Development

Question 1

What ages are regarded as neonates?

Answer 1

<4wks

Question 2

What ages are regarded as infants?

Answer 2

<12m

Question 3

What ages are considered toddlers?

Answer 3

1-2y

Question 4

What age is considered preschool?

Answer 4

2-5y

Question 5

What is involved in early development?

Answer 5

Gaining functional skills from birth to 5y via cell growth, migration, connection pruning and myelination (use it or lose it)

Question 6

What is involved in development in school?

Answer 6

Cognitive and thought development (early skills refined)

Question 7

What are the 5 key areas of development?

Answer 7

Gross motor
Fine motor
Speech and language 
Hearing and vision 
Social and self-help

Question 8

What are the red flags for poor development?

Answer 8

No social smile by 2m 
Not sitting up unsupported by 9 months 
Not walking unsupported by 18 months
No words by 2 years
Loss of skills
Hearing loss/low muscle tone/asymmetric muscle tone
OFC >99.6th/<0.4th decile

Question 9

What should you do if there is a red flag in development?

Answer 9

Refer for further assessment

Question 10

What are milestones?

Answer 10

Key developmental skills

Question 11

What must you do for premature babies when looking at the milestones?

Answer 11

Correct for prematurity until 2 years

Question 12

What should an infant be able to do by 6-8wks?

Answer 12

Social smile

Question 13

What should an infant be able to do by 8-9 months?

Answer 13

Sit readily without support

Question 14

What should a child be able to do by 9 months?

Answer 14

Pincer grasp/look for objects if they fall out your hand

Question 15

What should a toddler be able to do by 1?

Answer 15

Walk without help

Question 16

What should a 21-24 month old be able to do?

Answer 16

Make sentences

Question 17

What should a 3y old be able to do?

Answer 17

Draw circles

Question 18

What should a 3.5y old be able to do?

Answer 18

Follow 3 simple instructions

Question 19

What should a 4.5y old be able to do?

Answer 19

Draw person with 3 body parts

Question 20

What are the things affecting childhood development?

Answer 20

Genetics, environment, positive childhood experience

Question 21

What antenatal factors may influence development?

Answer 21

Infections - ToRCH

Toxins - alcohol/drugs/smoking/anti-epileptics

Question 22

What post-natal factors may influence development?

Answer 22

Infections (meningitis, encephalitis) 
Toxins (mercury, lead) 
Trauma (head injuries) 
Malnutrition (Folate, iron, vit D)
Metabolic (hypoglycaemia, hyponatriaemia) 
Maltreatment/understimulation/abuse
Maternal mental health

Question 23

Who is involved in assessing development of a child?

Answer 23

Parents, family, HVs, nursery, doctors

Question 24

What kinds of delay can you have?

Answer 24

Global delay or specific developmental delay

Question 25

Give an example of a group that would get extra assessment of their development?

Answer 25

Premature babies

Question 26

What are some factors that may make some children look like they have developmental delay when they don't?

Answer 26

Normal early/late development | Bilinguial families etc.

Question 27

What is involved in the healthy child programme?

Answer 27

Red book Health promotion Developmental screening Immunisation

Question 28

What is screened for on the day 5 blood spot?

Answer 28

PKU, CHT, CF, MCADD, sickle cell

Question 29

What are all newborn babies given?

Answer 29

Vit K to prevent haemorrhagic diseas eof the newborn

Question 30

When is the hearing assessment done?

Answer 30

By 28th day

Question 31

What is the first review and what is done?

Answer 31

6-8wk review Identification, feeding, parental concerns, development, measurements (OFC, length, wt), Ex of heart, testes, genitalia, femoral pulses, eyes, sleeping position (supine, prone, side) Maternal mental health

Question 32

When is the second review done and what is involved?

Answer 32

27-30m review Identification, development (social, behaviour, attention, emotion, communication, speech, language, gross/fine motor, vision/hearing & measurements again

Question 33

When is orthoptist screening done?

Answer 33

4-5y

Question 34

What is involved in health promotion?

Answer 34

Alcohol/drugs/smoking, nutrition, safety, dental health, support services

Question 35

How do you monitor growth in children?

Answer 35

WHO growth chart or UK growth chart

Question 36

When do you start measuring height as opposed to length?

Answer 36

2y

Question 37

What is a normal birth weight, length + OFC?

Answer 37

3.3kg, 50cm, 35cm

Question 38

What is a normal 4m weight, length?

Answer 38

6.6kg, 60cm

Question 39

What is a normal 1y weight, length and OFC?

Answer 39

10kg, 75cm, 45cm

Question 40

What is a normal 3y weight, length?

Answer 40

15kg, 95cm

Question 41

What is failure to thrive?

Answer 41

Child growing too slowly in form/function for age

Question 42

What does FFT mean?

Answer 42

Supply of energy < demand for energy

Question 43

What are the factors that can cause FFT?

Answer 43

Maternal: poor lactation/incorrect feeding Infant: prem, cleft palate, cerebral palsy, genetic Inc metabolic demands, e.g. lung/heart/liver/lung problem, infection, anaemia, IBD, malignancy etc. Excessive nutrient loss, e.g. GO reflux, pyloric stenosis, GE, coeliac, pancreatic insufficiency etc. Non-organic: poverty, dysfunctional family, lack of parental support, child neglect etc.

Question 44

What should be your approach to FFT?

Answer 44

Hx: presenting symptoms, dietary assessment, birth/family/social Ex: height/length/OFC, dysmorphic features, development Trial feed in hospital (observed feeding, handing, dieitican/SALT input) Good intake + wt gain --> non-organic Good intake + no wt gain --> organic Bad intake --> organic, non-organic, feeding disorder

Question 45

What are the important things to remember about vaccinating children?

Answer 45

Don't correct for prems No live vaccines, e.g. MMR for immunocomp (except HIV) Post-pone if unwell

Question 46

When do you give your DtaP, IPV, Hib, Hep B vaccination?

Answer 46

2 months, 3 months, 4 months

Question 47

When do you get your PCV vaccination?

Answer 47

2 months, 4 months, 12 months

Question 48

When do you get your MenB vaccination?

Answer 48

2 months, 4 months, 12 months

Question 49

When do you get your rotavirus vaccination?

Answer 49

2 months

Question 50

When do you get your Hib/MenC vaccination?

Answer 50

12 months

Question 51

When do you start getting influenza vaccinations?

Answer 51

12 months

Question 52

When do your get your MMR vaccinations?

Answer 52

12 months, 3y 4m

Question 53

When do you get your DtaP/IPV vaccination?

Answer 53

3y 4m

Question 54

When do girls get their HPV vaccination?

Answer 54

12-13y

Question 55

What strains of HPV does the vaccine immunise against?

Answer 55

Oncogenic strains - 16 and 18 | Viral warts - 6 and 11

Question 56

What vaccines do you get at 14y?

Answer 56

Td/IPV (tetanus, diptheria, polio) | MenACWY

Question 57

What other vaccines may those from outside UK get?

Answer 57

BCG if from high risk TB country