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notes to flashcards year 2 - LCRS1 > child development > Flashcards

child development Flashcards

1
Q

define development

A

process by which each child evolves into an independent adult

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2
Q

what are the antenatal environmental causes of damage to brain development?

A
  • infectious agents: toxoplasmosis, rubella, cytomegalovirus, herpes
  • hormones: androgenic agents, DES, maternal diabetes, maternal obesity
  • drugs: mainly valproic acid, alcohol
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3
Q

what are the postnatal environmental causes of damage to brain developmental?

A
  • infections
  • metabolic disorders
  • toxins
  • trauma
  • domestic violence
  • malnutrition
  • maternal mental health
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4
Q

what causes spina bifida cystica?

A

due to failure of ant or post neuropore

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5
Q

what are the consequences of this?

A
  • neuroggenic bowel and bladder incontinence
  • lower limb paralysis
  • fractures and joint contractures
  • developmental deformities and learning difficulties
  • hydrocephalus and meningitis
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6
Q

what are the 4 developmental domains?

A
  • gross motor performance
  • vision and fine motor
  • hearing, speech, language
  • social, emotional, behavioural
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7
Q

define median age and limit age

A

median age: when half of the standard population of children achieve that level
limit age: age by which they should have achieved the level and is equal to 2SD from mean age

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8
Q

what are the developmental milestones in gross motor performance?

A
  • New born: limbs flexed in symmetrical posture, head lag on pulling up
  • 6-8 weeks: raises head to 45 degrees in prone
  • 6-8 months: sits without support
  • 8-9 months: crawling
  • 10 months: cruising around furniture
  • 12 months: walks unsteadily
  • 15 months: walks steadily
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9
Q

what are primitive reflexes?

A
  • Protective and serve to promote support, balance and orientation
  • Should disappear by 4-6 months
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10
Q

what are the 5 primitive reflexes?

A
  • Stepping (baby appears to take steps when held upright)
  • Moro (response to sudden loss of support, when infant feels as if it is falling, involves arm abduction, adduction, crying)
  • Grasp
  • Asymmetric tonic reflex (which way babies head is turned, arm outstretches)
  • Rooting (stroke baby’s cheek, causes baby to turn and open mouth)
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11
Q

what are the protective reflexes and when do they develop?

A
  • Develop from 5 months
    1. Downward parachute reflex
    2. Sideward protective reflex
    3. Forward protective reflex
    4. Backward protective reflex
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12
Q

describe the downward parachute reflex

A
  • 5 months

- when held and rapidly lowered, infant extends and abducts both legs and feet are plantigrade

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13
Q

describe the sideward protective reflex

A

6 months

- infant puts arms out to save if tilted off balance

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14
Q

describe the forward protective reflex

A
  • 7 months

- arms and hands extend on forward descent to ground

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15
Q

describe the backward protective reflex

A
  • 9 months

- backward protective extension of both arms when pushed backwards in sitting position

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16
Q

what are the milestones in fine motor and vision domain?

A
  • 6 weeks: turns head to follow object
  • 4 months: reaches out to toys
  • 4-6 months: palmar grasp
  • 7 months: transfers between hands
  • 10 months: mature pincer grip
  • 16-18 months: marks with crayons
  • 14 months-4years: towering
  • 2-5 years: ability to draw without seeing how its done
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17
Q

what is object permanence? when is it attained?

A

9 months

idea that when out of sight, not out of mind

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18
Q

what are the developmental milestones in language and hearing?

A
  • new born: startles
  • 3-4 months: vocalizes alone or when spoken to
  • 7 months: turns to soft sounds out of sight
  • 7-10 months: uses sound indiscriminately or discriminately
  • 12 months: 2 to 3 words other than dada or mama
  • 18 months: 6-10 words
  • 20-24 months: makes simple phrases
  • 1.5-3 years: talk constantly on 3-4 word sentences
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19
Q

what are the milestones in social, behaviour and play domain?

A
  • 6 weeks: smile responsively
  • 6-8 months: puts food in mouth
  • 10-12 months: wave bye, play peek a boo
  • 12 months: drink from cup with 2 hands
  • 18 months: can eat by themselves
  • 18-24 months: symbolic play
  • 2 years: potty trained
  • 2.5-3 years: parallel play
20
Q

what are the limit ages of:

  1. walking independently
  2. fixes and follows visually
  3. joins words
  4. symbolic play
A
  1. 18 months
  2. 3 months
  3. 2 years
  4. 2-2.5 years
21
Q

what is delay?

A

slow acquisition of skills

may occur in one or more domain

22
Q

what is it called when one domain is affected? or more than 2?

A

One domain affected = domain-specific

>+2 domains affected = global

23
Q

what is it called when all domains are affected equally? or differently?

A

All domains affected equally = consonant delay

All domains affected differently = dissonant delay

24
Q

what is disorder?

A

maldevelopment of a skill

25
Q

what are some causes of abnormal development?

A
  • abuse, trauma, drugs, infection
  • autism, deficits in development
  • malnutrition, cerebral palsy
26
Q

when does the delay present?

A
  • routine surveillance
  • identified risk factors
  • parents/HCPs worried
  • oppurunisitic worries raised
27
Q

what are the causes of abnormal development antenatally? (ask in history)

A
  • illness/ infections
  • medications
  • drugs
  • environmental exposures
28
Q

what are the causes of abnormal development at birth?

A
  • premature

- prolonged/ complicated labour

29
Q

what are the causes of abnormal development post-natally?

A
  • illness/ infections

- trauma

30
Q

what are the causes of abnormal development linked to consanguinity?

A

inc. chance of chromosomal/ autosomal conditions

31
Q

what examinations should you carry out to assess abnormal development?

A
  • growth parameters: height, weight, HC
  • dysmorphic features
  • neurological exam
  • skin exam
  • standardised exam assessments
32
Q

where is cerebral palsy?

A

disorder of movement and posture due to a non-progressive lesion of motor pathways

33
Q

what are the features of cerebral palsy?

A
  • manifestations merge over time

- reflects the balance b/ normal and abnormal cerebral maturation

34
Q

what is the most common cause of motor impairment in children?

A

cerebral palsy

35
Q

what are the causes of cerebral palsy?

A
  • antenatal (80%): genetic syndromes, congenital infection
  • hypoxic ischaemia injury at birth (10%)
  • postnatal origin = infection/ trauma (10%)
36
Q

what is the presentation of cerebral palsy?

A
  • abnormal limb tone and delayed milestones
  • feeding difficulties
  • abnormal gait once walking
  • asymmetric hand function before 12 months
  • primitive reflexes persist
37
Q

what are the types of cerebral palsy?

A
  • 70%: spastic
  • 10%: ataxic hypotonic
  • 10% dyskinetic
  • 10% mixed pattern
38
Q

what are the associated problems?

A
  • learning difficulties
  • epilepsy
  • visual impairment
  • hearing loss
  • feeding difficulties
  • poor growth
  • resp probelms
39
Q

how do you manage cerebral palsy?

A
  • minimise spasticity

- manage associated symptoms

40
Q

what is autism?

A

neurobiological disorder characterised by:

  • impairment of social interactions/ communication
  • reptitive and stereotyped patterns of behaviour, interests and activities
41
Q

what are the comorbidites of autism?

A
  • learning difficulties
  • attention difficulties
  • epilepsy
42
Q

what is the criteria of development for attention deficit hyperactivity disorder

A
  • Inattention
  • Hyperactivity
  • Impulsivity
  • Lasting >6 months
  • Commencing <12 years and inconsistent with child’s developmental level
43
Q

how do they carry out diagnosis?

A
  • Questionnaires
  • Exclude medical causes such as hyperthyroidism
  • Hearing deficiets
  • Identify risk factors and co-morbidities
44
Q

what does ADHD lead to an inc. risk of?

A
  • conduct disorder
  • anxiety disorder
  • aggression
45
Q

what is the management of ADHD?

A
  • Psychotherapy – behavior therapy
  • Family therapy, drugs
  • Diet – exclusion of some drugs
46
Q

what are the causes of learning difficulties?

A 
25% no identifiable cause
30% chromosome disorder
20% other syndromes
20% post natal cerebral insults 
1% metabolic or degenerative disease
47
Q

what may learning difficulties present with?

A
  • Reduced intellectual functioning
  • Delay in milestones early
  • Dysmorphic features and associated problems e.g. ADHD, epilepsy, sensory impairment
  • MDT for long-term follow up and school recognition

notes to flashcards year 2 - LCRS1 (58 decks)

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