Approach to child Flashcards
A useful standardised screening tool to
use for further evaluation in a GP setting, if there
are concerns regarding development, is the ____________
Denver- II Developmental Screening Test
Gross motor skills we want to see emerge
(12 months to 6 years)
• _______ —walking up stairs holding onto an adult
hand, and possibly attempting alternating feet with
each stair
• _______ —observing a child being able to jump
• _______ —starting to try and to use a tricycle
• _______ —weaning the trainer wheels off the bike
• _______ —skipping
2 years
2½ years
3 years
5–6 years
6 years
An easy way to remember the principles of fine
motor development is to think of the ________
in terms of whole-hand activity, and the _________ as individual digit activity
first 9 months
second 9 months (9–18 months of age)
Between 3 and 6 months, _______ (using consonants—that is, involving the tongue and lips to change sounds) will
appear.
babble
Receptive language usually precedes
expression, so at the________ check, even if a
child is not saying many words, his or her increasing
understanding of speech should be evident
18-month
Between ________, the combination
of words and small sentences and increasingly
reciprocal (back-and-forth) conversation expand
markedly
18 months and 3 years
Articulation also improves over this
time, with around 25% of articulation intelligible at
____ months, 50–75% intelligible at ______and 75–
100% at ______
18
2 years
3 years
At what month
includes grasping objects passed to the
child, looking at objects he or she is holding (‘object
regard’) and banging objects onto a surface, such as a
tray in a high chair
3–6 months
—banging objects together. By 9 months,
babies should be doing hand-to-hand transfers and
purposefully releasing objects
6–9 months
Pointing is an important milestone, and is often there by
______ and should be there by _____
12 months
18 months
At around ______of age, separation anxiety
will usually appear.
6 months
Separation anxiety often peaks
around ________ months and then decreases through
the preschool years.
14–18
Stranger anxiety, usually appearing around
_____months and reducing after months of age, is
similar in many ways to separation anxiety.
7–9
Tantrums, which are common between __________occur because the child lacks the skills to deal with an emotionally challenging event
18 months and 3 years (or older),
In the second year of life, two emerging skill
sets dominate social development: speech and
play, particularly _______
pretend play
Red flags for autism
• Lack of babbling or pointing by _______
• No sharing of interest in objects or activities with
another person
• No single words by _______, or no two-word
(non-echoed) phrases by ______
• Any loss of language or social skills at any age
12 months
16 months
24 months
Most (96%) Australian women initiate breastfeeding, but almost a third will have introduced formula or stopped
breastfeeding by ________
3 months
It is also recommended that the woman
continues to breastfeed while introducing appropriate
solid food until ______ of age and beyond
12 months
Exclusively
breastfed infants do not require additional fluids up
to________
6 months of age.
If formula is used, a _______ should be
used up until 12 months
cow’s milk-based type
postpartum women are vulnerable to
suggestions of lactation failure, which is a risk factor
for__________
postnatal depression
The only other fluid besides breast milk and
formulas suitable to be given to infants is_____
boiled and
cooled tap water (i.e. no bottled water, juice, cordial
or other beverages).
Honey
should be avoided because of the risk of______
botulism.
Hard, small, round (e.g. whole nuts) and/or sticky
foods are not recommended because of _______
choking and
aspiration risk
_________ should not be used
in the first 2 years of life, and soy and other milks
(e.g. goat’s milk, sheep’s milk, coconut milk, almond
milk) are inappropriate alternatives to breast or
formula or pasteurised whole cow’s milk
Low-fat milks
From _______, milk and other
drinks should be offered in a cup rather than a feeding
bottle
12 months
The ages by which most children are fully trained
are:
- daytime—between _______
- night-time—by __________
2½ and 4 years
8 years of age
On toilet training:
Nagging does not work; a __________
approach is far better. This can include reward
systems such as reward charts and stickers
positive-reinforcement
Indications that a child is ready to start
toilet training
1 2 3 4 5
• Interest in others going to the toilet
• Has a dry nappy for 1–2 hours or more
• Tells you when they have wet or soiled their
nappy or are about to go
• Doesn’t like wearing a nappy, especially when it is
wet or soiled
• Has the motor skills to pull training pants up and
down and get on and off the toilet (may need a
step) or potty
Arthralgia (lower limbs) + rash (buttocks,
legs) ± abdominal pain
HSP
Pallor + drowsiness + fever
Meningits
Pallor + abdominal pain (severe and
intermittent) + inactivity
intussusception
(<12 months): drowsiness + cough + wheezing
bronchiolitis
(<3 months, usually male): weakness +
weight loss + vomiting (severe, intermittent)
pyloric stenosis
vomiting (after first feeds) + drooling + abdominal distension
oesophageal or duodenal atresia
Malaise + pallor + bone pain
acute lymphatic leukaemia
Malaise + pallor + oral problems
gingival hypertrophy, bleeding, ulceration
acute myeloid leukaemia
Abdominal pain + pallor + a/n/v
acute appendicitis
Abdominal pain + malar flush + fever ± URTI
mesenteric adenitis
Drowsiness + tachypnoea + chest wall recession
pneumonia
Drowsiness + fever + purpuric rash
meningococcal infection
URTI + brassy cough + inspiratory stridor
croup
Coughing + wheezing + chest wall recession
asthma or aspirated foreign body
Fever + conjunctivitis + skin changes
(cracked red lips, maculopapular rash,
erythema of palms/soles, desquamation of
fingertips)
Kawasaki syndrome
Malaise + abdominal pain (vague) +
abnormal behaviour
lead poisoning
(<2 years): lethargy + irritability + pallor
iron deficiency anaemia
Fever + malaise (extreme) + a/n/v ± anaemia
neuroblastoma
Headache + a/n/v + ataxia
medulloblastoma
Speech communication skills +
poor socialisation + repetitive/obsessive
behaviour/restriction of interests
autism
spectrum disorder
Male): snorting, blinking, etc. + oral
noises (e.g. grunts, hisses) ± loud expletives
Tourette syndrome
Mid to low back pain/discomfort
+ inability to touch toes + kyphosis
Scheuermann disorder
Knee pain (after activity) + tender knee ‘lump’ + pain on kneeling
Osgood–
Schlatter disorder
(Adolescent): limp + knee pain + hip pain
slipped capital femoral epiphysis
