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Year 3 - Paediatrics > A Child's Journey - Growth, Development and Health > Flashcards

A Child's Journey - Growth, Development and Health Flashcards

1
Q
  • Recognise and describe the normal pattern of childhood development.
  • To be familiar with the principle developmental domains and their key component skills.
  • Describe the key components of the Child Health/ Healthy Child Programmes.
  • Know the current UK vaccination schedule.
  • Understand growth monitoring and a basic approach to a child who has faltering growth
A

.
UK Childhood immunisation
Routine childhood surveillance

Normal patterns and developmental assessment

Abnormal patterns and delay!!!!!

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2
Q

What age are children at these phases of childhood

  • neonate
  • infant
  • toddler
  • pre-school
  • school
  • teenager
A 
Neonate: <4 weeks
Infant: <1 year
Toddler: 1-2 years
Pre-school: 2-5 years
School: 5-12 years
Teenager: 13+
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3
Q

Development of key functional skills usually occurs from birth to what age

A

5

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4
Q

5 key developmental domains

A 
Gross motor skills
Fine motor skills
Speech + language
Hearing + vision
Social + self help
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5
Q

Key component skills of each developmental domain

  • Gross motor skills
  • Fine motor skills
  • Speech + language
  • Hearing + vision
  • Social + self help
A

Gross motor - walking, jumping etc

Fine motor - grasping –> pinching, drawing

Speech - fluent sentences

Social + self help - interacting, doing things when asked, self-feed, changing clothes

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6
Q

Key milestones

A 
Social smile
Sitting
Crawling
Walking
First words
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7
Q

The following should be achieved by what age

  • social smile
  • sitting
  • walking
  • words
A

Social smile - 2 months
Sitting - 9 months
Walking - 18 months
Words - 18 months - 2 years

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8
Q

Factors affecting normal childhood development (3)

A 
Genetics
Positive childhood experience 
Environmental
-antenatal/post-natal insults
-abuse + neglect
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9
Q

Adverse environmental ANTENATAL factors that could affect childhood development (2)

A

Infections, e.g. rubella, CMV

Toxins, e.g. drugs, alcohol, smoking

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10
Q

Adverse environmental POSTNATAL factors that could affect childhood development (2)

A 
Infection, e.g. meningitis
Toxins, e.g. alcohol, smoking
Trauma
Malnutrition
Metabolic, e.g. hypoglycaemic, hypo/hypernatraemic
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11
Q

Why is developmental assessment needed?

A

Reassurance and showing progress

Early diagnosis and intervention of any conditions

Discuss positive stimulation/parenting strategies

Genetic counselling of any inherited disease

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12
Q

Who assesses a child’s development?

A 
Parents
Health visitors
Teachers
GPs/other doctors in acute setting
Paediatricians
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13
Q

Key components of the Healthy Child Programme (HCP) UK

a programme from antenatal period until 5 years of age

A 
Antenatal appointments 
Screening
Immunisations 
Health and development reviews 
Supplemented by advice around health, wellbeing and parenting (health promotion)
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14
Q

When assessing development, what questions to ask yourself?

A

What sequence of events has come before this?

What skills have been achieved and what has not been achieved?

Is one developmental field falling behind compared to the other?

Are the skills gained age appropriate?

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15
Q

Development is not the same in every child, what normal variations should you be aware of?

A

Early developers
Late but normal developers
Bottom shufflers - indicating walking delay
Bilingual kids may have a language delay

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16
Q

RED FLAGS OF DEVELOPMENTAL DELAY

A

No social smile by 2 months
Not sitting unsupported by 9 months
Not walking unsupported by 18 months
No words by 2 years

Problems with vision
Hearing loss
Low muscle tone
Asymmetrical movements
Head circumference (OFC) >99.6th or <0.4th gentile
17
Q

How to assess developmental as a non-specialist (i.e. someone who’s not a doctor)

A

Drawing skills
Throwing skills
Recognising colours/shapes
Animal sounds

18
Q

Approximating a child’s age based on a description of skills given (usually can be worked out by any of the domains described and what skills they are able of)

A

.

19
Q

Being able to match skills to its respective developmental domain

A

.

20
Q

Expected skills for 6 month old

  • gross motor
  • fine motor
  • language
  • social
  • self-help
A

Gross motor - SITTING UNSUPPORTED (by 9), back to belly

Fine motor - grasping toy from one hand to another

Language - BABBLES, RESPONDS TO NAME

Social - reaches for familiar people

Self-help - self-feed BISCUIT

21
Q

Expected skills for 1 year old

  • gross motor
  • fine motor
  • language
  • social
  • self-help
A

Gross motor - WALKING UNSUPPORTED (by 18), run maybe (but falls)

Fine motor - stack blocks, pincer grip (by 9 months)

Language - SIMPLE SINGLE WORDS (some are meaningful)

Social - SHARED ATTENTION/POINTING TO THINGS OF INTEREST, copies others

Self-help - self-feed with SPOON

22
Q

Expected skills for 2 year old

  • gross motor
  • fine motor
  • language
  • social
  • self-help
A

Gross motor - kicking ball, climbing on ladders/slides

Fine motor - SCRIBBLING WITH CIRCULAR MOTION

Language - vocal of 30 words min, PUTS FEW WORDS TOGETHER INTO SENTENCES

Social - PRETEND PLAY (e.g. tea party), helps with simple tasks, points at things when asked, e.g. where’s nose

Self-help - takes off clothes

23
Q

Expected skills for 3 year old

  • gross motor
  • fine motor
  • language
  • social
  • self-help
A

Gross motor - ride on tricycle, walk backwards

Fine motor - DRAWS OR COPIES COMPLETE CIRCLE

Language - starts questioning (why, how), simple sentences, colours

Social - playing with other children, sorts objects into categories, follows simple instructions

Self-help - self-toileting

24
Q

Child health programme includes what scheduled appointments from birth (6)

A 
Newborn examination by 72 hours
Blood screening by 5 days
Newborn hearing screening by 4 weeks
6-8 week review by GP or HV
27-30 month review by HV
Orthoptist vision screening at 4-5 years
25
Q

What does the blood spot test on day 5 screen for

A 
Phenylketonuria (PKU)
Congenital Hypothyroidism
Cystic Fibrosis 
Medium Chain Acyl-CoA Dehydrogenase Deficiency (MCADD) 
Sickle Cell Disorder (SCD)
26
Q

If child is immunocompromised, cannot give what type of vaccine

A

Live vaccine, e.g. MMR

27
Q

3 key physical measurements taken to monitor growth of babies/children

A

Weight
Length or height (if >2)
Head circumference (OFC)

28
Q

Normal values for a newborn

  • weight
  • length
  • OFC
A

Weight - 3.3kg
Length - 50cm
OFC - 35cm

29
Q

Normal values for a 12 month old

  • weight
  • length
  • OFC
A

10kg
75cm
45cm

30
Q

On growth charts, they talk about centiles

What is a centile?
What is the 50th centile?
What is the 0.4th centile?

A

% division of the reference population sampled

50th centile - the average measurement of that population sampled so if 100 kids sampled then 50 above and 50 below that point

0.4th centile - if 100 children sampled, then 4 below this point and 96 above

31
Q

Basic approach to a child who has faltering growth/failure to thrive (FTT)

(FTT = growing too slowly at expected rate for his/her age due to supply < demand for energy/nutrients)

A

.

32
Q

Causes of failure to thrive

  • maternal causes
  • infant causes
A

Poor lactation
Incorrectly prepared feeds

Premature
Cleft palate
Neuromusuclar disease, e.g. cerebral palsy
Genetic disorders

33
Q

Causes of failure to thrive due to increased metabolic demands

A 
Congenital lung/heart/liver/renal disease
Infection
Anaemia
Inborn errors of metabolism
CF
IBD
34
Q

Causes of failure to thrive due to excessive nutrient loss

A

GOR
Pyloric stenosis
Gastroenteritis
Malabsorption, e.g. milk allergy, coeliac, short bowel syndrome

35
Q

Non-medical causes of failure to thrive

A 
Low socio-economic status
Dysfunctional family
Lack of parental support 
Lack of parenting education, e.g. poor feeding skills
Child neglect
36
Q

Know the immunisation schedule

A

See infection table

Year 3 - Paediatrics (11 decks)

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