Paeds Vivas · growth-development-and-behaviour
Children with developmental disability in acute care — branching viva
Structured oral on diagnostic overshadowing, pain tools and reasonable adjustments in ED.
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Target exams
RACP DCEMRCPCH Clinical
Prompt
ED: non-verbal child with developmental disability, new agitation, parent says 'not their normal'. No passport found initially.
Opening (2 minutes)
Examiner: "How do you approach this child?" [6]
Strong answer: ABC first like any child. Then caregiver baseline, search medical causes of behaviour change, apply reasonable adjustments, and score pain with an observational tool such as r-FLACC. Avoid diagnostic overshadowing. [1] [3] [6]
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References5Show ledgerHide ledger
- [1]Malviya S The revised FLACC observational pain tool: improved reliability and validity for pain assessment in children with cognitive impairment Paediatric anaesthesia, 2006.PMID 16490089
- [3]Richards B Caring for children with autism spectrum condition in paediatric emergency departments Emergency nurse, 2017.PMID 28703063
- [4]Garrick A An Australian Cross-Sectional Survey of Parents' Experiences of Emergency Department Visits Among Children with Autism Spectrum Disorder Journal of autism and developmental disorders, 2022.PMID 34061310
- [6]Lee ACK Health inequalities for people with learning disabilities: why it matters and what emergency physicians need to know British journal of hospital medicine, 2024.PMID 38416523
- [9]Shaban R Pain assessment in non-verbal children with neurocognitive impairment: a review on current tools, challenges, and clinical perspectives Frontiers in pain research, 2026.PMID 41987884