Child Development (incomplete) Flashcards
What are the primitive reflexes?
Asymmetric tonic neck reflex
Babinski (extensor plantar) reflex
Galant reflex
Grasp reflex
Moro reflex
Sucking (rooting) reflex
Walking (stepping) reflex
What is the walking/stepping reflex?
Supporting infant upright with soles touching surface causes each foot in turn to lift as if walking
Disappears at 2 months
What is the sucking/rooting reflex?
Coordinated suck and swallow and turning towards the breast. Rooting - stimulation of corner of mouth/cheek prompts baby to turn towards the source and open mouth
May not develop until 32-36 weeks gestation
Disappears at 4 months
What is the galant reflex?
Stroking to the side of the spine causes body to curve towards the stimulus (lateral curvature of spine)
Disappears at 4-6 months
What is the grasp reflex?
Fist clenches when palm stimulated
Disappears at 5-6 months
What is the moro reflex?
Throws head back
Extends then contracts limbs and clenches fists
Disappears at 5-6 months
What is the Asymmetric tonic neck reflex?
Extension of ipsilateral arm and contraction of contralateral elbow upon head turning (fencer’s posture)
Disappears at 6-7 months
What is the Babinski reflex?
Extension of toes upon stroking lateral surface of foot
Disappears at 2 years
What is congenital anosmia?
About 1% of total cases of anosmia
Most common cause is Kallman syndrome (associated with absent or incomplete puberty)
What is visual acuity?
Minimal distance that 2 targets need to be separated in order to be seen as distinct
An individual with ‘perfect’ vision can resolve 2 targets serparated by one minute of an arc (1/60th of a degree) i.e. 6/6 Snellen (or 20/20 by US measures)
How are the numbers on Snellen chart calculated?
Numerator - distance from chart, usually 6 meters (20 yards).
Denominator - number beneath smallest line patient can read
A child with 6/36 vision is reading print at 6 meters that an individual with ‘normal’ vision would be able to read at 36 meters
What is expected mean visual acuity for a newborn?
Visual acuity test for a newborn?
Visual field test for a newborn?
<6/60
Acuity test = fixation to lights
Field tests are not possible
What is expected mean visual acuity at 0-3 months?
Visual acuity test for 0-3 months?
Visual field test for 0-3 months?
6/60 - 6/38
Acuity: fixation to faces/large toys
Fields: visually elicited eye movements
What is expected mean visual acuity at 3-24 months?
Visual acuity test for 3-24 months?
Visual field test for 3-24 months?
6/38 improving to 6/12
Acuity: preferential looking cards (Teller/Cardiff) - preference to look towards more interesting stimulus
Fields: confrontation techniques
What is expected mean visual acuity at 2-4 years?
Visual acuity test for 2-4 years?
Visual field test for 2-4 years?
6/12 - 6/9
Acuity: picture optotype charts
Fields: ?confrontation techniques
What is expected mean visual acuity at 5+ years?
Visual acuity test for 5+ years?
Visual field test for 5+ years?
6/9 - 6/6
Acuity: letter optotype charts
Fields: Goldmann perimetry / automated perimetry
(Humphrey/Octopus sometimes possible)
Fields are notoriously difficult to test in children but by 5 years expected 150 degrees horizontal and 130 degrees vertical
What is logMAR?
Logarithmic minimal angle of resolution
Replacing Snellen charts in eye departments
Uniform 5 letters per line
Score 0.00 equivalent to 6/6, higher number = worse acuity
What is VEP?
Visual evoked potentials
VEP pattern reversal test
= way of objectively assesing acuity, skin electrodes measure cortical activity stimulated from reversing white/black chequerboard pattern
Acuity is quantified by the smallest check size to elicit a cortical reaction
Can be esp. useful in non-organic visual loss
What is variable angle squint?
Ocular misalignment
Common in neonates, reflects poor visual acuity at that stage of development. By 3 months, visual acuity should be sufficient to stimulate ocular alignment.
Squint after 3 months suggests vision is poor or squint is pathological
Ocular and cortical immaturity causes pursuit and saccadic eye movements to be jerky and inaccurate until what age?
3-4 months
When is vision routinely assessed in children?
Red reflex at birth
Orthoptist led service 4-5 years
