Children with Special Needs

Question 1

What are some features of normal development?

Answer 1

• Constant pattern
• Sequential acquisition of skills
• Median age vs limit age
• Genetic factors
• Environmental influences

Question 2

What are the 5 aspects of child development?

Answer 2

• Gross motor skills
• Fine motor skills
• Speech and language
• Social, personal and activities of daily living
• Performance and cognition

Question 3

What is developmental delay?

Answer 3

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

Question 4

How is learning disability different from developmental delay?

Answer 4

• Significant impairment in intellectual functioning and affects the persons ability to learn and problem solve in daily life
• Nearly always been present since childhood

Question 5

What does developmental delay present through?

Answer 5

• Routine health surveillance
• Parental concern
• Professional contact – nursery/daycare
• Opportunistic health contact
• UK Healthy Child Programme (HCP)

Question 6

What are different ways of assessing development?

Answer 6

• 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

Question 7

What are some primary care assessment tools used for development monitoring?

Answer 7

• 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

Question 8

What are some secondary care assessment tool for development delay?

Answer 8

• Griffiths mental development scales
• Bayley scales of infant development
• Wechsler preschool and primary scales of intelligence

Question 9

What are the 3 different ways to quantify developmental ability?

Answer 9

• Delay
  
  • Global or isolated
• Disorder
  
  • Abnormal progression and presentation such as autism
• Regression
  
  • Loss of milestones

Question 10

What parts of the history are particularly important for developmental delay?

Answer 10

• 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

Question 11

What parts of the examination are important for developmental delay?

Answer 11

• 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

Question 12

What are examples of common syndromes?

Answer 12

• Down syndrome
• Fragile X syndrome
• Williams syndrome

Question 13

What are some positive and negative red flag signs in terms of developmental delay?

Answer 13

• 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

Question 14

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

Answer 14

• 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

Question 15

What are some common investigations for developmental delay?

Answer 15

• 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

Question 16

What genetic testing is often used to investigate developmental delay?

Answer 16

• Chromosomal analysis (karyotype)
• Fragile X, FISH, array

Question 17

What are some common developmental problems in each area:

• motor
• sensory
• language/cognitive
• social/communication

Answer 17

• Motor
  
  • Delayed maturation
  • Cerebral palsy
  • Developmental coordination disorder
• Sensory
  
  • Deafness
  • Visual impairment
  • Multisensory impairment
• Language/cognitive
  
  • Specific language impairment
  • Learning disability
• Social/communication
  
  • Autism
  • Asperger syndrome
  • Elective mutism

Question 18

What is the general management for developmental delay?

Answer 18

MDT approach:

• Developmental paediatrician
• Speech and language therapist
• OT/PT
  
  • Functional impairments and strengths
• Psychologist
• Social worker
• Geneticist

Question 19

What are some local services for developmental problems?

Answer 19

• Community paediatric clinics
• Child development teams
• MDT assessment
• Therapy services

Question 20

When are children said to have additional support needs?

Answer 20

Child is said to have this if they need additional support with their education

Question 21

What does ASL stand for?

Answer 21

Additional support for learning

Question 22

What are some reasons a child might need additional support for learning?

Answer 22

• Difficulties with mainstream approaches to learning
• Disability or health needs such as motor or sensory impairment, learning difficulties or autistic spectrum disorder
• Family circumstances
  
  • Such as young people who are carers or parents

Question 23

What are different kinds of unique plans for children with additional support needs?

Answer 23

• Personal development plan (PDP)
• Individualised educational plans (IEP)
• Co-ordinated support plan (CSP)
  
  • Only legal document
• Child’s plan

Question 24

What plan for additional support for learning is the only legal document?

Answer 24

• Personal development plan (PDP)
• Individualised educational plans (IEP)
• Co-ordinated support plan (CSP)
  
  • Only legal document
• Child’s plan

Question 25

What is on a personal development plan?

Answer 25

* Plans how child learnings * Assesses progress * Allows action

Question 26

What is on an individualised educational plan?

Answer 26

* Detailed plan for child’s learning * Contains specific, short term learning targets and the time scale for them to be reached * Targets are * Specific, measurable, achievable, relevant, timed

Question 27

What is the purpose of a co-ordinated support plan?

Answer 27

* Legal document * Ensure all professionals helping child work together * Is for children in local authority school education and needing significant additional support * Complex or multiple needs * Needs likely to continue for \>1 year * Support required by \>1 agency

Question 28

What is the criteria to have a co-ordinated support plan?

Answer 28

* Is for children in local authority school education and needing significant additional support * Complex or multiple needs * Needs likely to continue for \>1 year * Support required by \>1 agency

Question 29

What legislation is the childs plan apart of?

Answer 29

* In line with the ‘Getting it right for every child’ (GIRFEC) approach * **Part of the Children and Young People Act 2016** * Created if child or young person needs extra support to meet their wellbeing needs such as access to mental health services or respite care * Contains information about * Why child needs support * Type of support needed * How long support should be provided * Can include a IEP or CSP

Question 30

What information is on a child's plan?

Answer 30

* In line with the ‘Getting it right for every child’ (GIRFEC) approach * Part of the Children and Young People Act 2016 * Created if child or young person needs extra support to meet their wellbeing needs such as access to mental health services or respite care * **Contains information about** * **Why child needs support** * **Type of support needed** * **How long support should be provided** * Can include a IEP or CSP

Question 31

What is the long term outlook for children with developmental issues?

Answer 31

* Depends on nature of problem * Acquisition skills * Social and emotional needs