Child growth & development

Question 1

What are centile charts?

Answer 1

Centile charts are based on surveys of large numbers of children with age (x axis) plotted against height (y axis). 50% of children will be shorter than the 50th centile, 25% of children shorter than the 25th centile etc.

Question 2

List some causes of abnormal growth

Answer 2

Genetic syndromes (Turner, Down’s, prader willi)
skeletal dysplasias
IUGR
malabsorption
systemic disease (cystic fibrosis, rheumatoid arthritis)
endocrine disorders (cushings, GH def, T1DM)
malnutrition
psychosocial deprivation

Question 3

describe the hormonal control of growth

Answer 3

Hypothalamus - GHRF (neg feedback from GH)
Pit gland - GH (inhibited by somatostatin)
Target organs - ILGF-1

protein synthesis and cell division

Question 4

What are the 4 developmental domains?

Answer 4

1) gross motor and posture
2) fine motor and vision
3) language and hearing
4) social, emotional and behaviours

Question 5

Key gross motor development at 2 years

Answer 5

kicks ball

climbs stairs two feet per step

Question 6

Key fine motor and vision development at 18 months

Answer 6

builds tower of 2-4 cubes

hand preference emerges

Question 7

key social, emotional and beavioral development at 12 months

Answer 7

imitates activities
object permanence
stranger anxiety
points to indicate wants

Question 8

Give some examples of developmental delay

Answer 8

Biological factors such as folate deficiency can increase the risk of neural tube defects.

Global developmental delay due to down’s syndrome, fetal alcohol syndrome, meningitis, trauma.

Delay in talking due to stammering, hearing deficit, maturational delay, environmental factors.

Delay in walking due to maturation delay, severe learning disabilities, cerebral palsy.

Question 9

What are the signs of developmental delay?

Answer 9

• Antenatal- illnesses/ infections; medications; drugs
• Birth- premature; prolonged/ complicated labour
• Postnatal- illness/infections; trauma
• Consanguinity- increases chances or chromosomal and recessive conditions
• Developmental milestones delayed
• Growth parameters- height, weight and head circumference
• Dysmorphic features

Question 10

What are the features of autism?

Answer 10

• impaired social interaction
• speech and language disorder
• imposition of routines with ritualistic and repetitive behaviour

Question 11

What are the features of ADHD?

Answer 11

inattention
hyperactivity
impulsivity