CHILD DEVELOPMENT Flashcards
What does the developing brain look like after week 4?
Future forebrain, midbrain, hindbrain and spinal cord present
Cephalic flexure, pontine flexure, cervical flexure present
What does the developing brain look like after week 5?
Telencephalon, diencephalon, pons and medulla present
What does the developing brain look like after week 8?
Developing cerebral hemispheres
Developing cerebellum
Ventricles/aqueduct present
Name some primitive reflexes that can observed to assess gross motor development and explain them
Moro reflex - Head is held and is suddenly allowed to fall back. Arms extend and abduct
Standing reflex - Baby held so they are in standing position, extension of lower extremities, hips slightly flexed and behind shoulder with head free to turn.
Grasp reflex - Object placed in hand of newborn and fingers grasp tightly, stroking of lateral hand opens fingers up
Parachute reflex - Baby tilted forward, outstretched hands to protect themselves
When do the each of the primitive reflexes develop/disappear?
Moro reflex develops 28-32 weeks gestation, disappears 3-6 months
Standing reflex present at 3 months
Grasp reflex replaced at 6-9 months with voluntary hand movement (fine motor development)
Parachute reflex develops 6-9 months
What does persistence of primitive reflexes after a certain age suggest?
Impaired development
What are the 4 domains of child development?
Speech and language skills
Social skills
Gross motor skills
Fine motor skills
What are some signs of gross motor development?
Raise head to 45 degrees when in prone position (6-8 weeks)
A median age baby (3 months) should be able to lift head up as well when pulled up from laying. A newborn cannot due to immaturity of neck muscles
Roll by itself (3-5 months)
Sit without support
6 months - round back
8months - straight back
Crawling (8-9 months)
Cruises around furniture (10 months)
Walk unsteadily (12 months) Walks steadily (15 months)
What are all the variations of progression of an immobile infant to a walking toddler?
Commando crawl Crawling on all fours Bottom shuffling (usually takes them longer to walk)
What are the signs of vision and fine motor development?
Follows moving object or face by turning the head (6 weeks)
Reaches out for toys (4 months)
Palmar grasp (4-6 months)
Transfers toys from one hand to another (7 months)
Mature pincer grip (10 months)
Makes marks with crayon (16-18 months)
Block towers (14+ months)
Draw without seeing how its done (2-5 years)
What are the signs of hearing, speech and language development?
Startles to loud noises (newborn)
Vocalises alone/when spoken to (3-4 months)
Turns to sounds (7 months)
Indiscriminate sound (7 months)
Discriminate sound (10 months)
2/3 words other than dada/mama (12 months)
6-10 words and shows 2 parts of body (18 months)
Simple phrases (20-24 months)
Constant talking in 3-4 word sentences (2.5-3 years)
What type of babble will a child with hearing impairment have?
Monotone
What are the signs of social, emotional and behavioural development?
Smiles responsively (6 weeks)
Self feeding (6-8 months)
Waves bye bye, plays peek-a-boo (10-12 months)
Drinks from a cup with 2 hands (12 months)
Holds spoon and gets food safely to mouth (18 months)
Symbolic play (18-24 months)
Potty training (2 years)
Parallel play/playing together(2.5-3 years)
What are the different patterns of development?
Slow but steady
Plateau
Regression
What are limit ages?
Ages at which certain abilities should have developed
What are the limit ages of gross motor control?
Head control - 4 months
Sitting independently - 9 months
Standing independently - 12 months
Walking independently - 18 months
What suggests evolving cerebral palsy in a baby?
Unable to life head or push up on arms with stiff extended legs at limit age 2 months
Why do stiff arms, extended legs or stiff, crossed legs occur in abnormal motor development?
Disinhibition of the lower motor neurones
What is an excessive tiptoe gait caused by?
Excess motor activity which is uninhibited by corticospinal neurones
What are the limit ages of vision and fine motor development?
Fixes and follows visually - 3 months
Reaches for objects - 6 months
Transfers - 9 months
Pincer grip - 12 months
What are the limit ages of hearing speech and language development?
Polysyllabic babble - 7 months Consonant babble - 10 months 6 words with meaning - 18 months Joins words - 2 years 3 word sentences - 2.5 years
What are the limit ages of social, emotional and behaviour development?
Smiles - 8 weeks Fear of strangers - 10 months Feeds self/spoon - 18 months Symbolic play - 2/2.5 years Interactive play - 3/3.5 years
Who should be carrying out developmental assessing?
Parents
All doctors
Nursery nurses
Teachers
When should developmental assessing be carried out?
Opportunistically
Planned as part of programme of reviews e.g. the healthy child programme
What are the key components of the healthy child programme?
Screening
General examination and immunisation
Health education/promotion
What are some prenatal factors which may affect the developing human?
Folate –> spinal cord development
Iron–> cofactor for brain development
What are some perinatal factors which may affect the developing human?
Delivery (traumatic event)
Oxygen deprivation (brain development)
Drugs used in neonatal period
What are some postnatal factors which may affect the developing human?
Trauma, meningitis
How should you evaluate a child with abnormal development?
History (parental concern, birth history, family history)
Past medical history (developmental history, current skills)
Examination (developmental assessment, general and neurological examination, investigations)
What should be assessed in development assessment?
Milestones proceeding age (developmental history)
Expected milestones for age
Next important milestones (alerting patients to look out for them)
What are the 4 factors causing developmental delay?
Lack of physical/psychological stimuli
Ill health
Sensory/motor impairment
Reduced inherent potential
What are the types of developmental delay?
Specific - language, motor, sensory or cognitive
Global - in all 4 aspects
What are some causes of global delay?
Chromosomal abnormalities e.g. Down's Metabolic e.g. hypothyroidism Antenatal/perinatal factors e.g. infections, drugs Environmental-social issues Chronic illness
What are some causes of motor delay?
Cerebral palsy Congenital dislocation of hip Social deprivation Muscular dystrophy - duchenne's Neural tube defects Hydrocephalus
What are some causes of language delay?
Hearing loss
Learning disability
Autistic spectrum
Lack of stimulation
Impaired comprehension of language - developmental dysplasia
Impaired speech production - stammer, dysarthria
What are some commonly used assessment tools for the development of a child?
Standardised tests:
- Schedule of growing skills
- Griffiths developmental scale
- Bailey developmental scale
- Denver developmental screening tests
