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Paediatrics > Child Development > Flashcards

Child Development Flashcards

1
Q

Red Flag - can’t sit at___

A

9 mo

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2
Q

Red Flag - can’t walk by ____

A

18 mo

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3
Q

Red Flag - no pincer grasp by ____

A

12 mo

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4
Q

Red Flag - hand dominance at

A

<18mo

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5
Q

Red Flag - no response to name by ____

A

12 mo

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6
Q

Red flag - <15 words by ___

A

18 mo

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7
Q

Red Flag - no two word sentences at

A

2 years

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8
Q

Red Flag - no pretend play by

A

3 years

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9
Q

Red flag – does not point to desired object by ___

A

15 mo

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10
Q

Other general red flag

A

regression at any age

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11
Q

Developmental Hx

A 
med hx, prenatal
diet
sleep
hearing, vision
seizures
milestones
famhx
soc hx
corroboration - teachers, etc
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12
Q

Developmental physical exam

A

growth (HC, wt, ht)
full exam
esp: neuro, dysmorphic features, neurocutaneous signs
developmental observation

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13
Q

Developmental Disorder - DDx / categories

A
  • motor: CNS (e.g. CP), PNS (e.g. MD), developmetnal coordination disorder
  • language: oromotor anatomy, hearing impairment, language disorder, ASD
  • emotional/social: ASD, neglect, social communication disorder
  • if 2+ areas: global developmental delay (language, social, cognitive, motor (fine, gross))
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14
Q

Developmental disorder w/u

A
  • hearing, vision
  • genetic syndromes potentially
  • MRI head (if neuro findings, seizures, macro/microcephaly)
  • metabolic testing
  • EEG if ?seizures
  • lead + iron studies possibly
  • TSH
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15
Q

Autism Spectrum Disorder - diagnostic criteria

A

A criteria (persistent + multiple contexts):

  • deficit in social-emotional reciprocity, affect, fail to initiate/respond
  • deficit in non-verbal communication
  • deficit in relationships

B restrictive behaviours

  • repetitive motions / speech
  • insistence on routine
  • restricted + fixed interests
  • hyper or hypo-reactivity to sensory input

Present early in development, cause impairment, not explained by ID or GDD

If co-occur with ID, ASD social communication is below expected for IQ

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16
Q

ASD risk factors

A
  • genetic, epigenetic, environment
  • males
  • sibling /w autism
  • advanced paternal age
  • downs, NFT, tuberous sclerosis, fragile X, angelman, rett syndrome
  • prematurity, low BW
17
Q

ASD w/u and diagnosis

A
  • screen: 18-24mo
  • M-CHAT-R, ADOS-2
  • DSM5 to dx
  • speech, OT, maybe psych assessments
  • chromosome microarray + fragile X testing
  • hearing test if speech delay
  • +/- genetic test, MRI, EEG, metabolic test, CBC, TSH, lead
  • psychoeducational testing for school
18
Q

ASD management

A
  • early multi-D intervention
  • applied behavioural analysis therapy
  • SLP, OT, behaviour support
  • meds if refractory aggression
  • social skills + vocational training
19
Q

Cerebral Palsy Description / types

A

non-progressive movement disorder from peri-natal brain injury. Hypertonia.

types:
- spastic (uni or bilat)
- ataxic
- dyskinetic (dystonic or choreoathetosis - kernicterus)

20
Q

investigations for CP

A

MRI
**vision + hearing **
EEG if seizures
coagulopathy profile if hemiplegic
metabolic + genetic testing NOT routine

21
Q

CP management

A

physio, OT, speech therapy

hypertonia: botox, diazepam, dantrolene, baclofen, tizanidine

intrathecal baclofen pump

surgery: contractures, neuro (dorsal rhizotomy)

22
Q

CP possible associations

A 
speech delay
ID
LD
hearing + vision issues
seizures
feeding/swallowing
constipation
23
Q

Global developmental delay definition

A

delay in 2 domains (motor, speech/language, cognition, social, ADLs)

only for kids <5, may become ID when older

24
Q

Global Dev Delay w/u

A 
chromosome microarray + fragile X
basic metabolic testing
hearing + vision
others based on physical: EEG, lead, iron, genetics consult
MRI if neuro, seizures, abnormal HC
25
Q

Intellectual Disability criteria

A

3 criteria (meets all)

  • deficit in intellectual functioning (reasoning, problem solving, planning, etc) by clinically + testing
  • deficit in adaptive functioning (independence, ADLs, social role)
  • onset during developmental period

mild, mod, severe, profound levels (based on adaptive function)

diagnosed by psychologist

26
Q

FASD criteria

A

Can be either
with sentinel features
- (all 3) smooth philtrum, thin lip, short palpebral fissures
- prenatal EtoH confirmed or unknown AND
- evidence of impairment in 2+ neurodev domains OR microcephaly if infant

without sentinel features

  • impaired in 3+ neurodev domains AND
  • confirmed prenatal EtOH

associated defects: CHD, cleft palate, hearing loss, renal, eye

high risk of mental illness, criminality, peer issues

27
Q

Learning Disabilities - diagnostic criteria

A

4 criteria

  • learning difficulty in 1+ area (word reading, comprehension, writing, numbers, math reasoning)
  • academics below grade level
  • begin in school years
  • not explained by ID, hearing/vision, psychosocial, psych

Co-occurs: ADHD, ASD, anxiety, dev coordination

28
Q

2 months

A
  • raises chin briefly when prone
  • coos / sounds
  • social smile
  • follows movement with eyes
29
Q

3 months

A
  • head control

- hand regard

30
Q

4 months

A
  • rolls to supine
  • hold object briefly if put in hand
  • reach for midline objects
  • turn head to sound
  • excited reaction to people
31
Q

6 months

A
  • sits tripod / briefly
  • transfer objects hand to hand
  • babbles
  • stranger anxiety
32
Q

9 months

A
  • sits well
  • crawl/shuffle
  • pull to stand
  • stand /w support
  • pincer grasp
  • points
  • raises arms to be picked up
  • object permanence
  • social games (peek a boo)
  • separation anxiety
  • seeks joint attention
33
Q

12 months

A
  • stands with support
  • walks while holding on
  • holds cup to drink
  • cubes into cup / release
  • first word, up to 3 words
  • follows simple command
  • responds to name
34
Q

15 months

A
  • walks without support
  • self feed finger foods
  • imitates, scribbles
35
Q

18 months

A
  • runs stiffly
  • stoop + recover
  • eat /w spoon
  • 10+ words
  • three body parts
  • eye contact, affection
36
Q

2 years

A
  • upstairs 1 at a time
  • draws lines, circular stroke
  • 50% intelligble
  • 2 step directions
  • says 50+ words
  • temper tantrums
  • parallel + pretend play
37
Q

3 years

A
  • tricycle
  • copy circle
  • 3-4 word sentence
  • 75% intelligble
  • recognizes colours
  • toilet training
  • make-believe / role play
38
Q

4 years

A
  • stairs alternating feet
  • hop on 1 foot
  • buttons / zippers
  • dresses with help
  • copies a cross
  • sings nursery rhymes
  • 100% intelligible
  • toilet trained at day
39
Q

5 years

A
  • ride bike
  • copies square / triangle
  • full sentences
  • counts to 10, tell story
  • group play
  • separate easily

Paediatrics (23 decks)

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