xwith hyperlinks - Tagged

Developmental Delay

• Definition: Developmental delay refers to a significant lag in a child's physical, cognitive, behavioral, emotional, or social development compared to peers.

Neurological Assessment of the Child

Purpose

• Assess the neurodevelopmental status of the child to identify any delays in growth and development.

Assessment and Evaluation Process

Assessment

• Definition: A systematic process of obtaining a history, performing a systems review, and administering tests.

• Aims to gather data about the child’s functional abilities.

• May require referral to additional professionals for comprehensive evaluation.

Evaluation

• Involves clinical judgments made by the physiotherapist based on collected data.

• May result in referring the child to other healthcare professionals when necessary.

Diagnosis

• May not always result in a specific diagnosis.

• Both a process and an outcome involving the evaluation of examination data to identify areas needing intervention.

Prognosis

• Physiotherapist estimates the level of optimal improvement achievable through intervention and the timeframe for this improvement.

Episode of Care

• Refers to the entire course of treatment provided to a child, including ongoing evaluations.

Intervention

• Defined as purposeful, skilled interactions with the child that align with the established diagnosis and prognosis.

• Involvement of other professionals is included when appropriate.

• Ongoing evaluation helps assess the effectiveness of the intervention and may lead to further referrals.

Outcomes

• Evaluation of outcomes can concern various domains:

  • Pathology

  • Impairments

  • Functional limitations and disabilities

  • Health and wellness

  • Societal resources

  • Patient/client satisfaction

Continuous Assessment and Reassessment

• Importance: Continuous assessment is crucial for adapting treatment.

• The therapist adjusts handling techniques according to the child's responses and abilities.

• Assessment is aimed at identifying barriers preventing the child from achieving functional skills appropriate to their developmental stage.

Types of Assessment

Naturalistic Assessment

• Observational assessment within the child’s home or classroom environment.

• No physical intervention; utilizes toys and materials present in the environment.

Arena Assessment

• Involves a multidisciplinary team where one therapist leads the assessment process.

• All team members participate actively to evaluate the child holistically.

Standardized Assessment

• Utilizes developed tools to yield a raw score that correlates with age equivalency or developmental quotients.

Causes of Developmental Delay

• External Factors: Includes forms of neglect and deprivation.

• Neuromuscular Issues: Abnormal muscle tone affecting motor functions.

• Systemic Impairments: Involvement of other bodily systems such as:

  • Cardiovascular

  • Musculoskeletal

  • Integumentary (e.g., burns, skin damage)

• Cognitive Factors: Learning disabilities, communication difficulties, emotional and behavioral responses.

Causes of Mild Gross Motor Development Delay

• Benign Muscular Hypotonia: Represents one of the underlying causes.

• Lack of Experiences: Insufficient gross motor experiences can hinder development.

• Genetic Conditions: Conditions ranging from mild to severe impact gross motor skills.

• Cerebral Palsy (CP): A diagnosis related to motor function deficits.

Assessment Activity

Observation of Bottom Shuffling

• Assess patterns of movement and functionality of two 10-month-old babies observed in provided video clips.

• Evaluate their communication skills and play behavior.

• Consider any concerns regarding their development based on observations.

Hypotonicity

Definition

• A condition characterized by excessively low resistance to passive stretch, often impacting muscle tone and coordination.

Causes

• Results from loss of afferent or efferent neural activity affecting lower motor neurons, leading to alterations in musculoskeletal tissue.

• Problems with descending pathways associated with cerebellar or vestibular disorders disrupt muscle tone regulation.

Child Presentation

• Child exhibits poor posture using joint extension to hold position.

• Standard posture includes arms hanging, excessive kyphosis or lordosis, and legs locked in extension.

• Movement becomes challenging, characterized by reduced coordination and lack of precision in transitions and muscle activation.

Treatment Approaches

Aims

• Support the child in achieving developmental milestones.

Techniques

• Employ small equipment and engage in developmental activities.

• Focus on improving proprioception and activating extensor muscles.

• Protect at-risk joints and strengthen weaker muscle groups.

• Integrate co-contraction activities through age-appropriate play activities.