Development Flashcards
1
Q
What are common early signs of Cerebral Palsy?
A
- Hand preference <12mo
- Stiffness or tightness in the legs <12mo
- Inability to sit by 9mo
- Persistent fisting of hands >4mo
- Delays or asymmetry in movement or posture
2
Q
What are signs of childhood onset fluency disorder vs. normal dysfluency?
A
- Stuttering: ≥2 freq of syllable repetition per word or prolongations per 100 words, +tension, +frustration, faster tempo, more broken words with stress
- DD: ≤1 freq of syllable repetition per word or prolongations per 100 words, normal tempo, airflow rarely interrupted, no tension or frustration, no change with stress, no silent pauses within a word
3
Q
What are the expected milestones for gender identity in children?
A
- 2yo: conscious of physical differences b/w girls and boys
- < 3yo: most children can easily label themselves as either a boy or girl
- 4yo: stable sense of gender identity
- 6-7yo: many children reduce gender expression, feel confident others recognize gender → gender dysphoria may arise
- >8yo: most children will have a gender identity that matches the sex assigned at birth, however as puberty begins, some youth may realize that their gender identity is different
4
Q
What are the conditions most commonly misdiagnosed as ADHD (in decreasing order of frequency)?
A
- Learning disorder
- Sleep disorder
- Oppositional defiant disorder
- Anxiety disorder
- Intellectual disability
- Language disorder, mood disorder, tic disorder, conduct disorder
- Autism spectrum disorder
- Developmental coordination disorder
5
Q
What are genetic conditions that are at greater risk of ADHD?
A
Fragile X, Turner, TS, NF1, 22q11 deletion
6
Q
What are risk factors for ASD?
A
-
Genetic/familial
- Specific genetic syndromes / risk variants
- Male sex
- 1st degree relative or other family history of ASD
-
Prenatal
- Older parental age (>35yo)
- Maternal obesity, diabetes, or HTN
- In utero exposure to valproate, pesticide or traffic-related air pollution
- Maternal infections (e.g. rubella)
- Close spacing of pregnancies (<12mo)
-
Postnatal
- Low birth weight, extreme prematurity
7
Q
What are the essential elements of an ASD diagnostic assessment?
A
- Step 1: Medical records review
- Step 2: Interviewing parents, family members, and other caregivers
- Step 3: Assessment for Core Features of ASD
- Step 4: Comprehensive physical exam and additional investigations
- Step 5: Consider differential diagnosis and co-occuring conditions
- Step 6: Establishing an ASD Diagnosis
- Step 7: Communicating ASD Diagnostic Assessment Findings
- Step 8: Comprehensive assessment for intervention planning
8
Q
What is the management steps of infant colic as per the aap?
A
- Parental support and reassurance are key!
- PPI & simethicone are ineffective
- Consider probiotic or limiting maternal dairy intake
- If formula-fed: consider switching to hydrolyzed formula
9
Q
What are red flags for gross motor development?
A
- Persistent primitive reflexes
- Abnormal tone or movement patterns at any age, spasticity, hypotonia, absent DTRs
- Asymmetry
- Poor head control at 5mo
- Not sitting independently with hands-free at 8mo
- Not rolling back-front, not taking weight well on the legs when held at 9mo
- Not walking by 18mo
10
Q
What are red flags for fine motor development?
A
- Lack of transfer at 7 months
- Using one hand exclusively at any age
- Delayed self care (ADLs) at 4yo
- Delayed printing at school entry
11
Q
What are red flags for S+L development?
A
- Problems with feeding and/or swallowing
- Parents suspect hearing loss, babbling stops at >6mo, lack of response to sound
- No single words by 15mo
- No combos by 24mo
- Stutter past 3.5yo (or earlier if anxiety/mannerisms)
- Idiosyncratic speech, disordered sequence of development
- Poor intelligibility for age
12
Q
What are red flags for cognitive development?
A
- Lack of developmentally appropriate response to visual stimuli
- Immature play (like younger children)
- Stereotypic play; lack of pretend
- School failure
13
Q
What are red flags for social development?
A
- Emotional dysregulation
- Abnormal attachment pattern (e.g. clingy)
- Limited social smiling and sharing enjoyment by 6mo
- Limited gestures like pointing, response to name, joint attention by 12mo
- Limited social imitative play by 18mo (e.g. imitating housework)
- Limited pretend play by 24mo
- No friends at school-age
14
Q
What is the timing of onset and duration of primitive reflexes: Palmar grasp, rooting, moro, tonic neck, parachute
A
- Palmar grasp - onset at 28wk GA, duration 2-3mo postnatal
- Rooting - onset at 32wk GA, duration less prominent after 1mo post-natal
- Moro - onset 28-32wk GA, duration 5-6mo post-natal
- Tonic neck - onset 35wk GA, duration 6-7mo post-natal
- Parachute - onset 7-8mo post-natal, duration remains throughout the life
15
Q
When does the following milestones occur:
- Run well
- Kick a ball
- Walk up and down stairs
- Throw a ball overhand
- Using a spoon
A
- Run well → 18 months
- Kick a ball → 24 months
- Walk up and down stairs → 24 months with both feet on each step
- Throw a ball overhand → 24 months
- Using a spoon → 22 months
