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A childs journey Flashcards

1
Q

How old are neonates?

A

< 4 weeks

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2
Q

How old are infants?

A

< 12 months

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3
Q

How old are toddlers?

A

1 - 2 years

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4
Q

How old are pre school aged children?

A

2 - 5 years

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5
Q

Main childhood objectives

A 
To grow
To develop and achieve their potential 
To attain optimal health 
To be safe
To develop independence 
To be cared for
To be involved
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6
Q

What is development?

A

Gaining functional skills throughout childhood

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7
Q

When does development occur?

A

Typically birth to 5 y/o (but brains develop in utero)

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8
Q

Physiology of development

A

Cell growth, migration, connection, pruning and myelination (use it or lose it)

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9
Q

What age is the brain the most connective as it will ever be?

A

2 y/o

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10
Q

In development, if what you see in motor wise is normal, what are the chances?

A

Chances are what follows will be normal

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11
Q

In development, if what you see in motor wise is abnormal, what are the chances?

A

What came before and what comes after may well be abnormal

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12
Q

What development occurs during school age?

A

Cognitive and thought development (early skills become more refined)

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13
Q

Key developmental fields

A 
Gross motor skills
Fine motor skills
Speech and Language 
Social and self help 
Hearing and vision
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14
Q

What is involved in gross motor skills?

A 
Sitting
standing 
holding neck 
walking
stairs etc
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15
Q

What is involved in fine motor skills?

A

Hands - e.g. grabbing things - begin to be more precise

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16
Q

What is involved in social and self help?

A 
Toilet
Feeding yourself
Imaginary play 
Copying others
Reciprocate emotion
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17
Q

What are milestones?

A

Achievement of key developmental skills

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18
Q

Examples of milestones

A

Social smiling
Sitting
First words
First steps

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19
Q

What is done in prematurity and milestones?

A

Prematurity is counted for until 2 y/o

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20
Q

What is the association between bottom shufflers and crawling?

A

Bottom shufflers crawl later

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21
Q

When are children referred for milestones?

A

If not reached by age limit

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22
Q

Why is development important?

A

Learning functional skills for later in life
Hone skills in a safe environment
Allow our brains genetic potential to be fully realised
equip us with tools needed to function as older children and adults

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23
Q

Influencing factors of development

A

Genetics (family, race, gender)
Environment
Positive early childhood experience
Developing brain vulnerable to insults

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24
Q

What does environment influence in development?

A

language

Skills developed

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25
Examples of insults that the developing brain is vulnerable to
``` Antenatal - infections (CMV, rubella) - toxins (alcohol, smoking) Post natal - infections (meningitis) - toxins (lead, mercury) - trauma (head injuries) - malnutrition (iron, vit D) - metabolic (hypoglycaemia) - maltreatment - under stimulation - domestic violence - maternal mental health issues - abuse and neglect ```
26
What screening is done for childs development?
Healthy child programme (HCP) UK
27
Examples of ways to check development skills
Bricks (motor skills / fine motor skills) Crayons Balls (movement / motor skills) Books (recognition of colours / numbers / language)
28
Link to development and bilingual families
Apparent language delay (total words may be normal)
29
Normal variation
``` early developers late normal bottom shufflers - walking delay bilingual families - apparent language delay familial traits ```
30
Red flags for development
Loss of developmental skills Parental / professional concern r.e. vision Hearing loss Persistent loss muscle tone / floppiness No speech by 18 months esp if no other communication Asymmetry of movements / increased muscle tone Not walking by 18 months Persistent toe walking OFC > 99.6th / <0.4th / crossed two centiles / disproportionate to parental OFC Clinician uncertain / thinks that development may be distorted
31
What age should children be able to sit comfortably?
6 months
32
What age should children be able to pull to stand?
10 months
33
What age should children be walking / running?
1 - 2 years
34
Main components of child health screening
Health promotion Developmental screening (including hearing) Immunisation
35
What programmes are used in child health screening?
Child Health programme | UK - healthy child programe
36
What is used if concerned / to refer?
Red book
37
What does the child health programme involve?
``` New born exam and blood spot screening New born hearing screening (by day 28) Health visitor first visit 6-8 week review (max 12w) 27-30 months review (max 32 months) Orthoptist vision screening (4-5 years) ```
38
What is looked at in the 6 - 8 week review by the GP / HV?
``` Feeding (breast / bottle / both) Parental concerns Development Measurements (weight, OFC, length) Examination (heart, hips, testes, genitalia, femoral pulses and eyes (red reflex) Sleeping position (supine, prone, side) ```
39
What is looked at in the 27-30 month review by the HV?
Development Physical measurements (height and weight) Diagnoses / other issues
40
What is looked at in the Healthy child programme?
Antenatal Birth - 1 week (feeding, hearing, exam, vit K immunisations, blood spot) 2 weeks (exam, maternal mental health, jaundice, SIDS) 6 - 8 weeks (exam, imm, measure, maternal mental health) 1 yr (growth, health promotion, questions) 2 - 2.5 y (development, concerns, language) 5 y (imms, dental, support, hearing, vision, dev) Health promotion - smoking - alcohol /drugs - nutrition - hazards and safety - dental health - support services
41
Why do we immunise?
A public health measure for the reduction and eradication of diseases
42
Who gets immunised?
All children and additional people if at risk
43
Do you correct immunisations for pre term babies?
NO - immunisations are done in chronological age
44
When can a child not get a live vaccine?
If the child is immunocompromised (except HIV)
45
Why do childhood immunisations get postponed?
If unwell - fever - systemic symptoms
46
S / Es of immunisations
Mild temperature Discomfort Swelling Anaphylaxis - RARE
47
What are the 3 key parameters used in growth monitoring?
Weight (g and kg) Length (cm) or height (if > 2 y) Head circumference (OFC) (cm)
48
When is a child measured in height instead of length?
> 2 y/o
49
What OFC should a baby have at Birth?
35cm
50
What OFC should a child have at 12 months old?
45cm
51
What weight should a baby be at birth?
3.3kg
52
What weight should a baby be at 4 months?
6.6kg
53
What weight should a baby be at 12 months?
10 kg
54
What weight should a baby be at 3 years?
15 kg
55
What length should a baby be at birth?
50cm
56
What length should a baby be at 4 months?
60 cm
57
What length should a baby be at 12 months?
75 cm
58
What length should a baby be at 3 years?
95cm
59
Who has their head circumference size doubled?
Prem babies
60
What is a centile?
% of population sampled
61
What does failure to thrive (FTT) mean?
Child growing too slowly in form and usually in function at the expected rate for his / her age
62
Pathology of FTT
Supply of energy and / or nutrients < demand for energy and / or nutrients
63
Causes of FTT
``` Deficient intake - poor lactation - incorrectly prepared feeds - unusual milk or other feeds - inadequate care - prematurity - small for dates - oro palatal abnormalities e.g. cleft palate - Neuromuscular disease e.g. CP - genetic disorders Increased metabolic demands - Congenital lung disease - Heart / lung / liver / renal disease - infection - anaemia - inborn errors of metabolism - cystic fibrosis - thyroid disease - crohn's / IBD - malignancy Excessive nutrient loss - Gastro oesophageal reflux - pyloric stenosis - gastroenteritis (post infectious phase) - malabsorption (food allergy, persistent diarrhoea, coeliac, pancreatic insuffiency, short bowel syndrome) Dysfunctional family interactions Poverty / socio economic status Neglect Poor feeding or feeding skills disorder ```
64
At what age should a child acquire good pincer grip?
12 months
65
What age should a child wave bye bye?
12 months
66
What age should a child know and respond to their own name?
12 months
67
What age should a child be able to tower 3 blocks?
18 months
68
What age should a child be able to point with a finger?
9 months
69
What age should a child crawl?
9 months
70
What age should a child say mama and dada?
9 months
71
What age should a child turn towards sound?
3 months
72
What vaccination is given at birth if at risk?
BCG
73
What vaccination is given at 2 months?
6 in 1 vaccine Oral rotavirus vaccine Men B
74
What is in the 6 in 1 vaccine?
``` Diptheria Tetanus Whooping cough Polio Hib Hepatitis B ```
75
What vaccinations are given at 3 months?
6 in 1 vaccine Oral rotavirus vaccine PCV
76
What vaccinations are given at 4 months?
6 in 1 vaccine | Men B
77
What vaccinations are given 12 - 13 months?
Hib/Men C MMR PCV Men B
78
What vaccinations are given at 2-8 years annually?
Flu
79
What vaccinations are given at 3 - 4 years?
4 in 1 pre school booster | MMR
80
What is in the 4 in 1 pre school booster?
Diptheria Tetanus Whooping cough Polio
81
What vaccination is given at 12 - 13 y/o?
HPV
82
What vaccination is given at 13 - 18 y/o?
3 in 1 teenage booster | Men ACWY
83
What is in the 3 in 1 teenage booster?
Tetanus Diptheria Polio
84
What is Men ACWY?
Meningococcal vaccine covering A, C, W and Y stereotypes
85
What age do the majority of children achieve nighttime and day time urinary continence?
3 - 4 y/o
86
What type of vaccine is the rotavirus vaccine?
Oral, live attenuated vaccine
87
What age would the average child play alongside with, but not interacting with, other children?
2 years
88
Describe the moro reflex
Head extension causes abduction followed by adduction of the arms
89
When is the moro reflex present?
Birth - 3/4 months of age
90
What is the grasp reflex?
Flexion of fingers when an object is placed in the palm
91
When is the grasp reflex present?
Birth to around 4 - 5 months of age
92
Describe the rooting reflex
Assists in breastfeeding
93
When is the rooting reflex present?
Birth to approx. 4 months
94
What is the stepping reflex also known as?
Walking reflex
95
When is the stepping reflex present?
Birth to 2 months of age
96
How do you account for prematurity when assessing milestones?
Age of baby - number of weeks born early from 40 weeks
97
The corrected age of prematurity and milestones is used until what age?
2 y/o

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