A Child's Journey- Growth, Health and Development

Question 1

What are the recognised phases of childhood?

Answer 1

Neonate = <4 weeks
Infant = <12 months
Toddler = 1-2 years
Pre-school = ~2-5
School age
Teenager/adolescent

Question 2

What are the key developmental fields?

Answer 2

Gross motor
Fine motor
Social and self help
Speech and language
Hearing and vision

Question 3

What are the red flag missed milestones?

Answer 3

No social smile by two months
Not sitting unsupported by nine months
Not walking unsupported by eighteen months
No words by two years

Question 4

What are the main milestones that should be met by 6 months?

Answer 4

Gross motor- Sits steadily without support
Fine motor- Transfers toys from one hand to another, uses two hands to pick up big objects
Language- Responds to name. Two syllable babbles
Social- Reaches for familiar people
Self help- feeds self biscuits or similar food

Question 5

What are the main milestones that should be met by 12 months?

Answer 5

Gross motor- walks without help
Fine motor- stacks two or more blocks, pincer grasp (by 9 months)
Language- has 1/2 words with meaning, uses mama/dada/similar specifically
Social- shows shared interest/points to things of interest
Self help- feeds self with spoon

Question 6

What are the main milestones that should be met by 18 months?

Answer 6

Gross motor- runs well with few falls
Fine motor- scribbles with crayons
Language- starts to join words into sentences
Social- early pretend play
Self help- eats with fork, eats with spoon spilling little

Question 7

What are the main milestones that should be met by 2 years?

Answer 7

Gross motor- Climbs on play equipment
Fine motor- scribbles with circular motion
Language- has vocabulary of 30-50 words
Social- “Helps” with simple household tasks
Self help- opens door by turning knob

Question 8

How are milestones altered for premature babies?

Answer 8

Corrected up until 2 years of age

Question 9

What are the influencing factors in the developmental process?

Answer 9

Genetics
Environment
Positive early childhood experience
Developing brain vulnerable to insults

Question 10

What are some possible adverse environmental factors in the developmental process?

Answer 10

Antenatal:
-Infections- CMV, Rubella, VZV
-Toxins- alcohol, smoking, anti-epileptics
Postnatal:
-Infection- meningitis, encephalitis
-Toxins
-Trauma- head injury
-Malnutrition
-Metabolic- hypoglycaemia
-Maltreatment
-Maternal mental health issues

Question 11

What are the red flags with regards to child development?

Answer 11

Loss of developmental skills
Parental or professional concern regarding vision
Hearing loss
Persistent low muscle tone/floppiness
No speech by 18 months
Asymmetry of movements/ increased muscle tone
Not walking by 18 months/persistent toe walking
Head circumference >99.6th centile or <0.4th centile

Question 12

What are the main components of child health screening?

Answer 12

Health promotion
Developmental screening
Immunisation

Question 13

What are the steps in the child health programme?

Answer 13

New-born exam and blood spot screening
New-born hearing screening by 28 weeks
Health visitor review
6-8week review
27-30month review
Orthoptist vision screening by 4-5yrs

Question 14

What measurements are used in growth monitoring?

Answer 14

Weight
Length if <2 years, height if >2 years
Head circumference (OFC- occipital frontal circumference)

Question 15

What are the average weights of children for birth, 4 months, 12 months and 3 years?

Answer 15

Birth- 3.3kg
4 months- 6.6kg
12 months- 10kg
3 years- 15kg

Question 16

What are the average lengths of children for birth, 4 months, 12 months and 3 years?

Answer 16

Birth- 50cm
4 months- 60cm
12 months- 75cm
3 years- 95cm

Question 17

What are the average OFCs of children for birth and 12 months?

Answer 17

Birth- 35cm

12 months- 45cm

Question 18

What does failure to thrive mean?

Answer 18

Failure to thrive (FTT)/weight faltering refers to a child that is growing too slowly in form and usually function at the expected rate for his or her age

Question 19

What are some medical causes of failure to thrive?

Answer 19

Deficient intake due to maternal factors:
-Poor lactation
-Incorrectly prepared feeds
-Unusual milk or other feeds
Deficient intake due to infant factors:
-Prematurity
-Small for dates
-Neuromuscular disease
Increased metabolic demands:
-Congenital disease
-Infection
-Anaemia
Excessive nutrient loss:
-GORD
-Pyloric stenosis
-Gastroenteritis

Question 20

What are some non-medical causes of failure to thrive?

Answer 20

Poverty
Dysfunctional family interactions (especially maternal mental health or drug abuse issues)
Lack of parental support
Child neglect
Emotional depravation
Poor feeding or feeding skills disorder