development and developmental milestones Flashcards
6 weeks gross motor
head control in vertical plane
3 months gross motor
no head lag on pulling to sit
6 months gross motor
- pushes onto arms when lying on stomach
- weight bears on legs
9 months gross motor
- leans forward from sitting
- stands holding onto furniture
- may crawl
12 months gross motor
- pulls to stand
- cruises furniture
18 months gross motor
- runs
- climbs onto adult chair
2 years gross motor
up and down stairs with 2 feet
3 years gross motor
- takes stairs 1 foot at a time
- can jump off of stairs
- stands on 1 foot
- sit and steer on tricycle
4 years gross motor
- hops
- walks and runs on tip toes
5 years gross motor
rides a bike
6 weeks fine motor and vision
follows torch with eyes
3 months fine motor and vision
regards hands held in midline
6 months fine motor and vision
- grasps toys
- passes things from hand to hand
- palmar grasp
9 months fine motor and vision
uses index finger to point
12 months fine motor and vision
- bangs toys and throws them away
- pincer grip
18 months fine motor and vision
builds a tower of 3 bricks
2 years fine motor and vision
- scribbles
- builds a tower of 6-7 bricks
3 years fine motor and vision
- builds a tower of 9 bricks
- copies circle
4 years fine motor and vision
able todraw simple picture of a man
5 years fine motor and vision
draw a triangle
6 weeks language and hearing
stills to voice
3 months language and hearing
starting to vocalise
6 months language and hearing
- babbles
- screams when annoyed
9 months language and hearing
- localises to sound
- babbling for self amusement
12 months language and hearing
responds to name
18 months language and hearing
- knows 5-20 words
- points to body parts
2 years language and hearing
- understands simple instructions
- > 50 words
3 years language and hearing
- knows own name
- asks lots of questions
4 years language and hearing
- recounts stories
- counts to 20
6 weeks social and play
social smile
3 months social and play
reacts pleasurably to similar sounds
6 months social and play
friendly with strangers
9 months social and play
- distinguishes strangers
- plays peek a boo
12 months social and play
drinks from cup
18 months social and play
- feeds with spoon
- mimics adults
2 years social and play
- puts on shoes
- feeding less messy
- symbolic play
3 years social and play
- washes hands
- vivid imagination
- understands sharing
4 years social and play
- dresses and undresses
- understands turn taking
5 years social and play
ties shoe laces
is it normal for kids to have a hand preference < 18 months
no (could be sign of cerebral palsy)
what is a specific delay
delay in one of the four developmental areas
what is a global delay
significant delay in 2 or more of the 4 developmental areas
what is developmental regression
when there is normal development followed by a loss of skills previously attained (Rett syndrome, metabolic disorders)
give 7 red flags of abnormal development
- asymmetry of movement
- not reaching for objects by 6 months
- unable to sit unsupported by 12 months
- unable to walk by 18 months
- no speech by 10 months
- concerns over vision or hearing
- loss of skills
what is trisomy 21
Down Syndrome
Down syndrome features
- dysmorphic face
- low set ears
- single palmar crease
- short little finger
- gap between hallux and second toe
- duodenal atresia
- atlantoaxial instability
- Hirschsprung’s disease
what is trisomy 18
Edwards syndrome
Edwards syndrome features
- microcephaly
- micrognathia
- small jaw
- low set ears
- wide spaced eyes
- absent radius
- rocker bottom feet
- webbing of second and third toes
- overlapping of fingers
what is trisomy 13
Patau syndrome
Patau syndrome features
- cyclopia
- microcephaly
- extra fingers
- microcephalic
- small eyes
- cleft lip/palate
- polydactyly
- scalp lesions
what syndrome is deletion chromosome 5
Cru di Chat
Cru di chat features
- microcephaly and micrognathias
- hypertelorism
- learning difficulties
- feeding difficulties and poor weight gain
- high pitched characteristic cry (due to larynx and neurological problems)
- moon face with widespread eyes
Fragile X features
- long protruding/large ears
- long face
- high arched palate
- flat feet
- hypermobility of joints
- macrocephaly
- learning difficulties
- macro-orchidism
- most common genetic cause of learning disability
- x-linked
what syndrome is deletion chromosome 22
DiGeorge syndrome
DiGeorge syndrome
- cardiac abnormalities (tetralogy)
- abnormal face (flat, cleft)
- hypocalcaemia
- increased risk of infections and future risk of schizophrenia
Noonan syndrome features
- webbed neck
- pectus excavatum
- short stature
- pulmonary stenosis
Pierre-Robin syndrome features
- micrognathia
- posterior displacement of tongue (may result in upper airway obstruction)
- cleft palate
Prader-Willi syndrome features
- hypotonia
- hypogonadism
- obesity
William’s syndrome features
- short stature
- learning difficulties
- friendly, extrovert personality
- transient neonatal hypercalcaemia
- supravalvular aortic stenosis
what is Duchene’s muscular dystrophy
x-linked recessive muscular dystrophy caused by maturation in dystrophin gene
Duchene’s muscular dystrophy presentation
- boys aged 1-6 who are struggling to walk
- proximal muscle wasting with pseudohypertrophy of calves
- waddling gait
- Gower’s manoeuvre (uses their hands to push themselves onto feet)
Duchene’s muscular dystrophy diagnosis
very high serum CK
Duchene’s muscular dystrophy complications
- mobility will progressively get worse
- death due to cardiac and respiratory failure in 20s
- most common heart lesion is dilated cardiomyopathy
what is Becker’s muscular dystrophy
slower onset form of Duchenne’s muscular dystrophy (semi-functional dystrophin produced)
Becker’s muscular dystrophy presentation
- later presentation than Duchene’s
- proximal muscle wasting with pseudohypertrophy of calves
- on examination
- waddling gait
- Gower’s manoeuvre (uses their hands to push themselves onto feet)
what is cerebral palsy
umbrella term used to describe a chronic disorder of posture and movement caused by non-progressive CNS lesions sustained before 2 years old
prenatal causes of cerebral palsy
- alcohol
- TORCH infections
perinatal causes of cerebral palsy
- hypoxia
- distress
- trauma
- kernicterus
- hypoglycaemia
postnatal causes of cerebral palsy
- periventricular haemorrhage
- hypoxia
- encephalitis
cerebral palsy presentation
- delayed motor development
- learning disability
- progressive CNS signs (weakness, altered sensations)
- characterised based on distribution of neurological deficits
what is affected in hemiplegic cerebral palsy
one arm and one leg
what is affected in paraplegic cerebral palsy
both legs
what is affected in diplegic cerebral palsy
both legs with minimal movements elsewhere
what is affected in quadriplegic cerebral palsy
both arms and both legs
