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]

SAQ 2 (10 marks)

Parents of an autistic child describe previous ED visits as traumatic because of noise, long waits and dismissed pain. [3] [4]

1. List reasonable adjustments you will implement today. (4) [3]
2. Explain how parent survey evidence should change system practice. (3) [4]
3. State discharge communication essentials. (3) [3] [4]

Model answer

Quieter bay, fewer staff, predictable sequence, visual supports, caregiver present, batch procedures, avoid unnecessary restraint. [3]

Parent experience data show sensory distress and pain-recognition gaps — design pathways that reduce waits and train staff on autism-aware care. [4]

Written plan, what worked, red flags, analgesia plan, GP/community follow-up, offer passport update. [3] [4]