Child development

Question 1

age ranges of neonates/infants/toddler/pre-school

Answer 1

(<4w)

(<12m/1y)

(~1-2y)

(~2-5y)

Question 2

give examples of gross motor skills

Answer 2

sitting 
standing 
running
lifting 
kicking
walking

Question 3

give examples of fine motor skills

Answer 3

writing
cutting
holding pencil etc
playing

Question 4

when may some infants start walking?

Answer 4

9-10 months
- 50% by 1 year
refer if not walking by 18 months

Question 5

influencing factors for child development?

Answer 5

Genetics (Family, race, gender)
Environment
Positive early childhood experience
Developing brain vulnerable to insults:
Antenatal
Post natal
Abuse and neglect

Question 6

Adverse environmental factors - antenatal - infections vs toxins

Answer 6

Infections (CMV, Rubella, Toxoplasmosis, VZV)

Toxins (Alcohol, Smoking, Anti-epileptics)

Question 7

Adverse environmental factors - postnatal -give examples

Answer 7

Infection (Meningitis, encephalitis)
Toxins (solvents mercury, lead)
Trauma (Head injuries)
Malnutrition (iron, folate, vit D)
Metabolic (Hypoglycaemia, hyper + hyponatraemia)
Maltreatment/ under stimulation/ domestic violence
Maternal mental health issues

Question 8

Why do we do a developmental assessment?

Answer 8

• Reassurance and showing progress
• Early diagnosis and intervention
• Discuss positive stimulation/parenting strategies
• Provision of information
• Improving outcomes (pre-school years critical)
• Genetic counselling
• Coexistent health issues

Question 9

Developmental Assessment- How?

Answer 9

How do they move their body around? - gross motor skills

What do they do with their hands?

How do they communicate? (polysyllabic)

What can they do for themselves?

Question 10

Deciding what is normal?

Answer 10

look at each developmental field

• what has come before?
• what has not been achieved?
• global delay vs specific developmental delay?
• are the skills age appropriate?

Question 11

Recognise Red Flags - name some

Answer 11

Loss of developmental skills - HOSPITAL

Parental/ professional concern re. vision (simultaneous referral to paediatric ophthalmology)

Hearing loss (simultaneous referral for audiology/ ENT)

Persistent low muscle tone/ floppiness

No speech by 18 months, esp if no other communication (simultaneous referral for urgent hearing test)

Asymmetry of movements/ increased muscle tone

Not walking by 18m/ Persistent toe walking

OFC > 99.6th / < 0.4th / crossed two centiles/ disproportionate to parental OFC

Clinician uncertain/ thinks that development may be disordered