Neurological Disorders and Cognitive Perceptual Problems in Children Paper

Neurological Disorders and Cognitive Perceptual Problems in Children Paper

Neurological Disorders and Cognitive Perceptual Problems in Children Paper

Neurological disorders in childhood are mainly identified when the child exhibits developmental milestones and delays. Slow language and motor skills, seizures, and unresponsive episodes are also signs of neurological and cognitive-perceptual problems in children (Garfinlke et al., 2020). This discussion presents the application of the clinical case study to understand the most likely diagnosis of an 11-month female patient who is dragging her feet rather than crawling on both hands and legs. The differentials in this case, the expected developmental milestones, and the best course of action/treatment plan for the patient at this visit will also be explored.

The clinical case involves an 11-month female brought to the clinic for a well-child visit. The parents are concerned that the baby drags the legs other than crawling and does not stand. From the previous well-child clinic, at 6 months, it was noted that the child was not rolling over and could not sit. The physical examination shows that the child maintains a scissoring posture when held from the axillae.

The most likely diagnosis for this patient is Cerebral Palsy. According to Appleton and Gupta (2019), some early signs of cerebral Palsy in children include abnormal posture, developmental milestone delays, and abnormal muscle tone. From the clinical case scenario, it is evident that the patient had developmental milestone delays, such as not sitting and rolling over by the age of 6 months. Additionally, she maintains an abnormal scissoring posture, the most prevalent sign of Cerebral Palsy (Appleton & Gupta, 2019). Thus Cerebral Palsy is the most likely diagnosis.

The three differentials in this care are metabolic and genetic disorders, hereditary spastic paraplegia, and Rett Syndrome. The three conditions are differentials to Cerebral Palsy since they are also associated with developmental delays and a scissoring gait. According to Falisse et al. (2020), metabolic and genetic disorders affect behavioral, cognitive, and motor skills, thus a differential of Cerebral Palsy. Hereditary spastic paraplegia is an inherited disorder causing stiffness and weakness in leg muscles. It is a differential in this case due to the child’s leg muscle weakness depicted in the inability to stand and crawl. Rett syndrome is a neurological developmental disorder that affects motor and language skills. The patient, in this case, presents with delays in motor skills, thus a differential.

The developmental milestones expected at the age of 11 months include sitting on their own and pulling themselves into a standing position, communicating using one or two words, and hand gesturing. The child is also expected to perfect their grasp and cognitive development in that they can understand words and gestures.

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I believe the best course of action for this appointment is to inform the parents about their child’s diagnosis and advise them to take action as soon as possible. Patel et al. (2020) note that Cerebral Palsy in children requires immediate intervention to minimize progression and other effects, such as pressure sores and limited movement. The treatment plan, in this case, is beginning Botox injection. The medication provides muscle relief for 3-6 months, depending on the severity of the child’s spasticity. However, the effect of the medication wears off with time, thus the need to supplement treatment with physical therapy and exercise to strengthen the muscles.

Children’s neurological disorders and cognitive, perceptual problems should be addressed as soon as they are detected. The diagnosis, in this case, is Cerebral Palsy, which will be treated using Botox injection, and supported using exercise and physical therapy to strengthen the muscles and improve gait.

References

Appleton, R. E., & Gupta, R. (2019). Cerebral Palsy: not always what it seems. Archives of Disease in Childhood, 104(8), 809–814. https://doi.org/10.1136/archdischild-2018-315633

Falisse, A., Pitto, L., Kainz, H., Hoang, H., Wesseling, M., Van Rossom, S., Papageorgiou, E., Bar-On, L., Hallemans, A., Desloovere, K., Molenaers, G., Van Campenhout, A., De Groote, F., & Jonkers, I. (2020). Physics-Based Simulations to Predict the Differential Effects of Motor Control and Musculoskeletal Deficits on Gait Dysfunction in Cerebral Palsy: A Retrospective Case Study. Frontiers in Human Neuroscience, 14, 40. https://doi.org/10.3389/fnhum.2020.00040

Garfinkle, J., Li, P., Boychuck, Z., Bussières, A., & Majnemer, A. (2020). Early clinical features of cerebral Palsy in children without perinatal risk factors: a scoping review. Pediatric Neurology, 102, 56-61. https://doi.org/10.1016/j.pediatrneurol.2019.07.006

Patel, D. R., Neelakantan, M., Pandher, K., & Merrick, J. (2020). Cerebral Palsy in children: a clinical overview. Translational Pediatrics, 9(Suppl 1), S125–S135. https://doi.org/10.21037/tp.2020.01.01

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Clinical Case Study: Neurological Disorders and Cognitive Perceptual Problems in Children

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered. For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned.

To support your work, use your course textbook readings and the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates’ initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite sources in your responses to other classmates. Complete your participation for this assignment by the end of the week.

For this assignment, you will read the clinical case scenario below based on the course objectives and content for the week. Finally, apply the information from the clinical case scenario and your readings to answer the discussion questions that follow.

Clinical Case Scenario

An 11-month-old girl, well-known to your clinic since birth, arrives for a well-child visit. The parents report that their baby drags her legs rather than crawling on both hands and legs. They are concerned that this is abnormal. The father says that the child only recently began crawling and she does not pull to a stand. You noted at her 6-month visit that she was not rolling over or sitting; previous visits were unremarkable as was the mother’s pregnancy and vaginal delivery. While examining the baby, you note that when she is held by the axillae her legs are extended and crossed (i.e. the “scissoring” posture).

What is the most likely diagnosis? Why?

What would be three differentials in this case? Why?

What developmental milestones are expected at this age?

What do you believe is your best course of action/treatment plan for this appointment? Why?