Child development Flashcards
What is child development?
- The biological, psychological, and emotional changes that occur between birth and adolescence as the individual progresses from dependency to increasing autonomy.
Name some influences on child development?
1) Maternal nutrition
2) Genetics
3) Mothers health during pregnancy
4) Prematurity
5) Domestic violence
6) Exposure to substances
7) Abuse
8) Neglect
9) Nutrition
4 Developmental domains?
1) Gross Motor
2) Vision and Fine Motor
3) Hearing, speech and language
4) Social, behavioural and emotional
- Development in each skill field follows a pattern between children (sequentially constant) but may vary in rate.
- Deficiency in one skill area can impair or affect other areas (e.g. hearing impairment affects child’s language, social and communication skills)
Gross Motor developmental milestones?
- Newborn: Limbs flexed, symmetrical position, notable head lag on pulling up.
- 6-8wks - Lift head up 45 degrees in prone
- 6-8m - Sits up supported, round back to straight back (9m limit age)
- 8-9m - crawling
- 10m - pulls to stand, cruises around furniture
- 12m - walks unsteadily, broad gait with hands apart
- 15m - walks steadily (18m LIMIT AGE for walking - check CK for Duchenne’s in boys)
- 2yrs - walks up steps
- 3yrs - jumps
- 4yrs - hops
- 5yrs - rides bike
Vision and fine motor developmental milestones?
- 6wks - fixes and follows (3m limit age)
- 4m - reaches for objects (6m limit age)
- 4-6m - palmar grasp
- 7m - transfers from one hand to another (9m limit age)
- 10m - pincer grip (12m limit age)
- 18m-4yrs - Brick building: 18m - tower of 3, 2yrs - tower of 6, 3yrs - builds bridge, 4yrs - builds steps (HAND PREFERENCE BEFORE 18m - RED FLAG)
- 2-5yrs - Drawing: 2yrs - line, 3yrs - circle, 3.5yrs - cross, 4yrs - square, 5yrs - triangle.
Hearing, speech and language?
- Newborn - startles to loud noises
- 3-4m - laughs and squeals
- 7-10m - mama/dada
- 12m - 2 words other than mama/dada
- 2yrs - 2 word sentences and names body parts
- 3yrs - speech mainly understandable
- 4yrs - knows colours, can count 5 objects
- 5yrs - knows meanings of words
Social, emotional and behavioural?
- 6wk - smiles responsively (8wk limit)
- 6-8m - food in mouth
- 9m - stranger danger (10m limit)
- 10-12m - waves bye, plays peek-a-boo
- 12m - drinks from cup with 2 hands
- 18m - holds spoon and safely places food in mouth
- 1.5-2yrs - symbolic play (2.5yrs limit)
- 2yrs - dry by day, pulls some clothing off
- 2.5-3yrs - interactive play (3.5yrs limit)
Development screening:
- Checks of whole populations of children at set ages, with child health surveillance and promotion programme.
- Problems with it:
1) Subjective clinical opinion
2) Single observation of development may be limited if child is tired, hungry, shy.
3) Large focus on motor development - poor predictor of cognitive function
4) Development of speech and language better predictor of cognitive function but is harder to assess rapidly.
Developmental assessment - screening tools used?
- Schedule of growing skills
- Denver development screening test
- Infants and young children - Griffiths or Bayleys infant developmental scales
- Specific tests for domains:
1) Reynell’s language scale
2) Gross motor function measure
3) Autistic diagnostic review
Healthy child programme:
- Surveillance programme spanning from birth to 19yrs
- offers families a programme of: screening tests, immunisation, developmental reviews and health promotion.
- Encourages care, protects children from disease (screening and immunisation), promotes healthy lifestyle, ensures preparation for school, identifies ‘at risk’ families for intensive support.
- Universal surveillance - neonatal examination, new baby review (14 days old), babies 6-8wk examination: growth and development checks, parental concerns, identifies at risk families.
- ‘AT RISK’: drugs, alcohol, parents with learning disabilities, obesity.
What is developmental delay?
- The slow acquisition of all skills (global delay)
- Slow acquisition of one particular field or area of skill (specific delay).
- Usually in 0-5yrs age group.
Global developmental delay?
- Usually becomes apparent in the first 2 years of life
- Associated with cognitive difficulties - become apparent several years later.
- When child becomes older - describe individual difficulties (learning disability, motor disorder, communication difficulty) rather than developmental delay.
Genetic conditions that lead to developmental delay?
1) Chromosomal disorders (Downs, Duchenne’s, Fragile X)
2) Chromosomal microdeletions
3) Single gene disorder - Duchenne, Rett
4) Polygenic - Autism, ADHD
Factors in pregnancy leading to developmental delay?
1) Congenital infections
2) Drugs and alcohol
3) Hypothyroidism
4) Vascular occlusion/haemorrhage - cerebral palsy
Factors around birth leading to developmental delay?
1) Prematurity
2) Hypoxic-ischaemic encephalopathy
3) Kernicterus - hyperbilirubinaemia
