Child development

Question 1

Define development

Answer 1

Complex interplay between somatic and neurologic transformations psychosocial and environmental influences.

Question 2

When does most of the development happen in a person

Answer 2

Most of the changes happen antenatally:

Organogenesis - most vulnerable = first 3 months of life
Potential insult can last for life.
Foetal programming

Question 3

What are the four main domains of development?

Answer 3

Cognitive
Gross motor skills (walking, sitting , running)
Fine motor skills (use of hands)
Social skills (speech and language, understanding)

Question 4

What are developmental milestones? Describe some

Answer 4

Stages in each of the four domains a child should be at by a certain age. Examples:
Gross motor: Child can sit by 6 months, by 9 months they can start crawling, around a year the child can walk.
Social skills: First start to say things at 9-12 months old. At two years old they can start to make phrases.
Cognitive: Object permanence exists at 9 months - babies like to play peek-a-boo. 9 months old they start having separation anxiety.
Fine motor: At 2 months they realise their hands are theirs; 3 months the child can start knocking things together.

So if a parent comes in a says their children can’t walk at 2 years old you should be worried.

Question 5

What are the commonly used assessment tools?

Answer 5

Standardised tests
Schedule of growing skills
A bunch of developmental scales

Question 6

What are patterns of abnormal development?

Answer 6

Regression - is a sever sign suggests autism

Slow, steady, plateau or regression of development.

Question 7

How do you evaluate the child with abnormal development?

Answer 7

History

• parental anxiety (antenatal history)
• birth history
• family history

PMHX

• Developmental history
• Current skills

Examination

• Developmental assessment + general and neurological examination
• Investigations - as appropriate

Question 8

What are the different types of developmental delays?

Answer 8

Developmental delay

• Global (all 4 domains)
• Specific (individual domains)

Causes:
Perinatal
Prenatal
Postnatal

Question 9

What are some postnatal factors causing developmental delay?

Answer 9

Environmental-social issues
Chronic illness 
Social depravation
Hearing loss
Lack of stimulation

Question 10

What are some causes of global delay?

Answer 10

Chromosomal abnormalities
Metabolic 
Antenatal and perniatal factors 
Environmental-social issues 
Chronic illness

Question 11

What are causes of languages delay?

Answer 11

Hearing loss
ASD (Autism spectrum disorder)
Learning disability
Lack of stimulation

Question 12

What are the principles of management?

Answer 12

• Maximise mobility
• Minimise discomfort
• Promote speech and language
• Promote social and emotional health

Other people need to help - physio, speech therapist, psychologist, occupational therapists = MULTIDISCIPLINARY TEAM required

Question 13

Describe autism

Answer 13

Impairment of these 3 domains:

• Social interactions
• Communications
• Behaviour, interests, activities

They like to spin things - repetitive movements
Lining up of objects

Question 14

Describe ADHD

Answer 14

• Inattention, increased distractability
• Poor impulse control
• Motor overactivity and motor restlessness

Anger, day dreaming, concentration and lashing out.