Growth and Development Flashcards
What are the recognised phases of childhood?
Neonate (<4weeks), infant (<12m), toddler (1-2yrs), pre-school (2-5yrs), school age and teenager/ adolescent
Describe what is meant by development in children
Gaining functional skills throughout childhood
Gradual but rapid process
Typically birth to 5 years
Consistent pattern but rate rate varies
Cell growth, migration, connection, pruning and myelination
What are some key developmental fields?
Gross motor, fine motor, social + self help, speech + language, and hearing + vision
What does milestones in childhood?
Achievement of key developmental skills
Social smile, sitting, walking and first words
Variation of what is normal
Refer if not achieved by limit age (if not walking by 18months)
What are influencing factors on development?
Genetics, environment, positive childhood experience and developing brain vulnerable to insults (antenatal, post-natal and abuse/ neglect)
What are adverse environmental factors affecting development?
Antenatal - infections and toxins
Post-natal - infection, toxins, trauma, malnutrition, maltreatment and maternal mental health issues
Who assess the development?
Assessors - parents. wider family, health visitors, nursery, teachers, GPs, A+E, students and paediatricians
Healthy child programme (HCP) UK
How is development assessed?
How do they move their body, what do they do with their hands, how do they communicate and what can they do for them themselves
Watch carefully and let parents help
What red flags are recognised in development?
Loss of developmental skills, parental/ professional concern on vison or hearing, persistent low tone, no speech by 18 months, asymmetric movements, not walking by 18 months and OFC>99.6th
Describe child health screening
UK Healthy child programme and child health programme
Based in primary care
Main components - health promotion, developmental screening and immunisation
Where is progress recorded?
Red book - personal child health record
Describe the child health programme
New born exam and blood spot screening
New born hearing test
Health visitor first visit
6-8 week review and 27-30 month review
Orthoptist vision screening
Describe the 6-8 week review
GP and HV
Feeding, parental concerns, development (gross motor, hearing, communication, vision and social awareness), measurements and examination (hearts, hips, genitalia, femoral pulses and eyes)
Sleeping position
Describe the 27-30 month review
Identification, development (social and communication), physical measurements and diagnoses/ other issues
What stages are the healthy child programme
Antenatal, birth at 1 week, 2 weeks, 6-8 weeks, 1 year, 2-2.5 years and 5 years
What does health promotion include?
Smoking, alcohol/ drugs, nutrition, hazards/ safety, dental health, support services and mental health
Additional input for immunisation
Describe immunisation history taking
Frequently updated schedule
Different schedules in different countries
Older children may not be immunised to current list
Check with parents and red book
Mil temp, discomfort and swelling is common
Describe growth monitoring
3 key parameters - weight, length and head circumference
Derived - weight for age, length for age, BMI, weight for length and rate of weight gain
What are some reference values to remember?
Birth - weight is 3.3kg and length 50cm, OFC is 35
4 months - weight is 6.6kg, length is 60
12 months - 10kg, length is 75 and OFC is 45
3 years - 15kg and 95 in length
What does centiles mean?
% divisions of the reference population sampled
50% - average 100 children, 50 above and 50 below
Describe failure to thrive/ weight faltering
Child is growing too slowly in form and usually in function at the expected rate for the age
Significantly low weight gain
What does failure to thrive mean?
Demand is more than supply for energy and nutrients
What are deficient intake causes of failure to thrive in early in life?
Maternal - poor lactation, incorrectly prepared feed, and unusual milk
Infant - prematurity, small for dates, oro-palatal abnormalities, neuro disease and genetic disorders
What are increased metabolic demand cause of failure to thrive?
Congenital lung disease, heart disease, liver disease, renal disease, infection, anaemia, CF, thyroid disease, Chron’s and malignancy
What are excessive nutrient loss causes of failure to thrive?
GORD, pyloric stenosis, gastroenteritis and malabsorption
What are non-medical causes of failure to thrive?
Poverty, dysfunctional family interactions, lack of parental support, lack of preparation, child neglect and emotional deprivation
