Child development

Question 1

What is development?

Answer 1

Global impression of a child which encompasses growth, increase in understanding, acquisition of new skills + more sophisticated responses + behaviour

Question 2

What are teratogens?

Answer 2

Environmental agents that cause congenital anomalies by interfering with fetal organogenesis, growth or cellular physiology or by disrupting previously normal tissue

Question 3

Give 3 examples of antenatal teratogens

Answer 3

Maternal infections
Toxins e.g. alcohol
Drugs

Question 4

Give 3 examples of postnatal teratogens

Answer 4

Infections e.g. meningitis, encephalitis
Metabolic disorders e.g. hypoglycaemia
Trauma

Question 5

What are the 4 domains of the brain?

Answer 5

Gross motor + posture
Fine motor + vision
Language + hearing
Social, emotional + behaviour

Question 6

In terms of development, what is a milestone?

Answer 6

Acquisition of a key performance skill

Question 7

What is the pattern of development like between children?

Answer 7

Follows a constant pattern but there is variation in rate

Question 8

In terms of development, what is the median age?

Answer 8

Age when half of a standard population of children achieve that level

Question 9

In terms of development, what are limit ages?

Answer 9

Age by which they should have achieved= 2 SD from mean

Question 10

What are the different stages of gross motor and posture development?

Answer 10

6 weeks- Raised head to 45 degrees in prone
6 months- Sits without support
9 months- Crawls
10 months- Cruises
12 months- Walks unsteadily (broad gait + hands apart)
18 months- walks steadily

Question 11

What are primitive reflexes useful for?

Answer 11

Protective + survival value
Promote proper orientation
Promote postural support + balance

Question 12

Name 5 primitive reflexes

Answer 12

Stepping
Moro
Grasp
Asymmetric tonic reflex 
Rooting

Question 13

What does fine motor and vision assess?

Answer 13

Hand function + hand-eye coordination

Question 14

What are the stages of fine motor and vision development?

Answer 14

6 weeks- Follows moving object or face by turning head
6 months- Palmar grasp
9 months- Mature pincer grip
18 months- Builds basic tower

Question 15

What are the stages of development for language and hearing?

Answer 15

Newborn- Startles to noises
3 months- Turns to sound
6 months- Vocalisations
9 months- 2 syllable babble
12 months: 1-2 words
18 months- 6-12 words

Question 16

What are the development stages for social behaviour and play?

Answer 16

6 months- Puts food in mouth
9 months- Waves bye, plays peek a boo
12 months- Imitates activities
18 months- Uses spoon

Question 17

Give a brief breakdown of ages of first steps:

Answer 17

25% by 11 months
50% by 12 months
97.5% by 18 months

Question 18

What is cerebral palsy? What are most cases caused by? List 3 associated problems

Answer 18

A disorder of movement + posture arising from a non-progressive lesion of the brain acquired before age 2
Antenatal
Learning difficulties, Epilepsy + Poor growth

Question 19

What does management of cerebral palsy aim to do?

Answer 19

Minimise spasticity + manage associated problems

Question 20

Describe the prevalence of autism spectrum disorder

Answer 20

3-6 per 1000

Boys > Girls

Question 21

List 3 features of Autism

Answer 21

Impaired social interaction
Speech + Language disorder
Imposition of routines with ritualistic + repetitive behaviour

Question 22

What 2 associated comorbidities are associated with autism?

Answer 22

Learning + attention difficulties

Epilepsy

Question 23

What is the management approach for Autism?

Answer 23

Intensive support for child + family

Question 24

List the diagnostic criteria for Attention deficit hyperactivity disorder

Answer 24

Inattention
Hyperactivity
Impulsivity
Lasting > 6 months
Commencing < 7 years + inconsistent with the Childs developmental level

Question 25

What are children with ADHD have increased risk of?

Answer 25

Conduct disorder Anxiety disorder Aggression

Question 26

Describe 4 management approaches for ADHD

Answer 26

Psychotherapy Family therapy Drugs Diet

Question 27

What is the prevalence of moderate learning disability?

Answer 27

30 per 1000

Question 28

List 4 causes of learning disabilities

Answer 28

Chromosome disorders Other identifiable syndromes Postnatal cerebral insults Metabolic or degenerative disease

Question 29

List 3 features of a child presenting with learning disabilities

Answer 29

Reduced intellectual functioning Delay in early milestones Dysmorphic features

Question 30

List 3 associated problems experienced by children with learning disabilities

Answer 30

Epilepsy Sensory impairment ADHD

Question 31

What is the management approach for children with learning disabilities?

Answer 31

Establishing a diagnosis + input from the MDT with long term follow-up

Question 32

What does abnormal development refer to?

Answer 32

Slow acquisition of skills, can follow 3 patterns: Slow but steady Plateau Regression

Question 33

List 4 factors influencing developmental delay

Answer 33

Ill health Reduced inherent potential Sensory/ motor impairment Lack of physical/ psychological stimuli

Question 34

How can developmental delay be classified?

Answer 34

Global | Specific (Language, motor, sensory or cognitive)

Question 35

List 5 commonly used assessment tools for developmental delay

Answer 35

``` Standardised tests Schedule of Growing Skills Griffiths developmental scale Bailey developmental scale Denver developmental screening test ```

Question 36

What is assessed in a physical examination to determine developmental delay?

Answer 36

``` Appearance Growth Hearing + vision Skin Genitalia ```

Question 37

What tests may be performed to determine developmental delay?

Answer 37

``` FBC + Ferritin TSH Chromosomes Lead Ultrasound CT/ MRI ```

Question 38

What are the 4 key objectives of management of developmental delay?

Answer 38

Maximise mobility Minimise discomfort Promote speech + language Promote social + emotional health

Question 39

List 6 common features of developmental delay

Answer 39

``` Delayed walker Clumsy child Delayed speech + language Odd social interaction- ASD/Aspergers Hyperactivity Specific learning difficulties ```