Developmental milestones

Question 1

A 2 month old chid

Answer 1

Gross: lift head to 45, extend arms forward
Fine motor: follow across midline, grab clothes
Language:Coos
Social/Adaptive: Regards faces, social smile (6wks)

Question 2

6 months

Answer 2

Gross: Sits unsupported
Fine motor: reaches for toys, ulnar grasp
Language: Babbles, imitates sounds
Social/Adaptive: Stranger anxiety

Question 3

8 Months

Answer 3

Gross: Stands if held
Fine motor: transfers across midline
Language: mama, dada (non-specific sounds)
Social/Adaptive: waves bye

Question 4

9 Months

Answer 4

Gross: Crawls, pulls to stand
Fine motor: fingers thumb grasp
Language: jabbers
Social/Adaptive: Separation anxiety, plays patty cake

Question 5

10 months

Answer 5

Gross: Cruises
Fine motor: Pincer grasp
Language: mama and dada specific
Social/Adaptive: Peek a boo

Question 6

12 Months

Answer 6

Gross:Walks alone or with support
Fine motor: Throws
Language: few words plus mama/dada
Social/Adaptive:drinks from cup

Question 7

15 Months

Answer 7

Gross: walks well, walks backwards
Fine motor: scribbles, tower of 2 cubes
Language: Points, follows simple commands
Social/Adaptive: hugs parents, spoon/fork, remove clothes

Question 8

18 Months

Answer 8

Gross: runs, walks upstairs, kicks ball
Fine motor: tower of 3-4 cubes
Language: 10 words
Social/Adaptive: feeds self, helps brush teeth, points to body parts.

Question 9

2 years

Answer 9

Gross: walks up/down stairs, throws overhead, jumps.
Fine motor: initiates pencil stroke, tower of 6
Language: 2-3 word phrases, 25% understandable.
Social/Adaptive: Dry at night, toilet training around 2-3 years

Question 10

3 years

Answer 10

Goes up stairs alternating feed, stand one foot, rides tricycle.
Fine motor: copies a circle/cross, hand preference
Language: knows name, 50-75% udnerstandable, knows age and gender.
Social/Adaptive: Plays with others, shares toys, partially dresses

Question 11

4 Years

Answer 11

Gross: Hops on one foot
Fine motor: Copies a square, uses scissors
Language: tells stories, asks questions.
Social/Adaptive:Interactive play, toilets alone, dresses self, brushes teeth

Question 12

5 eyars

Answer 12

Gross: Skips, rides bike with training wheels
Fine motor: copies triangle, ties shows, prints name, draws person of 6 parts.
Language: names 4 colors, fluent speech, says alphabet.
Social/Adaptive: plays competitive games with rules.

Question 13

Gross Motor Milestones

Answer 13

6 months sits; crawls-cruises at 10, walks at 15, stairs at 24, tricycle at 3 and bike at 5.

Question 14

Fine Motor Milestones:

Answer 14

Grasps at 3-4months, transfers at 8 months, pincer at 10 months, scribbles at 15 months and tower of 2 cubes at 18

Question 15

Language Milestones

Answer 15

4 months: coos; 6 months babbles; 12 months words; 24 months 2 word phrases

Question 16

Social Adaptive Milestones

Answer 16

6 wk social smile; stranger anxiety 6 months, peek a boo at 12 months; parrallel play at 24 months.

Question 17

Some disorders of developmental regression

Answer 17

Rett's syndrome (loss of hand movement, gait abnormality, mental retardation and loss of speech).
X-Linked Adrenoleukodystrophy
Leukodystrophy
Trauma, infections (HIV, CMV), strokes
Alexander's syndrome (GFAP!)
Muscular dystrophy
Abust/Neglect
Heavy Metal poisoning.

Question 18

Red Flags in developmental history

Answer 18

trauma, abuse/neglect, infections/fevers, fm history, dysmorphic features, neonatal history, epilepsy, new onset.

Question 19

Number one genetic cause of dev delay

Answer 19

Down’s Syndrome

Question 20

clinodactyly

Answer 20

bend or curvature of the 5th finger (normal or … russel Silver, Down’s, Feingold syndromes)

Question 21

Brachydactylyl

Answer 21

Small/short digits.

Question 22

Red Flags in Down’s Syndrome

Answer 22

• obstruction: delayed passage of meconium, abdominal pain/irritable, bilious vomiting
• Heart failure: dyspnea, edema, increased RR/HR,fatigue, diaphoresis, poor feeding, FTT
• Leukemia: fever, anorexia, weight loss, night sweats, fatigue, bone pain, xs bruising/infec-tions
• Spinal cord compression (2° to Cl (2 instability): neck pain/wry, weakness and spasticity, difficulty walking/loss of ambulatory skills, altered bowel or bladder function

Question 23

Failure to thrive defintions

Answer 23

Note: use WHO now
<3rd %tile weight for age. Wt loss greater than 10%, failure to regain bw or jaundice by 2 wks. No social smile by 6 wks. <6 wet diapers.

Question 24

Etiology of Failure to thrive

Answer 24

Not enough calories
Excessive caloric need/ineffective utilization
Malabsorption/Maldigestions

Question 24

Flags for genetic concerns

Answer 24

Consanguinity, fm hx, prenatal course, post natal course, infections, dysmorphic features

Question 25

Red flags for well child visits

Answer 25

Failure tonthrive, regression, developmental delay, dysmorphic features, abuse /neglect , substance abuse, school failures, early sexual risky activity , eating disorders, suicidality, homeless.

Question 26

Red flags for language/speech queries

Answer 26

Loss of language/social milestones, combined l/s delays, caregiver/teacher concern, neonatal complications, fm hx, abuse/neglect, dysphagia.

No babble at 12mo/words at 15, simple commands at 18, combos at 2.
Unintelligible to parents at 2, to strangers at 3, stuttering, teasing.

Question 27

Autism criteria

Answer 27

Impaired social, communication and stereotyped interests/behaviours

Onset under 3, not accounted for by other disorders.