMHX
- preceding milestones
- expected milestones for age
- Examination
- developmental assessment + general neurological examination
- further investigations
What is Cerebral palsy?
learning difficulties, epilepsy, visual impairment, hearing loss, feeding difficulties, poor growth, and respiratory problems.
- 0.1-0.2% incidence
- most causes: antenatal
- non-progressive lesion in the brain before the age of 2
Summarise the main features and characteristics about autism spectrum disorders
- Prevalence is 3-6 per 1000 live births
- Boys>girls
- Usually presents between 2 – 4 years of age
- Features include
- (1) impaired social interaction;
- (2) speech and language disorder; and
- (3) imposition of routines with ritualistic and repetitive behaviour.
- Comorbidities include learning and attention difficulties, and epilepsy
Summarise the main features and characteristics of ADHD
Attention deficit hyperactivity disorder
Diagnosted via
- (1 )Inattention;
- (2) Hyperactivity;
- (3) Impulsivity;
- (4) Lasting > 6 months;
- (5) commencing < 7 years and inconsistent with the child’s developmental level
- Boys more common than girls
- associated with other onduct disorder, anxiety disorder & aggression
- Adults: are more likely to become antisocial + more criminal and ilicit drug use
Summarise the management of ADHD
- Psychotherapy – Behavioural therapies
- Family therapy
- Drugs – If behavioural therapy alone insufficient; stimulants, e.g. methylphenidate (Ritalin), amphetamines (dexamphetamine)
- Diet – Some children benefit noticeably from exclusion of certain foods from their diet, e.g. red food colouring
Summarise the main facts about lerning disabilities
Classified as mild, moderate, severe and profound
Prevalence: Moderate: 3%, severe 0.4%
Causes
- 25% not identifiable
- 30% chromosomal
- 20% other identifiable syndromes
- 20% postnatal cerebral insults
- 1% metabolic/degenerative
Presentation
- reduced intellectual functioning,
- delay in early milestones,
- dysmorphic features, ± associated problems (epilepsy, sensory impairment, ADHD)
What are the main developmental warning signs?
- Different patterns of develpment
- slow but steady
- REgression
- Plateau
- persistance of primitive reflexes
Explain the role of MDTs in abnormal develpment of children
Needed for
- Assessment
- Diagnosis and disclosure
- Development of Management programme
- Social support
What are the objectives of management of developmental delays in children?
Maximise mobility
Minimise discomfort
Promote speech and language
Promote social and emotional health
What are the main milestones in gross motor develppment of children?
- Usupported sitting at 9 Month
- Crawling 9 Monts
- Walking at 1 year
