Development Flashcards
Moro, rooting + grasp reflex - what is it, when does it appear + when does it go?
Moro = sudden extension of head causes symmetrical extension then flexion of hands, present at birth, disappears 3-4 months
Rooting = turns head towards a stroke of the cheek. Present at birth, disappears at 4 months
Grasp = flexion of fingers when object is in palm
Tonic neck reflex, labyrinthine righting + postural support reflex - when does it appear + when does it leave?
Tonic neck = lying supine, infant adopts outstretched arm to side which head turns
Present at 1 month, integrated by 4 months
Labyrinthine righting = head moves in opposite direction to which body is tilted
Present at birth, integrates within a few months
Postural support/ stepping = when upright, legs take weight and bounce
Present at birth, disappears at 5-6 months
Lateral propping + parachute reflex
Lateral propping = when sitting, arm extends on side to which child falls
Parachute = when upside down, arms extend
6 week developmental milestones
Head lag, head in line when held
Fixes + follows object through 90’
Startles to loud noise, cries/ coos
Smiles
6 months developmental milestones
Sits without support, rolls front to back, grasps feet
Transfers objects between hands, mouths
Turns to voice, babbles
Finger feeds, laughs, holds bottle
1 year developmental milestones
Stands independently, cruises around
Pincer grip, bangs cubes
1-2 words, understands name
Drinks from cup, waves, empties cupboards
15 months developmental milestones
Broad based gate, pushes wheeled toy
Palmer grasp of pencil, random scribble , builds tower of 2, follows toy pulled 3m away
2-6 words, understands simple commands
Feeds self with spoon, can help dressing, indicates wants without crying
2 years developmental milestones
Kicks ball, climbs furniture
Circular scribble, tower of 6, turns pages
50+ words, joins 2 words, 2 step request understood
Won’t share, plays near but not with others
Red flag ages for smiling, not rolling over, unable to sit unsupported
Smiling = 6 weeks Not rolling over = 6 months Unable to sit unsupported = 9 months
Red flag ages for being unable to crawl or walk
Crawling = 12 months Walking = 18 months
Types of squint
Concomintant Paralytic
What is a concomintant squint?
Refractive error - treat with glasses Common with neurodevelopmental delay Squinting eye turns inwards (convergent) Squint is constant in all directions of gaze
What is a paralytic squint?
Varies with gaze direction due to paralysis of motor nerves (LR6 SO4) Possibility of SOL
RF for squints
Low birth weight Preterms Neuromuscular disorders Brain or eye tumours Infections
How to diagnose squints
Corneal light reflex test - if light reflection is in different positions Cover test - when fixing eye is covered, squinting eye moves to take up fixation
ASD S+S
Impaired social interaction Speech + language disorder Imposition of routines with ritualistic + repetitive behaviour
Genetic causes of blindness
Cataracts Albinism Retinal dystrophy Retinoblastoma
Antenatal + perinatal causes of blindness
Congenital infection Retinopathy of prematurity Cerebral damage Optic nerve hypoplasia
Postnatal causes of blindness
Infection JIA Vit A deficiency
Types of deafness
Sensorineural = lesion in cochlea or auditory nerve, present at birth Conductive = abnormalities of ear canal or middle ear, usually due to OME
Causes of sensorineural hearing loss
Genetic Congenital infection (Rubella) Preterm HIE Hyperbilirubinaemia Drugs: aminoglycosides, furosemide
Causes of conductive hearing loss
OME Eustachian tube dysfunction: DS, cleft palate, Pierre Robin sequence
What is fragile X?
X linked recessive disorder Learning difficulty Macrocephaly Macro-orchidism Long face, large ears, prominent mandible, broad forehead Mitral valve prolapse, joint laxity, autism, ADHD
Management of ADHD
Stimulants: methylphenidate or dexamphetamine
12 week training scheme
SE of methylpenidate
Reduced appetite Slowed growth Insomnia Stomach pains
Rooting + stepping reflex
Rooting = head turns to stimulus when touched near mouth Stepping = stepping movements when held vertically
What is Angelman’s syndrome?
Developmental regression, epilepsy
Due to deletion of maternally inherited CH15
When can honey be introduced and why?
12 months due to risk of botulism
When are children able to draw a X and a box?
4 years
Gross motor milestones (6-8 weeks, 8 months, 9 months, 10 months, 12 months, 15 months)
6-8 weeks = raises head 45’ when prone
6-8 months = sits without support
8-9 months = crawls
10 months – cruising
12 months = walks
15 months = walks steadily
Language milestones for 3-4 months, 7-10 months, 12 months, 18 months, 2 years, 3 years
3-4 months = vocalises alone, laughs
7-10 months = first words
12 months – 2-3 words
18 months – 6-10 words. Shows body parts
2 years = simple phrases
3 years = talks in 3-4 word sentences
Fine motor + vision milestones (6 weeks, 4 months, 6 months, 7 months, 10 months, 18 months, towers + drawing ages)
6 weeks = follows moving object
4 months = reaches out for toys
4-6 months = palmar grasp
7 months = transfers toys between hands
10 months = pincer grip
18 months = marks with crayon
3 block tower = 18 months
6 block tower = 24 months
8 block tower = 2.5 years
Line = 2 years Circle = 3 years Cross = 3.5 years Square = 4 years Triangle = 5 years
Social milestones (6 weeks, 8 months, 10 months, 12 months, 18mths, 24mths, 2 years, 3 years)
6 weeks = smiles
6-8 mths = food in mouth
10-12 = waves bye, plays peek a boo
12 months = drinks from cup with 2 hands
18 mths = holds spoon + gets food into mouth
18-24 mths = symbolic play
2 years = dry by day
3 = parallel play, takes turns
What age can children build towers of 3, 6 + 9?
3 = 18 months
6 = 2 years
9 = 3 years
When can a child copy + draw shapes?
Copy 6 months before they can draw
What is the cutoff for acceptable weight loss in the first 7 days?
10%
When can a child hop on one leg?
4 years
What is the definition of delayed puberty?
Lack of onset of development of secondary sexual characteristics by 13 in girls + 14 in boys
What is the average weight of a 1 year old?
10kg
How many hours does a newborn sleep?
16 hours
When to children get hand preferences?
18 months
What is fetal anti-convulsant syndrome?
Defects occurring from mother taking anti-convulsants during pregnancy
NTD, heart defects, orofacial + urogenital defects
Which drugs cause craniofacial abnormalities in newborns?
ACEi, alcohol, carbamazepine, valproate, warfarin
What do you give in grey baby syndrome?
Chloramphenicol
3 month milestones
Hands to midline, fixes + follows through 180’
No head lag, lifts chest + head when prone
Turns to sound
Social smile
9 month milestones
Points with index finger, early pincer, looks for fallen toy
Sits unsupported for 15 mins, rolls back to front, pulls to stand
Understands ‘no’ + ‘bye’, says ‘mama’ + ‘dad’
Stranger anxiety, finger feeds
18 month milestones
Tower of 3 bricks, linear scribble, hand preference
Walks well, walks upstairs with hand held, runs
6-20 words, points to body parts
Feeds independantly, symbolic play, indicates toilet needs
2.5 years milestones
Tower of 7, tripod grip, picks up tiny objects with eye covered
Runs well, walks upstairs 2 feet to a step, steers pedal cycle
200+ words, echolalia, questionning
Feeds self skilfully, pulls down pants, role play
3 years milestones
tower of 9, copies brick train + bridge, copies circle, cuts with scissors
Walks upstairs, throws ball, stands on 1 leg momentarily
3-4 word sentences, counts to 10, knows name + sex
Uses knife + fork, dry by day, separates from mother easily
4 year milestones
Tower of 10, copies square, matches 4 primary colours
Hops, stands on 1 fot for 3-5s
Speech grammatically correct, knows full name + address, counts to 20
Shares toys, dry by day + night, uses toilet alone
5 year milestones
Copies triangle, builds steps of 3
Runs up and down stairs, catches ball, skips
Fluent speech, defines words
Chooses friends, washes + dries hands, comforts in distress
