Development
Terms
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- Causes of developmental delay
- 1. physical or psychosocial needs not being met 2. poor health 3. developmental disorder 4. neuro disease or damage 5. genetic 6. sensory impairment
- Causes of motor delay
- cerebral palsy muscular dystrophy spina bifida global - Downs
- causes of language delay
- hearing problem environmental deprivation oromotor problem eg cleft palate, cerebral palsy general delay (syndrome)
- Causes of global delay
- genetic (chromosomal) metabolic (PKU) structural (hydrocephalis) antenatal (teratogens, infection, malformation) perinatal (premature, hypoxia) postnatal (trauma, infection)
- When to suspect a hearing problem
- Not startled by noise at 3 months Doesn't turn to noise at 3-4 months Speech delay, learning problems, behavioural problems
- Causes of sensorineural hearing loss
- genetic ante/perinatal: infection, asphyxia, preterm, bilirubin raised postnatal: meningitis, encephalitis, head injury, medications Hearing loss does not improve, requires implant or signing
- Causes of conductive hearing loss
- secretory otits media (glue ear) eustachian dysfunction (Downs, cleft palate) wax build up
- When to suspect vision problems
- lack of eye contact visual inattention random eye movements squint, nystagmus, photophobia, no red reflex, white pupil
- Causes of visual impairment
- genetic - cataract, retinoblastoma anti/perinantal - congenital infection, retinopathy of prematurity (ROP), hypoxic/ischaemic encephalopathy, cerebral injury post natal - trauma, infection
- Causes of white pupils
- retinoblastoma retinopathy of prematurity cataracts pseudoglioma
- Cerebral palsy
- chronic disorder of posture and movement, caused by non-progressive CNS lesion sustained before 2 yrs. Results in poor motor development +/- learning disability +/- epilepsy incidence of 2:1000 lifespan of 20yrs if quad
- Features of cerebral palsy
- - weakness, paralysis, delayed milestones (GM esp), seizure, language delays (oromotor issues) - difficulty co-ordinating purposeful movement - spasticity (pyramidal lesion) - dystonia (basal ganglia)
- Aetiology of cerebral palsy
- Strong association with LBW, preterm Timing: - 75% prenatal (alch, CMV, rubella, XR, antepartum haemorrhage (hypoxia)) - 10-15% perinatal (birth trauma, low glucose, raised bilirubin) - 5-10% postnatal (trauma, IVH, meningoencephalitis)
- Autism
- Triad of difficulties before 3 yrs: 1. Language disorder: 1/2 never speak, poor comprehension, echo 2. Difficulty relating to others: indefferent, no eye contact, no normal attachemnts, loners, don't appreciate others feelings 3. Rituals/routines with poverty of imagination: same foods, ways of doing things, disruptive, tantrums, odd motor patterns, seizures