Children with developmental disability in acute care — formative SAQs

SAQ 1 (10 marks)

A non-verbal 8-year-old with intellectual disability presents with new self-injury and tachycardia. Staff document “behavioural.” The caregiver insists this is not baseline. ^{[6] [9]}

1. Define diagnostic overshadowing and why it matters here. (3) ^[6]
2. Outline your assessment priorities including pain measurement. (4) ^{[1] [9]}
3. List three medical differentials you will actively exclude. (3) ^[6]

Model answer

Diagnostic overshadowing: attributing new symptoms to the disability label and stopping the medical search — drives missed illness and inequality. ^[6]

ABC/glucose first; caregiver baseline and hospital passport; reasonable adjustments; examine systematically; use observational pain tool (e.g. r-FLACC); treat pain and reassess. ^{[1] [3] [9]}

Differentials: occult pain (ear/abdomen/fracture), infection/sepsis, constipation/retention, seizure/shunt issues, safeguarding injury. ^{[6] [9]}