GLOBAL DEVELOPMENTAL

DELAY

MENTAL RETADATION

PREVENTION OF MR

DAYEM PEDO/FACEBOOK

BY

PROF DR HUSSEIN ABDELDAYEM

PROF OF PEDIATRIC NEUROLOGY

MENTAL RETARDATION

DEFINITION

< 5 YERS (GDD)

ADAPTIVE SKILLS

SELF CARE

SAFETY

SOCIAL SKILSS

COMMUNICATION

USE OF

COMMUNITY

RESOURCES

HOME LIVING

ACADEMIC

ACHIEVEMENT

WORK

LEISURE

SELF DIRECTION

Investigation

s

Intelligence quotient (IQ) =

mental age

chronological

age

X 100

Intelligence Scale for Children

The WISC or

Stanford Binnet can

be used to assess a

child's cognitive

development, with

respect to the child's

chronological age

N IQ: 85 -110

IQ between 71 – <85 :

border line

(slow learner) (

below average) بطء تعلم

Mild

<70-50

Moderate

<50-35

Severe

<35-20

Profound

<20

<110 - 85

85- 70

NORMAL

Cases of MR diagnosed by Face

1

2

3

4

5

6

7

Fragile X syndrome8

TREATMENT1- Rehabilitation SESSIONS

COGNITIVE, LANUAGE , MOTOR ,

BEHAVIOR, ETC

2- tt of association

EPILEPSY:AED

ADHD

Dr Hussein Abdeldayem

Prof of Pediatric

Neurology

DEVELOPMENT

DAYEM PEDO /facebook.com

GROWTH

GROWTH

Increase in physical size ,

height and weight of the body

DEVELOPMENT

FUNCTIONAL and PHYSIOLOGICAL maturation of systems and organs

Leading to developing of new skills , adaptation ability and assuming responsibilities

Denotes maturation of brain. Leading to increase in Mental, Physical, Social and Emotional abilities of the child.

CHILD DEVELOPMENT

Age – related development terms are: -

Newborn (1st 4 wks after birth)

Infant (1 – 12 m)

Toddler, early childhood, preschool (1 – 4 yrs)

School – aged child (5 – 12 yrs)

Adolescent (12 – 20 yrs)

1. Directional Pattern:

– Cephalocaudal Pattern ( Head to Tail)

– Proximal to Distal (Midline to peripheral)

2. Sequential Pattern:.

- Sequence of development is the similar in all

children but differs in rate ( slow in DS)

- There is personal variation

DEVELOPMENT

Why emphasize early detection of

Development Delay

1- start early intervention and

treatment.

2- supply the parent an explanation

for their inquiries about difficulties

with their children as feeding,

handling, sleeping, and

temperament.

3- to look for associated findings for

managing

Developmental Milestones 5

cognitive

language

Developmental Milestones

Motor

Developmental Milestones

Social

Developmental Milestones

Self -dependence

Developmental Milestones

Developmental milestones 5’s

COGNITIVE SKILLS

LANGUAGE SKILLS

MOTOR SKILLS

SOCIAL SKILLS

SELF-DEPENDENCE

SKILLS

Global Developmental Delay

GDD

Significant delay* in two or more of fiveof the following five developmental skills:

cognitive

motor ( fine and gross)

language

self-dependence

social

Age : 3 - 5

Who should be screened for

development delay ?

All young children especially

those with risk factor

At birth

Gross motor Fine motor Cognitive Social Language

Crying to

indicate need.

Eg. Crying for

breast milk

At ONE MONTH

Gross motor Fine motor Cognitive Social Language

Raised head

on prone

slightly

Tight palmar

grasp

ALERT TO

SOUND

REGARDS

FACE

Crying differs

according to need

At TWO MONTHS

Gross motor Fine motor Cognitive Social Language

SOCIAL

SMILE

COO

3 monthsGross motor Fine motor Cognitive Social Language

Supports head

when held erect

Opens hands

spontaneously

Fix to near

objects and

Increase

interest in his

surroundings

e.g.

Swings at and

reaches for

dangling toys

At FOUR/ FIVE MONTHS

Gross motor Fine motor Cognitive Social Language

Rolls front to

back, then

back to front

Supports on

wrists when

prone (sphinx

like)

Grasps hands

together

Knows mother LAUGHING

6 months

Gross motor Fine motor Cognitive Social Language

Sits

momentary,

supported.

Transfer

objects from

hand to hand.

use 4 fingers

Understand

objects and

know what to

expect of

them.e.g

Bottle means

feeding time.

Recognizes

strangers

Show likes

and dislike

Babbles

(“ba, ba”

sounds)

7 months

Sits without support

8 months

Crawl (Lion like)

9 months Gross motor Fine motor Cognitive Social Language

Creeps or

crawls or

pulls to stand

Pincer grasp

Shows

interest in

picture books.

Watches

activities of

others with

interest.

Plays

peek-a-

boo

Repetitive

sounds mama

dada

SELF

Dependenc

e

Feeds self

10 months

Bye-bye,

Stand supported

11 months

12 months

Gross motor Fine motor Cognitive Social Language

Stands

unsupported

Release an

object when

commanded

Responds to

simple

instructions.

Uses trial-

and-error to

learn about

objects.

Knows what

"no" means

and reacts.

Comes when

called. Plays

simple game

1-2 meaning

full words

Papa

Mama

Respond to his name

18 months

Gross motor Fine

motor/self

dependence

Cognitive Social language

Walks

unsupported

Walks up

stairs with one

hand held

Seats himself

in small chair

Feeds from a

spoon

Enjoys simple

picture books.

Explores

environment.

Knows the

names of

parts of his

(4)body.

Index

pointer

Mimics action

of others

At least 6

words

2years (19-24months)Gross motor Fine motor Cognitive Social/ self

dependence

Language

1-Runs.

2-Kicks large

ball. 3-Squats.

4-Walks up and

down stairs 2

feet per step.

Turns picture

book pages

one at a time.

Recognises

details in

pictures. Uses

own name to

refer to self.

Match two

objects

together by

colour, shape

or size.

Builds tower of

6 cubes.

1-Plays with

others.

2- Tantrum.

3- Spoon-fed

4-drinks from

cup. 5- Aware

of physical

needs.

1-Joins 2-3

words in

sentences.

2-Talks to self

continuously.

3-Speaks >30

words, and

accumulate

new words very

rapidly.

IMPORTANT POINTS

LANGUAGE COGNITIVE/SOCIAL

2-<6 MO:COO

6-<12MO: BABLING

1-<2YS: WORDS (

START BY 2 UP TO 30-

40WORDS)

2 YS +: SENTENCES

5 MONTHS: KNOWS

PARENT AND

LAUGHING

10 MONTHS: BYE

BYE

15 MONTHS: SEND

KISSES

FINE MOTOR RISK FOR AUTISM

6MO:TARNSFER

OBJECTS

9 MO:PINCER

POSITION

9 MO: PICK-A-BOO

10 MO: PREFER OBJECTS THAN FACES

12MO:POINTING

12 MO:RESPOND TO NAME:

DELAY MOTOR

DELAY LANGUAGE

18 MONTHS: MIMICK ACTIONS

TREATMENT

fully intergrated Early intervention

Rehabilitation

MENTAL RETARDATION

PREVENTION

Dr Hussein Abdeldayem

Alex University

Prevention

Primary Prevention

prevent the occurrence of the disease

as: by immunization

by Genetic counseling

NO DISEASE

Vaccine as German measles

Dr Hussein Abdeldayem

Alex University

Prevention

Secondary Prevention

early detection of the disease for stopping or

reversing its progress

as: by prenatal diagnosis

by newborn screening

DISEASE but

NO or MILD CP

Inborn error of metabolism

PKU, Cong Hypothyroidism, Galactosemia

Dr Hussein Abdeldayem

Alex University

Prevention Tertiary Prevention

stop the development of

complication of the previously

diagnosed disease

as: by EIP as in GDD,

by treating ABM with

corticosteroid AND follow up for

complications (ABR)

DISEASE but

Few C/P and NO Complication

DS