Development Flashcards
true/false - severe malnutrition below 1m results in permanent brain damage
false - severe malnutrition at any age <6m results in permanent brain damage
environmental factors affecting development?
smoking, alcohol, drugs opportunity to practice emotional deprivation excess screen time head injury
normal variations to 4 point crawl?
bottom shuffle
commando crawl
roll
reverse torpedo crawl
true/false - preterm neonates have their developmental milestones compensated
true, up to the age of 2
4 categories of development?
gross motor
fine motor and vision
language and hearing
social behaviour and play
gross motor development at 3m
can control head movement, no head lag on pulling to sit
gross motor development at 6m
sits up unsupported with straight back
pushes arms up in prone
gross motor development at 9m
crawling
gross motor development at 12m
stands independently, begins to walk
gross motor development at 18m
running
gross motor development at 24m
stairs with 2 feet
gross motor development at 36m
stairs with alternate feet
gross motor development at 48m
hopping
what is ATNR
asymmetric tonic neck reflex
evolutionary to prevent rolling on unstalbe surface
usually lost 3/4m
often continues in CP
fine motor and vision development at 3m
regards hand in midline
fine motor and vision development at 6m
palmar grasp
fine motor and vision development at 9m
scissor grip
fine motor and vision development at 12m
pincer grip
fine motor and vision development at 18m
stacks 3-4 blocks
scribble randomly
fine motor and vision development at 24m
stacks 6-7 blocks
scribbles more coherently
fine motor and vision development at 36m
tower of 9 blocks
copies circle
fine motor and vision development at 48m
draws cross or simple man
hearing and language development at 3m
vocalises
hearing and language development at 6m
babbles
hearing and language development at 9m
imitates sounds
hearing and language development at 12m
knows name
hearing and language development at 18m
2 body parts/5-20 words
hearing and language development at 24m
can follow simple instruction, 50+ words
hearing and language development at 36m
complex instruction/can ask question
hearing and language development at 48m
can tell stories of experience
social behaviour and play development at 6 weeks
social smile
social behaviour and play development at 3m
pleasure on friendly handling
social behaviour and play development at 6m
plays with feet
friendly with strangers
social behaviour and play development at 9m
peek a boo
stranger awareness
social behaviour and play development at 12m
drinks from cup/waves bye bye
social behaviour and play development at 18m
feeds with spoon
social behaviour and play development at 24m
symbolic play, puts on spme clothes
social behaviour and play development at 36m
pretend interactive play
toilet trained
social behaviour and play development at 48m
understands turn taking
gets dressed fully
define global developmental delay
> 2 domains affected
define specific developmental deay
1 domain affected
define developmental deviation
different from normal q
define developmental regression
loss of skill
what is a learning disability and how does it differ from learning difficulty
cannot cope independently
cannot earn new skills or complex tasks
IQ<70
learning difficulties are ore common and less severe
red flags for development
asymmetry of movement increased/reduced tone not reaching for objects by 6m cannot sit unsupported by 12m cannot walk by 18m concern about hearing or vision loss of skill at any age
what is defined as a significant global developmental delay
> 2SD from mean in >2 of the development categories
prenatal causes of global developmental delay
down syndrome PKU, hypothyroidism micro/macroencephaly TORCH infection toxins
perinatal causes of global developmental delay
premature
asphyxia
postnatal causes of global developmental delay
meningitis
trauma
malnutrition/neglect
medical issues relating to down syndrome
cardiac thyroid hearing and vision sleep growth development
causes of motor specific developmental delay
CP
coordination disorders
duchenne muscular dystrophy
features of DMD
impaired mobility and motion
impaired speech and language
calf pseudohypertrophy
arching of back
what is gowers manoeuvre results in DMD
prox muscle weakness of pelvic girdle muscles
what is diplegic CP
usually lower limb, both legs affected
walks on tiptoe, contractures
what is hemiplegic splastic CP
normal side with other side arm and leg affected, walks on tiptoe
what is quadraplegic CP
arms, head, mouth may twist strangely
4 limbs affecrted
knees press together
feet and legs turn inewards
types of CP
ataxic, hypotonic, dyskinetic, spastic
besides motor function, what else may CP affecr
communication, seizure, learning, sensation
specific sensory developmental delay causes
treacher collins sensorineural hearing loss CP hydrocephalus oculocutaneous albinism
what is oculocutaneous albinism
conditions affecting pigmentation of skin, hair and eyes
reduced pigmentation of retina and eyes
reduced visual acuity, nystagmus, photophobia
features of treacher collins syndrome
conductive hearing loss
normal cognition
underdeveloped facial bones, small jaw, absent or small ears
medical issues associated with CP
motility, spasticity and ortho learning difficulty epilepsy visual/hearing impairment communication difficulty feeding difficulty sleep problems behaviour problems
what is the most common visual defect in spastic CP
inferior visual field defect
what is the autistic triad
communication
social interaction
flexibility of thought/imagination
autistic triad - features of communication
delayed, abstract language
echo, odd pitch
issues with eye contact, gesture, expression
restricted conversation
autistic triad - features of social interaction
struggles with turn taking
cannot share pleasure
no need for social approval
struggle with empathy and relationship, others views
autistic triad - features of flexibility of thought/imagination
struggle with time concept concrete and literal routine changes in environment ritualistic behaviour
sensory issues with ASD
fussy eater clothes texture hair/nail cutting sleep toilet training noise
investigation of developmental delay
oligoarray CGH and FRAX guthrie test MRI/EEG CK Metabolic studies
what formal assessment is used in 0-6
griffiths
what formal assessment is used in 0-3
bayleys
what formal assessment is used in ASD
ADOS
who should be spoken to first during paeds history
always the child
why is play important in hospital?
sense normality aids recovery development understand illness trust reduce stress
what is play preparation and when is it used
prepare for procedures and help understand illness and treatment
encouraging child to act it out with play
when is referral to play therapists used and what does it involve
feat, trauma, misconception around healthcare related things
procedural play to help build relationship and understanding
why do mothers with diabetes tend to have larger babies
insulin acts as a growth factor
what is a Z score
number of SDs a person has from mean
in a normal distribution of 100 people, how many will fall in 1SD
68
in a normal distribution of 100 people, how many will fall in 2SD
95
centile lines of a growth chart are spaced how many SDs away
2/3rd
how is normal growth compared on a growth chart
compare growth to centile lines
compare rate of growth
why is the normal distribution of growth charts getting a right tail
increasing height and obesity
measuring head circumference?
measure widest part of head 3 times and take average
true/false- children <2 are measured as length, not height
true, and >2 is height
why are overweight children more likely to enter puberty sooner
they have more adipocytes, so more leptin leading to raised GnRH
what is the testicular volume when puberty has begun
4ml
how is tanner stage measured in boys?
testicular volume
pubic hair, unreliable
how is tanner stage measured in girls?
breast development
pubic hair, unreliable
when is puberty regarded as early?
<8 girls
<9 boys
when is puberty regarded as late?
> 13 girls
>14 boys
when is height velocity peak girls
12
generally start of puberty
when is height velocity peak boys
14
generally end of puberty
in investigating growth problem, what may be used to determine issues with height, and describe it
mid parental height
parents height charted and the parental centile is used
this is compared to childs centile
if ±2SDs then abnormal
investigation of growth issues?
gonads IGF1 test/oestradiol karyotype anti-TTG bone age dynamic testing MRI brain USS uterus
causes of dysmorphic disorders leading to short stature
down syndrome
turner syndrome
achondroplasia
prader-wili
