我们将神经发育理解为中枢神经系统在整个童年时期获得技能和能力的过程。它是一个层次化、顺序化和刻板化的过程，由基因编码，但受环境调节。

Podemos clasificar el neurodesarrollo en distintos dominios, en función de las habilidades que se encuentran involucradas.

Además hay algunas habilidades específicas multidominio que son de utilidad a la hora de valorar el neurodesarrollo de un niño.

Por otro lado, muchas funciones fisiológicas también están condicionadas por el neurodesarrollo, por lo que en los niños deben valorarse teniendo en cuenta a éste.

Valoración cuantitativa.
Hitos del desarrollo. ¿Que queremos decir?
  • Para su correcta valoración es necesario conocer cuales son los hitos esperables según la edad.
  • Tradicionalmente en pediatría se han aprendido teniendo en cuenta la edad a la que la media de la población los adquiere, en vez de conocer su distribución estadística en el tiempo o ventana de desarrollo (edad a la que lo alcanza el percentil 10, el percentil 50 y el percentil 90).

mm_windows_graph释放
  • Está plenamente demostrado que la utilización de tests de screening es mucho más precisa en la valoración clínica, ya que permite realizar una evaluación mejor que aplicando un listado de «hitos normales».
丹佛-II 测试是一种基于美国人口的筛查工具。
丹佛 II 测试释放
Haizea-Llevant 测试基于西班牙人口。

Haizea-Llevant 测试释放
Cuantificación del desarrollo. La mejor estrategia para comparar.

Los test de Screening, no obstante, sólo sirven para conocer la situación del desarrollo en un momento determinado del tiempo, y poder diferenciar a los niños neurotípicos, de aquellos que presentan síntomas de alarma.

Cuando hemos identificado un niño con problemas de neurodesarrollo, es necesario medir a traves de una escala de desarrollo, los distintos dominios y el desarrollo global, y compararlo con una población estandarizada. Las escalas de desarrollo suelen permitir el cálculo de una «edad equivalente o de desarrollo«.

Con una edad de desarrollo podremos calcular el cociente de desarrollo. Se pueden clasificar en retraso leve (CD 70-100), moderado (CD 50-70) y grave (CD menor de 50).

Algunas escalas de desarrollo entregan incluso una puntuación estandarizada con la posición estadística del niño respecto a la cohorte normal (puntuación z o T), pudiendo saber la desviación estadística y por lo tanto la gravedad del problema.

Trayectorias de desarrollo. La herramienta más potente para pronosticar.

Sin embargo, una medida aislada en el tiempo sólo permite conocer la situación estática. Cuando obtenemos varias medidas sucesivas, podemos inferir una trayectoria de desarrollo, que es una herramienta muy potente a la hora de poder inferir un pronóstico. Es especialmente importante conservar registros evolutivos para poder diagnosticar tempranamente la regresión del desarrollo.

正常神经发育的发育轨迹和变异性。

Valoración cualitativa.

Además de valorar si el desarrollo se está produciendo con decalaje respecto al desarrollo normotípico, es necesario considerar si existen síntomas cuya presencia por si misma suponga un síntoma de alarma (banderas rojas).

Herramientas de entrenamiento:

有多种工具可用于训练神经发育评估。

  • 在网络上 途径 根据实际年龄提供正常发育里程碑的视频。
  • CUDAP 网站上有一个 筛选测试 并附有视频供家长使用。

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