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68 Cards in this Set

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Developmental disabilities present in an ______ related manner
age
What are some neonatal factors for the development of disabilities?
-severe prematurity
-maternal use of illicit material
-aphyxia
-inborn metabolic disorder
-congenital infections
What are some early childhood risk factors for the development of a disability?
-serious illness/infections
-congenital malformations
What are some other risk factors for the developement of disabilities?
-lack of prenatal care
-medical neglect
-poor nutrition
-young parents
-poor social structure
-mentally disabled parents
To qualify for mental disability your IQ must be what and dx before what age?
70 or less and dx by 18
Subdivisions of IQ:
-mild
-moderate
-profound
-severe
-undefined
-50-70
-35-50
-20-35
-below 20
-can't be tested
What are some chromosomal disorders that can cause mental disabilities?
-Trisomy 13, 18, 21 and Kleinfelters
What are some genetic syndromes that can cause mental disabilities?
-Fragile X
-Prader-Willis Syndrome
What are some developmental brain abnormalities that can cause mental disabilities?
-hydrocephalus with or without meningomyelocele
What are some inborn errors fo metabolism/Neurodegenerative disorders that can cause mental disabilities?
-PKU
-Tay-Sachs
What are some congenital infections that cause mental disability?
-HIV
-CMV
-TOXO
-Rubella
-Herpes
-Syphillis
What are some familial retardation causes of mental disabilities?
-environmental
-syndromic
-genetic

don't really follow this either, but such is life
What are some perinatal causes of mental disability?
-hypoxic ischemic encephalopathy
-IVH
-PVL
-FAS
What are some postnatal causes of mental disibility?
-trauma
-meningitis
-hypothyroidism
What are some clinical manifestations found in a newborn with a mental disability?
-dysmorphic syndromes
-microecephaly
-macrocephaly
-major organ system dysfunction
What are some clinical manifestations found in an early infant (2-4 months) with a mental disability?
-failure to interact with the environment
-concerns about vision and hearing
What are some clinical manifestations found in an older infant (6-18 months) with a mental disability?
-gross motor delay
What are some clinical manifestations found in a toddler with a mental disability?
-language delays or difficulties
What are some clinical manifestations found in preschoolers with a mental disability?
-language dealy
-behavior difficulties including play
-delays in fine motor skills, cutting, coloring, and drawing
What are some clinical manifestations found in school aged children with a mental disability?
-academic underachievement
-behavior difficulties (attention, anxiety, mood, conduct)
What is the dx term used to describe a group of motor syndromes resulting from disorders of early brain development?
cerebral palsy (CP)
WHat is the most commoan can costly form of chronic motor disability that begins in childhood?
CP
What is the incidence of CP?
2 in 1000 life births
Most children with CP are born at term with what?
no complications in either labor or delivery
Less than 10% of children with CP had evidence of what at birth?
intrapartum asphyxia
What are some causes of CP?
-intrauterine exposure to maternal infection
-low birth weight <1000g
-severe prematurity
What are the 4 different manifestations of types of CP?
-spastic hemiplegia
-spastic diplegia
-spastic quadriplegia
-choreoathetoid/ dyskinetic CP
In spastic hemiplegia, there is decreased what?
spontaneous movement on the affected side with hand dominance at an earlier age
What key feature should raise the suspicion of spastic hemiplagia in a child?
hand dominance earlier than 18 months of age
Give me 4 more characteristics of spastic hemiplagia.
-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
In spastic diplegia, there is bilateral spasticity of the what?
legs greater than the arms
What is the first indication of spastic diplegia?
occurs during crawling where the infant drag legs
If spastic diplegia is severe, what becomes impossible?
application of the diaper due to adduction of the hips
In spastic diplegia if there is paraspinal muscle involvement, what might the child not be able to do?
sit up
In spastic diplegia, what is maintained when a child is held by the axillae?
scissoring
Why is spastic quadriplegia the most severe form of CP?
because of marked motor impairments of all extremities and the high association with mental retardation and seizure disorder
Why do people with spastic quadriplegia ahve swallowing difficulities?
due to supranuclear bulbar palsies leading to aspiration pneumonia
What does an MRI show in spastic quadriplegia?
PVL with multicystic cortical encephalomalacia
In spastic quadriplegia, exam show what in all extremeties?
increased tone and spasticity
What is the less common type of CP?
-Choreoathetoid/Dyskinetic cerebral palsy
Chroreoathetoid CP is characteristically hypotonic with what?
poor head control
Give me three characteristics of Choreoathetoid CP?
-seizures are uncommon
-speech is impaired
-intellect is usually preserved
Choreoathetoid CP is most likley associated with what?
asphyxia and kerineterus
What will MRI show in Choreoathetoid CP?
lesions in the globus pallidus and or the thalamus and basal gnaglia
In general, CP treatments require the involvment of what people?
-parents
-physicians
-occupational and physical therapists
-speech pathologist
-social workers
-educators
-developmental psychologists
What are some adaptive equitment that is used for the tx of spastic diplegia?
-walkers
-poles
-standing frames
Tell me about sx for spastic diplegia?
-if pt has marked spasticity to reduce muscle spasm

-prodecure involves a partial rhizotomy
What sx is done in spastic hemiplegia?
release of tight heel cord using tenectomy of the Achilles tendon
What are 3 speicialized things that those with quadriplegia CP need?
-motorized wheel chairs
-special feeding devices
-specialized typewriters
What are some drugs that can be used in Quadriplegia?
botulinum toxin and dentrolene
A neurodevelopmental disorder of unknown etiology buth with strong genetic basis is what?
Autism
Autism is characterized by what?
qualitative impairment in the areas of language developement, social skills and reciprocity, and imagination play
Autism is usually dx before what age/
3
Autism varies based on what?
severity of symptoms
Most ppl with autism ahve impairment in what?
joint attention
Tell me 5 clinical features of play found in autism.
-aberrant characterized by little or nor symbolic play
-ritualistic rigidity
-preoccupation with parts of objects
-streotypical body movements
-marked need for sameness
What 4 cognitive questions are asked at 18-24 month screening to check for autism?
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
What are 4 social or emotional questions that are asked at the 18-24 month visit to screen for autism?
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
What is the mainstay of treatment for Austism?
intensive behavioral therapy beginning at age 3 and targeted twoard speech and language development
For kids with autism, what might need to be added later to help with issues related to lack of social skills?
psychotherapy
What is the most common neurobehavioral disorder of childhood?
ADHD
What are the clinical features of ADHD?
-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
In ADHD what might an MRI show?
asymmetry in the brain and a smaller brian volume of specific structures such as the prefrontal cortex and the basal ganglia
What is the tx for ADHD?
psycho stimulants
Dyslexia is characterized by what?
an unexpected difficulty in reading in children who otherwise possess the intelligence, motivation and opportunities to learn considered necessary for accurate and fluent reading
What are 3 clinical manifestations of dyslexia?
-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
What is the early tx for dyslexia?
-remediation of reading problems
What is the later tx for dyslexia?
-penomic awereness
-fluency
-accommodation