DEVELOPMENTAL HIP DYSPLASIA
people w ith
or those who
have any other medical condition.
Inappropriate contraction of the detru-
sor muscle in the wall of the
that causes an uncontrollable release of
urine even when the bladder is not suf-
ficiently full to trigger urination. It may
have various causes, including bladder
inflammation, obstruction of the blad-
der outlet (for example, by a stone or,
in men, by an enlarged
or damage to the nerves supplying the
bladder. (See also
A tumour of one of the
in the foot.
The process of growth and change by
w hich an individual matures physically,
mentally, emotionally, and socially. It
takes place in major phases: during the
first two months of pregnancy
and, to a lesser extent, during
the rest of pregnancy (see
ing the first five years of life (see
and then again during
A term used if a baby or young child
has not acquired new skills w ithin the
expected time range. Normally, new
abilities and new patterns of behaviour
behaviour patterns change and some-
times disappear (see
affect the development of one or more
of the following skills: hand-eye coor-
dination, walking, listening, language,
speech, or social interaction.
A child who is late in most aspects of
development usually has a generalized
problem. This may be due to a severe
visual or hearing impairment, limited
intellectual abilities (see
or damage to the brain before,
during, or after birth. For further infor-
mation on possible causes of generalized
delay, see the table above.
SPECIFIC FORMS OF DELAY
Delay in movement and walking often
has no serious cause. In some cases,
however, there are specific causes; these
Delay in developing manipulative
Physical or emotional deprivation (child
abuse). Lack of affection, stimulation,
Severe visual impairment. Vision is vital
for normal development in all areas.
Children learn to recognize objects
before learning their names, they learn
about sounds by seeing which objects
make which sounds, and they become
motivated to crawl and walk by the
desire to explore their surroundings
vision, disorders of; blindness
Severe hearing impairment (see
Damage to the brain before, during, or
after birth, or in infancy. The results of
damage depend on which parts ofthe
brain are damaged and on severity (see
brain damage; cerebral palsy).
Severe, prolonged disease of any organ or
body system (such as bone, heart, kidney,
muscle, and nutritional disorders).
skills (the ability to pick up and use
objects with the hands) is often due to
lack of adequate stimulation.
have various causes. The most im por-
w hich may cause the
child to be unresponsive to sound.
is a rare cause; in this condition,
hearing is normal but the child may
be unresponsive to the human voice.
Another possible cause is generalized
difficulty w ith muscle control, w hich
may affect speech production; this may
occur in children who have cerebral
palsy. Damage to, or structural defects
or the mouth may also
cause speech difficulties, as may any
disorder that affects the speech area of
the brain (see
Children vary enormously in the age
at w hich they gain control of bladder
control is acquired first. Delay in blad-
der control is much more common
delays have many possible causes (see
Delays may first be noticed by parents;
if this is the case, a health visitor or
doctor should be consulted promptly.
Delays may also be detected during
routine developmental checks w ith a
health visitor, family doctor, or paedia-
trician. These checks are performed at
various ages, but usually at birth, six
weeks, six to eight months, 18 to 24
months, three years, and five years.
A child who shows signs of develop-
mental delay should undergo a full
assessment. This w ill usually include a
physical examination, along with
and a thorough
may need to undergo further investiga-
tions, such as blood tests, to check for
any genetic abnormality, or referral to a
specialist such as a neurologist, speech
therapist, or physiotherapist.
The treatment depends on the severity
and probable cause of the delay. It may
include a course of
or provision of physical
aids such as
ents are often of prime importance in
providing help for their child. In some
cases, however, the child may also ben-
efit from being admitted to a school or
special unit that provides education for
children with specific difficulties.
developmental hip dysplasia
A disorder present at birth in w hich the
head of the
(thigh-bone) fails to
fit properly into the cup-like socket in
to form a normal joint. One
or both of the hips may be affected.
CAUSE AND INCIDENCE
The cause of developmental hip dyspla-
sia is not known. The condition is more
common in girls, especially in babies
pregnancies in w hich there was an
abnormally small amount of amniotic
fluid surrounding the fetus.
If the dislocation is detected in early
are applied to the thigh
to manoeuvre the ball of the joint into
the socket and keep it in position. These
months and usually correct the prob-
lem. Progress may be monitored by
tive surgery may also be required.
If treatment is delayed, there may be
lifelong problems with walking. W ith-
leads to shortening of the leg, limping,
in the joint.