A child's journey Flashcards
What are some notable developmental milestones?
Social smile
Sitting
Walking
First words
When should inability to walk be referred?
Not walking by 18 months
What are some important influences in development?
Genetics
Environment
Positive early childhood experience
Developing brain vulnerable to antenatal/postnatal insult and abuse/neglect
What are some of the main antenatal infectious threats?
CMV
Rubella
Toxoplasmosis
VZV
What are some big antenatal toxin threats?
Alcohol
Smoking
Anti-epileptics
What are the main postnatal infectious threats?
Meningitis
Encephalitis
Sepsis
What are the main postnatal toxin threats?
Solvents
Mercury
Lead
When might a language delay be normal?
Multilingual families
When is lack of speech development considered a red flag?
18 months
Especially if no other communication
Urgent referral for hearing test
Is asymmetry of movements/increased muscle tone a significant sign?
Yes
Red flag
Is low muscle tone/floppiness a red flag?
Yes
Is hearing loss a red flag symptom?
Yes
Refer to audiology/ENT immediately
Is vision concern always a red flag?
Yes
What is the Healthy Child Programme?
UK child health screening
Overview of health and development
Based in primary care
Main concerns are health promotion, developmental screening, immunisation
When is new-born hearing screening performed?
By day 28
When is the orthoptist vision screening?
4-5 years
What does the 6-8 week review address?
Feeding Parental concerns Development Measurements Examination Sleeping position (supine, prone, side)
What does the 27-30 month review address?
Development
Physical measurements
Diagnoses
What are some developmental concerns at the 6-8 week review?
Gross motor Hearing Communication Vision Social awareness
What are some developmental concerns at the 27-30 month review?
Social Behavioural Attention Emotion Communication Speech Gross and fine motor Vision Hearing
Is egg allergy a contraindication to MMR?
No
Could you use live vaccines (eg MMR) in immunocompromised children?
No
What are the 3 key parameters for growth monitoring?
Weight
Length
Head circumference
What are some maternal factors which may cause failure to thrive?
Poor lactation
Incorrectly prepared feeds
Unusual milk or other feeds
Inadequate care
What are some infant risk factors for failure to thrive?
Prematurity
Small for dates
Oro palatal abnormalities (e.g. cleft palate)
Neuromuscular disease (e.g. cerebral palsy)
Genetic disorders
What are some causes of excessive nutrient loss which may cause failure to thrive?
Gastro oesophageal reflux
Pyloric stenosis
Gastroenteritis (post-infectious phase)
Malabsorption
What are some causes of malabsorption?
Food allergy Persistent diarrhoea Coeliac disease Pancreatic insufficiency Short bowel syndrome
What are some non-medical causes of failure to thrive?
Poverty Dysfunctional family interactions Lack of parental support Lack of parental education Neglect Emotional deprivation
What are some conditions associated with failure to thrive?
GOR Coeliac Crohn's Chronic renal failure Cystic fibrosis Hypothyroidism Inborn errors of metabolism Neglect
