Exam 2 General Flashcards
“…a flexible, continuous process in which knowledgeable professionals perform skilled observations of children during child health care.”
Developmental Surveillance
Components of developmental surveillance
Eliciting and attending to parents’ concerns
Obtaining relevant developmental history
Skillfully observing children’s development
Sharing opinions with other professionals
Define Developmental Screening
Brief test to “sort out those who probably have problems from those who probably do not”
A part of surveillancwe
American Academy of Pediatrics Guidelines for developmental surveillance
Perform developmental surveillance at each health supervision visit → if concerns, administer screening test
When should you perform structured developmental screening?
at 9, 18 and 30 months
may need to do at 24 months instead of 30 months due to insurance
Benefits of parent-report screening tools
less time, same or better psychometrics
administer so complete by the time provider enters the room
foundation for counseling and anticipatory guidance
brings concerns to attention of parents and reassures others
reduces “oh by the way..”
Define global developmental delay
delay in 3 or more areas
Define isolated developmental delay
delay in 1 area most often speech and language
Define atypical developmental delay
Asynchronous, or “out
of order”
uneven development, advanced in some areas, behind in others “splintering”
Think ASD
What may a parent be trying to convey when they say “It seems like my child can’t hear. I call his name, but he just ignores me.”
“My child has poor joint attention”
What are the 4 components of joint attention?
Oriented and attending to a social partner
Coordinating attention between people and objects
Sharing affect and emotional states with people
Being able to draw others’ attention to objects or events to indicate need or to share experiences
What age should a child develop affective reciprocity (back and fourth baby talk)?
3-6 mo
What age does a child develop joint attention (shared experience brining someone in to share)?
12-18 mo
What age does a child develop theory of mind (not everyone thinks like me)?
30 mo
What age does a child develop intuitive psych (feed baby doll because recognize it may be hungry)?
4-5 yrs
How much speech is intelligible at 2 yrs?
3 yrs?
4 yrs?
2 yrs - 50%
3 yrs- 75%
4 yrs - 100%
When do you expect a child to be able to turn head towards sound by?
6 mo
Possible causes of failure to thrive
Not enough food offered Child not taking enough food Emesis Malabsorption Increased metabolic demand
What are sentinel injuries?
Warning signs for potential abuse
What bruising sites cause concern for abuse?
face/head chest/abd back buttocks arms
What age children have the highest rate of maltreatment?
<1 yo
child abuse FRAMER
F: Give parents a listing of the FACTS that have led to your concern
R: Explain that you are REQUIRED TO REPORT on behalf of the child (not against the parents)
A: State that a formal ASSESSMENT is needed to determine the exact nature of the problem and need for treatment
M: Present a MENU of alternatives for evaluation and treatment services (Team Approach)
E: EMPATHY. Acknowledge how difficult a process this is for everyone
R: Insist that you receive a REPORT BACK from the assessment and have open communication with the child protection worker
no pubic hair
pre-pubertal breast
SMR 1
sparse pubic hair, vellus
bud under areola
SMR 2
