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Paediatrics > Developmental milestones > Flashcards

Developmental milestones Flashcards

1
Q

What are the four domains of child development?

A
  • Gross motor
  • Fine motor
  • Language
  • Personal and social
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2
Q

What is meant by gross motor developement?

A

Gross motor refers to the child’s development of large movements, such as sitting, standing, walking and posture. Development in this area happens from the head downwards.

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3
Q

Run and kick a ball?

A

2 years: Run. Kick a ball.

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4
Q

Cruising?

A

12 months: They should stand and begin cruising (walking whilst holding onto furniture).

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5
Q

Walk unaided?

A

12 months: Walk unaided.

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6
Q

Trunk supported on pelvis

A

6 months: They can keep their trunk supported on their pelvis (i.e. maintain a sitting position) by 6 months, however they often don’t have the balance to sit unsupported at this stage.

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7
Q

Sitting unsupported - can bounce on their legs when supported.

A

9 months: They should sit unsupported by 9 months. They can also keep their trunk and pelvis supported on their legs (i.e. maintain a standing position) and bounce on their legs when supported.

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8
Q

Crawling

A

9 months

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9
Q

Hop and climb stairs like an adult|:

A

4 years: Hop. Climb and descend stairs like an adult.

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10
Q

Gallops

A

4 years

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11
Q

Fine motor development in children means what?

A

Fine motor refers to a the child’s development of precise and skilled movements, and also encompasses their visual development and hand-eye coordination.

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12
Q

Holds crayon and scribbles randomly

A

12 months: Holds crayon and scribbles randomly

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13
Q

Fixes their eyes on an object 30 centimetres in front of them and makes an attempt to follow it. They show a preference for a face rather than an inanimate object.

A

8 weeks

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14
Q

Palmar grasp of objects (wraps thumb and fingers around the object).

A

6 weeks

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15
Q

Scissor grasp

A

9 months: Scissor grasp of objects (squashes it between thumb and forefinger).

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16
Q

They can clumsily use a spoon to bring food from a bowl to their mouth.

A

14-18months

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17
Q

Mature tripod grasp of a pencil

A

5 years

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18
Q

Language in child development:

What are the two types?

A

Language refers to the child’s development of understanding and using speech and language to communicate. There are two components:

Expressive language

Receptive language

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19
Q

Has around 5 – 10 words

A

18 months

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20
Q

Combines 3 – 4 words

A

2.5 years

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21
Q

Combines 2 words. Around 50+ words total.

A

2 years

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22
Q

Cooing noises

A

3 months

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23
Q

Makes noises with consonants (starting with g, b and p)

A

6 months

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24
Q

Babbles, sounding more like talking but not saying any recognisable words

A

9 months

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25
Q

Tells stories

A

4 years

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26
Q

Using basic sentences

A

3 years

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27
Q

Says single words in context, e.g. “Dad-da” or “Hi”

A

12 months

28
Q

Listens to speech

A

9 months

29
Q

Follows very simple instructions

A

12 months

30
Q

Understands verbs, for example “show me what you eat with”

A

2 years

31
Q

Understands nouns, for example “show me the spoon”

A

18 months

32
Q

Responds to tone of voice

A

6 months

33
Q

Recognises parents and familiar voices and gets comfort from these

A

3 months

34
Q

Understands adjectives, for example “show me the red brick” and “which one of these is bigger?”

A

3 years

35
Q

Follows complex instructions, for example “pick the spoon up, put it under the carpet and go to mummy”

A

4 years

36
Q

1 key word, for example “show me the spoon”

A

18 months

37
Q

Personal and social development

A

Personal and social refers to the child’s development of skills in interacting, communicating, playing and building relationships:

38
Q

Curious and engaged with people

A

6 months

39
Q

Smiles

A

6 weeks

40
Q

Startles to loud noises

A

6 weeks

41
Q

Communicates pleasure

A

3 months

42
Q

Has best friend. Dry by night. Dresses self. Imaginative play.

A

4 years

43
Q

Imitates activities such as using a phone

A

18 months

44
Q

Engages with others by pointing and handing objects. Waves bye bye. Claps hands.

A

12 months

45
Q

They become cautious and apprehensive with strangers

A

9 months

46
Q

Extends interest to others beyond parents, such as waving to strangers. Plays next to but not necessarily with other children (parallel play). Usually dry by day.

A

2 years

47
Q

They will seek out other children and plays with them. Bowel control.

A

3 years

48
Q

Developmental red flags

A

Lost developmental milestones

Not able to hold an object at 5 months

Not sitting unsupported at 12 months

Not standing independently at 18 months

Not walking independently at 18 months

Not running at 2.5 years

No words at 18 months

No interest in others at 18 months

49
Q

Top tip:

A

When talking to the child, you can encourage them in a way that lets the examiner know you have noticed certain things, such as “that is a really good pincer grip”, “you built a tower of six bricks, that is great” and “that is really good walking”.

50
Q

Developmental assessment skim the summary

A

During the initial part of the assessment try to develop rapport with the child so they engage with you. Make it a game and fun, and give plenty of praise when the child succeeds in a task. Make sure you remember and use their name. Children generally enjoy showing what they can do. If they are shy or don’t want to engage try using the parent to encourage them and don’t be afraid simply to observe and note what they are doing. If they absolutely do not want to engage you may want to ask their parent about the milestones.

Start by making a visual estimate of the rough age of the child and observing what they are doing before asking them to do something different. Test milestones that you think the child should be able to achieve at that age and work your way up until they are unable to complete the task. For example, if they look around 2 years and you want to assess fine motor, start with a tower and see how many bricks they can build, then challenge them to build a train, then a bridge, then steps. When they fail at a task, move on to assessing their drawing ability.

51
Q

When is not standing independantly a red flag

A

18 months

52
Q

When is no words a red flag?

A

No words at 18 months = red flag

53
Q

No interest in others

A

No interest in others at 18 months = red flag

54
Q

Not sitting unsupported is a red flag when?

A

Not sitting unsupported at 12 months = red flag

55
Q

Not able to hold an object at what age is a red flag?

A

Not able to hold an object at 5 months = red flag

56
Q

Squats to pick up ball

A

18 months

57
Q

Pulls to standing

A

8-10 months

58
Q

You are reviewing a 11-month-old baby with a viral upper respiratory tract infection. She is clinically well but at the end of the consultation her mother asks you about her development. You notice that she points and babbles ‘mama’ and ‘dada’ but has no other words. She is shy and cries when you try to examine her. There is an early pincer grip and she can roll from front to back but she cannot yet sit without support. How would you describe her development?

A

Isolated delay in gross motor skills.

Most babies can sit without support at 7-8 months so this probably represents a delay in gross motor skills. If still present at 12 months she should be considered for referral to a paediatrician. The other development features are normal for her age.

59
Q

Walks unsupported

A

12-15 months (Refer at 18 months)

60
Q

Rides a tricycle using pedals

A

3 years

61
Q

Walks up stairs without holding on to rail

A

3 years

62
Q

At what age would the average child start to play alongside, but not interacting with, other children?

A

2 years

Parallel play at 2 years (think of 2 parallel lines).

63
Q

At what age can a child stack 3 blocks?

A

18 months

The more widely quoted milestone is that of 3 blocks at 18 months. The MRCPCH development guidelines state that 4 blocks should be reached by this age.

64
Q

Tower buidling

3 age?

6 age?

9 age?

A

Tower of 3 = 18 months
Tower of 6 = 2 years
Tower of 9 = 3 years

65
Q

Palmar grasp

A

5-6 months

There is a difference between the grasp reflex (involuntary) and palmar grasp (voluntary).

Paediatrics (3 decks)

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