Clin Skills + Understanding Flashcards
What are the main domains in child development?
- Social, emotional + behavioural
- Gross motor
- Fine motor + vision
- Language, hearing + speech
How is a child’s growth assessed? How should normality be evaluated?
- Head circumference up to X years
- Length (up to 1 year old) and then Height
- Weight
- BMI (adjusted for age)
- Bone age
- Pubertal stage
Compared using growth charts, special charts are available for special kids e.g. those w/ Down’s or closely monitored infants. Imp to evaluate the absolute measure and the trend. (abnormality in 1 value vs growth has slowed from initial normal trend).
What are the limit ages of the key milestones in Gross Motor?
18 months walking unaided.
How should a premature child be assessed in terms of development and growth?
If they are born prior to 37 weeks their age should be adjusted for until the age of 2. e.g. expected development stage of 9 month (chronological age) born at 28 weeks, 3 months early, would be that of a 6 month old.
What are the key milestones in the gross motor domain and their age of development? And what are the limit ages of the key skills?
- Head control - 3 months
- Roll 4-5 months
- sit unaided 7- 9 months
- crawl 8-10 months
- stands independently 10-12 months
- walk unaided 13-18 months
RED FLAGS: head control 4 months; sit unaided by 9 months; stands with support 12 months; walk unaided 18 months.
What are the key milestones in the language domain and their age of development? And what are the limit ages of the key skills?
- Cry + startles to loud noise - Birth
- Vocalize - 8 weeks
- Laughing - 4 months
- responds to name - 7 months
- single words- 12 months (e.g. apart from mama/ dada)
- 6 - 10 words - 18 months (including 2 parts of body)
- join 2 words into simple phrase - 24 months (want teddy)
RED FLAGS: 6 words with meaning by 18 months, joins 2 words 2 years; 3 word sentences 2.5 years.
What are the key milestones in the social domain and their age of development? And what are the limit ages of the key skills?
- Smiles responsively 6-8 weeks
- finger feeds solids - 6 months
- waves bye-bye - 9 months
- drinks from a cup 12-15 months
- symbolic play 18-24 months
- feeds with knife and fork - 3 years
RED FLAGS: Smiles responsively 8 weeks - concern sight/ neglect; fear of strangers 10 months; feeds self with spoon 18 months; symbolic play 2-2.5 years, interactive play 3-3.5 years.
What are the key milestones in the fine motor domain and their age of development? And what are the limit ages of the key skills?
- visual fixing and following by turning head - 6 weeks
- reaches out - 4 months
- palmar grasp - 4-6 months
- passing things from hand to hand - 7 months
- pincer grip - 10 months
- makes marks on paper 16- 18 months
- tower of 3 blocks - 18 months
- draw a line w/o copying / tower of 6 blocks - 2 years
- draw circle without copying - 3 years
- draw cross w/o copying - 3.5 years
- draw square - 4 years
- draw triangle - 5 years
RED FLAGS: fixes and follows visually - 3 months; reaches for objects - 6 months; transfers from hand to hand - 9 months; pincer grip - 12 months.
What are the circulatory changes observed at + around birth?
Pressure in R heart of fetus > L heart bc it receives systemic blood + blood from placenta whereas L receives little blood from the lungs due to small return. most blood shunted from R heart to L heart via FO due to high resistance to flow from lungs due to presence of fluid and favourable P gradient from R to L heart. Blood also diverted away from lungs via Ductus Arteriosus which links Pul a to Aorta allowing blood at high P in Pul a to move into aorta to go the body.
Oxygenated blood is found in R heart bc it receives blood from placenta. FO and DA allow oxygenated blood to enter aorta to supply the body.
When baby takes first breath at birth, resistance to pulmonary blood flow drops + blood flow to lungs increases dramatically. volume of blood to R heart drops due to the exclusion of the placenta from circulation. These P changes cause the FO to be closed shut and the DA follows suit in the days following birth. In some kids, the DA is critical due to lesions within the heart and therefore their condition deteriorates rapidly on its closure.
I am 6 months, what can I do in each domain?
GM: Sitting supported (with round back)
FM: Palmar Grasp, transferring objects between hands
SL: turns to sound, single syllable “aa”
SEB: Finger feeds
I am 3 years old, what can I do in each domain?
GM: stand 1 leg for 1 second, take stairs 1 foot per step
FM: draw a circle, tower 9 blocks
SL: 3-4 word sentences
SEB: can put on some clothing, may be toilet trained
I am 18 months old, what can I do in each domain?
GM: walk well
FM: build tower of 3-4 blocks, scribbles
SL: say 6-10 words, 2 body parts
SEB: symbolic play
I am 6 weeks old, what can I do in each domain?
GM: hold my head level with my body when lying prone (on belly)
FM: Fix and follow with my eyes
SL: becomes still in response to noise
SEB: Smile
I am 3 months old, what can I do in each domain?
GM: hold head up at 90 degrees when prone
FM: reach out for things, hold things in hands when placed there
SL: vocalises + squeals
SEB: hand observing, laughs
I am 12 months old, what can I do in each domain?
GM: Cruises, may stand unsupported, pulls to stand
FM: can put cube into cup
SL: can say 1-2 words except mama and dada
SEB: drinks from cup with 2 hands, stranger danger
