Child's journey - growth, development, and health Flashcards

1
Q

What are the recognised phases of childhood?

A
Neonate (<4w)
Infant (<12m)
Toddler (around 1-2y)
Preschool (around 2-5y)
School age
Teenager/adolescent
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2
Q

What are the 5 key development fields?

A
Gross motor - general  movements
Fine motor - Precise movements eg pincer grip
Speech and language
Hearing and vision
Social and self help
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3
Q

What are the main childhood objectives?

A
To grow
To develop and achieve their potential
To attain optimal health
To develop independence
To be safe
To be cared for
To be involved
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4
Q

What are milestones?

A

Key skills

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5
Q

What are examples of milestones?

A

Smiling - around 2 months, issue if not by 4 months
Sitting - around 6 months, issue if not by 10 months
First steps - around 12 months, issue if not by 18 months
First words - around 12 months but if not by 2 years then concerns

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6
Q

What should happen to a child who is premature regarding developmental milestones?

A

Their prematurity should be taken off their age

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7
Q

What is the limit age of normal for milestones?

A

2 standard deviations from the mean

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8
Q

Why is development important?

A

Learning functional skills for later life
Hone skills in a safe environment
Allow our brain’s genetic potential to be fully realised
Equip us with tools needed to function as older children and adults
Many are completely automatic

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9
Q

What are influencing factors for development?

A

Genetics (family, race, gender)
Environment
Positive early childhood experience
Developing brain vulnerable to insults - antenatal, post natal, abuse and neglect

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10
Q

What are antenatal adverse environmental factors?

A

Infections - CMV, rubella, toxoplasmosis

Toxins - alcohol, smoking, anti-epileptics, etc

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11
Q

What are post natal adverse environmetal factors?

A
Infection - meningitis, encephalitis
Toxins - solvent mercury, lead
Trauma - head injury
Malnutrition (iron, folate, vit D)
Metabolic - hypoglycaemia
Maltreatment/neglect
Maternal mental health issues
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12
Q

Why do we assess development?

A
Reassurance and show progress
Early diagnosis and intervention
Discuss positive stimulation/parenting strategies
Provision of information
Imrpoving outcomes - pre-school years
Genetic counselling
Coexistent health issues
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13
Q

What children are especially assessed for development?

A

Premature
Syndromes
Adverse events

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14
Q

Who assesses development?

A

Parents and wider family
Health visitors, nursery, teachers
GPs, A&E, FYs, STs, students
Paediatricians and community paediatricians

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15
Q

What is used to assess development?

A

Healthy child programme (HCP) UK

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16
Q

What toys can we use to assess development?

A

Blocks - picking up, transferring to each hand, stacking
Crayons - drawing, fine motor skills
Ball - gross motor skills
Tea cup and tea set - imaginary play and social and language skills
Books - language

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17
Q

Whats important to consider about the progress of each developmental field?

A

One may be more prominently deficient than others - global vs specific delay

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18
Q

What are developmental red flags?

A
Loss of developmental skills
Parental/professional concern
Hearing loss
Persistent low muscle tone
No speech by 18 months, especially if no other communication
Asymmetry of movement
Not walking by 18 months
19
Q

Who performs child health screening?

A

GP
Health visitor
Midwife

20
Q

What are the main components of child health screening?

A

Health promotion
Developmental screening (including hearing)
Immunisation

21
Q

What is tested for in the blood spot screening?

A
PKU
Hypothyroid
CF
Sickle cell
MCADD
22
Q

When do children have their health checked?

A
New-born exam and blood spot screening
New-born hearing screening (day 28)
Health visitor first visit
6-8w review
27-30m review
Orthoptist vision screening (4-5y)
23
Q

What is assessed at the 6-8w review?

A

Identification data
Feeding
Parental concerns (appearance, hearing, eyes, sleeping, etc)
Development
Measurements (weight, length)
Examination (heart, hips, testes, genitalia, femoral pulses, eyes)
Sleeping position

24
Q

What is done at the 27-30m review?

A

Identification data
Development
Physical measurements (height and weight)
Diagnoses

25
Should you give vaccines if a child is immunocompromised?
No
26
Is egg allergy contraindicated for MMR?
No
27
What do we monitor in growth?
Weight (grams) Length or height if over 2y (cm) Head circumference (OFC) (cm)
28
What can be derived from growth measurements?
``` Weight for age Length/height for age BMI Weight for length Rate of weight gain (only in infants) ```
29
What is the weight, length, and head circumference of a newborn?
Weight - 3.3kg Length - 50cm OFC 35cm
30
What is the weight, length, and head circumference of a 12 month old?
Weight - 10kg Length - 75cm OFC - 45cm
31
What is failure to thrive?
Child growing too slowly in form and usually in function at the expected rate for his or her age Significantly low grade of weight gain
32
What are maternal causes of deficient intake leading to failure to thrive?
Poor lactation Incorrectly prepared feeds Unusual milk or other feeds Inadequate care
33
What are infant causes of deficient intake leading to failure to thrive?
``` Prematurity Small for dates Oro palatal abnormalities ie cleft palate Neuromuscular disease Genetic disorders ```
34
What increased metabolic demands lead to failure to thrive?
``` Congenital lung disease Hypothyroidism Liver disease Heart diease Renal disease Infection Anaemia Cystic fibrosis IBD Malignancy ```
35
What are causes of excessive nutrient loss leading to failure to thrive?
Gastro oesophageal reflux Pyloric stenosis Gastroenteritis Malabsorption
36
What are causes of malabsorption in the child?
``` Food allergy Persistent diarrhoea Coeliac disease Pancreatic insufficiency Short bowel syndrome ```
37
What are non medical causes of failure to thrive?
``` Poverty/socio-economic status Dysfunctional family interactions Difficult parent-child interactions Lack of parental support Lack of preparation for parenting Emotional deprivation Poor feeding or feeding skills disorder Difficult baby ```
38
What should you ask about in history about failure to thrive?
Presenting symptoms Dietary assessment Birth/family/social
39
What should be assessed on physical examination in failure to thrive?
Dysmorphic features Anthropometry Systems, development
40
What is anthropometry?
Measurement of body proportions
41
What is done during trial feeding in failure to thrive?
Observe feeding and mothers handling Dietician/SALT assessment Developmental assessment
42
What can cause poor food intake in hospital in trial feeding?
Organic cause Feeding disorder Non-organic or mixed
43
What can cause no weight gain in trial of feeding despite good food intake?
Organic - investigate accordingly