To: [Name] Thank you for referring [Name], 2 and 7/12-year-old ambidextrous male for evaluation of "developmental delays." Please allow me to review the history for my records. [Name] is accompanied by his mother and physical therapist today. The patient has had global developmental delays since shortly after birth. He was 1st formally evaluated in July 2006, when he was not to sitting, talking, or standing. This developmental evaluation has recently been repeated. This showed essentially developmental stagnation. During the 1st evaluation the child's developmental age was approximately 8 months; during the 2nd evaluation it was 6 months, not significantly different. [Name] has never had seizures. There has been no true developmental regression. …show more content…
[Name]'s only other medical problem is asthma. He uses albuterol as needed. He is on no routine medications, and has no known drug allergies. Family history is largely unknown. The patient's mother is unable to read. There are 2 siblings of different fathers and another, the mother is currently pregnant. Socially the patient is involved in early intervention services. Review of systems is negative for any known opthalmologic, ENT, cardiovascular, respiratory, gastrointestinal, genitourinary, musculoskeletal, skin, psychiatric, endocrine, hematologic, or immunologic problems. [Name]'s general physical examination is remarkable for his relative microcephaly. He has somewhat of a low brow line. There are no other true dysmorphisms. He has no neurocutaneous stigmata. There is no hepatosplenomegaly. Peripheral pulses are normal. A comprehensive neurologic examination that included: Testing of the skull, spine, and meninges; cranial nerve 2 through 12; muscle mass,10; strength; sensation; deep tendon reflexes; and plantar responses was significant for his mild-to-moderate hypotonia. He is not hyperreflexic. The patient's Developmental Evaluation, and MRI scan _____(and labs) are reviewed
L.H. report no concurrent or severe headaches; There was no head trauma, syncope or vertigo. Patient wears corrective lens with no difficulty of vision or diplopia; absent of inflammation, discharge or lesion. Last eye exam was in September of 2016 with no history of glaucoma, cataracts. L.H. denies having any frequent colds, sinusitis, epistaxis and trauma. Patient reports having obstruction stating, “it happens when I am lying down” with an occasional postnasal drip.
Visual fields are full to confrontation. Extraocular muscles intact. PERRLADC. Normal facial symmetry, sensation, and movement. Tongue and uvula are midline. Normal auditory acuity. Normal shoulder shrug.
Visual fields full to confrontation. Extraocular muscles intact. PERRLADC. Normal facial symmetry, sensation and movement. Tongue and uvula are midline. Normal auditory acuity. Normal shoulder shrug.
Based on the information presented by the child’s father, meets the physical milestones which include large motor and fine motor skills, given that he is able to balance himself on one foot for 2-3 seconds, copy squares and circles, pedal a bicycle and walks up stairs alternating feet as required for a three-year-old child (Gerber et al., 2010). The patient also meets language development milestones given that his speech is 75% understandable to strangers and talks in short sentences (Stevenson & Richman, 2016). The repetition of words including those at the beginning of sentences without the repetition of consonants and or syllables is very normal for a three-year-old especially when expressing important messages (Bellman et al., 2013). Also, the child meets the cognitive milestone given that he recognizes three colors. Lastly, the child meets the social milestones of a three-year-old given that he normally engages in imitative play, and has an imaginary friend in addition to talking about favorite activities, friends, and family, as required at his
Developmental disability is a diverse group of chronic conditions that are due to mental or physical impairments. Developmental disabilities cause individuals living with them many difficulties in certain areas of life, especially in language, mobility, learning, self-help, and independent living. Developmental disabilities are usually identified early in childhood and will probably persist throughout the individual’s lifespan.
The family I interviewed has a son named Cuyler that is 22 years old. I talked to Cuyler’s mom Cathie. He is the oldest of three kids. Cuyler was born at 24 weeks’ gestation and had a grade 3 brain bleed. Because of being born premature and the bleeding in his brain it led to some of the disabilities Cuyler has. His mom told me that Cuyler has spastic quadriplegia. His disabilities include cerebral palsy, blindness, and he is nonverbal. She also told me that Cuyler also has seizures at least once a month, is hypotonic, and is fed by a g-tube. As far as physical movement the only gross motor skills that Cuyler can do is roll over.
As ethical and moral physical therapists, it is essential to consider all possible sources of the impairment and figure out how to resolve, educate, and prevent future implications for patients. In order to be able to complete such a task, physical therapists must be able to look at functional status through all of its domains, biophysical, psychological, and sociocultural.2,5 In the realm of pediatrics, performing screenings, functional tests, and questionnaires offer a great diagnostic and prognostic data for children. The DDST3 enables a PT to get a sense of a child's cognition, motor functions, and behavior. Identifying possible delays or problems early on is vital in order to ensure proper development, especially since many systems have
The 42 month assessment from Age and Stages Questionnaire (ASQ) was selected. The child that was interviewed is 44 months old, equating to three and a half years old. This assessment was conducted around noon following lunch with her mother in the child's home in approximately about two and a half hours. The ASQ contained the following assessment sections: Fine Motor, Problem Solving, Personal-Social development, Communication, Gross Motor, and overall clinical results.
Hypotonia and developmental delay are generally evident by three to six months of age and are the most common symptoms of nervous system impairment. Traits that are present in affected individuals are lack of speech, irritability, late in sitting up, moreover most never crawl or walk. During the first few years of life, dystonia, choreoathetosis, and opisthotonus can present as a result of extrapyramidial involvement. Extensor plantar reflexes, hyperreflexia, and spasticity can occur and are signs of pyramidial involvement. Often, individuals are initially diagnosed with athetoid cerebral palsy due to the similar neurological aspects. Most individuals will never walk and become lifelong wheelchair users due to the extent of motor disability.
Physical examination today reveals a weight of 6.8 kg, between the 15th and 50th percentile, a length of 64.5 cm, between the 15th and 50th percentile, and a head circumference of 41.7 cm, between the 15th and 50th percentile. Heart sounds were normal and the chest was clear. The remainder of the general physical examination was unremarkable. Neurologically, tone and deep tendon reflexes were
A review of the records reveals the member to be a young male with a birth date of 12/25/2004. The member has diagnoses of Autism Spectrum Disorder (ASD) and ADHD (Attention Deficit Hyperactivity Disorder). His provider, Charles Kennedy, Ph.D. has requested MT at the continued rate of 4 hours per week for 120 days.
Pupils equal and round, reactive to light. Wears glasses, had injury to eye in 2008 where traumatic Cataract removed and lens was implanted.
4 year old male with Childhood Disintegrative Disorder (CDD) also known as Heller’s Syndrome is under the umbrella of Autism Spectrum Disorders. The disorder is very rare, occurring in more often in boys than girls. The onset usually occurs after two years of age with development having been normal until onset. The child begins to experience significant loss in expressive and receptive language, social skills, adaptive behavior, bladder and bowel control, and motor skills. After onset, the child development suddenly and quickly regresses. For SR, regression was completed within 6 months of onset. SR’s mom was baffled by the regression. The family was living in Italy at the time and the doctors in Italy couldn’t arrive at a diagnosis. Upon
An observation was held in the alpert Jewish community center. A variety of children between the ages of three to five were observed in activities ranging from physical and motor to social and cognitive development “The Gross Motor Function Measure was designed specifically to evaluate change in gross motor function in children with CP (Russellet al1989). It consists of 88 items
DCD may coincide with delays in one or more of the following areas: gross motor skills, fine motor skills, and speech production (Gaines & Missiuna, 2007). Gross motor deficits may involve problems with balance, coordination, muscle strength, reaction times, and the ability to distinguish left from right. In addition, recent research suggests an association between CDC and left- or mixed- handedness (Vasconcelos, 2009). Fine motor deficits may be associated with problems using writing implements, problems using scissors, and problems performing a variety of adaptive tasks, such as feeding, dressing, and toileting (Trawick-Smith, 2010). Finally, speech production may pertain to complications during articulation, breathing, and the utilization of grammatical structures (Carlson, 2007).