Abnormal Development

?

What are the areas of development?

Social

Fine motor

Gross motor

Language and hearing 

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What is classes as abnormal development?

If a baby has delayed development in all four areas then they have global development delay. It is only called this for children aged 5 or under. If they are over 5 they have a learning disability 

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What is normal development?

The normal development trajectory is that over time you gain more skills.

A huge worry is if you are not gaining more skills or if you learn a skill and then go backwards and no longer have the skill. 

If a child regresses than is it a neuro-developmental emergency 

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What is a mild/moderate learning difficulty?

quite common and affect 1/100 children

defined by measuring IQ

Very few children are measured or measured by a psychologist. 

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What is a severe learning difficulty?

1 in 1000

IQ below 35

Often co-morbid. E.g if a child can only babble this is normal for a 1 year old but not of a 3 year old. 

Complex health, social and educational needs 

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What is cerebral palsy?

Occurs 2/1000

Caused by a single injury to the brain.

Commenst cause - happens in the womb and baby is born with it. It is often undetected until 9 months-3.

May happen during birth also but this is less common.

May also happen if the child has a head injury when they are young.

Problems with moving and posture 

Different Classifications

Prenatal vs  Perinatal vs Postnatal causes

Has a really broad phenotype

Developmental delay but not always

VERY WIDE SPECTRUM DEPENDING HOW MUCH OF TEHE BRAIN WAS INJURED AND WHERE IT WAS INJURED 

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What is abnormal language development?

When both Expressive and receptive language are affected

language delay = not reaching milestones when supposed too 

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what is autism?

1/100 - common

Triad of functional impairments affecting:

-socialisation , communication and repetitive behaviour

Pervasive - the chid will have these three types of behaviours in every setting , all of the time

3M:1F= More common for males .

Spectrum - At one end you may have a child who is non verbal and cannot communicate via words , gesture or eye contact . At the other end you have a child with aspergers who has normal language development but who cannot read a social situation. 

Picture exchange cards - child may hand a picture of banana to nursery worker to show they want a bannana. 

Have to look at what is going on with the child though e.g has he witnessed domestic violence or is it because he is autistic?

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What is a hearing impairment?

Sensorineural Impairment e.g connection between ear and brain - rare

Conductive impairment e.g ear stopping sound getting through to the brain- common

Can present in delayed speech

Newborns are always screened for hearing loss but not all children are picked up

Children with conductive hearing loss will have such bad hearing it will affect their development 

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What is a visual impairment?

Common - 10% of children have refractive errors

More common with other disabilities e.g autism, hearing impairment and cerebral palsy

Squint- common

Blind baby = developmental emergency. - Identifed by baby not reacting to visual stimulations or not following adult around the room with their eyes.

Causes - eye or brain

Visual impairment affects all domains. If you cannot see it will affect your gross motor - tripping up. Harder to socialise. Delayed crawling and walking. Effecrs fine motor skills e.g jigsaw puzzle. Effects language development as adult cannot ppint to a tree and say tree.

QTVI will come in to schools and advice teachers how to teach adequately 

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What are specific learning difficulties?

e.g dyslexia

presents with school problems

diagnosis is made by educational psyhcologist 

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What is ADHD?

Affects 5%.

Children under 5 rarely diagnosed as all kids are hyperactive/attention seeking.

Triad - Impulsivity, Reduced attention span, Hyperactivity

Born with it but persists into school and affects your learning/socialisation

Medical genetic disorder

Often confused with poor parenting but can come hand in hand e.g adhd parent=poor parenting and genetics passed on- runs in families

Sometimes abnormally active in the womb

Often parent may be undiagnosed 

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What is down-syndrome?

Floppy muscles

Delay in learning to sit, walk etc.

Learning difficulties associated

Get a variety of other medical problems e.g heart problems. But also almost guaranteed to have hearing problems and visual problems. May also struggle with language which may or may not be associated with hearing and visual problems.

Often a global delay

Vast majoirty of children will be able to walk despite floppy muscles. 

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How can prematurity cause abnormal development?

Brain problems e.g may develop cerebral palsy.

Might have no problems at all.

Might have behavioural problems such as inactivity and hyperactivity.

Probably will need support with breathing. If baby needs support with breathing for a large period of time , the baby may develop problems with their lungs.

Normal pregnancy lasts up to 42 weeks. Babies can survive from 22 weeks with extreme support but they will have a number of problems and perhaps a poor quality life too. 

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How can neglect and abuse affect development?

Affects development adversely

Neglect may mean that the baby cannot interact or communicate. If an adult isnt talking to you or engaging in conversation then you are not going to pick up language.

Neglected children may not grow properly/growth is often limited.

Children will feel enormous amounts of anxiety if they witness traumatic experiences such as domestic violence. 

Terrible untreated nits can cause anameia. Anaemic children find learning and activity difficult because they experience exhaustion. 

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How can you work with children who need support?

Working together.

Picture a circle with the child and their family in the middle . Surrounding them is acute health services, schools, the local community, social services, voluntary sector, specialist health services, GP, Community health.

Family has to work with a variety of teams to promote development. 

E.g specialist health servicees - down syndrome may mean child has hole in her heart.

Volunatry sector - give parents a break every now and then by providing services for child. 

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