Day 4: Child Development

Question 1

What antenatal maternal infections can cause problems with child development

Answer 1

TORCH

Zica

Question 2

Prenatal

Answer 2

Genetic (down’s Fragile X, Retts, Autism)
IUGR
Infection
Toxins (drugs, alcohol)

Question 3

Illness

Answer 3

Infection (group b strep)
Endocrine (phenylketonuria, hypothyroid glycogen storage disease)
Any chronic conditions
Neurological (cerebral palsy, epilepsy)
Problems with hearing & vision

Question 4

Birth

Answer 4

Prematurity

Asphyxia

Question 5

Social

Answer 5

Neglect

Emotional abuse

Question 6

To get facial feature os fetal alcohol syndrome when must you binge

Answer 6

Around day 40 (when face is developed)

Question 7

For each of the following cards: say what you’d expect to see and concerns you would have.

0-8 months

Answer 7

holds toys in hand
rolls over 
smiles first
holds head up
Sits by self 
smiles 

Concern:
Persistent head lag/primitive reflexes
not faxing/squint 
Fisting/hand preference (should be none)
no smile

Question 8

8-18

Answer 8

crawling 
2-3 words 
cruising 
pincer grip
posting toys
walking by yourself

Concern:
Not sitting/ weight bearing
Persistent hand regard
Absence of babbling/ cooing

Question 9

18-24month

Answer 9

Pushing along trike
play alongside peers
scribble 
up & down stairs 
2-3 stage commands 
50+ words

Concern:
Not walking
Unable to understand simple commands
No vocalisation
Casting persists

Question 10

24-36

Answer 10

2-3 sentences
copy a circle 
scooter 
sociable with other children
dry by day 
Lots of pretend play

Concern:
Unstable gait
Cannot joint words together
No pretend play (autism)

Question 11

shapes

Answer 11

2: circle
3: circle with face
4: square
5: triangle

Question 12

Essentil milstones
4-6 weeks
6 months
12 months
2 yrs

Answer 12

smile
sit palmer grasp
walks, mature pincer grasp, 2-3 words
stairs

Question 13

What is the Denver chart

Answer 13

Developmental assessment tool

Question 14

Investigations

Answer 14

Chromosomes, screening for fragile x
MRI brain (GA)
EEG
Lead level, TFTs, metabolic test
Autism assessment/ SALT assessment

Question 15

18 month girl: not walking, bright social, several single words.

Answer 15

GP: Hx & Examination (follow up)

FY2: Hx & Examination
Health visitor to see them

Father hx: walked at 2
- Late walker follow up

Question 16

3 yr old, few words, ↓ eye contact, tantrums, quiet boy 1st word 20/12

Answer 16

• deaf
• autism

Full Hx & Exam

• preg, birth, neonate
• PMH, FHX, Six
• Dysmorphic?

Investigate (genetics/scan)
Refer full assessment baby multidisciplinary team
(physical, psychologist, speech & language, social assessment, assessment of movement, neurological assessment)

Question 17

18 month, not walking, RS preference, bright child who has single words. He was born at 27/40 & difficult neonatal course.

Answer 17

• L sided weakness (floppy or stiff)
• cerebral palsy? hypoxia, intraventricular bleed (swings of BP, leaky vessels, ↑ CO2)

Normal intellectual function.