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68 Cards in this Set
- Front
- Back
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Developmental disabilities present in an ______ related manner
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age
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What are some neonatal factors for the development of disabilities?
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-severe prematurity
-maternal use of illicit material -aphyxia -inborn metabolic disorder -congenital infections |
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What are some early childhood risk factors for the development of a disability?
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-serious illness/infections
-congenital malformations |
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What are some other risk factors for the developement of disabilities?
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-lack of prenatal care
-medical neglect -poor nutrition -young parents -poor social structure -mentally disabled parents |
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To qualify for mental disability your IQ must be what and dx before what age?
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70 or less and dx by 18
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Subdivisions of IQ:
-mild -moderate -profound -severe -undefined |
-50-70
-35-50 -20-35 -below 20 -can't be tested |
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What are some chromosomal disorders that can cause mental disabilities?
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-Trisomy 13, 18, 21 and Kleinfelters
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What are some genetic syndromes that can cause mental disabilities?
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-Fragile X
-Prader-Willis Syndrome |
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What are some developmental brain abnormalities that can cause mental disabilities?
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-hydrocephalus with or without meningomyelocele
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What are some inborn errors fo metabolism/Neurodegenerative disorders that can cause mental disabilities?
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-PKU
-Tay-Sachs |
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What are some congenital infections that cause mental disability?
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-HIV
-CMV -TOXO -Rubella -Herpes -Syphillis |
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What are some familial retardation causes of mental disabilities?
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-environmental
-syndromic -genetic don't really follow this either, but such is life |
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What are some perinatal causes of mental disability?
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-hypoxic ischemic encephalopathy
-IVH -PVL -FAS |
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What are some postnatal causes of mental disibility?
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-trauma
-meningitis -hypothyroidism |
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What are some clinical manifestations found in a newborn with a mental disability?
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-dysmorphic syndromes
-microecephaly -macrocephaly -major organ system dysfunction |
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What are some clinical manifestations found in an early infant (2-4 months) with a mental disability?
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-failure to interact with the environment
-concerns about vision and hearing |
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What are some clinical manifestations found in an older infant (6-18 months) with a mental disability?
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-gross motor delay
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What are some clinical manifestations found in a toddler with a mental disability?
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-language delays or difficulties
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What are some clinical manifestations found in preschoolers with a mental disability?
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-language dealy
-behavior difficulties including play -delays in fine motor skills, cutting, coloring, and drawing |
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What are some clinical manifestations found in school aged children with a mental disability?
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-academic underachievement
-behavior difficulties (attention, anxiety, mood, conduct) |
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What is the dx term used to describe a group of motor syndromes resulting from disorders of early brain development?
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cerebral palsy (CP)
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WHat is the most commoan can costly form of chronic motor disability that begins in childhood?
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CP
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What is the incidence of CP?
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2 in 1000 life births
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Most children with CP are born at term with what?
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no complications in either labor or delivery
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Less than 10% of children with CP had evidence of what at birth?
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intrapartum asphyxia
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What are some causes of CP?
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-intrauterine exposure to maternal infection
-low birth weight <1000g -severe prematurity |
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What are the 4 different manifestations of types of CP?
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-spastic hemiplegia
-spastic diplegia -spastic quadriplegia -choreoathetoid/ dyskinetic CP |
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In spastic hemiplegia, there is decreased what?
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spontaneous movement on the affected side with hand dominance at an earlier age
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What key feature should raise the suspicion of spastic hemiplagia in a child?
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hand dominance earlier than 18 months of age
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Give me 4 more characteristics of spastic hemiplagia.
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-arm is more involved than the leg
-hand manipulation difficulties are abvious by age one -walking is delayed until 18-24 months -affected child often walks on tiptoes |
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In spastic diplegia, there is bilateral spasticity of the what?
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legs greater than the arms
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What is the first indication of spastic diplegia?
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occurs during crawling where the infant drag legs
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If spastic diplegia is severe, what becomes impossible?
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application of the diaper due to adduction of the hips
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In spastic diplegia if there is paraspinal muscle involvement, what might the child not be able to do?
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sit up
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In spastic diplegia, what is maintained when a child is held by the axillae?
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scissoring
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Why is spastic quadriplegia the most severe form of CP?
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because of marked motor impairments of all extremities and the high association with mental retardation and seizure disorder
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Why do people with spastic quadriplegia ahve swallowing difficulities?
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due to supranuclear bulbar palsies leading to aspiration pneumonia
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What does an MRI show in spastic quadriplegia?
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PVL with multicystic cortical encephalomalacia
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In spastic quadriplegia, exam show what in all extremeties?
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increased tone and spasticity
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What is the less common type of CP?
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-Choreoathetoid/Dyskinetic cerebral palsy
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Chroreoathetoid CP is characteristically hypotonic with what?
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poor head control
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Give me three characteristics of Choreoathetoid CP?
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-seizures are uncommon
-speech is impaired -intellect is usually preserved |
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Choreoathetoid CP is most likley associated with what?
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asphyxia and kerineterus
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What will MRI show in Choreoathetoid CP?
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lesions in the globus pallidus and or the thalamus and basal gnaglia
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In general, CP treatments require the involvment of what people?
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-parents
-physicians -occupational and physical therapists -speech pathologist -social workers -educators -developmental psychologists |
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What are some adaptive equitment that is used for the tx of spastic diplegia?
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-walkers
-poles -standing frames |
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Tell me about sx for spastic diplegia?
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-if pt has marked spasticity to reduce muscle spasm
-prodecure involves a partial rhizotomy |
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What sx is done in spastic hemiplegia?
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release of tight heel cord using tenectomy of the Achilles tendon
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What are 3 speicialized things that those with quadriplegia CP need?
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-motorized wheel chairs
-special feeding devices -specialized typewriters |
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What are some drugs that can be used in Quadriplegia?
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botulinum toxin and dentrolene
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A neurodevelopmental disorder of unknown etiology buth with strong genetic basis is what?
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Autism
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Autism is characterized by what?
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qualitative impairment in the areas of language developement, social skills and reciprocity, and imagination play
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Autism is usually dx before what age/
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3
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Autism varies based on what?
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severity of symptoms
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Most ppl with autism ahve impairment in what?
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joint attention
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Tell me 5 clinical features of play found in autism.
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-aberrant characterized by little or nor symbolic play
-ritualistic rigidity -preoccupation with parts of objects -streotypical body movements -marked need for sameness |
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What 4 cognitive questions are asked at 18-24 month screening to check for autism?
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Does child:
-point to indicate intrest in something -point to ask for something -enjoys climbing on things such as up stairs -plays properly with small toys w/out just mouthing or dropping them |
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What are 4 social or emotional questions that are asked at the 18-24 month visit to screen for autism?
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Does the child:
-engage in make believe and pretend play -play peek a boo/hide in seek -brings toy to share with or show caregiver -take an interest in other children |
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What is the mainstay of treatment for Austism?
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intensive behavioral therapy beginning at age 3 and targeted twoard speech and language development
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For kids with autism, what might need to be added later to help with issues related to lack of social skills?
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psychotherapy
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What is the most common neurobehavioral disorder of childhood?
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ADHD
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What are the clinical features of ADHD?
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-inattention, including increased distractibility and difficulty sustaining attention
-poor impulse control and decreased self-inhibitory capacity -motor overactivity and motor restlessness -affected children experience academic underachievement, problems with interpersonal relationships, and low self esteem |
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In ADHD what might an MRI show?
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asymmetry in the brain and a smaller brian volume of specific structures such as the prefrontal cortex and the basal ganglia
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What is the tx for ADHD?
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psycho stimulants
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Dyslexia is characterized by what?
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an unexpected difficulty in reading in children who otherwise possess the intelligence, motivation and opportunities to learn considered necessary for accurate and fluent reading
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What are 3 clinical manifestations of dyslexia?
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-cardinal signs are labored approach to decoding words, word recognition, and text reading
-listening comprehension is typically robust -difficulty in spelling typically reflects the phonologically based difficulty observed in reading |
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What is the early tx for dyslexia?
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-remediation of reading problems
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What is the later tx for dyslexia?
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-penomic awereness
-fluency -accommodation |
