Pediatric Exam 2 (Final)
What is the diagnostic criteria for intellectual disability?
-IQ below 75
-limitations in 2 or more areas within community environments typical of age,
peers and culture
-present before age 18
What can cause intellectual disability?
-injury (before or after birth)
-Disease
-Birth defects
-infections (before, during or after)
-severe head injury
-stroke
What can help prevent intellectual disabilities?
-vaccinations
-prenatal care
-genetic counseling
-prenatal diagnosis (ultrasound or amniocentesis)
What conditions are associated with intellectual disability?
-down syndrome
-fragile X
-autism
-adhd
-CP
What precent of children with CP have intellectual disabilities?
50%
What percent of the world has intellectual disabilities?
1-3%
When is the typical diagnosis for intellectual disability?
it depends....
prenatal or perinatatal
delayed motor milestones
regression (Rett Syndrome)
Autism (infancy)
What is the most common associated impairments with intellectual disability?
Basis in CNS pathology
-flexibility
-force production/strength
,-coordination
-postural control and balance
-endurance
-efficiency
How can someone with a intellectual impairment learn?
-fewer items
-repetition
-harder time maintaining skills
-slower response time
-less responses available in tool belt
What outcome measure is used for adaptive behaviors, self-help and mobility
skills?
PEDI- pediatric evaluation of disability inventory
norm referenced for (6 mon to 7 years)
criterion referenced for (older or equal to 7 years brain capacity)
What is the Bayley Scales of Infant Development?
a measure that evaluates an infant's motor performance development from 2
to 42 months
Why do we use intellectual referencing?
used to determine whether children are eligible for services
downsyndrome is caused by
Trisomy 21 95% of the time
What is the prevalence of down syndrome?
1 in every 772 births, about 5100 in US each year
Incidence of down syndrome goes up with what?
maternal age.
35 = 1 in 350
40 = 1 in 100
45= 1 in 30
What is the diagnosis of down syndrome prenatally versus at birth?
prenatally: "markers", 100% accuracy diagnostic tests (via amniocentesis or
chorionic villus sampling)
At birth: identified by presence of physical traits, chromosomal analysis
confirmation, and a genetic test
What are common characteristics of motor development in children with down
syndrome?
hypotonia
hyperflexibility
postural control and balance deficits
, delayed motor skills
Gross motor level off around 3 years of age
What does the common cognitive progression look like for someone with
down syndrome?
mod to severe intellectual disabilities
IQ decreases with age
early onset dementia (around 40)
may have low motivation
Common medical problems with down syndrome?
1. congenital heart defects (may need pre-med)
2. hearing impairments
3. seizures
4. vision deficit
5. obesity
6. skin conditions
7. hypothyroidism
8. atlantoaxial instability
What predictive outcome measures do we use for ID and DS?
TIMP
GMFCS
What current performance outcome measures do we use for ID and DS?
PEDI
GMFM
What are some PT interventions for DS?
-positive reinforcement
-instructions or modeling (physical prompts/facilitation)
-using shaping or chaining (reinforce components to the target behavior.
(standing from a chair to walking to opening doors in order to be able to walk
to lunch)
What are the types of AMC? (arthogryposis multiplex congenita)
amyoplasia
What is the etiology of AMC?
presence of contractures in 2 or more areas
cause is unknown
usually fetal akinesia
weakness immobilizes the fetal joints
What is the clincal presentation of AMC?
contractures of various joints
typically legs and arms affected (LE more than UE)
underdevelopment muscles of affected limb (soft, doughy)
What is the diagnostic criteria for intellectual disability?
-IQ below 75
-limitations in 2 or more areas within community environments typical of age,
peers and culture
-present before age 18
What can cause intellectual disability?
-injury (before or after birth)
-Disease
-Birth defects
-infections (before, during or after)
-severe head injury
-stroke
What can help prevent intellectual disabilities?
-vaccinations
-prenatal care
-genetic counseling
-prenatal diagnosis (ultrasound or amniocentesis)
What conditions are associated with intellectual disability?
-down syndrome
-fragile X
-autism
-adhd
-CP
What precent of children with CP have intellectual disabilities?
50%
What percent of the world has intellectual disabilities?
1-3%
When is the typical diagnosis for intellectual disability?
it depends....
prenatal or perinatatal
delayed motor milestones
regression (Rett Syndrome)
Autism (infancy)
What is the most common associated impairments with intellectual disability?
Basis in CNS pathology
-flexibility
-force production/strength
,-coordination
-postural control and balance
-endurance
-efficiency
How can someone with a intellectual impairment learn?
-fewer items
-repetition
-harder time maintaining skills
-slower response time
-less responses available in tool belt
What outcome measure is used for adaptive behaviors, self-help and mobility
skills?
PEDI- pediatric evaluation of disability inventory
norm referenced for (6 mon to 7 years)
criterion referenced for (older or equal to 7 years brain capacity)
What is the Bayley Scales of Infant Development?
a measure that evaluates an infant's motor performance development from 2
to 42 months
Why do we use intellectual referencing?
used to determine whether children are eligible for services
downsyndrome is caused by
Trisomy 21 95% of the time
What is the prevalence of down syndrome?
1 in every 772 births, about 5100 in US each year
Incidence of down syndrome goes up with what?
maternal age.
35 = 1 in 350
40 = 1 in 100
45= 1 in 30
What is the diagnosis of down syndrome prenatally versus at birth?
prenatally: "markers", 100% accuracy diagnostic tests (via amniocentesis or
chorionic villus sampling)
At birth: identified by presence of physical traits, chromosomal analysis
confirmation, and a genetic test
What are common characteristics of motor development in children with down
syndrome?
hypotonia
hyperflexibility
postural control and balance deficits
, delayed motor skills
Gross motor level off around 3 years of age
What does the common cognitive progression look like for someone with
down syndrome?
mod to severe intellectual disabilities
IQ decreases with age
early onset dementia (around 40)
may have low motivation
Common medical problems with down syndrome?
1. congenital heart defects (may need pre-med)
2. hearing impairments
3. seizures
4. vision deficit
5. obesity
6. skin conditions
7. hypothyroidism
8. atlantoaxial instability
What predictive outcome measures do we use for ID and DS?
TIMP
GMFCS
What current performance outcome measures do we use for ID and DS?
PEDI
GMFM
What are some PT interventions for DS?
-positive reinforcement
-instructions or modeling (physical prompts/facilitation)
-using shaping or chaining (reinforce components to the target behavior.
(standing from a chair to walking to opening doors in order to be able to walk
to lunch)
What are the types of AMC? (arthogryposis multiplex congenita)
amyoplasia
What is the etiology of AMC?
presence of contractures in 2 or more areas
cause is unknown
usually fetal akinesia
weakness immobilizes the fetal joints
What is the clincal presentation of AMC?
contractures of various joints
typically legs and arms affected (LE more than UE)
underdevelopment muscles of affected limb (soft, doughy)
