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Medicine II: Pediatrics > Child Development II > Flashcards

Child Development II Flashcards

1
Q

Boys @ 9-­‐14 yo

A

Testes begin to enlarge, scrotal skin reddens and thickens

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2
Q

Pubarche in Boys

A

10-­‐15, penis starts growing, so do you

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3
Q

Spermarche

A

12-­‐16

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4
Q

Boys @ 12-­‐16

A

SPERMARCHE! Peak of height spurt, facial and body hair begin to grow, voice begins to deepen, penis is done

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5
Q

Pubic hair growth completed (both boys and girls)

A

14-­‐16

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6
Q

Thelarche

A

8-­‐13, also begins growth spurt

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7
Q

Girls Pubarche

A

8-­‐14

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8
Q

Girls @ 10-­‐16

A

Menarche, adult stature, axillary hair, breast growth completed

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9
Q

Early Adolescents age range:

A

10-13

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10
Q

Early Adolescents Body Image

A

preoccupation w/self and pubertal changes, uncertainty about appearance.

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11
Q

Early Adolescents Peers

A

intense relationships w/ same sex friend

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12
Q

Early Adolescents Independence

A

less interest in parental activities

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13
Q

Early Adolescents Identity

A

increased cognition, increased fantasy world, idealistic vocational goals, increased need or privacy, lack of impulse control

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14
Q

Middle Adolescence age range:

A

14-16

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15
Q

Middle Adolescence Body Image

A

general acceptance of body, concern over making body more attractive

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16
Q

Middle Adolescence Peers

A

peak of peer involvement, conformity w/ peer values, increased sexual activity and experimentation

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17
Q

Middle Adolescence Independence

A

peak of parental conflicts

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18
Q

Middle Adolescence Identity

A

increased scope of feelings, increased intellectual ability, feeling of omnipotence, risk-­‐taking

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19
Q

Late Adolescents age range:

A

17+

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20
Q

Late Adolescents Body Image

A

acceptance of pubertal changes

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21
Q

Late Adolescents Peers

A

peer group less important, more time spent in sharing intimate relationships

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22
Q

Late Adolescents Independence

A

reacceptance of parental advice and values

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23
Q

Late Adolescents Identity

A

practical, realistic vocational goals, refinement of moral/religious/sexual values, ability to compromise and set limits

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24
Q

Personality Development

A

The effect of a particular experience will be influenced by the child’s development, and the child’s temperament
will influence the responses of others in the child’s environment

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25
Q

Temperament:

A

The style with which the child interacts with the environment

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26
Q

What do variations in children’s behavior reflect?

A

A blend of intrinsic biologic characteristics and the environments with which the children interact

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27
Q

What is a Learning Disability?

A

Impairment in the acquisition and/or use of spoke (oral) language, written language (reading/spelling/writing) and mathematical skills. Characterized by academic functioning that is substantially below that expected, given the individual’s age, schooling and level of intelligence.

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28
Q

Types of Learning Disabilities:

A

Reading disorder
Disorder of written expression
Mathematics disorder
Learning disorder not otherwise specified

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29
Q

Learning Disability Risk Factors

A

Complications during prenatal/perinatal period, infections of CNS, traumatic brain injury, epilepsy, psychiatric disorder, chronic or debilitating health conditions

Family history: speech and/or language delay, difficulty learning to read or spell, grade retention, behavior problems or trouble in school, school failure

30
Q

Learning Disability Management

A

Parent education.
Therapies and special ed targeted at child’s specific needs/deficits.
Special devices: hearing aide, orthotics.
Medications: specific target symptoms, outcomes.
Medical follow up.

31
Q

What is the single greatest predictor of good outcomes for Learning Disabilities?

A

Early identification

32
Q

Developmental Surveilence

A

Informal assessment of child’s development at each visit

33
Q

When do we do Developmental Screening and Surveillance?

A

Every 9, 18, 24 or 30 months (general development) OR 18 & 24 months (autism)

34
Q

5 components of Developmental Surveillance

A
  1. Eliciting and attending to the parents’ concerns about their child’s development.
  2. Documenting and maintaining a developmental history.
  3. Making accurate observations of the child.
  4. Identifying risk and protective factors.
  5. Maintaining an accurate record and documenting the process and findings
35
Q

Developmental Screening

A

The administration of a brief standardized tool aiding the identification of children at risk of a developmental disorder.

36
Q

Developmental Evaluation:

A

A complex process aimed at identifying specific developmental disorders that are affecting a child.

37
Q

Developmental Screening Tools

A

Parental Eval of development @ 0-­‐8y: To elicit parents concerns.

Ages and Stages @ 0-­‐4y

Denver Developmental Test (tests motor function/adaptive
personality) @ 0-­‐4y

Bayley Neurodevelopmental Screen @ 3-­‐24 mo; assesses neural and developmental achievements.

Draw a person test @ 3-­‐10y : estimates approx. mental age

Pediatric Symptom checklist @ 6-­‐16y: looks into problem behaviors

38
Q

Objective, physiologic methods are used for hearing screening:

A

Auditory brainstem response (ABR) and Otoacoustic emission (OAE)

39
Q

Hearing loss risk factors:

A
  • Developmental delay
  • CNS infection(bacterial meningitis)
  • Ototoxic medications
  • Neurodegenerative d/os
40
Q

Communication Disorders

A

Expressive and receptive language d/os

41
Q

The defining features of spoken language disorders are:

A

Impairments in oral expression and/or listening comprehension associated with dysfunction in one or more subdomain of language, including: 1) morphology (word structure) 2) semantics (word meaning) 3) syntax (sentence structure)

Deficits must significantly interfere with academic achievement and/or social communication

42
Q

Causes of Speech/Language Delay Disorders:

A

Significant hereditability, bilingual households, Otitis media

43
Q

Global Developmental Delay:

A

Significant delay in 2 or more developmental domains: Gross/fine motor, Speech/language, Cognition, Social/personal

44
Q

Intellectual Disability Etiology:

A

Genetic, Teratogenic toxins, Infections, Traumatic, Deprivation, or Idiopathic

45
Q

Intellectual Disability Clinical presentation:

A

1) Deficits in intellectual functioning: IQ 2 SD below mean (70-­‐75).
2) Deficits in adaptive function: ie: conceptual skills (money, time, self-­‐direction), social skills (including ability to follow laws), practival skills (ADLs, IADLs)
3) Disability originates in the developmental period

Typically present with SPEECH DELAY (also hyperactivity and behavior problems)

46
Q

Intellectual Disability Diagnosis

A

Dx: cognitive and adaptive skills (standardized tests), strengths and needs (5 dimensions), supports and services needed

47
Q

Intellectual Disability (ISP) Classifications:

A

Mild (IQ 55-­‐69)
Moderate (IQ 40-­‐54)
Severe (IQ 25-­‐39)
Profound (IQ <24)

48
Q

Mild Disability:

A

(IQ 55-­‐69; Intermittent need for support): Learns to read at 3rd–6th grade level, learns at ½-­‐2/3 normal velocity; Usually lives independently, often marries
and parents, job competitive.

49
Q

Moderate Disability:

A

(IQ 40-­‐54; Limited need for support): Learns at 1/3 to ½ normal velocity, 1st-­‐3rd grade reading level; ADL skills teaching, lives in supervised group home, rarely marries or parents, sheltered employment

50
Q

Severe Disability:

A

(IQ 25-­‐39; Extensive need for support): Learns at ¼ to 1/3 normal velocity, sight reading, life skills class, will likely need assistance w/ ADLs; Highly supervised group
home, does not marry or parent, sheltered work is possible

51
Q

Profound Disability:

A

(IQ <24; Pervasive need for support): Learning less than ¼ normal velocity, no reading skills; Life skills in hospital, needs assistance w/ ADLS, often co-­‐existing
medical conditions.

52
Q

Risk Factors for Intellectual Disability:

A

Most common genetic cause: Down syndrome
Most common inherited cause: Fragile X syndrome
Most common medical cause: Fetal Alcohol Syndrome

53
Q

Prenatal/Perinatal Causes for Intellectual Disability:

A

Maternal illness, infection, malnutrition; Toxins, teratogens, alcohol, illicit drugs; Chromosome abnormalities; Decreased fetal movement, IUGR; Perinatal asphyxia (Apgars of 0-­‐3 at 5 minutes); Perinatal seizures; Prematurity

54
Q

Post Natal Causes for Intellectual Disability:

A

Meningitis, encephalitis; Seizure disorder; Traumatic brain injury; Acquired metabolic and endocrine disorders; Severe chronic illness; Malnutrition; Child abuse and neglect; Adverse psychosocial factors

55
Q

3 core features of autism spectrum disorders:

A

Abnormal social interactions, atypical communication, restricted activities, interests, play and repetitive actions

56
Q

Autism Spectrum Disorders

A

Evidenced by: Impaired ability to make friends w/ peers, initiate or sustain a conversation w/ others, absence or impairment of imaginative and social play, repetitive/unusual use of language, restricted patterns of interest w/abnormal intensity, preoccupation w/ certain objects or subjects, inflexible adherence to routines or rituals, repetitive motor behavior

57
Q

Epidemiology:

A

Rise in prevalence, 1 in 88, 3-­‐4x higher in boys

58
Q

Etiology:

A

Neurobiologic disorder, gene/environment interaction, advanced parental age, immune system dysfunction

59
Q

Presentation:

A

Language delay, behavior problems, delayed
and disordered communication, atypical social interactions,
restricted range of interests, deficits in joint attention, social referencing, theory of mind

60
Q

Screening:

A

At well child visits-­‐ surveillance (elicit parent concerns), screening (at 9,18,30 mo), screening for autism at 19 and 30 months; Use M-­‐CHAT from 18 mo to 4 years; detects ASD, language impairments, MR

61
Q

Diagnosis:

A

Qualitative impairment in social interaction,communication, restricted repetitive and stereotyped patterns of behavior

62
Q

Associated medical conditions:

A

Fragile X syndrome, tuberous sclerosis, down syndrome, William syndrome, turner syndrome, NF, metabolic disorders, landau kleffner syndrome

63
Q

Most commonly diagnosed neurobehavioral disorder in childhood:

A

Attention Deficit/Hyperactivity Disorder

64
Q

Elements of Attention Deficit/Hyperactivity Disorder

A
  • Hyperactivity

* Impulsiveness

65
Q

Hyperactivity

A

fidgets, unable to stay seated, inappropriate running/climbing, difficulty in engaging in leisure activities quietly, on the go, talks excessively

66
Q

Impulsiveness

A

blurts out answer before question is finished, difficulty awaiting turn, interrupts or intrudes on others

67
Q

Inattentiveness

A

to details, careless mistakes, difficulty sustaining attention, seems not to listen, fails to finish tasks, difficulty organizing, avoids tasks requiring sustained attention, loses things, easily distracted, forgetful

68
Q

Attention Deficit/Hyperactivity Disorder in Children 6-­‐12 yo:

A

Easily distracted, errors in homework, poorly organized or incomplete, disruptive in class, out of seat, unwilling/unable to complete chores at home, fails to wait turn in games

69
Q

Attention Deficit/Hyperactivity Disorder in Adolescents 13-­‐18:

A

Hyperactivity less visible, displays inner restlessness, disorganized schoolwork, difficulty working independently, difficulty interacting w/ peers

70
Q

Attention Deficit/Hyperactivity Disorder in Adults:

A

Problems w/inattention and concentration, failure to plan ahead, disorganization, difficulty initiating and completing projects, premature shifting of activities, time management, forgetfulness, impulse decisions

71
Q

Attention Deficit/Hyperactivity Disorder Pathophysiology:

A

Dopamine and Norepi have best documented roles in attention, concentration and cognitive function.

72
Q

Attention Deficit/Hyperactivity Disorder Treatment:

A

Education about disorder, medication, behavioral therapy, environmental support

Medicine II: Pediatrics (8 decks)

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