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21 Cards in this Set
- Front
- Back
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What is "Developmental Surveillance"?
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The classic method when pediatricians, experts in child behavior and development, observe the child and/or parent-child interaction and determines if this is normal or not
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3 developmental screening tests
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Denver Developmental Screening Test II (DDSTII)
Ages and Stages Parents Evaluation of Developmental Status (PEDS) |
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Denver Developmental Screening Test II (DDSTII)
what is sensitivity and specificity? |
80%/80%
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What is the format of the Ages and Stages test
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Parent completed developmental questionnaire with data specific by age
Separate packet for ages 4 months to age 5 years – 2 month intervals to age 2 years, then 3 month to age 3, then every 6 months to age 5 |
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Pros of Ages and Stages test
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Most detailed for parents who are motivated
Teaches parents (and learners) milestones expected Provided as a CD to print forms |
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Cons of Ages and Stages test
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Developmental ages do not always match with AAP periodicity…14 month standard at 15 month
Storage and confusion for staff Significant parent time to complete may mean fewer answered comprehensively |
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Pros of denver test
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Teaches milestones
Easy to interpret in busy office Inexpensive Fun to do with a cooperative child Serves as a recorded, developmental “growth chart” |
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Cons of denver test
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Requires cooperation of infant or toddler
Have to use the DDST II “kit” to do test Not all tasks are culturally appropriate for all kids (blocks stacking not always with blocks at home!) Significant time to use |
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What is sensitivity and specificity of Ages and Stages test
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80/80
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Describe the Parents Evaluation of Developmental Status
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Predicated on two assumptions
Parents know their children the best Parents are naturally inclined to compare their children with other kids of the same age Simple 10 item questionnaire that is the same for ages birth to 8 years. |
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Pros of PEDS test
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Very easy to administer
Elicits behavioral concerns even if not part of surveillance Simple forms for the chart Performs as well as others, even if simple! |
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Cons of PEDS test
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Feels “different” when use it…not milestone driven, so still do some surveillance with it
Dependent on English Language or foreign language forms; validated version wording specific May seem to recommend over-referral |
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High yield issues:
Initial office visit (1-2 weeks) Discuss fussy crying coming Prevent _______ baby syndrome Two and Four month visit rarely with behavioral concerns Use this time for safety and _______ Six months – start of __________ and stranger anxiety, should sleep through night |
High yield issues:
Initial office visit (1-2 weeks) Discuss fussy crying coming Prevent shaken baby syndrome Two and Four month visit rarely with behavioral concerns Use this time for safety and nutrition Six months – start of separation and stranger anxiety, should sleep through night |
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High yield issues:
Nine months – preparing for exploration Review ______ prevention in the house Twelve months – beginning of _________ Set limits, reward wanted behaviors Expected appetite drop and finicky eating Limit the rules and be consistent Fifteen months – Emerging independence Use discipline to ______, not punish, review time out vs. corporal punishment |
High yield issues:
Nine months – preparing for exploration Review Injury prevention in the house Twelve months – beginning of tantrums Set limits, reward wanted behaviors Expected appetite drop and finicky eating Limit the rules and be consistent Fifteen months – Emerging independence Use discipline to teach, not punish, review time out vs. corporal punishment |
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High yield issues:
Eighteen months Allow assertiveness within limits Expect nightmares _______ training approaches Screen for _______ (either 18 months or 2 years) |
High yield issues:
Eighteen months Allow assertiveness within limits Expect nightmares Toilet training approaches Screen for Autism (either 18 months or 2 years) |
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Screening Test for autism (modified)
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M-CHAT
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High yield issues:
Two years – “The TERRIBLE Twos” Beginning ______ training when ready Anticipate the broad range of behavior issues “Independent” play together – don’t expect _______ of toys After the third birthday, behavior issues calm down…in many ways until adolescence! Encourage Head Start (or Pre-K, if not available) if able to easily separate from parents |
High yield issues:
Two years – “The TERRIBLE Twos” Beginning toilet training when ready Anticipate the broad range of behavior issues “Independent” play together – don’t expect sharing of toys After the third birthday, behavior issues calm down…in many ways until adolescence! Encourage Head Start (or Pre-K, if not available) if able to easily separate from parents |
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Genetics of autism:
Genetics – identical twins – one with autism, other has a __% chance; fraternal 3% May be associated with Fragile X, Tuberous Sclerosis, Congenital Rubella, and untreated PKU. Thalidomide during pregnancy increases risk |
Genetics of autism:
Genetics – identical twins – one with autism, other has a 75% chance; fraternal 3% May be associated with Fragile X, Tuberous Sclerosis, Congenital Rubella, and untreated PKU. Thalidomide during pregnancy increases risk |
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Cause of autism
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yet to be determined
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Meds for autism
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Medications used for behavior control only – only risperdone is approved, others “off-label”
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Autism and vaccines
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No relationship to MMR
No relationship to thimerosol Very few any longer have this – most pediatric vaccines are now unit dose to avoid preservative No drop in autism since this shift |
