Development and Adolescence Flashcards
average age for a girl to enter puberty
- reason for precocious
- 11
- 8-13 considered normal
- there is a secular trend in which girls are entering puberty earlier than previous generations, this may be due to increased leptin (fatter)
stages of female puberty
- adrenarche - greasy skin, spots, hair
- therlarche - breast development
- menarche
how long after thelarche does menarche usually occur
2- 3 years
average age for boys to enter puberty
- 11.5
- ≥14 - delayed
- <9 - precocious
delayed puberty in boys an girl s
boys ≥14
girls ≥13
average age for boys to have their pubertal growth spurt
14
how is abnormal growth indicated
crossing centiles on growth chart
define adolesence, youth and young person
- Adolescence: 10-19 years
- Youth: 15-24 years
- Young people: 10-24 years
what is used as a scale of physical development in children
Tanner stages
how is the developmental stage assessed
STEP
- sexual maturation and growth
- thinking
- education/employment
- peers/parents
guidance if a young person aged 0-18 refuses treatment
- always act in best interests of young person
- Parents cannot override the competent consent of a young person to treatment that you consider is in their best interests
- In Scotland, parents cannot authorize treatment a competent young person has refused.
define competence
- Ability to understand simple terms and nature, purpose and necessity for proposed treatment
- Understand benefits, risks and effects, as well as alternatives to, non-treatment
- Understand that the information applies to them
- Retain information long enough to make a choice
- Make a choice free from pressure
in scotland, a person over which age can consent to their own medical treatment when deemed competent
16
can parents authroize treatment a young person has refused
no
what happens if the treatment is in the best interest of the young person and they refuse
seek legal advice
what age do confidnetiality rules apply to
irrespective of age
when can confidentiality be broken
- health, safety or welfare of patient or others would be at grave risk without disclosure
what might we want to discuss with young people
- Home
- Education/employment
- Eating – weight, body image
- Activities
- Drugs
- Sex – activity, orientation, STI
- Suicidality
- Safety
what is the clinical relevance of being an adolescent
- many disease states begin in adolescence
- obesity
- mental health
- gains in childhood are negated by losses at adolescent stage
- poorly managed morbidity in adolescence carries over into adulthood
pros and cons of adolescent units
Pros:
- Developmentally appropriate care and environment
- Staff are used to discussing and dealing with risk behaviours
- Increased independence from parents
Cons:
- Mimicry of others’ harmful behaviours
- Inappropriate behaviours
- Ward too comfortable – may not want to go home
- Loss of expertise and experience outwith the unit
what is the average height difference between boys and girls, and why
- 13cm
- testosterone makes one grow gaster
- boys pre-existing years of normal growth means that their epiphyses fuse later
obesogenic environment
- term used to describe the modern environment that encourages foods high in energy density but low in nutrients and decreased physical activity levels
- chronic positive energy imbalance
how many hours of screen time per day are recommended
no more than 2
prescribing Orlistat
only in severely obese adolescents (BMI>99.6th percentile) with comorbidities attending a special clinic
regular reviews and monitoring required
bariatric surgery
- BMI >40 or >35 with severe co-morbidities
- nutritional assessments must be made after
3 phases of child growth
infant
child
pubertal
what drives each stage of child growth
- Infant – nutrient led
- Child – growth hormone led
- Pubertal – sex steroid led
what is the mean intake for protein like
above the RNI for each age group
how are children doing on estimated average requirement for energy
over half are exceeding it
vitamin intake in children
- vitamin A and C are above RNI
- vitamin D are below RNI - also found in oily fish and eggs
what is recommended for all children consumin <500mls/d of infant formula
that from 6 months, they should take vitamin A C and D supplements
what is recommended for breast feeding mothers
that they take vitamin D supplements of 10ug per day
soidum intake in children
exceeded RNI
UK physical activity guidlines
- those not yet walking: encouraged and minimise time spent sedentary
- those walking: walk for 180 min throughout day and again minimise sedentary time
- 5-18 year olds: ≥60 min of moderate-vigorous intensity physical activity, 3days a week vigorous
what is recommended for the first 6 months of an infants life
exclusive breast feeding
- increase IQ?
- lower obesity risk later in life
- aids post pregnancy weight loss
- lower maternal breast cancer risk
when should cow milk be introduced
- breast milk is no longer enough to meet nutritional needs from 6 months
- full fat intoroduced slowly
- semi skimmed can be given after 2y
- skimmed can be given after 5 y
foods rich in what are recommended in babies
rich in absorable iron eg red meat, canned fish and well cooked eggs
consequences of late weaning
- complemenary feeding is important in the development of gross motor, fine motor and oral motor development/speech elements
- inadequate energy and nutrients - growth faltering and malnutrition
when are children vulnerable to chronic disease, and disordered eating patterns
- school age - learning to be independent and developing eating and behaviour patterns
- adolesence - eating disorders, obesity and pregnancy
- susceptible to faddism
what is an early introduction into solid foods associated with
- deprived areas
- influence
- personal opinion
- food availability
name a child dental programme
childsmile
