Development Flashcards
What is the ‘median age’
The age at which half a standard population of children will have acquired a skill
What is the ‘limit age’
The maximum age at which a child should have developed a skill (usually 2 standard deviations above the mean)
What is the staging system used to define the different points of puberty?
The Tanner Staging System
What are the 3 stages of puberty as defined by the Tanner System
Pre-puberty
In puberty
Completing puberty
What is the age of precocious puberty for boys and girls?
Girls - Under 8 years old
Boys - Under 9 years old
What defines the ‘pre-pubertal’ stage of puberty for boys and girls?
Girls: No breast or nipple enlargement, no pubic hair growth
Boys: High voice, no growth of testes or penis, no pubic hair growth
What defines the ‘in puberty’ stage of puberty for boys and girls?
Girls: Breast enlargement only when accompanied by nipple enlargement, some development of pubic and axillary hair
Boys: Reddening of scrotum with growth of testes and growth of penis, early voice deepening, development of pubic and axillary hair
What defines the ‘completing puberty’ stage of puberty for boys and girls?
Girls: Breast and nipple enlargement, pubic and axillary hair developed, periods started
Boys: Voice fully deepened, adult size of penis, growth of pubic and axillary hair, growth of moustache and early facial hair growth
At what age is puberty described as ‘delayed’ for boys and girls?
Girls - Over age 13
Boys - Over age 14
What are the primitive reflexes?
Moro Sucking Babinski Rooting Stepping Grasping Asymmetrical tonic neck reflex
What are the warning signs for developmental delay at 6 weeks?
No smiling Excessive head lag No fixing and following No response to sounds Asymmetrical primitive reflexes
What are the warning signs for developmental delay at 8 months?
Persistence of primitive reflexes
Hand preference
Squinting
Fisting
What are the median ages for drawing ability in infants and young children? This reflects their fine motor and visual skills.
18 months = Linear and circular scribble 2 years = Line 3 years = Circle 4 years = Cross (+) 5 years = Square, then triangle 6 years = Diamond
True / False: About 80% of cerebral palsy results from antenatal causes
True
What are the different types of cerebral palsy?
Spastic cerebral palsy
Dyskinetic (Choreathetoid) cerebral palsy
Ataxic (hypotonic) cerebral palsy
Which pathway is damaged in spastic cerebral palsy?
Upper motor neurons - pyramidal or corticospinal tracts
What are the 3 types of spastic cerebral palsy?
Hemiplegia
Quadriplegia
Diplegia
Which type of cerebral palsy results from damage to the basal ganglia?
Choreathetoid (dyskinetic) cerebral palsy
Give 2 causes of dyskinetic (choreathetoid) cerebral palsy
Kernicterus
Hypoxic-ischaemic encephalopathy
What is the triad of presenting characteristics f autism spectrum disorders?
- Impaired reciprocal social interaction
- Retualistic or repetitive behaviours
- Speech and language disorder
What is the inheritance pattern of Rett’s syndrome?
X linked dominant
Which gender is primarily affected by Rett’s syndrome?
Females
When do features of autism generally emerge?
Before the age of 3 years old
What is thelarche?
Development of breast tissue
Is precocious puberty more common in males or females?
Females
True / False: Precocious puberty in males usually has an underlying organic cause?
True
Is delayed puberty more common in males or females?
Males
Is most cerebral palsy in the UK acquired in the antenatal, perinatal or postnatal period?
Antenatal
What is cerebral palsy?
Abnormality in motor function and posture resulting from abnormalities in brain function. Can also result in learning difficulties, cognitive impairment, behavioural anomalies and seizures. The brain lesion occurs before the age of 2 and is non-progressive, although the symptoms themselves may progress such that the condition appears to be degenerative.
What might be the findings on neurological examination of a child with spastic cerebral palsy?
‘Clasp-knife’ spasticity
Brisk reflexes
Up-going plantars
Distribution will depend on the sub-type of cerebral palsy (e.g. hemiplegic, diplegia, quadriplegic)
What is athetosis and when might it be seen?
Slow, within movements, especially distally (e.g. fanning of hands)
Seen in dyskinetic (choreoathetoid) cerebral palsy
What is dystonia and when might it be seen?
Contraction of agonist and antagonist muscle groups together, which results in a twisting movement
Seen in dyskinetic (choreoathetoid) cerebral palsy
What are the 4 functional areas assessed in development?
Gross motor
Fine motor (includes vision)
Speech, language and hearing
Social, emotional and behavioural
When should an infant / child have the ability to smile socially?
6 weeks
What might you expect a child to be able to do at 6 weeks?
Gross motor: Lift head to 45 degrees when prone
Fine motor / vision: Fixing and following
Speech, language, hearing: Startles to loud noises
Social: Smiling
At what age would you expect a child to be able to transfer object from one hand to another?
6 months
At what age would you be concerned if a child could not sit up by themselves?
9 months
Sitting unsupported should happen at 6-8 months
At what age would you expect a child to be able to say ‘mama’ or ‘dada’?
12 months
At what age would you be concerned if a child could not walk unsupported?
18 months
What fine motor / vision skill is usually acquired by 12 months?
Fine pincer grip
At what age does a child normally start crawling?
6-9 months
A child can walk unaided and is able to drink from a cup. They can say ‘mama’ and ‘dada’ but not many other words. When given 3 bricks they can pick 2 up and bang them together but don’t make an attempt to make a tower. What age might this child be?
About 1 year old:
Gross motor by 1 year = Walking unaided
Fine motor / vision by 1 year = Pincer grasp
Speech and language by 1 year = ‘Mama’, ‘dada’
Social and behavioural by 1 year = Drinks from a cup
At what age might you expect a child to be able to build a small tower of 3-4 bricks?
18 months
What might you expect to see on developmental assessment of an 18 month old child?
Gross motor = Walking unsupported, climbs stairs
Fine motor / vision = Builds tower 3-4 blocks, fine piece grip e.g. turns pages, scribbles
Speech / language = Identifies 4 body parts, able to say several words
Social / emotional / behavioural = Puts food to mouth using spoon
Describe how you would assess a child’s age by observing how they use building blocks. What domain of development is this assessing?
Assesses fine motor / vision: 18 months = Tower of 2-3 blocks 2 years = Tower of 6 blocks 2 and 1/2 years = Tower of 8 blocks or 'train' of 4 blocks 3 years = Bridge with 3 blocks 4 years = Steps (with demonstration)
How many blocks would you expect a child of 2 years old to build into a tower?
2 years = Tower of 6 blocks
What are the 2 ways that fine motor / vision skills can be assessed, particularly in children aged over 18 months?
Building blocks
Writing
A child can draw a circle and can build a bridge using 3 blocks. They cannot form the bricks into steps when you show them how. How old might this child be?
3 years old
Fine motor / vision at 3 years = Builds a bridge using 3 blocks, draws a circle
Fine motor / vision at 4 years = Builds steps using bricks (with demonstration), draws a cross (+)
What age might a child be if they can hop on one leg?
4 years old
What age can a child ride a tricycle?
3 years
What fine motor skill would you expect to see in a 3-4 month infant?
Reaching out for object
A baby is lying on a play mat ‘cooing’. She sees an object you hold in front of her and follows it when you move it. She also reaches out for that object. What age might you expect this baby to be?
3-4 months
Fine motor / vision at 3-4 months = Reaching out for object
Language / speech at 3 months = cooing
At what age would you expect a baby / infant to be able to roll over by themselves?
6 months
What age would you expect a child to be able to dress / undress themselves?
5 years
What is the asymmetrical tonic neck reflex?
One of the primitive reflexes - when supine, the baby adopts an outstretched arm to the side when the head is turned in that direction
What is dyspraxia?
Disorder of motor planning and / or execution, with no neurological cause
What is dyslexia?
Disorder of reading skills, usually defined if a child’s reading age is less than 2 years what is expected
What is dyscalculia?
Disorder of calculation ability
What is dysgraphia?
Disorder of writing ability
What is the first sign of puberty in boys?
Testicular enlargement
What is usually the last stage of puberty in girls?
Menarche
Which type of cerebral palsy typically results from intraventricular haemorrhage in the neonatal period?
Spastic diplegic cerebral palsy
