Development Flashcards
When does weaning usually start
6 months
From milk to normal food start with pureed food then progress up to 1 yr old
What is plotted on a growth chart and how is it plotted
Plotted using a dot
Age on x-axis (age at bottom as baby’s are young)
Head circumference, weight and height on y axis
You want the child to maintain their centile in a pattern
What defines an overweight/ obese child
85th percentile - overweight
95th percentile- obese
What are some potential causes of failure to thrive
Nutritional intake issues
-Mum malabsorption if breastfeeding
-Iron def anaemia
-Family issues/ neglect
-Poverty
Difficulty feeding
-Poor suck (cerebral palsy)
-Cleft lip/ palate
-Genetic conditions (face issues)
-Pyloric stenosis
Malabsoprtion
-CF -Coeliac -IBD
-Cows milk intolerance
-Chronic diarrhoea
Increased energy requirements
-Hyperthyroid
-Chronic disease (congential heart disease/ CF)
-Malignancy
-Chronic infections
Can’t process nutrients
-Errors of metabolism
-T1DM
What investigations and management are done in failure to thrive
Pregnancy/ birth history
Feeding/ eating history
Height/ weight/ BMI
Mid parental height centile
Urine dipstick for UTI
Coeliac screen- anti TTG, anti EMA
Management
Dietician
Reduce milk and improve other foods
Structured meal times
Energy dense foods
Nutritional supplement drinks
Enteral feeding tube if other measures fail
What are the features of constitutional delay in growth and puberty
Short stature in childhood, normal in adulthood
Puberty delayed and growth spurt in puberty lasts longer
Delayed bone age - when Xray of hand and wrist done
Reassurance to parents
What are the gross motor developmental milestones for a child from birth - 4
4 months- hold head up
6 months- Sit up (not unsupported)
9 months- sit up unsupported
1 yr- stand and walk whilst holding furniture
15 months- walk unaided (not concerning until 18 months if not)
18 months- squat and pick things up
2 years- run kick ball
3 years- stairs one foot at a time
4- Hop, climb stairs like adult
What are some fine motor skills a child develops from birth
8 weeks- fixes eyes on object and follows
6 months- palmar grasp
9 months- Scissor grasp
12 months- pincer grasp and can scribble with crayon
14-18 months- feed themselves (clumsy)
2 yrs - can draw a vertical line
3 yrs- can draw a circle
What are some expressive language developmental milestones
3 months -Cooing noises
6 months- consonants
9 months- Babbles
12 months- single words
18 months- 5-10 words
2 yrs- combines 2 words
2.5 yrs- 3-4 words
3 yrs- basic sentences
What are some receptive language developmental milestones
3 months- recognises parents voice
6 months- responds to tone
9 months- listens
12 months- Follows simple instruction
18 months- understands nouns (spoon)
2 years- understands verbs
What are some developmental red flags
Can’t hold an object at 5 months
Can’t sit unsupported at 12 months
Not standing independently at 18 months
Not walking independently at 2 years
Not running at 2.5 years
No words at 18 months
No interest in others at 18 months
What are the 4 key pillars of capacity if needing to use them with a child who has learning disability
Understand the decision being made
Retain the information to make the decision
Weigh up pros and cons
Communicate the decision
When does normal puberty usually start/ how long does it last
girls 8-14
boys-9-5
lasts 4 years
What are some causes of hypogonadotrophic hypogonadism
Deficiency of LH and FSH- leads to deficiency of sex hormones
Abnormal hypothalamus/ pituitary
Causes
-Previous damage to either
-Growth hormone deficiency
-Hypothyroidism
-Hyperprolactinaemia
-Chronic conditions (CF, IBD)
-Excessive diet/ exercise
-Constiutional delay in growth and development
-Kallman syndrome (all low- poor sense of smell too)
What are the causes of hypergonadotrophic hypogonadism
Gonads don’t respond to stimulation from LH and FSH
High LH and FSH, low oestrogen and test
Causes
Think of all you syndromes**
Kleinfelter’s
Turner’s
Damage to gonads
Congenital absence
