Development Flashcards
What ages are regarded as neonates?
<4wks
What ages are regarded as infants?
<12m
What ages are considered toddlers?
1-2y
What age is considered preschool?
2-5y
What is involved in early development?
Gaining functional skills from birth to 5y via cell growth, migration, connection pruning and myelination (use it or lose it)
What is involved in development in school?
Cognitive and thought development (early skills refined)
What are the 5 key areas of development?
Gross motor Fine motor Speech and language Hearing and vision Social and self-help
What are the red flags for poor development?
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
What should you do if there is a red flag in development?
Refer for further assessment
What are milestones?
Key developmental skills
What must you do for premature babies when looking at the milestones?
Correct for prematurity until 2 years
What should an infant be able to do by 6-8wks?
Social smile
What should an infant be able to do by 8-9 months?
Sit readily without support
What should a child be able to do by 9 months?
Pincer grasp/look for objects if they fall out your hand
What should a toddler be able to do by 1?
Walk without help
What should a 21-24 month old be able to do?
Make sentences
What should a 3y old be able to do?
Draw circles
What should a 3.5y old be able to do?
Follow 3 simple instructions
What should a 4.5y old be able to do?
Draw person with 3 body parts
What are the things affecting childhood development?
Genetics, environment, positive childhood experience
What antenatal factors may influence development?
Infections - ToRCH
Toxins - alcohol/drugs/smoking/anti-epileptics
What post-natal factors may influence development?
Infections (meningitis, encephalitis) Toxins (mercury, lead) Trauma (head injuries) Malnutrition (Folate, iron, vit D) Metabolic (hypoglycaemia, hyponatriaemia) Maltreatment/understimulation/abuse Maternal mental health
Who is involved in assessing development of a child?
Parents, family, HVs, nursery, doctors
What kinds of delay can you have?
Global delay or specific developmental delay
Give an example of a group that would get extra assessment of their development?
Premature babies
What are some factors that may make some children look like they have developmental delay when they don’t?
Normal early/late development
Bilinguial families etc.
What is involved in the healthy child programme?
Red book
Health promotion
Developmental screening
Immunisation
What is screened for on the day 5 blood spot?
PKU, CHT, CF, MCADD, sickle cell
What are all newborn babies given?
Vit K to prevent haemorrhagic diseas eof the newborn
When is the hearing assessment done?
By 28th day
What is the first review and what is done?
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
When is the second review done and what is involved?
27-30m review
Identification, development (social, behaviour, attention, emotion, communication, speech, language, gross/fine motor, vision/hearing & measurements again
When is orthoptist screening done?
4-5y
What is involved in health promotion?
Alcohol/drugs/smoking, nutrition, safety, dental health, support services
How do you monitor growth in children?
WHO growth chart or UK growth chart
When do you start measuring height as opposed to length?
2y
What is a normal birth weight, length + OFC?
3.3kg, 50cm, 35cm
What is a normal 4m weight, length?
6.6kg, 60cm
What is a normal 1y weight, length and OFC?
10kg, 75cm, 45cm
What is a normal 3y weight, length?
15kg, 95cm
What is failure to thrive?
Child growing too slowly in form/function for age
What does FFT mean?
Supply of energy < demand for energy
What are the factors that can cause FFT?
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.
What should be your approach to FFT?
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
What are the important things to remember about vaccinating children?
Don’t correct for prems
No live vaccines, e.g. MMR for immunocomp (except HIV)
Post-pone if unwell
When do you give your DtaP, IPV, Hib, Hep B vaccination?
2 months, 3 months, 4 months
When do you get your PCV vaccination?
2 months, 4 months, 12 months
When do you get your MenB vaccination?
2 months, 4 months, 12 months
When do you get your rotavirus vaccination?
2 months
When do you get your Hib/MenC vaccination?
12 months
When do you start getting influenza vaccinations?
12 months
When do your get your MMR vaccinations?
12 months, 3y 4m
When do you get your DtaP/IPV vaccination?
3y 4m
When do girls get their HPV vaccination?
12-13y
What strains of HPV does the vaccine immunise against?
Oncogenic strains - 16 and 18
Viral warts - 6 and 11
What vaccines do you get at 14y?
Td/IPV (tetanus, diptheria, polio)
MenACWY
What other vaccines may those from outside UK get?
BCG if from high risk TB country
