Child development

Question 1

What percentage of children have special educational needs?

Answer 1

20%

Question 2

What percentage of children have severe disability?

Answer 2

2%

Question 3

What are the 4 domains of child development?

Answer 3

Speech and language skills, hearing.
Social skills, emotional and behavioural.
Gross motor skills and posture.
Fine motor skills and vision.

Question 4

How are speech and language skills assessed in children?

Answer 4

Vocalisation
Words
Understanding
Imaginative play

Question 5

How are social skills assessed in children?

Answer 5

Social interaction
Stranger reaction
Eating skills
Dressing

Question 6

How are gross motor skills assessed in children?

Answer 6

Position 
Head lag
Sitting
Walking
Running

Question 7

How are fine motor skills assessed in children?

Answer 7

Use of hands
Grasp and fine pincer
Bricks
Crayon
Puzzles

Question 8

What is child development?

Answer 8

The global impression of child which encompasses growth, increase in understanding, acquisition of new skills and more sophisticated responses and behaviour.
It gives the child increasingly complex skills in order to function in society.

Question 9

What does developmental progress depend on?

Answer 9

The interplay between biological and environmental influences. Follows a constant pattern at variable rates among children.

Question 10

How can developmental progress by monitored or identified?

Answer 10

Through developmental screening or by the use of standardised developmental tools.

Question 11

What are the three main patterns of abnormal development?

Answer 11

Slow but steady
Plateau
Regression
Abnormal development is a slow acquisition of skills.

Question 12

At 6 weeks old, what skills should a child have?

Answer 12

Gross motor: head level with body in ventral suspension.

Fine motor and vision: fixes and follows.

Hearing, speech and language: becomes still in response to sound.

Social, emotional and behavioural: smiles.

Question 13

At 3 months old, what skills should a child have?

Answer 13

Gross motor: holds head at 90 degrees in ventral suspension.

Fine motor and vision: holds an object placed in the hand.

Hearing, speech and language: turns to sound.

Social, emotional and behavioural: hand regard, laughs, and squeals.

Question 14

At 6 months old, what skills should a child have?

Answer 14

Gross motor: no head lag on pull to sit, sits with support, in prone position lifts up on forearms.

Fine motor and vision: palmar grasp of objects, transfers objects hand to hand.

Hearing, speech and language: vocalisations.

Social, emotional and behavioural: may finger feed self.

Question 15

At 9 months old, what skills should a child have?

Answer 15

Gross motor: crawls, sits steadily when unsupported and pivots around.

Fine motor and vision: pincer grasp, index finger approach, bangs 2 cubes together.

Hearing, speech and language: 2 syllable babble, non-specific consonant-vowel, e.g. ‘mama’.

Social, emotional and behavioural: waves bye-bye, plays pat-a-cake, indicates wants, stranger anxiety emerging.

Question 16

At 12 months old, what skills should a child have?

Answer 16

Gross motor: pulls to stand, cruises, may stand alone briefly, may walk alone.

Fine motor and vision: puts block in cup, casts about.

Hearing, speech and language: one or two words, imitates adults’ sounds.

Social, emotional and behavioural: imitates activities, object permanence established, stranger anxiety established, points to indicate wants.

Question 17

At 18 months old, what skills should a child have?

Answer 17

Gross motor: walks well, runs.

Fine motor and vision: builds tower of 2-4 cubes, hand preference emerges.

Hearing, speech and language: 6-12 words.

Social, emotional and behavioural: uses spoon, symbolic play- ‘talking’ on telephone, domestic mimicry- ‘helps’ in household chores like sweeping, wiping surfaces.

Question 18

At 2 years old, what skills should a child have?

Answer 18

Gross motor: kicks ball, climbs stairs 2 feet per step.

Fine motor and vision: builds tower of 6-7 cubes, does circular scribbles.

Hearing, speech and language: joins 2-3 words, knows some body parts, identifies objects in pictures.

Social, emotional and behavioural: can remove some clothes.

Question 19

At 3 years old, what skills should a child have?

Answer 19

Gross motor: stands briefly on one foot, climbs stairs one foot per step.

Fine motor and vision: builds tower of 9 cubes, copies a circle.

Hearing, speech and language: talks in short sentences that a stranger can understand.

Social, emotional and behavioural: eats with fork and spoon, puts on clothing, may be toilet trained.

Question 20

Give an example of a biological factor that may impact on child development.

Answer 20

Folate deficiency increases the risk of neural tube defects which, in its most severe form, can result in limb paralysis, neurogenic bladder and bowel, and intellectual impairment.

Question 21

How may children present with developmental concerns?

Answer 21

Through identification of antenatal or postnatal risk factors.
Through developmental screening.
Through concerns raised by parents or other health care professionals.
May present at any age.

Question 22

What information needs to be gathered in a clinical history in order to assess child development?

Answer 22

Antenatal- illnesses/infections; medications; drugs; environmental exposures.

Birth- prematurity, prolonged/complicated labour.

Postnatal- illnesses/infections; trauma.

Consanguinity- increases chances of chromosomal or autosomal recessive conditions.

Developmental milestones from parent.

Question 23

What information needs to be gathered in a clinical examination in order to assess child development?

Answer 23

Growth parameters- height, weight and head circumference.

Dysmorphic features.

Neurological examination and skin.

Systems examination to identify associations, syndromes.

Standardised developmental assessment- SOGSII, Griffiths.

Question 24

What is cerebral palsy?

Answer 24

A disorder of movement and posture arising from a non-progressive lesion of the brain acquired before the age of 2 years.

Incidence 1-2 per 1000 live births.

Most causes (about 80%) are antenatal.

Presentation may evolve and vary with age.

Associated problems exist- learning difficulties, epilepsy, visual impairment, hearing loss, feeding difficulties, poor growth, and respiratory problems.

Question 25

What is the management strategy for children with cerebral palsy?

Answer 25

Aim is to minimise spasticity and manage associated problems.

Question 26

What is autism spectrum disorder?

Answer 26

Impaired social interaction, speech and language disorder, imposition of routines with ritualistic and repetitive behaviour.
Comorbidities include learning and attention difficulties, and epilepsy.
Prevalence is 3-6 per 1000 live births.
Boys > girls.
Usually presents between 2-4 years of age.

Question 27

How is autism spectrum disorder managed?

Answer 27

Intensive support for child and family.

Question 28

What are the diagnostic criteria for attention deficit hyperactivity disorder?

Answer 28

Inattention.
Hyperactivity.
Impulsivity.
Lasting > 6 months.
Commencing < 7 years and inconsistent with the child’s developmental level.
These features should be present in more than one setting, and cause significant social or school impairment.
Also have an increased risk of conduct disorder, anxiety disorder and aggression.

Question 29

How is ADHD managed?

Answer 29

Psychotherapy- behavioural therapies.
Family therapy.
Drugs- if behavioural therapy alone insufficient: stimulants, e.g. methylphenidate (ritalin), amphetamines (dexamphetamine).
Diet- some children benefit noticeably from exclusion of certain foods from their diet, e.g. red food colouring.

Question 30

What is the prevalence of moderate learning difficulty?

Answer 30

30 per 1000 children.

Question 31

What is the prevalence of severe learning difficulty?

Answer 31

4 per 1000 children.

Question 32

What percentage of children with severe learning disability have no identifiable cause?

Answer 32

25%.

Question 33

What are the causes of learning disability?

Answer 33

Chromosome disorders (30%).
Other identifiable syndromes (20%).
Postnatal cerebral insults (20%).
Metabolic or degenerative diseases (1%).

Question 34

How is learning disability classified?

Answer 34

Mild, moderate, severe or profound.

Question 35

How may learning disability present?

Answer 35

Reduced intellectual functioning, delay in early milestones, dysmorphic features, associated problems (epilepsy, sensory impairment, ADHD).

Question 36

How is learning disability managed?

Answer 36

Involves establishing a diagnosis and input from the MDT with long-term follow up.

Question 37

What factors influence developmental delay?

Answer 37

Lack of physical or psychological stimuli.
Ill health.
Reduced inherent potential.
Sensory/motor impairment.

Question 38

What are some common developmental problems?

Answer 38

Delayed walker.
Clumsy child.
Delayed speech and language.
Odd social interaction- ASD/Aspergers.
Hyperactivity.
Common behaviours:
-sleep onset/freq night walking
-eating
-toileting
Specific learning difficulties.