Growth and Development Flashcards
CHILDREN (1-5 y/o)
- dental eruption
- behavioral problems: urinary incontinence, toilet training, temper tantrums, head banging, phobias, pica, night terrors, sleep disturbances
MIDDLE CHILDHOOD (6-11 y/o)
- school performance
- sexual development (Tanner’s Maturity Rating)
ADOLESCENCE (12-20 y/o)
HEADS/S/FIRST
- home
- education, eating behaviors
- activities
- drugs/alcohol/tobacco use, depression
- sexuality
- suicidal ideation
- safety
- spirituality
Menstrual history
Growth vs Development
• BOTH can be MEASURED.
- Growth: quantitative
- Development: qualitative
DOMAINS OF DEVELOPMENT
- MOTOR DOMAIN
- gross
- fine
- LANGUAGE
- receptive
- expressive
- COGNITIVE
- PERSONAL/PSYCHOSOCIAL
DOMAINS OF DEVELOPMENT
- MOTOR DOMAIN
- gross
- fine
- LANGUAGE
- receptive
- expressive
- COGNITIVE
- PERSONAL/PSYCHOSOCIAL
MOTOR BEHAVIOR
- gross vs fine
GROSS MOTOR:
• posturing of the head, trunk and extremities
• movement of all the body
• e.g., complex body posturing (4 mos.), dancing, running, hopping on one foot
FINE MOTOR
• well-coordinated movement of small muscles
• e.g., milk bottle & spoon and fork handling, holding the pen, buttoning the shirt, writing and coloring, combing your hair
LANGUAGE DEVELOPMENT
- receptive vs. expressive
RECEPTIVE LANGUAGE
• ability to understand another person
• comprehension
EXPRESSIVE LANGUAGE
• ability to make oneself understood
ADAPTIVE/COGNITIVE DOMAIN
- most significant area/domain
- e.g.:
• co-opting behavior from parents thinking that is correct behavior
• observing adults
• asking why questions
• inquisitive of their environment
• when the patient is put in a situation, they know how to adapt to said situation.
PERSONAL AND PSYCHOSOCIAL DOMAIN
- affected by environment and culture, and states of neuromuscular coordination
- e.g.:
• habits affecting feeding
• sleeping
• bowel and bladder control
• ability to get along with other people
OBJECT PERMANENCE
2 months vs. 8 months
2 months: LACK of object permanence - “out of sight, out of mind”
8 months: PRESENCE of object permanence
NEONATAL PERIOD
birth to 4 weeks
EARLY INFANCY
0 to 12 months
LATE INFANCY
12 to 24 months
FIRST YEAR OF LIFE: INFANCY
- period of rapid physical growth and development
- period of neural plasticity
INFANCY
“synaptogenesis”
- Formation of synapses
INFANCY
“synaptic pruning”
- During synaptic pruning, the brain eliminates extra synapses that are not used.
EARLY PRIMITIVE REFLEXES
- Newborn Developmental Reflexes
- assessment of integrity of the nervous system
- reflect the functional capacity of the brainstem and spinal cord at the earliest stage of life
- disappearance of reflexes: maturation of the cerebral hemispheres
- persistence of reflexes beyond expected age: maturational lag or impaired CNS function
MORO REFLEX OR STARTLE REFLEX
- provides protection from harm in the outside environment
- “survival instinct”
ELICITED BY:
○ Carrying the baby on its back and pretend to
the drop the baby onto your hands, OR
○ Tapping the crib or the examining table.
EXPECTED RESPONSE:
○ Extension of the extremities followed by
flexion
RESULTS:
- present at birth, and disappears after 6 months
- absence: preterm babies, severe systemic disorder or infection, infants with bilirubin encephalopathy
- persistence beyond 6 months: neuro degenerative disorders like cerebral palsy
PALMAR GRASP REFLEX
- involuntary response to a mechanical stimulus
- present in newborn
ELICITED BY:
○ Infant should be laid in a symmetrical supine
and comfortable position while he/she is
awake.
○ Then the examiner strokes the palm of the
infant with his index finger.
EXPECTED RESPONSE:
○ Finger closure and clinging
○ Palmar flexion
○ Thumb is NOT affected.
- reflex disappears at 6 months: cortical maturation and development of voluntary motor milestones
PLANTAR GRASP REFLEX
- same with PALMAR grasp reflex
ELICITED BY:
○ Applying pressure on the ball of the foot.
EXPECTED RESPONSE:
○ Curling of the toes
- present at birth, disappears at 6 months
- absence/diminished reflex: sensitive indicator of spasticity
ROOTING REFLEX
- baby’s basic survival instinct
- involuntary: mediated by the brainstem
- helps the baby find and latch onto the bottle or mother’s breast to begin feeding
It is initiated when the corner of the mouth is stimulated.
• When the corners of the mouth are touched or
stroked, the baby will turn his head towards the
stimulus and open the mouth with tongue
thrusting.
- present at birth, disappears at 4 to 6 months until the frontal lobe develops
SUCKING REFLEX
- responsible for coordination of breathing and swallowing, which starts to develop at 37 weeks age of gestation
- starts to appear at around 30-35 weeks age of gestation
It is initiated when the roof of the newborn’s mouth is stimulated.
ELICITED BY:
○ Inserting the nipple towards the baby’s mouth to feed. They should automatically start sucking.
‼️ ABSENCE OF ROOTING AND SUCKING REFLEXES: recent feeding, depressed babies, extremely preterm neonates
ASYMMETRICAL TONIC NECK REFLEX
- aka FENCER’S/FENCING REFLEX
- presents as consistent one-sided movement of the body where the newborn turns their head on one side assuming a position as if to attack an enemy or challenging an opponent
- importance: helps the baby move through the birth canal during the vaginal birth, and promotes hand-eye coordination
ELICITED BY:
• Rotating the head to one side causing the ipsilateral extension of the extremities towards which the face is turned and contralateral extension of the extremity.
- essential for postural tone, instability, gross and fine motor movements, eye tracking and midline crossing which is crucial for reading, telling the time, and left-right discrimination among others.
- present while the baby is still in the utero, starting as early as 18 weeks AOG
- most prominent: 1 to 4 months
- disappears by 3 to 9 months, or up to 1 year of life
