Child Development Flashcards
what are the 3 definitions of development?
o The global impression of a child which encompasses growth, increases in understanding, acquisition of new skills and more sophisticated responses and behaviour.
o A dynamic process of growth, transformation, learning and acquisition of abilities to respond to and adapt to the environment in a planned, organised and independent manner.
o A process by which each child evolves into an independent adult.
what are the antenatal factors that affect development?
- infections maternally e.g. herpes, rubella
- toxins
- drugs e.g. valproic acid, alcohol
- hormones e.g. androgenic agents, maternal diabetes and obesity
what are the postnatal factors that affect development?
- infections
- metabolic disorders
- toxins
- trauma
- domestic violence (maltreatment)
- malnutrition
- maternal mental health disorders.
what are the complications of spina bifida?
o Neurogenic bowel and bladder incontinence.
o Lower limb paralysis.
o Fractures and joint contractures.
o Developmental deformities and learning disabilities.
o Hydrocephalus and meningitis.
IMPORTANT
what are the 4 Development Domains?
1) Gross motor performance and posture
2) Vision and fine motor.
3) Hearing, speech and language.
4) Social, emotional and behavioural.
how does acquisition of skills occur during development?q
key performance skills are attained at milestones. There is a constant pattern but a variable rate of attainment.
what is median age in context of development?
age when half of the standard population of children achieve that level of development
what is limit age in context of development?
age by which they should have achieved the level and is equal to 2 S. Ds from the mean age.
the measures are corrected for prematurity (<2)
what are the developmental milestones in gross motor performance?
o New-born – limbs flexed in symmetrical posture, head lag on pulling up. o 6-8 weeks – raises head to 45degrees in prone. o 6-8 months – sits without support. o 8-9 months – crawling. o 10 months – cruising around furniture. o 12 months – walks unsteadily. o 15 months – walks steadily.
what primitive reflex is present till about 3-6 months?
Moro reflex: response to a sudden loss of support and involves three distinct components: spreading out the arms (abduction) pulling the arms in (adduction) crying (usually)
what is the purpose of the Moro reflex?
protective and serve to promote support, balance and orientation
when do primitive reflexes disappear? examples of primitive reflexes?
3-6 months Stepping. Moro. Grasp. Asymmetric tonic reflex – which way babies head is turned, arm outstretches. Rooting
when do protective reflexes develop? examples of protective reflexes
from 5 months
- downward parachute reflex
- sideward protective reflex
- forward and backward protective reflex
when is object permanence attained?
at 9 months of age – the idea that when out if sight, not out of mind.
what are the milestones in fine motor and vision?
o 6 weeks – turns head to follow object. o 4 months – reaches out to toys. o 4-6 months – palmar grasp. o 7 months – transfers between hands. o 10 months – mature pincer grip. o 16-18 months – marks with crayons. o 14 months-4 years – towering. o 2-5 years – ability to draw without seeing how it’s done (after seeing it can be done 6m earlier).
what are the milestones in language and hearing?
o New born – startles. o 3-4 months – vocalises alone or when spoken to. o 7 months – turns to soft sounds out of sight. o 7-10 months – uses sound indiscriminately or discriminately. o 12 months – two to three words other than dada or mama. o 18 months – six to ten words. o 20-24 months – makes simple phrases. o 1.5-3 years – talk constantly in 3-4 word sentences.
what are the developmental milestones in social, behaviour and play?
o 6 weeks – smile responsively. o 6-8 months – puts food in mouth. o 10-12 months – wave bye, play peek-a-boo. o 12 months – drink from cut with two hands. o 18 months – can eat by themselves. o 18-24 months – symbolic play. o 2 years – potty trained. o 2.5-3 years – parallel play.
give examples of limit ages
o Walking independently - 18 months. o Fixes and follows visually - 3 months. o Joins words - 2 years. o Symbolic play - 2-2.5 years.
what is does delay in development mean?
slow acquisition of skills
this can occur in one or more domains
- global delay= >1 domain
- specific delay = 1 domain
what are the types of delay regarding number of domains affected?
- global delay= >1 domain
- specific delay = 1 domain
what are the types of delay regarding how the domains are affected?
in global:
- consonant delay=
All domains affected equally - dissonant delay=
All domains affected differently
what does disorder in development mean?
mal-development of a skill
what kind of delay patterns are there (not in the normal range) ?
- slow but steady
- plateaued
- regressive
overtime the gap between the normal and delayed pattern becomes wider so the deficits become more apparent
what are the causes of abnormal development?
o Abuse, trauma, drugs, infection.
o Autism, deficits in development.
o Malnutrition, cerebral palsy, etc.
when does delayed development become obvious?
o Routine surveillance.
o Identified risk factors.
o Parents/HCPs worried.
o Opportunistic worries raised.
what are some signs of development problems?
- delayed walker
- clumsy
- delayed speech and language
- odd social interactions (ASD, Aspergers)
- hyperactivity
what must be part of there history taken to assess abnormal development?
o Antenatal
– illnesses/infections, medications, drugs and environmental exposures.
o Birth
– premature, prolonged/complicated labour.
o Post-natal
– illness/infections, trauma.
o Consanguinity
– increased chance of chromosomal/autosomal conditions.
o Developmental milestones from parents.
what must be examined in the assessment of development?
o Growth parameters
– height, weight, head circumference.
o Dysmorphic features.
o Neurological examination and skin examination
o Systems examination
– identify syndromes and associations.
o Standardised developmental assessments
– SOGSII, Griffiths, Denver, Specialised assessments
what screening investigations can be done?
- cytogenic studies
- metabolic screens (function tests and blood profiles)
blood ammonia and lactate - urine and blood amino-acids, creatine kinase
- imaging and nerve/muscle biopsies.
management by MDT
