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RC Studying > Development > Flashcards

Development Flashcards

1
Q

When should a child be referred to developmental pediatrics?

A
  • When parents concerned
  • Not responding to name by 9 months
  • No words or pointing by 12 months
  • Less than 20 words at 18 months
  • Social communication concerns
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2
Q

A 6 year old reverses her letters. The mom is concerned. What do you say?

A

Reassurance - this is normal between 5-8 years.

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3
Q

What are the key milestones for GM skills?

A
  • Head control 3 months
  • Arms 6 months
  • Trunk 9 months
  • Legs 12 months
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4
Q

What time period is the moro reflex present?

A

Birth-4 months

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5
Q

What time period are the grasping reflexes present?

A

Birth-4 months

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6
Q

What time period is the stepping reflexes present?

A

Birth-6 weeks

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7
Q

What time period is the parachute reflex present for?

A

6 months-adulthood

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8
Q

What time period is the gallant reflex present for?

A

Birth-6months

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9
Q

What is sleep onset association disorder and how is it managed?

A

-Inability to fall asleep on own
-Falls asleep easily when parent present
-Frequent night wakenings
Management: bedtime routine, remove maladaptive sleep assoc., teach child to fall asleep on own

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10
Q

What are the key/progression of fine motor skills?

A
  • 4 months transfers objects
  • 6-8 months palmar grasp
  • 7-11 months pincer grasp
  • 2 years uses spoon
  • 4-5years snaps, buttons, zippers
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11
Q

What are the key/progression speech and language for expression?

A
  • 3 months cooing
  • 6 months babbling
  • 12 months language emergence
  • 2 years 2 word combination , 50%
  • 3 years 3 word combination, 75%
  • 4 years phrased speech, 100%
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12
Q

What can you expect from the average 18 month old?

A
  • 15-25 words
  • Running
  • Word explosion
  • Single step commands
  • Knows body parts
  • Lots of gestures, pointing
  • Symbolic and parallel play
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13
Q

What can you expect from the average 2 year old?

A
  • 300-350 words (too many to count)
  • 2-3 word phrases
  • pronoun use
  • 2 step commands
  • enjoys other children
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14
Q

Which features of stuttering increase concern?

A

Physical tension, concern, frustration/self consciousness, pausing between words, no improvement with initial strategies in 1 month

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15
Q

What are the features of developmental dysfluency?

A
  • Occasional (once every 10 seconds)
  • Brief (0.5 seconds or less)
  • Repetition of sounds, syllables or words (no prolongations; at start of word)
  • Worse when tired, excited, complex language, questions, anxious
  • NO tension in facial muscles
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16
Q

What is the diagnostic criteria for developmental coordination disorder?

A

A. Acquisition and execution of coordinated motor skills are substantially below expectations for a child’s chronological age and opportunities for motor skill learning. (Sx: clumsy, slow, inaccurate).
B. Interferes with ADLs for age, impacts life
C. Onset in early development
D. Deficit not better explained by intellectual disability, visual impairment, or a neurological condition affecting movement

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17
Q 
Which of the following medical conditions is associated with a higher prevalence of ADHD?
A. CHD
B. Epilepsy
C. Celiac disease
D. Hypotonia
A

Prevalence of ADHD in epilepsy is 2-3x higher - particularly inattentive
Genetic conditions have higher prevalence as well (Fragile X, Turner, TS, NF, 22q11del)

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18
Q 
Which of the following is the most common comorbidity with ADHD?
A. Disruptive behaviour disorders
B. Anxiety/OCD
C. Tic disorders
D. Specific learning disorders
A

D. Specific learning d/o: MOST common comorbid condition

The other options are all comorbid w/ ADHD but CPS says specific learning d/o is MOST common.

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19
Q

How do you treat ADHD in a patient <6 years of age?

A

Parent behaviour training! Psychostimulants are NOT approved in this group.

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20
Q

What is the DSM5 diagnostic criteria for ADHD?

A
  • Symptoms must occur <12 years
  • Symptoms present in >/=2 settings
  • Symptoms interfere with social, academic, occupational functioning
  • Not explained by another d/o
  • Need >/= 6 inattentive symptoms or hyperactive symptoms
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21
Q

What is the recurrence risk for ASD in younger siblings when an older sibling has ASD?

A

7-19% (compared to 1.5% in the general population)

22
Q

What are some early warning signs of ASD @ 6-12 months?

A
  • Less smiling
  • Limited eye contact
  • Atypical/reduced babbling, gesturing
  • Limited response to name when called
23
Q

What are some early warning signs of ASD @ 9-12 months?

A
  • Emerging repetitive behaviours (spinning or lining up objects)
  • Unusual play (intense visual or tactile exploration of toys)
24
Q

What are some early warning signs of ASD @ 12-18 months?

A
  • No single words
  • Absence of compensatory gestures (such as pointing)
  • Lack of pretend play
  • Limited joint attention (initiating, responding, sharing of interests)
25
Q

What is an early warning sign of ASD @ 15-24 months?

A

-Diminished, atypical or no spontaneous or meaningful two word phrases

26
Q

A school aged child’s parents are divorcing. What do you anticipate their response will be?

A

Strong sense of rules and fairness, prone to loyality and taking sides

27
Q

A 4yo child’s parents are divorcing. What do you anticipate their response will be?

A

Blame themselves for separation, separation anxiety, excessive fears of abandonment

28
Q

How many symptoms are required for diagnosis of ADHD?

A

> /= 6
- Symptoms must be present prior to age 12y, severe and persistent and inappropriate for age/developmental level, associated with impairment

29
Q

What type of car seat should an infant have?

A

Rear facing

30
Q

When can a child have a forward facing car seat?

A

2 years old w/ 5 point harness until at least 18kg/40lb

31
Q

When can a child use a booster seat?

A

4 years old and at least 18kg/40lb

32
Q

How tall does a child need to be to use an adult seat belt?

A

145cm - should have high back booster seat if a vehicle’s back seat does not have adjustable head rest

33
Q

What is first line therapy for a child with ADHD <6yo?

A

Parent behaviour training

34
Q

What are the benefits associated with ADHD pharmacotherapy?

A
  • Improved academic outcome
  • Lower comorbid anxiety and depression
  • Improved function
  • Reduced morbidity and mortality related to MVAs
35
Q

Name 3 conditions which are higher risk for ADHD.

A

-ASD, ID and prematurity

36
Q

What is the first line management for ODD?

A

Behavioural parent training, CBT

37
Q

What are the first line investigations for a child with GDD/ID?

A
  • Hx&PE, if something targeted, investigate that, think about cong. infection
  • Vision & hearing
  • Microarray (47% yields dx)
  • Fragile X
  • MECP2 to r/o Retts if female & sx of same present
  • Thyroid (yield is essentially 0 if N NMS)
  • Lead and ferritin (if PICA/mouthing)
  • Metabolic (if strongly suspected)
38
Q

What is often the earliest indication of neuromotor dysfunction (ie. CP)?

A

Persistent fisting at 3 months of age

39
Q

Which SSRI is contraindicated in long QT syndrome?

A

Citalopram

40
Q

At what age does head banging become concerning?

A

Child psychiatry referral is recommended if it persists beyond 3 years or if there is a lack of social interaction.

41
Q

What are the contraindications to breastfeeding per the CPS statement?

A
  • HIV +
  • Cytotoxic chemotherapy
  • Radioactive isotopes or radiation therapy
  • Galactosemia
42
Q

Name two developmental red flags at 9 months.

A
  1. Not sitting well

2. Decrease in vocalizations

43
Q

Name two developmental red flags at 12 months.

A
  1. No words or name recognition

2. Not pulling to stand

44
Q

Name two developmental red flags at 18 months.

A
  1. Less than 15 words

2. Social communication concerns

45
Q

Name 2 underlying neurologic disorders associated with ASD.

A
  1. Tuberous sclerosis
  2. NF-1
    - Rett syndrome
    - Angelman
    - T21
46
Q

What are the early onset side effects of stimulants?

A

Decreased appetite, sleep, exacerbation of tics

47
Q

What is a late onset side effect of stimulants?

A

Depression

48
Q

What are the common early warning signs for cerebral palsy?

A
  • Hand preference before 12 months
  • Stiffness or tightness in the legs before 12 months
  • Inability to sit by 9 months
  • Persistent fisting of hands beyond 4 months
  • Delays or asymmetry in movement or posture
49
Q

What is the most likely etiology of spastic unilateral or hemiplegic CP?

A

Stroke or cerebral malformation

50
Q

What is the most likely etiology of spastic bilateral CP?

A

Prematurity typically secondary to periventricular white matter injury

51
Q

Who is more likely to have seizures? A child with spastic unilateral CP or bilateral CP?

A

Spastic unilateral CP due to stroke or cerebral malformations are particularly vulnerable to seizures, children with spastic B/L CP from PVL develop seizures less frequently as the cortex is often relatively spared

52
Q

What is the most common comorbid disorder with ADHD?

A

Intellectual disability

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