It means that in the process of children's development, at least two areas are backward and limited in adapting to behavior, sports, language and social interaction. You may be diagnosed with mental retardation in the future. It can be a symptom or manifestation of a disease, or it can exist independently for unknown reasons.
Second, develop diagnosis.
Geissel Development Scale: Suitable for children aged 4 weeks to 6 years.
It includes five fields: adaptive behavior, big movements, small movements, language and individual-society.
According to the developer, the development level:
& lt diagnosis of developmental retardation
76~85 non-edge state
Above 85 is normal.
Third, develop diagnosis.
Development results change with children's development.
3 ~6 months review
For example: 1, children A: 6 ~ 10 months ago, only gross movements were backward, but fine movements were low, but at 18 months, their language and social adaptability were backward, and their intelligence was low at the age of 4~5. 2. Children B: 8 ~ 10 months, the diagnosis is completely backward, comprehensive rehabilitation treatment 1~2 years, and the follow-up of 3~4 years old is normal.
Fourth, wechsler adult intelligence scale:
IQ 50~69 Mild mental retardation
IQ 35~49 Moderate mental retardation
IQ is 20~34.
Correlation between overall developmental retardation and mental retardation in the future
The adaptability and fine motor development in the scale are closely related to intelligence.
Children's language comprehension ability and individual-social ability can be used as indicators to predict intelligence to some extent.
A single rough motion has little correlation.
Verb (abbreviation for verb) is the result of overall slow development.
Mental retardation or borderline intelligence:
Often complicated with other obstacles, such as ADHD, epilepsy, cerebral palsy, autism and so on.
autism
Cerebral palsy
Related to a specific disease
normal reach
Sixth, diagnostic medical evaluation
Medical history:
Family calendar
Maternal pregnancy history: previous pregnancy history, this pregnancy experience, etc.
Perinatal period: before, during and after delivery.
Period.
History of children's development: including milestones, development process and progress
Stagnation or retrogression.
Seven, physical examination:
1, observation: in the natural state, provide toys, and observe the communication, communication, attention and skills in handling things with parents.
2, head circumference, body surface abnormalities, such as face, facial features, hand and foot characteristics, external genitalia, skin pigment or markings changes, whether the liver and spleen are swollen.
Eight, laboratory and auxiliary inspection:
Because there are many causes, we should choose the examination according to the medical history and physical examination results, in order to make clear the diagnosis of the cause or syndrome.
Chromosome examination:
Routine chromosome examination may find abnormalities in those with obvious appearance characteristics, but routine chromosome analysis is still often negative, and high-resolution examination will increase the positive results. In 20 1 1 year, the American Neurological Association evaluated the existing methods for detecting neurodevelopment, saying that microarrays can identify the genetic causes of 8% children with systemic developmental retardation.
Genetic examination: for those with family history and significant changes in characteristics, you can choose examination, which is not helpful for treatment and is used for genetic counseling and prenatal diagnosis.
Genetic metabolism screening:
1, routine examination: blood routine, blood sugar, urine routine, ketone.
Body, electrolyte, blood gas, myocardial enzymes, liver and kidney functions, etc.
2. Special inspection:
Electrophysiological examination:
Electroencephalogram is not helpful for the diagnosis of total developmental delay.
Visual evoked potential is helpful to judge the state of visual pathway.
Auditory evoked potential can judge auditory pathway and hearing.
Nine, diagnosis
Etiology and disease diagnosis
Classification:
Static: all developmental delays are in a relatively stable state,
Progress is slow.
Progressiveness: development in all fields is in a state of stagnation or retrogression.
X. Common causes of static growth retardation
Perinatal diseases:
Prenatal: hypoxia and diseases caused by various reasons.
During production: asphyxia, birth injury, etc.
After birth: brain injury, encephalitis, nutritional deficiency, social and cultural backwardness, etc.
XI。 Common causes of static developmental delay
Brain developmental malformation:
There are many reasons for deformity, and sometimes it is difficult to find out.
Common malformations: abnormal development of corpus callosum, abnormal development of cerebral cortex, absence of septum pellucidum, various syndromes, etc.
Common causes of static developmental delay
Intrauterine infection: giant cell, toxoplasmosis, syphilis, etc.
Maternal factors: maternal disease factors, such as pregnancy-induced hypertension, hyperthyroidism, infertility and so on.
All kinds of poisoning: chemical, physical factors, drugs, etc.
Common causes of slow static global growth
Chromosome diseases:
2 1 trisomy syndrome
Chromosome translocation, deletion and so on.
Common Micromalformations in Chromosome Diseases
Abnormal head size, wide eye distance, squint, small jaw, low ear position, high palatal arch, bent little finger, penetrating hand, large gap between first toe and second toe, long middle toe, rocking chair foot, abnormal dermatoglyphics, etc.
Neuromuscular diseases:
Such as: congenital muscular dystrophy
Case: female, more than 6 months old, with obvious hypotonia, knee reflex+,myocardial enzyme CK9000U, normal range of intellectual development, sitting alone at the age of 2, with lower intelligence than normal, walking alone at the age of 4-5, myopathy and mental retardation.
Common causes of slow static global growth
The reason is unknown:
More than 50% of mild developmental delay often can't find the exact reason.
With the progress of technology, there will be more discoveries.
Twelve. Progressive developmental delay
Clues to slow global growth:
1. History: Stagnation or retrogression of development milestones.
2, feeding difficulties, eating disorders, weight loss.
3. Low muscle tension and abnormal exercise.
4. Abnormal smell.
5, bone changes, special appearance.
6, hepatomegaly.
7. Epilepsy is difficult to control.
Thirteen. prevent and cure
Prevention: prenatal and pre-pregnancy examination, genetic counseling according to the cause.
Early detection and early intervention can reduce the damage caused by diseases and improve the prognosis, such as phenylketonuria.
If the patient has been injured, he should actively recover, promote his development and improve his function.
Treatment and rehabilitation
The plasticity of children's brain is strong before 2~5 years old, especially under 2 years old.
Early intervention and rehabilitation can greatly improve the prognosis and improve the quality of life in the future, which plays a decisive role.
Fourteen Treatment and rehabilitation
1, etiology and treatment
Comprehensive rehabilitation therapy for disorders
With the goal of improving cognitive development:
Hand function training and hand-eye coordination training can improve sensory perception and spatial cognitive ability.
Improve the cognitive ability of operation and from concrete to abstract through language training.
2. Treatment and rehabilitation
Children with suspected developmental delay should be given family training guidance and followed up regularly.
For children with critical development and developmental retardation, it is best to combine professional training with family guidance training.
Regular assessment during rehabilitation treatment, making plans and short-term and long-term goals according to the child's condition, family and environment.
3. Treatment and rehabilitation
Drugs for promoting the development of cranial nerves:
Brain protein hydrolysate, nerve growth factor and ganglioside can promote brain development and repair after injury, but they cannot rely too much on drugs.
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