significant sub-avg intellectual functioning

decrease intellectual functioning is accompanied by significant limitations in:

adaptive functioning in at least two adaptive skill areas of-->

communication, self-care, home living, social/interpersonal skills, use of community resources, self-direction, health and safety, functional academic skills, leisure and work

IQ of <70-75 & supports needed in environment and ofr participation

Developmental disabilities Assistance and Bill of Rights Act

Defines ID as something through out life

Need three areas

DO NOT need an IQ test

Learning a smaller # of things

Need increased number of repetitions in order to learn

Difficulty generalizing skills & maintaining those skill that are not regularly practiced

Slower response times

Limited repertoire of responses

Fragile X syndrome

Prader Willi Syndrome

Down Syndrome

Hypotonia

Poor Coordination

Poor motor planning

Seizures

Hyper-extensible fingers joints

Prminent jaw

Scoliosis

Mitral valve prolapse

Large body size

Developmental delay

Severe hypotonia

Feeding problems in infancy

Rapid weight gain

Poor fine and gross motor coordination

short stature small hands and feet

may be associated with cor pulmonale

Extra Gene on chromosome 21 (Trisomy 21)

Most common cuase of ID @ 1/800 or 1000 births

Increased incidence in mothers of advanced maternal age

Brachycephaly (flat back of the head)

Flat contoured face

Depressed nasal bridge with smal nasal openings (effects breathing)

Narrow, slightly slanted eyelids

Small mouth with narrow palate (effects eating)

Narrow slightly slanted eyelids

Protuberant abdomen (associated with hypotonia)

Small hands and feet

Single palmar crease ( 50%) aka siminin crease

Wide space between first and second toes

Microcephaly (smaller brain)

Decreased secondary sulci

increased alzheimer tangles with age

decreased and delayed myelination

COgnitive impairments

motor incoordination

hypotonia

sensory deficits (vision, hearing ,sensory intergration (could be either seeker or adverter of sensory info)

40% change of congenital heart defects such as:

Atrioventricular canal defects

Ventriculoseptal defects

shortness of breath and fatigue

can't put on wieght or finish bottle

Linear growth deficits (short fingers or toes)

Ligamentous Laxity (Collagen deficit)

Pes planus

Patellar instability

Scoliosis (52%) (lack ability to keep the trunk upright

Atlanto-axial instability (odontoid ligament hold altal to the dens)

Hip subluxation

Gait changes, urinary retention, reluctance to move neck, increased DTR

exaggerated neck flexion

extension

rotation

postions or movements that may cause twisting or undue forces

Roll ~6 months (Normal 4-6 mnths)

Sit by 12 months (6-8 mnths)

Creep by 24 mnths (8-10 mnths)

Walk by 30 mnths (10-18, 12)

Walk, Running, Jumping by or 4 or 6 yrs (3-5 yrs)

Is treadmill training with children w/ down syndrome helpful in aiding them in meetin developmental milestones?

what intensity should the treadmill be on?

what author researched this?

yes

High intensity turn that baby up. NOT jk low intensity is best! LOl BTW OMgosh

Same with posterior walker

Ulrich and Lloyd

Address gross and fine motor delay

Family education on atlanto-axial instability (do not scare them to much)

Orthotic management as indicated

PRevention and Tx of secondary impairments

Encourage general physical fitness

Looper J, orthotic needs in children w/ D.S. found what?

In loopers other article they found what?

SMO decreased cadence and increased cycle time

Other article: SMOs appear to have a detrimental effect on overall motor skill development in infants and new walkers

SMOs shoudl be postponed until walking independently

Autistic Disorder

Aspergers Disorder

Pervasive Developmental Disorder Not Otherwise Specified

REtt's Disorder

Childhood Disintegrative Disorder

Social interactions impairment

Communication deficits

Rigid repetitive behaviors

Delays  or abnormal function in at least one of the following areas with onset prior to 3 yoa:

social interaction

language as used in social communication

symbolic or imaginative play

The disturbance is not better accounted for by Retts disorder or Childhood disintegratvie disorder

Restricted patterns of behavior, interests and activites (might really like on kind of thing i.e. spinning ball)

Impaired social functioning

No clinically signigicant delay in language, congintive development, self-help skills or adaptive behaviors

High Functioning end of spectrum

For individuals who are on the spectrum but do not fully meet the criteria for another ASD

Still have significant challenges in social and language development

Can be refered to as sub threshold autism

25%: high-functioning with symptoms similar to Aspergers but have lag in language development and have midl cognitive delay

25%:  similar to autistic disorder but do not meet all diagnostic criteria

50%: meet all criteria for autistic disorder but have stereotypical and reptitve behaviors that are noticeably mild

Only in F

Normal development up to 6 months followed by significant regression

Loss of previously acquired purposeful hand skills (regression at 6 months)

Poor coordinated gait or trunk movements

Respiratory irregularities

Seizures

Progressive

Cognitive development does not progress past level of 1 year old

Stereotyical hand wringing

Does childhood disintegrative disorder have stereotypical hand wringing?

No

This is Rett's Disorder

Regressive autism

Developmental regression in several areas of functioning after at least 2 years of apparently normal development

Regression in bowel and bladder control, language, and social skills and regression in play skills motor skills or both

Typiclly produce full sentences before onset and regress to no language at all

Unkown ( hMm)

onset appears to be preceded by 2 phases of brain growth abnormailty:

Smaller than typical head size at birth

Sudden and excessive increase in head size between 1-2 months and 6-14 months of age

these two point not sure if they are risk factors or indicators that the child will have autism

COuld be:

genetics

Other disorders

Environment

Vaccinations

Developmental Screening Tests (Denver/Aims)

M-Chat screening (one of the most widely used):

16-30 months old

Assess risk for ASD

Childhood Autism Rating Scale (CARS)

Autism Spectrum Rating Scale (ASRS)

Wing Autistic Disorder Interview Checklist (WADIC)

What is generally the age when autism can be dx?

Who is on the team that assess the child?

Are there any objective measures?

2 yoa

Pediatrician, psychologist, ST OT, PT

No objective measures

Observation is how it is measured

 Early as 1 yoa (looking for traid of symptoms communicationg deficits, social interaction deficits, rigid repetitive behaviors)

No big smiles or other warm joyful expressions by 6 months or after

No back and forth sharing of sounds smiles or other facial expressions by 9 months

No babling by 12 months

No back and forth gestures such as pointing showing reaching or waving by 12 months

NO words by 16 months

No meaningful two word pharases (not including imitating or repeating by 24 months

Any loss of speech, babbling or social skill at any age

Does autism spectrum often accompany other medical conditions and challenges?

What can interventions due?

yes

Interventions can reduce symptoms and increase skills and abilities (no cure for autism though)

Intellectual Disability

Uneven cognitive skills

Hyperactivity

Short Attention span

Impulsivity

Aggressiveness, self-injurious behavior

Abnormalities of mood or affect

Abnormalities in eating and sleeping

Oversenitivity to sensory stimuli or might need lots of sensory stimuli

decreased coordination

Postural anomalies

rely on proprioceptive input for motor output (Haswell)

Increased slowness

Difficulty imitatiing and completing actions

Reliance on prompting

Increased passivity and appratent lack of motivation

What were the PT finding by Parker Foley weiss and Moran?

Decreased core strength

Altered speed and pattern on TUG

Gait variations

Throwing variations

Differences in hopping

Observable trend of impaired motor activity in children with autism: dyspraxia, postural control, gestures and motro imitation, early motor skills

PT needs to be a prt of tx team

more research in this area