Child development

Question 1

What is development?

Answer 1

Global impression of a child which encompasses growth, increase in understanding, acquisition of new skills and more sophisticated responses and behaviour

Question 2

What are teratogens?

Answer 2

Environmental agents that cause congenital anomalies by interfering with embryonic or fetal organogenesis, growth or cellular physiology or by disrupting previously normal tissue

Question 3

Give some examples of antenatal teratogens?

Answer 3

Maternal infections
Toxins- e.g. alcohol
Drugs

Question 4

Give some examples of postnatal teratogens?

Answer 4

Infections e.g. meningitis, encephalitis
Metabolic disorders- hypoglycaemia
Toxins
Trauma
Severe understimulation, maltreatment or domestic violence
Malnutrition especially deficiency of iron, folate and vitamin D
Maternal mental health disorders- most commonly depression

Question 5

Give some examples of infectious agents that are teratogens ?

Answer 5

Rubella
Cytomegalovirus
HSV
Varicella
Toxoplasmosis
Syphilis

Question 6

Give some examples of drugs that are teratogens?

Answer 6

Phenytoin
Vaproic acid
Trimethadone
Lithium
SSRIs
Amphetamines
Warfarin
ACE inhibitors
Mycophenylate
Alcohol

Question 7

Give some examples of hormones that are teratogens?

Answer 7

Androgenic agents
DES
Maternal diabetes
Maternal obesity

Question 8

How can maternal diet affect child development?

Answer 8

Lack of folate in the diet can lead to:
Failure of fusion neural tube defects
Anencephaly- failure of rostral defects
Spina bifida- failure of caudal fusion

Question 9

What are the complications of spina bifida cystica?

Answer 9

Neurogenic bowel incontinence
Neurogenic bladder incontinence
Lower limb paralysis
Fractures
Joint contractures
Developmental deformities
Learning impairment
Hydrocephalus -> meningitis

Question 10

What are the 4 domains of the brain?

Answer 10

Gross motor
Vision and fine motor
Hearing, speech and language
Social, emotional and behavioural

Question 11

In terms of development, what is a milestone?

Answer 11

Acquisition of a key performance skill

Question 12

What is the pattern of development like between children?

Answer 12

It remains constant between children but there is variation in rate

Question 13

In terms of development, what is the median age?

Answer 13

The age when half of a standard population of children achieve that level

Question 14

In terms of development, what are limit ages?

Answer 14

Age by which they should have achieved= 2 standard deviations from mean

Question 15

What are the different stages of gross motor and posture development?

Answer 15

New born- limbs flexed, symmetrical posture then marked head lag on pulling up
6-8 weeks- Raised head to 45 degrees in prone
6-8 months- Sits without support
8-9 months- Crawls
10 months- Cruises
12 months- Walks unsteadily (broad gait and hands apart)
15 months- walks steadily

Question 16

What are primitive reflexes useful for?

Answer 16

Protective and survival value
Promote proper orientation
Promote postural support and balance

Question 17

Name the primitive reflexes

Answer 17

Stepping
Moro
Grasp
Asymmetric tonic reflex 
Rooting

Question 18

What does fine motor and vision assess?

Answer 18

Hand function and hand-eye coordination

Question 19

What are the stages of fine motor and vision development?

Answer 19

6 weeks- Follows moving object or face by turning head
4 months- Reaches out for toys
4-6 months- Palmar grasp
7 months- Transfers toys from hand to another
10 months- Mature pincer grip
16-18 months- Makes marks with a crayon
14 months-4 years- Complexity of towers that they’re able to build increases
2-5 years- Ability to draw without seeing it done, complexity increases as age increases

Question 20

What are the stages of development for language and hearing?

Answer 20

Newborn- Startles to sound noises
3-4 months- Vocalises alone or when spoken to, coos and laughs
7 months- Turns to soft sounds out of sight
7-10 months- Sounds used indiscriminately then discriminately to parents
12 months- Two to three words other than dada or mama
18 months- 6-10 words. Show part of the body
20-24 months- Use two or more words to make simple phrases
2.5 yrs-3 years- Talks constantly in 3-4 word sentences

Question 21

What are the development stages for social behaviour and play?

Answer 21

6 weeks- smiles responsively
6-8 months- Puts food in mouth
10-12 months- Waves bye, plays peek a boo
12 months- Drinks from cup with 2 hands
18 months- Holds spoon and gets food safely to mouth
18-24 months- Symbolic play
2 years- Pulls off clothing
2.5-3 years- Parallel play, interactive play evolving and takes turns

Question 22

Give a brief breakdown of ages of first steps:

Answer 22

25% by 11 months
50% by 12 months
75% by 13 months
90% by 15 months
97.5% by 18 months