APK

Global developmental delay (GDD)

sometimes referred to as global developmental disorder, is a neurodevelopmental
diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
(DSM-5). GDD is a form of intellectual disability, which is diagnosed when an individual
under age five exhibits clear signs of a developmental delay but cannot be evaluated for
a more specific diagnosis due to their age.
For an individual to meet the criteria for GDD, they must experience delays in achieving
milestones in several areas of intellectual functioning and learning. A provider will re-
evaluate someone with a diagnosis of GDD as they get older to obtain a more specific
and accurate diagnosis
GDD does not have a specific set of symptoms like other DSM diagnoses but instead
refers to general delays that cannot be more specifically identified at the time of the
assessment.

Symptoms of GDD can include, but are not limited to:

Delays in motor skills (including crawling and walking)
Difficulty with fine motor skills
Language and communication delays
Difficulty understanding communication
Difficulty with problem-solving
Difficulty with social skills

Identifying and Diagnosing Global Developmental Disorder

Providers diagnose intellectual disabilities by assessing an individual’s cognitive and
adaptive functioning. Although adaptive functioning can be evaluated from birth, many
cognitive tests (also referred to as IQ tests) require that a child be at least six years old
for testing.
Some IQ tests can evaluate children younger than six, but long-term research shows
that these scores do not accurately predict future learning prior to age six.
Providers can identify developmental delays in many different ways, including:
Diagnostic Interview with the Parent or Guardian: This interview consists of
gathering extensive, detailed information about the child’s history so far,
developmental progress, and any known medical issues or injuries.
Vineland-3: The Vineland-3 measures adaptive functioning in several domains,
including communication, daily life skills, social skills, and motor skills. There is a
parent form that can be administered as early as birth, and there is a teacher
form that can be administered starting at age three.
Adaptive Behavior Assessment System-3: The ABAS-3 measures an individual’s
adaptive skills from birth through their lifespan and assesses for developmental
and learning disabilities, neuropsychological disorders, and physical
impairments.
Bayley-4: The Bayley scales measure cognitive, language, motor, social, emotional,
and adaptive behavioral growth in preschool-age children to determine whether
developmental delays are present.

Causes of Global Developmental Delay

Because GDD is a general term and not a specific diagnosis, many different things can
cause a child to experience a delay with this label. Sometimes, genetics can cause
developmental delays. Other times, the environment can cause GDD, both before and
after the child is born.4
GDD can begin before birth when caused by exposure to drugs or other toxic
substances, premature birth, prenatal infections, or hemorrhages. Following birth, head
traumas or certain infections such as meningitis can cause GDD. Finally, malnutrition,
abuse, or physical neglect can cause a child to experience developmental delays.

Treatment for Global Developmental Disorder

Sometimes, children outgrow developmental delays and catch up to their peers with
minimal intervention.However, many benefit from treatments and services to help them
reach their full potential.
Because “Global Developmental Disorder” is a general term for delays that can manifest
in many different ways, providers determine the most appropriate interventions on a
case-by-case basis.
Treatments that can help with GDDs include:
Birth to Three Programs: These programs emphasize helping a child reach missed
milestones and catch up to their peers.
Early Childhood Special Education: Preschool and kindergarten programs can offer
individual special education to help meet a child’s specific needs when the child
exhibits developmental delays.
Physical Therapy: Physical therapists can help a child by teaching them exercises
and skills to catch up on motor delays or recover from an injury that might be
causing a delay.
Speech Therapy: Speech therapists can help children learn to use language to
express their needs by emphasizing articulation, vocabulary, or other forms of
communication.
Occupational Therapy (OT): Occupational therapists help with adaptive skills. OT
can help alleviate sensory issues, develop fine motor skills, or complete other
functional tasks.
Re-Evaluation: Because GDD is a general term for unspecified developmental
delays, as the child gets older and can undergo more specific assessments, re-
evaluation can help identify and understand their delays and provide a more
specific diagnosis.
As the child gets older, they will need re-assessment to gather more specific information
about their delays and get more specific information about their diagnosis or diagnoses.

Understanding Global Developmental Delay vs. Autism

To put it simply, a developmental delay is when your child does not reach their
developmental milestones at the expected times, whilst Autism refers to a group of
complex neurodevelopmental disorders, present from early childhood which is
characterised by the difficulty in communicating and forming relationships with other
people, and using language and abstract concepts.
Global Developmental Delay is usually diagnosed in children under the age of five years
old, indicating a delay in a child’s development across several broad areas, including:
● Language or speech

● Vision

● Movements – motor skills

● Social and emotional skills

● Thinking -cognitive skills

Autism can be diagnosed in addition to Global Developmental Delay when a child has
difficulty in developing social and communication skills.
So, how does this impact a child? Global Developmental Delay may impact a child by
limiting their ability to:

○ Understand and retain information,

○ Solve problems,

○ Interpret social cues and social awareness,

○ Respond appropriately to others,

○ Gain personal independence and self-care skills,

○ Navigate their environment through movement (gross and fine motor

skills),

○ Interact and play with their same aged peers.

Children living with Global Developmental Delay vs. Autism

Children living with Global Developmental Delay vs. Autism, display a significant
difference in their communication developments and adaptive function, partly due to the
large number of potential underlying causes. Typically, children living with Global
Developmental Delay are less likely to engage in restrictive or repetitive behaviour
patterns and may present with better social skills.
Children living with autism typically present with:
 ○ Repetitive behaviours, such as repeating sounds for non-
communicative purposes, flapping their hands, rocking back and
forth.

○ Non-responsive to social interactions with others

○ Limited imitation of other people’s actions, sounds or words

○ Restricted behaviours for example fixations on non-functional

objects within their environment or fixations on one topic or toy.

Scabies
Scabies is an infestation of the skin by the human itch mite (Sarcoptes scabiei var.
hominis). The microscopic scabies mite burrows into the upper layer of the skin where it
lives and lays its eggs. The most common symptoms of scabies are intense itching and
a pimple-like skin rash. The scabies mite usually is spread by direct, prolonged, skin-to-
skin contact with a person who has scabies.

What are the signs and symptoms of scabies infestation?

The most common signs and symptoms of scabies are intense itching (pruritus),
especially at night, and a pimple-like (papular) itchy rash. The itching and rash each
may affect much of the body or be limited to common sites such as the wrist, elbow,
armpit, webbing between the fingers, nipple, penis, waist, belt-line, and buttocks. The
rash also can include tiny blisters (vesicles) and scales. Scratching the rash can cause
skin sores; sometimes these sores become infected by bacteria.

Prevention
Treating scabies as soon as possible is the best way to prevent outbreaks. The mites
that cause scabies usually die after 2–3 days away from human skin.

Prevent scabies from spreading with these steps:

avoid skin-to-skin contact with an infested person, especially if they have an itchy rash;
treat all members of the household if someone has scabies to prevent the mites from
spreading to others; wash and dry bedding and clothing that has been in contact with
the infested person, using hot water and drying in direct sunlight, a hot dryer cycle or
dry cleaning; seal items that can’t be washed in a plastic bag for a week to help
eliminate the mites; and clean and vacuum or sweep rooms after an infested person
has been treated, especially for people with crusted scabies.

Treatment
Scabies can be treated with topical creams or oral medication in more severe cases.
Itchiness often gets worse for 1–2 weeks after treatment starts.

Topical treatments that are applied to the whole body include:

5% permethrin cream
0.5% malathion in aqueous base
10–25% benzyl benzoate emulsion
5–10% sulphur ointment

Pediatric Community Acquired Pneumonia

PCAP is a lower respiratory tract infection occurring in a child who has not been in a
hospital or a healthcare facility in the preceding 14 days. This is caused by a bacterial
infection in the lungs. Children may acquire this in the first two years of their lives but
this condition is present in older children.

What are the signs and symptoms of PCAP?

Common signs and symptoms of PCAP include:
● Cough
● Impaired breathing
● Headaches
 ● Vomiting
● Fever

Identifying PCAP
In order to identify if the patient has pneumonia, the patient will have to get an x-ray
since this is the fastest way to know and is visible in the x-ray result. Other advanced
tests may include lab tests such as Arterial Blood Gas (ABG) to know how much the
oxygen content or level is in the blood or sputum tests to further know what kind of
bacteria is infecting the child.

Treatment for PCAP

Treatments of PCAP may include:
● Antibiotics such as cefuroxime and amoxicillin.
● If the patient is admitted, oxygen therapy is done.
● Breathing Treatments

Malnutrition
Malnutrition refers to deficiencies or excesses in nutrient intake, imbalance of essential
nutrients or impaired nutrient utilization. The double burden of malnutrition consists of
both undernutrition and overweight and obesity, as well as diet-related
noncommunicable diseases. Undernutrition manifests in four broad forms: wasting,
stunting, underweight, and micronutrient deficiencies.

Wasting is defined as low weight-for-height. It often indicates recent and severe weight
loss, although it can also persist for a long time. It usually occurs when a person has not
had food of adequate quality and quantity and/or they have had frequent or prolonged
illnesses. Wasting in children is associated with a higher risk of death if not treated
properly. Stunting is defined as low height-for-age. It is the result of chronic or recurrent
undernutrition, usually associated with poverty, poor maternal health and nutrition,
frequent illness and/or inappropriate feeding and care in early life. Stunting prevents
children from reaching their physical and cognitive potential. Underweight is defined as
low weight-for-age. A child who is underweight may be stunted, wasted or both.
Micronutrient deficiencies are a lack of vitamins and minerals that are essential for body
functions such as producing enzymes, hormones and other substances needed for
growth and development.

Malnutrition is quickly identified during ocular inspection. However things such as:

● unplanned weight loss

● muscle loss
● a low body mass index (BMI)
● vitamin and mineral deficiencies

Are factors that will also identify if the person is malnourished.

Common signs and symptoms of malnutrition include:

● loss of appetite and lack of interest in food or fluids

● unplanned weight loss - this might cause clothing, rings, watches or dentures to
become loose
● tiredness or low energy levels
● reduced ability to perform everyday tasks like showering, getting dressed or
cooking
● reduced muscle strength – for example, not being able to walk as far or as fast
as usual
● changes in mood which might cause feelings of lethargy and depression
● poor concentration
● poor growth in children
● increased risk of infection, recurrent infections, taking longer to recover and poor
wound healing
● difficulty keeping warm
● dizziness

A lot of conditions may cause malnutrition such as cancer, cystic fibrosis, mental health
conditions etc.
Treatment for malnutrition:

If you've lost weight or your appetite is poor, you can make simple changes to your
meals, snacks and drinks to help treat malnutrition.

Choosing nutrient-dense food and drinks can help improve your calorie intake. This
might not be suitable for everyone, especially those with other conditions like
dysphagia.