Child Development Flashcards
What are the stages of child development?
Baby – 0-1 year of age
Infant – 0- 2 years of age
Childhood – 2 -10 years of age
Pubertal - 10 years to adult
Where are growth charts held?
Parent held child health record (red book)
Which groups of children require adjustments to their growth charts or special charts?
Adjust chart for prematurity - less than 37 weeks
Special charts for Down’s syndrome and other common conditions
What measurements are recorded in the red book?
Weight
Length/Height: Infants
What is crossing a centile?
Crossing a centile line drawn on the centile chart
With regards to crossing centiles, when would you refer a child?
Refer a child who has fallen through 2 centiles
What might be causes of a child being small and thin?
Low weight, low height = Failure to thrive
Under nutrition
Chronic disease e.g. asthma, coeliac, cystic fibrosis, congenital heart malformations
Genetic Syndromes
Neglect
What can be causes of a child being tall and thin?
Most likely normal but monitor growth if concerned
Check weight following centiles
Some rare syndromes e.g. Marfan’s
What centiles would a tall overweight child fit into?
Ht 75 centile
Wt >98 centile
What are risks of a child being tall and overweight?
Early puberty and subsequent short stature
What could cause a child to be short and overweight?
Weight»_space; height
Growth hormone deficiency
Hypothyroidism
Describe the vicious cycle of childhood obesity
Healthy child watches TV, eats snacks, under active -> mildly obese child
Make excuses for less activity and gain further weight -> moderately obese child
Exercise becomes uncomfortable and physically difficult -> severely obese child
Develop conditions such as asthma, diabetes, MSK, CAD which prevent exercise through to adulthood -> obese adult
What is a head circumference measurement?
Occipito-frontal circumference – OFC
Measures brain growth
80% of brain growth before age 5 years
Paper tape measure
Describe infant brain growth
At full-term, baby’s brain has 100 billion neurons
Brain not fully developed, has to be “wired up” after birth and baby’s brain will increase in weight from 400g at birth, to 1000g at 1 year p
Increase in weight is caused by proliferation of synapses
What does proliferate and prune mean?
During sensitive period of brain development, proliferation of synapses Large numbers are generated in short space of time
Active synapses that are used will be stabilised and remain and ones not used will be “pruned”
“use it or lose it”
When does development of the orbitofrontal regions occur?
Post natally
How are experiences incorporated into developing synaptic connections?
Experience-expectant: environmental input that everyone experiences, which play a necessary part in organising developing nervous system eg visual cortex which expects to be exposed to light and patterned visual information and needs this experience for normal development
Experience-dependent mechanisms: unique experiences of each individual baby produces a unique wiring of their brain and therefore enables them to adapt to specific features of individual environment that they inhabit
What are important Experience-expectant aptitudes?
Sensory pathways of vision and hearing, social and emotional development, language and higher cognitive functions
Sets the scene for experience-dependent experiences, which supply the more detailed script based on each child’s individual experiences
When is experience dependant development optimised?
When it takes place during sensitive developmental periods
However, it can take place at any time not just during sensitive developmental period (defining characteristic)
Brain is plastic across lifespan which makes it possible for us to change our behaviours, learn new skills and recover following a stroke
What are the developmental domains?
Physical – posture, gross and fine motor/vision Cognitive Social and emotional Communication – speech and language/ hearing Locomotion Manipulation Speech/Language Behaviour
How can we assess development?
Use developmental milestones which are behaviours or physical skills
What are the Mary Sheridan (From Birth to Five Years) Stages of development Domains?
Posture and large movements
Vision and fine movements
Hearing and speech
Social behaviour and play
What are the five domains of the age and stage questionnaire?
Communication Gross motor Fine motor Problem solving Personal and social
What are reasons for developmental delay?
Chronic illness
Lack of stimulation
Sensory impairment
Developmental disorder
What are Important Milestones Social and Emotional?
Regards primary carer’s face
Smiles, coos, responds
Takes everything to mouth (sensory motor)
Aware of other people’s interests and experiences
Aware of strangers
What are Important Speech and language Milestones (hearing)?
Cries Startled by noises Laughs, chuckles and squeals in play Screams with annoyance Vocalises Babbles loudly and tunefully Understands “no” and “bye-bye” Immitates
At what age should a child comprehend simple instructions?
8-12 months
At what age should a child speak 2-6 comprehensible words?
12 - 18 months
At what age will a child be able to link words together?
Around 24 months
What are characteristics of IDS (infant directed speech)?
Higher pitch
Rising intonations
Exaggerated
Melodic
What are important gross motor milestones?
Head lag resolved Rolls over – front to back and back to front Lies prone with arms extended Takes weight on legs when supported Sits unaided Pulls to standing Stands holding on Sits back down Crawls Walks
What are important Milestones for vision and fine motor?
Turns to light
Follows finger or object
Grasps
Holds objects
Passes from hand to hand (palmar grasp and transfer)
Pokes an object
Picks up small object between finger and thumb – inferior pincer grip
What are Red Flag Warnings in development?
No social smile by 8 weeks
Not reaching for objects by 5 months
Not sitting unsupported by 10 months
Not walking alone by 18 months
Not saying any single words by 18 months
Not speaking in short phrases by 2 ½ years
What is the document used in children’s public health?
Healthy child program
What is Infant Mental health (IMH) ?
Developing capacity of child from birth to 3
Experience, regulate and express emotions
Form close interpersonal relationships
Explore environment
Learn in context of family, community and mental health expectations for young children
Synonymous with healthy social and emotional development
What is Emotional Behavioural Disorder?
Present with externalising or internalising behaviour
How many children have emotional behaviour disorder?
1 in 5
What is the difference between bonding and attachment?
The mother bonds to the baby
The baby makes an attachment to the parent
What is attachment?
Bio-behavioural mechanism activated by anxiety where primary goal is to reduce stress and to restore feelings of security
What are the Two Core behavioural Systems of attachment?
Infant: PROXIMITY seeking
SEPARATION PROTEST
Parents: SAFE HAVEN
SECURE BASE
What is PROXIMITY seeking?
Infant seeking security when hurt or upset
What is separation protest?
Crying when separated from attachment safety figures
What is SAFE HAVEN?
‘If I am upset, I can run to mum and she will comfort me’
What is secure base?
‘I am secure enough in my relationship with my mum to be able to begin to take an interest in the world around me and to explore it’
When is the Attachment System activated?
Anxiety and stress, crying
Describe the healthy attachment cycle
Baby has a need Baby cries Needs met by parent Trust develops Secure attachment promoted Repeat
Describe a disturbed attachment cycle
Baby has a need Cries Needs not met by parent Rage develops instead of trust Insecure or disorganised attachment promoted Repeat
Why does attachment develop?
Mechanism to promote infant’s safety and survival
Dyadic regulation of affect, emotion
Dyad (primary caregiver and infant) jointly regulate infant’s stress and emotions
Infants need help from their PC’s to both down-regulate and up-regulate their emotional states
What are the types of attachment that can form?
Secure
Insecure: Avoidant, Ambivalent, Disorganised
What percent of population will have secure attachments?
65%
What is avoidant attachment?
Not very explorative
Disengaged
Mother is emotionally distant and disengaged
Subconsciously believes needs will not be met
What is ambivalent attachment?
Anxious Insecure Angry Inconsistent parenting Can't rely on needs being met
What is disorganised attachment?
Depressed
Angry
Completely passive
Non responsive
Erratic parenting, frightened or frightening, passive or intrusive
Severely confused child with no strategy for needs being met
What is secure attachment?
Received caregiving that was responsive when they were distressed and they are able to be comforted by their caregiver and to use
their caregiver as a secure base
What are benefits of secure attachment?
Optimal later functioning across a range of domains including school, emotional, social and behavioural adjustment, peer-rated social status
What are outcomes of insecure attachment?
Poorer outcomes in later childhood: emotional, social and behavioural adjustment, scholastic achievement and peer-rated social status
Interfere with peer relations, intimacy, caregiving and caretaking, sexual
functioning, conflict resolution, and increased relational aggression
What is disorganised attachment a predictor of?
Significant later psychopathology
What type of attachment is common in neglect?
Disorganised
What are Dimensions of Sensitive Parenting?
Awareness – sensitive parents are alert to subtle cues from their babies
Responsiveness – Empathetic awareness of baby’s experience. Gives appropriate well-timed responses
Cooperation – respect for baby’s autonomy, non-intrusive and does not impose their own wishes
Acceptance – Capacity to bear frustrations of caring for a baby. To feel love and acceptance of the baby’s individuality
What is Parental Reflective Functioning?
Capacity to understand infant’s behaviour in terms of internal states/feelings
What is Low Reflective Functioning?
Associated with emotionally unresponsive maternal behaviours:
Withdrawal
Hostility
Intrusiveness
What are key aspects of early parenting that promote secure attachment and development of self?
Nurturance
Emotional and behavioural regulation
What are the stages of Cognitive Development?
Sensori-motor 0-2 years
Pre-operational 2-7 years
Concrete operations 7-11/12 years
Formal operations 11/12-16 years
What did Erickson say about Stages of Psychosocial Development?
Emotional and social development linked to cognitive and language development
The way adults respond to young children has potentially long lasting effects on their self-image
In infants - development of trust or mistrust is important
What did Jean Piaget say on Stages of Cognitive Development?
Activities should support thinking
What are Kohlberg’s Moral Developmental Stages?
Individuals develop moral reasoning in 6 stages and pass through 3 levels. Sex roles emerge as stage-like development in cognition
Level 1: pre conventional morality, punishment obedience orientation
Level 2: conventional morality, good boy nice girl law and order
Level 3: post conventional morality, social contract ethical principle
What is the key factor of Kohlberg’s infants?
Obedience versus punishment
What is the definition of adolescence?
Process of autonomisation: increasing competencies on own competences
Acquisition of a stable identity: who one is, what one’s life should look like, how others see one
10-19 years old
Describe the adolescent process
Early Adolescence (10-13 years) Middle Adolescence (13-16 years) Late Adolescence (17-20 years)
Describe changes in the adolescent changes
Brain developing and reorganisating
Increase in pruning (specialisation and honing of specific skills)
Myelination
More efficient but less adaptable
When do the frontal lobes develop?
One of the last areas of the brain to develop fully
What is the pre frontal cortex and when is it remodelled?
Decision-making part of brain, responsible for ability to plan and think about consequences of actions, solve problems and control impulses
Re-modelled last
Describe the Limbic system in brain development
Risk and emotionally driven behaviour is rooted
Adolescents don’t always have a lot of self-control or good judgment and are more prone to risk-taking behaviour
Describe the role of the Amygdala in brain development
Associated with emotions, impulses, aggression and instinctive behaviour
Adolescents rely on amygdala to make decisions and solve problems more than adults do
Adolescents show greater activity and vulnerability in their amygdala than adults
What does brain growth and development promote?
Thinking more logically
Thinking about things more abstractly – things are no longer so black or white
Picking up more on other people’s emotional cues
What effect can smoking during adolescence have on the brain?
More nicotine receptors develop and remain in place
What effects do drugs have on the adolescent brain?
Exposure to drugs during adolescence (cocaine) increases risk of addiction in adulthood
Cannabis hugely increases the risk of adolescents developing psychotic symptoms later
Describe dopamine levels in the adolescent brain
Human reward system (new and exciting activities) linked with dopamine
All addictive drugs increase dopamine levels. Dopamine levels are altered in adolescence
Adolescents dopamine systems can appear to be in overdrive
Is Adolescence an unhappy time?
Adolescence may be seen as an unhappy time because they require pleasure seeking to get a dopamine hit and counter low mood
What can be causes of teenage stresses?
Drugs, alcohol and high-risk behaviour, starting a new school, peer pressure, or major life events like moving house or death of a loved one
Describe the link between stress and the adolescent brain
Incidence of poor mental health increases during teenage years
Developing brain more vulnerable to stress factors than adult brain
What changes can lead to increased aggression?
Hormonal
Chemical
Why does Reassessment of body image occur?
Physiological clumsiness
Sexual arousal
How do adolescents sleep patterns differ from adults?
Naturally sleep and wake up 2 hours later than adults due to shifting of their melatonin release
What connection is there between peer relationships and adolescents?
Adolescents tend to identify increasingly with their peer group and become less dependent on their families
Earlier attachment relationships solid platform from which independence grows
Better peer relationships tend to go hand in hand with better parental relationships
What differences in attachment occur in adolescents?
More autonomous but at times of crisis return to parental secure base
What Predicts the quality of romantic relationships in early adulthood?
Quality of care-giving in first 42 months
What characteristics are Ambivalently Classified Adolescents likely to have?
Negative self-concept More prone to risky behaviour Drawn to their peers Emotionally volatile Negative reactions feel like the end of the world
What characteristics are avoidantly classified adolescents likely to have?
Don’t engage with issues of emotional need, anxiety or dependency
Talk vaguely about relationships with attachment figures
Greater risk of externalising and conduct disorders
Not good at asking for help
What characteristics are disorganised attachment adolescents likely to have?
Hyperarousal Controlling Disorganised-controlled attachments are complex (child has tried to manage a parent who is a source of fear and alarm) A way to stay safe is to be in control Survival has been the behavioural driver
What is the best predictor we have of serious psychopathology in
adolescence?
Disorganised attachment at a year
What are social developmental tasks?
Emotional separation from parents
Peer identity- development of social autonomy
Exploratory behaviours (smoking, drinking, drugs)
Development of intimate relationships
Development of vocational capabilities and financial independence Emergence of abstract thinking
Growing ability of absorbing the perspectives or viewpoints of others
Increased ability of introspection
Development of sexual identity
Establishment of a system of values
Increasing autonomy from family and personal independence
Emergence of skills and coping strategies to overcome problems and crises
What are Piaget’s stages?
Stage 1: sensorimotor period
Stage 2: preoperational period, symbolic thought
Stage 3: concrete operational period, concrete events
Stage 4: formal operation period, abstract ideas
Where are we in Kohlberg’s stages in adolescents?
Adolescents are making more sophisticated moral sense
Making distinction between law and morality
What is STEP?
Simple approach to considering adolescent development in clinical settings Sexual maturation and growth Thinking Education/employment Peers/parents
What are the domains of the ASQ?
Communication Gross motor Fine motor Problem solving Personal social skills
How do you measure attachment?
Awareness – sensitive parents alert to subtle cues from babies
Responsiveness – Empathetic awareness of baby’s experience. Gives appropriate well-timed responses
Cooperation – respect for baby’s autonomy, is non-intrusive and does not impose own wishes
Acceptance – Capacity to bear frustrations of caring for a baby. To feel love and acceptance of baby’s individuality
What is the Strange Situation Test?
Measures attachment when infant is 12 months
Observe infants at play and in situations of mild distress, takes around 20 minutes
What can be used to measure attachment before 12 months of age?
Parent-Infant Interaction Observation Scale (PIIOS)
Keys to Interactive Parenting (KIPS)
CARE-Index
Identify interactions, which if left unchanged, will result in insecure attachment
What can result in children who had a disorganised attachment as an infant?
Controlling behaviours toward parent Avoidance of the parent Dissociative symptoms Behavioural/oppositional problems Emotional disconnection Aggression toward peers Low social competence in preschool
What are different types of stress in infancy?
Positive stress – brief and mild/moderate in magnitude
Tolerable stress – greater magnitude of adversity or threat
Toxic stress – strong, frequent or prolonged activation of stress response system in absence of buffering of adult support
Toxic stress can result in high levels of cortisol which disrupts developing brain architecture. What affect can this have on the infant?
Physiology – hyper-responsive/chronically activated stress response
Behaviour – maladaptive responses such as behaviour problems
Learning - linguistic, cognitive and socio-emotional deficits
How might toxic stress levels come about in a child?
Infant’s caregiver may be so stressed themself that they are unable to provide comfort to their baby
Signs of caregivers stress signal danger to the baby and so increasing his or her anxiety
What effects can chronic raised cortisol levels have on the developing brain?
Stops development of new neural connections and pathways
Affects stress response system
Brain cells die and reduces connections in certain areas of the brain
Fewer cortisol receptors produced in hippocampus, so child’s stress thermostat permanently set on high (overactive)
What is the dissociative continuum?
Parasympathetic nervous system concerned with self-maintenance is over-activated so freezing reaction with reduced HR and RR
This learned helplessness common in neglected and abused children persistently threatened and only escape is to dissociate, and freeze both physically and cognitively
Mental mechanism of defence involves disengaging from external world and only attending to stimuli from internal world so becoming disconnected
What are public health priorities for breastfeeding? And preventing childhood obesity?
Increase proportion of mothers who breastfeed for six to eight weeks or longer
Focus on early identification and prevention of obesity in children through emphasis on breastfeeding, delaying weaning until babies are six months, introducing children to healthy foods, controlling portion size, limiting snacking on foods that are high in fat and sugar and encouraging an active lifestyle
What do centiles mean?
Indicate child’s size compared with children of same age and maturity who have shown optimum growth
Lines show expected range of weights and heights; each describes number of children expected to be below that line (e.g. 50% below 50th, 91% below the 91st)
What is the normal rate of weight gain and growth?
Babies do not grow at same rate
Most babies lose weight after birth, 80% will have regained this by 2 weeks of age
Fewer than 5% of babies lose more than 10% of their weight
1 in 50 are 10% or more lighter than birth weight at 2 weeks
Baby’s weight may not follow a centile line, most track within one centile space
Sustained drop through two or more centiles is unusual, these need assessing
Babies very small or very big can be sometimes be associated with underlying illness
What growth monitoring is performed in school?
National Child Monitoring Programme in England
BMI in children
Reception (4-5 years)
Year 6 (10-11 years)
Describe infant brain growth
At full-term a baby’s brain has 100 billion neurons, not fully developed
Baby’s brain has to be wired up after birth and baby’s brain will increase in weight from 400g at birth, to 1000g at 1 year of age
Increase in weight is caused by proliferation of synapses (i.e. connections between neurons)
What is experience dependent development?
Optimised when it takes place during sensitive developmental periods
Can take place at any time not just during sensitive developmental periods (defining characteristic)
Brain is plastic across the lifespan, makes it possible to change our behaviours, learn new skills and recover following a stroke
When do we start weaning foods?
WHO (prior to 2001) 4-6 months
2001 recommendation weaning should be commenced at 6 months
Recommendation applies to population, recognised that some mothers will be unwilling/ unable to follow this recommendation, these mothers should also be supported to optimise their infant’s nutrition. If before 6 months, no gluten
What weaning foods are available?
Commercially manufactured: check no salt and sugar
Home cooked
When might a parent notice coeliac disease in a baby?
When they start weaning - 6 months
What is the nutrient approach to weaning?
Macronutrients: fat, proteins, carbs
Micronutrients: vitamins, minerals, water (60-70%)
What is the food group approach to weaning?
Food standards agency: Bread, rice and pasta Fruit and vegetables Milk and dairy Meat, fish, beans, eggs Foods and drinks high in fats and sugar
What are the different approaches to weaning?
Nutrient approach
Food group approach
Eat well plate approach
What is the best way to wean?
Baby led weaning
Don’t add salt or sugar
What can toddlers consuming sugar based beverages result in?
Dental Caries
Describe food poverty in children
Children in poverty eat less fruit and vegetables and have higher fats and sugars
Impoverished families are more likely to have diets lacking in nutrients required to sustain an effective immune system
Worse diet, worse access, worse health, higher percentage of income on food, less choice from a restricted range of foods. Above all food poverty is about less or almost no consumption of fruit & veg
How long does baby’s iron store last for?
For 6 months
Born preemie, won’t have as much stores
How many toddlers are anaemic?
One in eight toddlers are anaemic
35% among minority ethnic children and white children from impoverished inner-city areas
Describe the prevalence of vitamin D deficiency in children
12%
as many as 40% of young children having levels below accepted optimal threshold
What is a leading cause of gastroenteritis in children?
Rotavirus
Although levels decreasing since vaccine introduced
What things are important for children’s meals?
Food safety
Sitting down to family meals - social development
When introducing new foods what do you need to be careful of?
Allergies/intolerance
How do you define childhood obesity?
Determined on basis of a growth chart and defined as a BMI greater than or equal to the 95th percentile for age
What are the origins of adult disease?
Origins of much adult disease lie in developmental and biological
disruptions occurring during early years of life
Describe social and emotional development in children
Babies need to learn how to regulate their emotions
Establish capacity for self-regulation via attachment relationship to primary caregiver
Parental sensitivity and parental reflective functioning are significant
predictors of attachment security
What effect does toxic stress have on the baby?
Infant’s prolonged exposure to severe stress not modulated by PC
PC may be cause of the stress
Identification of a child in Need
Toxic stress has significant impact on young child’s developing nervous system, development, health and wellbeing across the lifespan
What is parental attachment status?
Predicts infant’s likelihood of being securely attached
Parent’s ability to regulate their own stress, anger, anxiety and depression
Unresolved Parents - ghosts in the nursery that may affect how parents interpret their babies cues and respond to their baby
What is the lifecourse approach?
What happens early in life affects health and wellbeing in later life
What is the prevalence of childhood obesity?
17 per cent of boys and 16 per cent of girls up to age of 15 are obese
What should be done with regards to exercise in children?
Need to encourage increased exercise, only half of children and barely a third of girls meet the recommended standard
Public Health England work with local authorities, schools and relevant agencies to build on current efforts to increase participation in physical activity and promote evidence based solutions that lead to improved access to existing sports facilities
Describe mental health problems in children
Increasing numbers of children are suffering from poor mental health
75 per cent of lifetime mental health disorders start before 18 years of age
Peak onset of most conditions is 8 to 15 years
Which infant’s are more likely to suffer mental health problems?
Insecurely attached infants’ are more likely to develop mental health
problems and psychopathology in the early years
Adolescents rely on the amygdala to make decisions and solve problems more than adults do. What emotions is the amygdala associated with?
Impulses, aggression and instinctive behaviour
What does adolescent brain growth support?
Thinking more logically
Thinking more abstractly
Picking up on others emotional cues
What can hormonal and chemical changes during adolescence lead to?
Increased aggression
Identify some specific social developmental tasks exhibited by adolescents
Emotional separation from parents Peer identity Exploratory behaviours Development of intimate relationships Emergence of abstract thinking Development of personal and sexual relationships
Where are adolescents on Piaget’s cognitive developmental stages?
Formal operations
Where are adolescents on Erickson’s psychosocial development stages?
Identity vs. role confusion
Where are adolescents on Kohlberg’s moral development stages?
Conventional Morality
If a baby falls through 2 centiles what is this called?
Failure to thrive
What does a head circumference actually measure?
Occipito-frontal circumference (OFC)
How old is a child before their height is assessed standing?
2 years
How many neurons does a baby have at full term?
100 billion
How much does the baby’s brain grow during 1st year of life?
From 400g at birth to 1000g at I year
What is the cause of brain growth in babies?
Proliferation of synapses
If active synapses are not used and stabilised what happens?
Pruned away
Which area of the brain grows almost completely postnatally?
Orbitofrontal region
Developing synaptic connections are as a result of what 2 types of experience?
Experience expectant
Experience dependent
Brain is plastic across the lifespan but what is it considered to be for the first 1001 critical days?
Neuroplastic
How much brain growth occurs by age 5?
80%
Development is from head to toe and there is quite a wide variation in timing but little variation in pattern. Child developmental reviews are recorded for what universal programme in the UK?
Healthy child program
When are developmental reviews carried out from birth to 2 – 2 and a half?
New born examination (72 hours )
6-8 week review
9-12 month review
2-2 and a half review
Developmental review paperwork in PHCR categorises domains as: locomotion, manipulation, speech/language and behaviour. What developmental domains are presented to parents as part of the ASQ-3 questionnaire to be completed prior to 2-year check?
Communication Gross motor Fine motor Problem solving Personal-social
Identity 4 reasons for developmental delay
Chronic illness
Lack of stimulation
Sensory impairment
Developmental disorder
What ratio of children in the UK have Emotional Behavioural Disorders?
1:5
What is Infant Mental Health?
Developing capacity of child from birth to 3 to: experience, regulate and express emotions
What is attachment?
Bio-behavioural mechanism activated by anxiety, primary goal to reduce stress and restore feelings of security
When does attachment usually develop?
1st year of life
Bowlby identified attachment as secure or insecure. What measure of attachment did Ainsworth develop?
Strange Situation Experiment
What 2 types of insecure attachment did Ainsworth classify?
Ambivalent
Avoidant
Main found that not all children fitted into Ainsworth’s insecure classification. What classification was introduced by Main to describe these children?
Disorganised
What are 4 components of a healthy attachment cycle?
Baby has a need
Baby cries
Needs met by primary carer
Trust develops
Optimal later functioning can be seen in children who are securely attached across a range of domains. What are they?
Emotional
Social and behavioural
Scholastic
Peer-rated social status
Sensitive parenting is vital to promote secure attachment. Ainsworth identified dimensions of sensitive parenting. What are they?
Awareness
Responsiveness
Cooperation
Acceptance
What is parental reflective functioning?
Capacity to understand the infant’s behaviour in terms of internal states/feelings
Why do we use developmental milestones?
Identify developmental delay
Piaget identified 4 stages of cognitive development. According to Piaget at what stage would a baby be?
Sensorimotor
Erickson identified 8 stages of psychosocial development. At what stage would a baby be?
Trust vs mistrust
Kohlberg’s moral developmental stages are divided into 3 levels and 6 stages. At what stage would a baby be?
Obedience vs punishment
Who regulates labelling and composition of infant formula?
Department of Health
Food Standards Agency
What public health priorities are identified in the Healthy Child Programme (HCP) to focus on early identification and prevention of obesity in children?
Increase proportion mothers who breastfeed for 6 to 8 weeks or longer Delay weaning until 6 months of age Introduce children to healthy foods Control portion size Limit foods high in fat and sugar Encourage an active lifestyle
What do centiles mean?
Indicate a child’s size compared with children of same age and maturity who have shown optimum growth
What percentage of weight loss is normal after birth?
Usually less than 10% of baby’s birth weight
When is this weight lost after birth usually regained by?
80% of babies will have regained this by 2 weeks of age
What should babies not be introduced to prior to 6 months?
Gluten
What type of weaning is being encouraged in the UK?
Baby led weaning
How long does a baby’s iron store last for?
Usually 6 months
Less in babies born prematurely because they missed out on last month in utero when babies grow and put down stores
How many toddlers in the UK are anaemic?
1 in 8
What should not be added to baby’s food?
Salt and sugar
According to the CMO Report (2012) what per cent of toddlers consume sugar-sweetened beverages?
70%
What vitamin deficiency in children have we seen a resurgence of in the UK? What can this cause?
Vit D
Rickets
What do children in poverty eat more and less of?
Higher quantities of fats and sugars are consumed
Less fruit and vegetables are consumed
What should food safety involve when preparing foods for children?
clean, separate, cook and chill
At what age should we see Rolling over from prone to supine?
5-6 months
At what age should we see Rolling over from supine to prone?
6-7 months
At what age should baby sit with support?
6 months
At what age should baby attempt to crawl?
9 months
At what age should baby begin to walk?
12 months
At what age should baby pass objects from hand to hand?
6 months
At what age should baby poke at a small sweet?
9 months
What is an inferior pincer grip and when would we expect it to develop by?
Picks up small sweet between finger and thumb – 9 months
At what age should baby babble loud and tunefully?
9 months
At what age should baby understand no and bye bye?
9 months
At what age should baby speak 2-6 words?
15 months
At what age should baby speak 50 recognisable words?
2 years
At what age should baby combine 2 words?
1-2 years
At what age should baby refer to self by name?
2 years
At what age should baby distinguish strangers from familiars?
9 months
At what age should baby recognise themselves in a mirror?
18 months
At what age should baby recognise that others have different experiences to themselves?
2 years
