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Y2 LCRS 1 - RDA > Child development > Flashcards

Child development Flashcards

1
Q

Define child development

A
  • Development is the global impression of a child which encompasses growth, increase in understanding, acquisition of new skills and more sophisticated responses and behaviour
  • Serves to endow the child with increasingly complex skills in order to function in society
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2
Q

What are the developmental domains?

A
  1. Gross motor and posture
  2. Fine motor and vision
  3. Language and hearing
  4. Social, emotional and behavioural
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3
Q

What is abnormal development?

A
  • Refers to slow acquisition of skills and follows 3 main patterns: 1. Slow but steady 2. Plateau 3. Regression - Delay may occur in 1 or more domain(s)
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4
Q

What tools are available for assessing childhood development?

A
  • Developmental screening
  • Standardised developmental assessment - Schedule Of Growing Skills (II), Griffiths developmental scale
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5
Q

What are the key developmental milestones at 6 weeks?

A
  1. Gross motor: head level w/body in ventral suspension
  2. Fine motor + vision: fixes and follows
  3. COMMUNICATION/ HEARING: becomes still in response to sound
  4. SOCIAL SKILLS (self help): Smiles
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6
Q

What are the key developmental milestones at 3 months?

A
  1. Gross motor: holds head at 90 degrees in ventral supension
  2. Fine motor + vision: holds an object placed in hand
  3. COMMUNICATION/ HEARING: turns to sound
  4. SOCIAL SKILLS (self help): hand regard, laughs, squeals
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7
Q

What are the key developmental milestones at 6 months?

A
  1. Gross motor: no head lag on pull to sit; sits with support; in prone position lifts up on forearms
  2. Fine motor + vision: palmar grasp of objects; transfers objects hand to hand
  3. COMMUNICATION/ HEARING: vocalisations
  4. SOCIAL SKILLS (self help): may finger feed self
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8
Q

What are the key developmental milestones at 9 months?

A
  1. Gross motor: crawls; sits steadily when unsupported + pivots around
  2. Fine motor + vision: pincer grasp; index finger approach’ bangs 2 cubes together
  3. COMMUNICATION/ HEARING: 2 syllable babble, non-specific - consonant-vowel, e.g. mama
  4. SOCIAL SKILLS (self help): waves bye bye; plays pat-a-cake; indicates wants; stranger anxiety emerging
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9
Q

What are the key developmental milestones at 12 months?

A
  1. Gross motor: pulls to stand; cruises; may stand alone briefly; may walk alone
  2. Fine motor + vision: puts block in cup; casts about
  3. COMMUNICATION/ HEARING: 1-2 words; imitates adults’ sounds
  4. SOCIAL SKILLS (self help): imitates activities; object permanence (objects exist when cannot be seen) established; stranger anxiety established; points to indicate wants
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10
Q

What are the key developmental milestones at 18 months?

A
  1. Gross motor: walks well; runs
  2. Fine motor + vision: builds tower of 2-4 cubes’ hand preference emerges
  3. COMMUNICATION/ HEARING: 6-12 words
  4. SOCIAL SKILLS (self help): uses spoon; symbolic play - “talking” on phone; domestic mimicry - “helps” in household chores
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11
Q

What are the key developmental milestones at 2 years?

A
  1. Gross motor: kicks ball; climbs stairs 2 feet per step
  2. Fine motor + vision: builds tower of 6-7 cubes; does circular scribbles
  3. COMMUNICATION/ HEARING: joins 2-3 words; knows some body parts; identifies objects in pictures
  4. SOCIAL SKILLS (self help): can remove some clothes
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12
Q

What are the key developmental milestones at 3 years?

A
  1. Gross motor: stands briefly on one foot; climbs stairs 1 foot per step
  2. Fine motor + vision: builds tower of 9 cubes; copies a circle
  3. COMMUNICATION/ HEARING: talks in short sentences that a stranger can understand
  4. SOCIAL SKILLS (self help): eats with fork + spoon; puts on clothes; may be toilet trained
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13
Q

What is a cause of developmental milestone regression?

A

Autism

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14
Q

What are some patterns of abnormal development?

A
  1. Slow but steady
  2. Plateau
  3. Regression

Common presenting problems

  • Delayed walker
  • Clumsy child
  • Delayed speech and language
  • Odd social interaction- ASD/Aspergers
  • Hyperactivity
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15
Q

How are children with abnormal development evaluated?

A

History

  1. Antenatal - illnesses/infections; medications; drugs; environmental exposures, pregnancy supplements
  2. Birth –prematurity, prolonged/complicated labour
  3. Postnatal - illnesses/infections; trauma
  4. Consanguinity – increases chances of chromosomal or autosomal recessive conditions

PMHX

  1. Developmental milestones (history) from parent
  2. Current skills - Developmental assessment + general and neurological examination
  3. Investigations
  4. Parental anxiety
  5. Family history

Focussed physical examination

  • Look of child
  • Gorwth
  • OFC
  • Hearing and Vision
  • Skin
  • Genitalia

Bloods and imaging

  • FBC and ferritin
  • TSH
  • Chromosomes
  • Lead
  • US
  • CT/MRI
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16
Q

What are the types of developmental delay?

17
Q

What are the causes of global, motor and language delay respectively?

A

Causes of global delay

  • Chromosomal abnormalities e.g. Down’s syndrome, Fragile X
  • Metabolic e.g. hypothyroidism, inborn errors of metabolism
  • Antenatal and perinatal factors
    • Infections, drugs, toxins, anoxia, trauma, folate def
  • Environmental-social issues
  • Chronic illness

Causes of motor delay

  • Cerebral palsy
  • Global delay eg Down’s syndrome
  • Congenital dislocation hip
  • Social deprivation
  • Muscular dystrophy-Duchenne’s
  • Neural tube defects: spina bifida
  • Hydrocephalus

Causes of language delay

  • Hearing loss
  • Learning disability
  • Autistic spectrum disorder
  • Lack of stimulation
  • Impaired comprehension of language
    • Developmental dysphasia
  • Impaired speech production
    • stammer, dysarthria
18
Q

Summarise the examples of developmental delay

A
  1. Cerebral palsy - disorder of mvmt and posture
    • 4 different types = spastic, athetoid, ataxic and mixed type
  2. Autism spectrum disorder
  3. ADHD
  4. Learning disability - reduced intellectual functioning, delay in early milestones, dysmorphic features
  5. Other common behaviours –sleep onset/freq night waking, eating, Toileting
19
Q

What is happening to the incidence of autism + ADHD?

A

Increasing incidence

20
Q

What are the characteristics of autism?

A
  • Prevalence = 3-6 per 1000 live births - Boys>girls - Usually presents between 2-4yrs
  • Features:
    1. Impaired social interaction
    2. Speech and language disorder
    3. Imposition of routines with ritualistic and repetitive behaviour
  • Comorbidities include learning and attention difficulties, and epilepsy
  • Managed by intensive support for child + family
21
Q

What are the diagnostic criteria for ADHD?

A
  1. Inattention
  2. Hyperactivity
  3. Impulsivity
  4. Lasting > 6 months
  5. 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
  • Management Psychotherapy - Behavioural therapies Family therapy
22
Q

How is a child with developmental delay managed clinically?

A
  1. Investigations - Depends on suspected cause - E.g. cytogenetic studies - Metabolic screen (thyroid, renal, liver and bone profiles) - Blood ammonia and lactate - Urine and blood organic and amino acids - Creatine kinase - Imaging – CT, MRI; EEG - Nerve and muscle biopsy 2. Other professionals - Referral to members of MDT helps identify problems and target input.
23
Q

How is a child with developmental delay examined?

A
  1. Growth parameters – height, weight, head circumference 2. Dysmorphic features 3. Neurological examination and skin 4. Systems examination to identify associations, syndromes 5. Standardised developmental assessment – SOGSII, Griffiths
24
Q

What do children with ADHD have an increased risk of?

A
  1. Conduct disorder
  2. Anxiety disorder
  3. Aggression
  4. A significant proportion of children with ADHD will become adults with antisocial personality and there is an increased incidence of criminal behaviour and substance abuse.
25
Q

What are the risk factors for ADHD?

A
  1. Boys > girls, 4:1
  2. Learning difficulties and developmental delay - Neurological disorder, e.g. epilepsy, cerebral palsy
  3. First-degree relative with ADHD
  4. Family member with depression, learning disability, antisocial personality or substance abuse
26
Q

How is ADHD managed?

A
  1. Psychotherapy - behavioural therapies
  2. Family therapy
  3. Drugs - if therapy is insufficient - stimulants
  4. Diet e.g. excluding red food colouring
27
Q

What problems do children with ADHD face later in life?

A
  1. Antisocial personality
  2. Increased incidence of criminal behaviour + substance abuse

Y2 LCRS 1 - RDA (11 decks)

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