Growth and Development Flashcards
Crossing _____ standard deviation(s) on a growth curve is concerning for a pedi pt
2 or more
What is considered abnormal growth for a pedi pt? Is that considered pathologic?
Outside 5th-95th percentile
Not necessarily pathologic, esp. if the pt is following their own growth curve
Times of well-child checks. (8) Which ones involve immunizations?
- 2 wo and/or 1mo
- 2, 4, 6mo (S)
- 9mo
- 12, 15mo (S)
- 18mo
- 2yo (S)
- Annually after 2yo
- 4 yo (S)
Objective measurements of physical growth in children
- Weight
- Height
- Frontal-occipital circumference (FOC) if <2yo
When should objective measurements of physical growth be measured?
At ALL office visits
If the objective measurement of physical growth is concerning, what is your next step?
Remeasure!
Expect up to ______ weight loss during first _____ of life
10%
3-4 days
Infants should regain birth weight by ______
14 days old
Best index of nutrition/growth in pedi pts?
Weight
FOC is a reliable indicator of brain growth up to _____
2yo
Most cranial sutures close by ____
6mo (but don’t ossify until early adulthood)
MA Lead Law requires all children to be tested for lead at ____, ____, ____.
9-12mo
2yo
3yo
Screen for iron deficiency at what age?
1,2,6,4,5,6yo
Pediatric development consists of what 4 parts?
- Gross motor skills
- Fine motor skills
- Language
- Social responses in interactive situations
3 screening missteps
- Ignoring screening results
- Relying on informal methods (e.g. checklists)
- Assuming services are limited or nonexistent
Development of gross and fine motor skills progress most rapidly during _______.
First 3 years, esp. during 1st year
At what age can a pt roll from back to stomach?
4-10mo
At what age can a pt sit steadily without external support?
6-9mo
At what age can a pt pull to standing?
7-12mo
At what age can a pt stand alone?
9-16mo
At what age can a pt walk pretty well?
13mo
At what age can a pt stoop and recover?
15mo
At what age can a pt kick ball forward?
2yo
At what age can a pt throw a ball overhand?
3yo
At what age can a pt balance on one foot for 2 sec and hop?
4yo
At what age can a pt catch a ball?
5yo
At what age can a pt rake?
5-7mo
At what age can a pt perform radial digital grasp b/w thumb and side of index finger (i.e. lobster claw)?
8-10mo
At what age can a pt perfect pincer grasp b/w fingertips and thumb of index finger?
10-12mo
At what age can a pt scribble?
15mo
At what age can a pt imitate vertical or circular strokes and build a tower of 6 cubes?
24mo
What screening test is used in newborns/infants to measure brain response to sounds?
Auditory Brainstem Response
What screening test is used in newborns/infants to assess cochlear function?
Otoacoustic emissions
Quick hearing assessment in 0-3mo
Does baby startle to loud noises?
Quick hearing assessment in 4-6mo
Does baby turn eyes/head to sound of parent’s voice
Quick hearing assessment in 7-9mo
Does baby make string of sounds like ‘ba ba ba, da da da’?
1 cause of speech delay
Hearing loss
When should you refer a child for professional speech/language assessment?
- No speech by age 2
- Unintelligable speech or no sentences by age 3
- Child is embarrassed by his/her speech at any age
- Other known disorder (e.g. hearing loss, mental retardation, autism, dysarthria, stuttering)
At what age is stuttering normal?
2.5-4yo
Assessment of vision for pedi pts include what 3 things?
- Red reflex
- Corneal light reflex (misalignment)
- Cover/uncover test (strabismus)
What vision milestone should full-term newborn be able to perform?
Focus on face and briefly track objects
What vision milestone occurs at 2mo?
- Tracks across midline
- Responsive smile
- Follows movement 6ft away
What vision milestone occurs at 4-5mo?
- Reaches for object 12in. away
- Notice raisin 1 foot away
- Familiar smile
Social skill milestone at 2mo
Social smile
Social skill milestone at 6mo
Reach for object
Social skill milestone at 9mo
- Feeds self
- Passes object hand to hand
Social skill milestone at 12mo
Plays appropriately with toy
Social skill milestone at 18mo
Drinks from cup
Social skill milestone at 2yo
Uses spoon
Social skill milestone at 4yo
Puts on T-shirt
Name 3 things that occur in early adolescence (age 10-13)
- Rapid physical change
- Concerned if different than peers
- Concrete thinking
Name 3 things that occur in middle adolescence (age 14-16)
- May be more comfortable with bodies (or not)
- Abstract thinking
- Sense of omnipotence (sex, drugs, rock n’ roll)
Name 2 things that occur in late adolescence (age 17+)
- Less self-centered
- Abstract thinking (realistic future plans)
3 leading causes of death in adolescents
- Unintentional (accidents)
- Suicide
- Homicide
50% involve drugs and/or alcohol
PA’s are mandatory reporters of ______, ______, and ______
- Self-imposed danger
- Danger to others
- Abuse (physical & sexual)
What is the mature minor rule?
Special law in MA instead of formal emancipation that allows minor to consent to tx (except abortion) if minor is believed to be able to and is in best interest not to notify parents
Can minors access family planning services?
Yes
Can minors seek treatment for STDs?
Yes
Can minors consent to substance abuse tx?
Yes (except methadone maintenance) if age 12+ and found drug-dependent by at least 2 doctors
Minors age _____ can consent to admission to mental health facility
16-17
