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Child Health > Development > Flashcards

Development Flashcards

1
Q

What factors influence normal development?

A
  • genetic
  • nutritional
  • environmental
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2
Q

Define median age

A

‘age when 50% of the population achieve a skill’

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3
Q

Define limit age

A

‘age when skill should have been acquired by 97.5% of children’

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4
Q

Describe gross motor development within the first 6 weeks of life

A

Head control in vertical

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5
Q

Describe gross motor development within the first 3 months of life

A

No head lag on pulling to sit

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6
Q

Describe gross motor development within the first 6 months of life

A

Sits unsupported, weight bears on legs

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7
Q

Describe gross motor development within the first 9 months of life

A

Crawls, holds onto furniture to stand and reaches on

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8
Q

Describe gross motor development within the first 12 months of life

A

Pulls to standing, walks

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9
Q

Describe gross motor development within the first 18 months of life

A

Runs, climbs onto adult chair

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10
Q

Describe gross motor development by 2 years of age

A

Climbs stairs with two feet/step, sits and steers trike

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11
Q

Describe gross motor development by 3 years of age

A

Climbs stairs using alternate feet, jumps off bottom step

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12
Q

Describe gross motor development by 4 years of age

A

Hops and climbs ladders

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13
Q

Name five primitive reflexes

A 
Sucking and Rooting 
Palmar and Plantar grasp 
ATNR 
Moro 
Stepping and Placing
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14
Q

Describe the fine motor and vision development at 6 weeks

A

Follow torch with eyes

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15
Q

Describe the fine motor and vision development at 3 months

A

Hand regard in midline

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16
Q

Describe the fine motor and vision development at 6 months

A

Grasps toys, hand in hand

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17
Q

Describe the fine motor and vision development at 9 months

A

Scissor grip, points with index finger

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18
Q

Describe the fine motor and vision development at 12 months

A

Pincer grasp, bangs toys together

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19
Q

Describe the fine motor and vision development at 18 months

A

Tower of 3-4 bricks

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20
Q

Describe the fine motor and vision development at 2 years

A

Tower of 6-7 bricks, scribbles

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21
Q

Describe the fine motor and vision development at 3 years

A

Tower of 9 bricks, copies circle

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22
Q

Describe the fine motor and vision development at 4 years

A

Threads beads, draws simple man

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23
Q

Describe hearing and language development at 6 weeks

A

Stills to voice

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24
Q

Describe hearing and language development at 3 months

A

Starts to vocalise

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25
Q

Describe hearing and language development at 6 months

A

Babbles, screams when annoyed

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26
Q

Describe hearing and language development at 9 months

A

Imitates sounds, localises sound

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27
Q

Describe hearing and language development at 12 months

A

Knows and turns to name, many vowels and consonants

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28
Q

Describe hearing and language development at 18 months

A

5-20 words

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29
Q

Describe hearing and language development at 2 years

A

Simple instructions, 50+ words

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30
Q

Describe hearing and language development at 3 years

A

Asks questions, complex instructions, nursery rhymes

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31
Q

Describe hearing and language development at 4 years

A

Tells stories, counts to 20

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32
Q

Describe social and play development at 6 weeks

A

Social smile

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33
Q

Describe social and play development at 3 months

A

Pleasure on friendly handling

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34
Q

Describe social and play development at 6 months

A

Plays with feet, friendly with strangers

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35
Q

Describe social and play development at 9 months

A

Plays peek-a-boo, distinguishes strangers

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36
Q

Describe social and play development at 12 months

A

Drinks from a cup, waves bye bye

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37
Q

Describe social and play development at 18 months

A

Feeds with a spoon

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38
Q

Describe social and play development at 2 years

A

Puts on some clothes, symbolic play

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39
Q

Describe social and play development at 3 years

A

Toilet trained, washes hands, pretend interactive play

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40
Q

Describe social and play development at 4 years

A

Dresses and undresses, washes/dried hands, understands taking turns

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41
Q

Define developmental delay

A

Failure to attain appropriate developmental milestones for child’s correct chronological age

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42
Q

Name three types of abnormal development

A
  • delay (global/specific)
  • deviation (autism)
  • regression (Rett’s syndrome, metabolic disorders)
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43
Q

What is Rett’s Syndrome?

A

Genetic condition where children develop normally in first year and then plateau before losing developmental skills

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44
Q

States seven red flags for abnormal development

A
  1. Asymmetry of movement
  2. Not reaching for objects by 6 months
  3. Unable to sit supported by 12 months
  4. Unable to walk by 18 months
  5. No speech by 18 months
  6. Concerns re. vision or hearing
  7. Loss of skills
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45
Q

What is global developmental delay?

A 
Significant delay in 2 or more;
gross/fine motor 
speech/language 
cognition 
social/personal
ADL
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46
Q

What does Down’s syndrome screening consist of?

A
  • cardiac
  • vision
  • hearing
  • thyroid (annual)
  • sleep related breathing disorders
  • growth/development charts
  • genetic
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47
Q

What is the genetic defect in Down’s syndrome?

A

trisomy 21

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48
Q

What is the IQ range of a mild learning disability?

A

IQ 50-70

49
Q

What is the IQ range of a severe learning disability?

A

IQ <50

50
Q

What are specific developmental delays?

A

Delay in one of the subsections for development

51
Q

State three motor delays

A
  • duchenne muscular dystrophy
  • cerebral palsy
  • co-ordination disorders
52
Q

Name a language delay

A

Specific language impairment

53
Q

Name two sensory delays

A

Oculocutaneous albinism

Treacher-Collins

54
Q

Name a developmental deviation

A

Autism Spectrum disorders

55
Q

Describe Duchenne Muscular Dystrophy

A

X-linked recessive disorder which impacts all muscles and often presents with speech delay. Ultimately life limiting, patients have calf pseudohypertrophy but muscles have no increased tone. Lordosis is common.

56
Q

How is DMD investigated and what is the clinical test?

A

Measure CK - very high

Gower’s manoeuvre shows pelvic girdle weakness

57
Q

What is cerebral palsy?

A

Group of disorders of development of movement/posture due to - disturbances to the foetus in utero/during delivery or insult after birth leading to neurological ischaemia and loss of inhibitory messages

58
Q

What type is most cerebral palsy?

A

Spastic

59
Q

Name the three types of spastic cerebral palsy

A
  • hemiplegic (arm and leg on one side)
  • diplegic (both legs)
  • quadriplegic (both arms and legs)
60
Q

Name some conditions associated with cerebral palsy

A
  • mobility problems
  • learning difficulties
  • epilepsy
  • visual/hearing impairment
  • communication problems
  • feeding/sleep problems
61
Q

What does an MRI of cerebral palsy show?

A

Loss of white matter around ventricles

62
Q

Describe oculocutaneous albinism

A

Autosomal recessive disease affecting the pigment in hair/skin/eyes

63
Q

What do people with oculocutaneous albinism look like?

A

Very pale skin, light coloured hair and red eyes

64
Q

What eye problems can present in oculocutaneous albinism?

A

astigmatism

nystagmus

65
Q

What is hydrocephalus?

A

Build up of fluid on the brain which can cause serious problems including visual impairment

66
Q

What will an MRI of hydrocephalus look like?

A

Enlarged ventricles

67
Q

What causes hydrocephalus?

A

Spina bifida, mumps, rubella in utero

68
Q

How is hydrocephalus treated?

A

Ventriculoperitoneal shunt

69
Q

What is a middle ear effusion?

A

Build up of secretions behind the ear drum leads to conductive hearing loss - separation of air and bone conduction

70
Q

Other than conductive what is the other type of hearing loss?

A

Sensorineural - equal air and bone conduction

71
Q

How is an ear effusion treated?

A

Temporary grommets to drain fluid and keep eardrum open

72
Q

In terms of the CNS what do genes determine?

A
  • the correct sequence of brain development from conception to neuronal proliferation, migration and reorganisation
  • development of dendritic and axonal interconnections
  • development of synapses, receptors and neurotransmitters
73
Q

Other than genes what is another key factor in CNS development?

A

Environment

74
Q

What contributes to the intrauterine environment?

A
  • maternal health and disease
  • insults which may be continuous throughout pregnancy (alcohol, CMV, rubella)
  • placental function/nutrition
75
Q

Give an example of a maternal disease that can impact the intrauterine environment

A

Maternal PKU - phenylalanine levels must be controlled otherwise excess may impact foetal brain development

76
Q

What is the extrauterine environment made of?

A
  • physical factors (nutrition, environmental toxins)
  • emotional and social factors (neglect, lack of stimulation)
  • exposure to drugs, alcohol and other substances
77
Q

When is the embryonic period?

A

Conception - week 8

78
Q

Name the two layers the embryo starts as

A

Epiblast and hypoblast

79
Q

After the formation of the epiblast and hypoblast what happens?

A

Streak develops with a primitive node

80
Q

What are the opposite ends of the embryo called?

A

Rostral (top)

Caudal (bottom)

81
Q

What determines the way the cells migrate?

A

Nodal signalling

82
Q

What layer do the cells migrate within?

A

Mesoderm

83
Q

Name the three layers that form during gastrulation

A

ectoderm - skin, nails, hair & neural tissue
mesoderm - muscle, bone, cartilage, vasculature
endoderm - gut and respiratory system

84
Q

What is the first well defined neural structure and when does it form?

A

Neural tube between 20-27 days

85
Q

Explain the formation of the neural tube

A
  1. Neuronal progenitor cells form a neuronal plate
  2. Plate develops a groove
  3. Plate folds on itself to form a tube
86
Q

What is derived from the neural tube?

A

Brain (rostral tube) and spinal cord (caudal tube)

87
Q

What happens to the inside of the tube?

A

It is lined with neuronal progenitors to form the ventricular zone

88
Q

What does the the hollow centre become?

A

Ventricular system and the central channel is the spinal cord

89
Q

Name the three brain vesicles at the start of development

A
  • prosencephalon
  • mesencephalon
  • rhombencephalon
90
Q

What does the prosencephalon divide into?

A

Telencephalon and Diencephalon

91
Q

What does the telencephalon become?

A

Cerebrum

92
Q

What does the diencephalon become?

A

Eye cup

Thalamus/hypothalamus/epithalamus

93
Q

What does the mesencephalon become?

A

Midbrain

94
Q

Where do the pons and cerebellum originate from?

A

Mesencephalon

95
Q

What does the myelencephalon become?

A

Medulla Oblongata

96
Q

How is the neocortex formation regulated?

A

Variable concentrations of signalling molecules decide where the cells will go and what they will do

97
Q

Name two genes that encode for chemical which are distributed in the brain?

A

Emx2 and Pax6

98
Q

Describe the concentrations of Emx2 and Pax6 at the front and back of the brain

A

Front - low emx2 and high pax6

Back - low pax6 and high emx2

99
Q

What neurons are formed when there is a low emx2 and high pax6?

A

Motor neurons

100
Q

What neutrons form when there is a low pax6 and high emx2?

A

Visual cortex neurons

101
Q

When is the foetal period?

A

Week 9 to term

102
Q

What happens to the neural tube during the foetal period?

A

Out pouching of the neural tube and brain. Brain is originally lissencephalic (smooth) but gradually it develops folds

103
Q

Name the structures that form in the foetal period

A

Sulci - grooves

gyri - ridges

104
Q

Why are sulci and gyri required?

A

To accommodate the proliferating neuronal populations

105
Q

How do neurons migrate?

A
  • Somal translocation
  • Radial glial glial guide
  • Tangential migration
106
Q

What is the function of axons?

A

Transmit signals from the neuron, develops a synapse when it reaches another neuron

107
Q

What is the function of dendrites?

A

Gather information and transmit to neutrons often arranged in a ‘tree like’ formation around the neuron to put in lots of information

108
Q

What is the key CNS process that occurs after birth?

A

Myelination

109
Q

How does myelination occur?

A

Oligodendrocyte progenitor cells develop processes which wrap around axons to form myelin sheaths to insulate the neuron and increase conduction

110
Q

What is a key factor in CNS development postnatally?

A

Experience - stimulation and input

111
Q

What changes occur in adolescence?

A

Synapses are eliminated, there is an increase in white matter volume and a change in neurotransmitter systems

112
Q

After puberty how do the specific hormones cause different responses in boys and girls?

A

Girls - oestrogen makes them more prone to stress

Boys - androgens makes then more resilient

113
Q

Name the condition where the neural tube does not close at the top end

A

Anencephaly (babies don’t survive)

114
Q

Name the condition where the caudal tube does not close

A

Spina bifida

115
Q

Name the condition where the vesicles fail to form, what are the three types?

A

Holoprosencephaly

- lobar, semilobar, alobar

116
Q

What are the three types of myelination disorders?

A

Hypomyelination - does not myelinate fully
Dysmyelination - myelinated incorrectly
Demyelination - myelinates and then loses myelin

117
Q

Name an example of a myelination disorder

A

Pelizaeus Merzbacher Disease

118
Q

Describe Pelizaeus Merzbacher Disease

A

PLP1 gene codes for a protein which is in myelin responsible for main functions of the sheath

119
Q

How does Pelizaeus Merzbacher Disease present?

A

nystagmus, hypotonia, cognitive impairment progresses to spasticity and ataxia

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