Author: Ushna Nawaz
Neurodevelopmental disorders are a cluster of
disorder which affects the development of the central nervous system which
includes developmental brain dysfunction, manifested as neuropsychiatric
problems, or non-verbal communication, impaired motor function, learning, or
language.
Global developmental delay is one of the
types of neurodevelopmental disorders. Global developmental delay is a
condition in which the children are significantly delayed in their cognition
and physical development. Its diagnosis can be made based on one or more
delayed milestones, can be categorized as motor skills, emotional development,
cognitive skills, speech, and social development. According to DSM 5 global
development delay is diagnosed in children under the age of 5
years.
Sometimes the cause of
the global developmental disorder is unknown but mostly following are the main
known causes which can lead towards global developmental
delay:
- Maternal
infections during pregnancy
- Maternal
exposure to toxic materials during pregnancy
- Genetic
and chromosomal conditions such as Down Syndrome and Fragile X syndrome
- Premature
birth and infections such as Neonatal pneumonia
- Hypoxia
- Trauma
to the infant's brain
The main signs and symptoms of
the global developmental disorder are as follows:
- Slow
physical and cognitive development as compared to children of the same age
- Difficulty
in socializing and communication
- The
trouble with academic learning
- Inability
to do the daily task and to maintain routine
- Trouble
performing executive functions
Case History
Present illness
The client was diagnosed with a global
developmental delay as his all developmental milestones were delayed. He came
with the problem of lower limbs, speech, walk, sitting and behavioral problems.
Personal history
The client was a 4 years old boy. The client’s mother was having C-section along with some complications. She was having family pressure and stress during pregnancy but not at the time of delivery. The client’s mother reported significant complications throughout pregnancy. The doctor prescribed her allopathic treatment because of the low weight of children. She had twins, one of the twins died after 3 years. From the 7th month of pregnancy, the client’s mother was having a problem with blood pressure, diabetes, and back pain. The client’s first cry was delayed, there was a history of anoxia and his complexion was blue. He was admitted to the nursery for three hours. After that, he showed normal behavior for 25 days. On the 26th day, the client was having a chest problem and vomiting. He was admitted to the hospital when needed. After 6 months his vomiting stopped by changing milk. The client’s chest problem cured with medication after 3 years. It was reported that the client was having a neurological problem and her mother took him to the doctor. The doctor prescribed medicine for the neurological problem when he was one year old. The client was having physiotherapy at home and heat belting for 3 years. The client’s proper physiotherapy sessions started at the age of 3.5 years. The client was having cerebral palsy. The client’s developmental milestones were delayed. The client started neck holding at the age of 8 months. At the age of 1.5 years, he started sitting. The client started crawling at the age of 2.5 years. He started standing with support at the age of 3 years. At the age of 3.5 years, he started walking with support. He didn’t have toilet training yet.
Family history
The client belonged to a middle-class family and was having a joint family system. The client’s father was 29 years old. He was labor; by nature, he was humble, calm and supportive. The client’s mother was 29 years old. She was a housewife; by nature, she was aggressive but did not get angry with the client. The client's mother was taking care of his daily activities. The client’s mother had a good relation with in-laws and his husband. The client had a loving and supportive relationship with his parents.
History of physical problem
The client was having problems in his lower limbs.
Premorbid personality
The client’s problem started after the 25 days of her birth, before that he showed normal reflexes and senses.
Interventions
Following interventions can be used to manage global
developmental delay:
Behavior therapy
Behavior therapy act as
an effective treatment as it can be easily implemented to the child and it is
more feasible for the child to understand. Various behaviors can be learned
through behavior therapy and will obtain a sense of support and care that they
need while learning how to function as a productive member of society. It also
helps to improve self-awareness, self-management, and sensory needs.
Physical therapy
Physical therapy can be used
to learn the gross and fine motor skills as children with global developmental
delay have difficulty with motor skills. Physical therapy is also essential to
make the child work independently.
Speech therapy
Speech therapy aims to improve
the communication and speech of the child. It helps to develop verbal and
non-verbal skills. For those children who can talk, the advisor may take a shot
at delivering their speech more clear of building their vocabulary, instructing
them to talk in longer sentences or improve their tuning in and appreciation
abilities.
Occupational therapy
Occupational therapy helps the
child to maintain positive behavior and to improve the social skills. This
therapy helps the child to learn socially appropriate behavior and other school
skills. It also helps to develop social awareness and relationship skills.
Special education
Special education can help the
child to improve the play skills. It can also help the child to learn routine
tasks and self-care.
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