Epi and community paeds, CAMHS Flashcards
What are the fields of development?
- Gross motor
- Vision and fine motor
- Hearing, speech and language
- Social, emotional and behavioural
Also: cognitive development
Thinks to ask about in developmental Hx
- what stage for each field
- milestones (over limit ages?)
- sequence of development
- any fields of concern
- any regression/loss of skills
- overall development and how it relates to age
Limit ages for drawings
Line: 1y Squiggle: 2y Circle: 3y Cross: 4y Square: 5y Triangle: 6y
Limit ages: gross motor development
- head control 4m
- sits unsupported 9m
- stands with support 12m
- walks independently 18m
Limit ages: vision and fine motor development
- fixes and follows with vision 3m
- reaches for objects 6m
- transfers objects 9m
- pincer grip 12m
Limit ages: hearing, speech and language development
- polysyllabic babble 7m
- consonant babble 10m
- 6 words with meaning 18m
- joins words 2y
- 3-word sentences 2.5y
Limit ages: social, emotional and behaviour development
- smiles 8wks
- fear of strangers 10m
- feeds self/spoon 18m
- symbolic play 2-2.5y
- interactive play 3-3.5y
When are the developmental reviews in the UK healthy child programme?
- new baby
- 1y-1y1m (12-13m)
- 2y-2y6m
- health reviews at 10-11y (school transition) and 15-16y
When are NIPEs performed?
- within 72h of birth
2. at 6-8wks
When are children measured in the National Child Measurement Programme?
4-5y
10-11y
Hearing tests/screening in babies
Otoacoustic emission (OAE) within first few weeks of life
If abnormal: auditory brainstem response (ABR) audiometry
If on special care unit: both usually performed
What hearing test is used in infants 10-18 months?
visual reinforcement audiometry
What hearing test is used in children 18 months - 4 years?
performance and speech discrimination testing
What hearing test is used in children >4 years?
audiometry
Hearing checklist for parents
- by 1m - notices sudden prolonged sounds e.g. vacuum
- by 4m - quietens/smiles to sound of your voice
- by 7m - turns to voice across room/very quiet noises on each side
- by 12m - shows some response to their name and other familiar words
When is visual screening recommended?
4-5 years
Presentation of autism
- 4-5y 1 - impaired social interaction 2 - speech and language disorder 3 - ritualistic and repetitive behaviour - may have comorbidities e.g. seizures, LDs, affective disorders, ADHD
Presentation of ADHD
- cannot sustain attention
- excessively active
- social disinhibition
- easily distracted
- impulsive
- poor at relationships
- prone to temper tantrums
- poor school performance
Management of autism
Applied behaviour analysis - 25-30h per week; and appropriate educational setting
Management of ADHD
- educational psychologist assessment
- behavioural programmes in school
- parenting intervention
- medication if necessary and >6y (stimulants like methylphenidate or dexamphetamine, or non-stimulants like atomoxetine)
What is Conner’s scale used for?
assessing ADHD
Common SEs of methylphenidate
- appetite suppression
- sleep disturbance
Management of developmental coordination disorder
OT
Management of (isolated) language delay
SALT
What is an EHCP
education, health and care plan
- for children with special educational needs
- legal document
- until age 25
- states aims/plans/expectations for the child
Management of AN in adolescents
family therapy 1st line using Maudsley approach:
- STABILISE
- refeeding (weight restoration)
- negotiations for new relationship with food
- adolescent issues and closing things down
Which guidelines are used for managing AN
MARSIPAN - Management of Really Sick Patients with Anorexia Nervosa
What to cover when making a safeguarding referral
- documentation
- are they known to safeguarding?
- inform parents you are making a safeguarding referral (if safe to do so)
- names, DOB, school of other children in family/household
Features of accidental injury
- bony prominences
- match the Hx
- in keeping with development of the child
Features of non-accidental injury
- injuries to both sides of the body
- injuries to soft tissue
- injuries with particular patterns
- doesn’t fit with Hx
- doesn’t fit with development of child
- delayed presentation
- untreated injury
What to do if FGM identified in <18y
report to police
