Development

Question 1

Key milestones: Gross Motor

Answer 1

3 months - head control
6 months - sitting unsupported
9 months - pull to stand/cruise
12 months - walking
** Gross motor delay –> get a CK***

Question 2

Key milestones: Fine Motor

Answer 2

4 months: hands to midline, reaches for objects
6-8 months: palmar grasp
9-12 months: pincer grasp
2 years: uses spoon, copies vertical line
4-5 years: draws 10+ part person, dresses without buttons

Question 3

Key milestones: Speech and Language

Answer 3

2-4 months: visual attention
6-9 months: babbling
12 months: 1 word, language emergence
2 years: 2 word combos, 1/2 intelligible
3 years: 3 word combos, 3/4 intelligible
4 years: phrased speech, fully intelligible
8 years: all language sounds
speech language pathology –> get audiology

Question 4

Key milestones: Social & Emotional

Answer 4

5-6 months: stranger anxiety
9-15 months: separation anxiety
3-5 years: fear of monsters
4-6 years: having a best friend
7-10 years: fear of death

Question 5

Key milestones: Play

Answer 5

1-2 years: functional play
2-3 years: imaginative play
3-5 years: reciprocal play
6 years: knock-knock joke

Question 6

Key milestones: Cognitive

Answer 6

Starts with phonological awareness –> rhyming –> reading readiness
One to one correspondence –> counting
Letter reversal normal between 5-8
Kindergarten - Grade 3: learn to read and learn to write
After Grade 3: read to learn and write to demonstrate knowledge
“Magic 8 Ball”: everything in development comes together! (speech, gait, letter reversals)

Question 7

Average 18 month old patient?

Answer 7

• running
• scribble with fisted crayon
• 15-25 words
• word explosion
• joint attention
• single step commands
• lots of gestures, pointing
• knows body parts
• symbolic and parallel play

Question 8

When to refer to developmental peds?

Answer 8

• parental concern
• developmental regression
• by 9 months: not sitting well, decrease in vocalizations
• by 12 months: no words or name recognition
• by 18 months: less than 15 words, social communication concerns

Question 9

ASD Crtieria

Answer 9

Communication/Interaction (ALL)
- impaired reciprocal interaction
- maintaining relationships
- nonverbal communication problems

Repetitive/Restrictive behaviour (2/4)
- stereotyped or repetitive speech
- routines
- hyper interest
- altered reactivity to sensory input

Question 10

ADHD Criteria

Answer 10

6+ symptoms, > 6 months, 2 settings, impairing function
INATTENTION
- careless mistakes
- inattention
- not listening
- not following through
- avoids mental effort
- forgets things
- loses things
- disorganized
- easily distracted

HYPERACTIVE
- fidgets/squirms
- leaves seat
- blurts out
- cannot wait turns
- runs about
- cannot be quiet
- always on the go
- talks excessively
- interrupts