Growth and development

Question 1

what are the key developmental fields?

Answer 1

gross motor skills
fine motor skills
social and self-help
speech and language 
hearing and vision

Question 2

at what age should an infant sit without help?

Answer 2

6 months

Question 3

at what age should an infant be crawling?

Answer 3

9 months

Question 4

what is the average walking age?

Answer 4

12 months

Question 5

at what age should an infant be able to scribble with a crayon?

Answer 5

18 months

Question 6

at what age should a child start to scribble in circular motions?

Answer 6

2 years

Question 7

at what age would a child be able draw a complete circle?

Answer 7

3 years

Question 8

at what age should a child be able to hop on one foot?

Answer 8

3.5 years

Question 9

at what age is an infant able to pick up objects with pincer grasp?

Answer 9

9 months

Question 10

what are the red flag signs of developmental delay?

Answer 10

regression of developmental skills
concerns regarding vision
hearing loss
unable to walk by 18 months
unable to talk by 18 months
OFC >99.6th decile or <0.4% decile or inconsistence with parental OFC 
decreased tone/ floppiness 
increased tone / asymmetrical movements 
clinician unsure of thinks development distorted

Question 11

what factors influence development?

Answer 11

genetics
environment
positive childhood experiences 
neglect / abuse 
antenatal;
- infection i.e. rubella, CMV 
- toxins i.e. alcohol, smoking, anti-epileptics 
postnatal;
- infections i.e. toxoplasmosis
- toxins i.e. lead, mercury 
- trauma
- malabsorption i.e. folate, iron, vitamin D
- metabolic i.e. hypoglycaemia, hypo/hypernatraemia
- maternal health problems

Question 12

what is involved in the child health programme?

Answer 12

health promotion
immunisations
developmental screening

Question 13

what is failure to thrive?

Answer 13

supply is less than the demand of energy and/or nutrients

a description, not a diagnosis

Question 14

what parameters are used to monitor growth?

Answer 14

weight (g or kg)
length (cm) or height if > 2yrs
head circumference / OFC (cm)

Question 15

what is the average birth weight, length and OFC?

Answer 15

weight = 3.3kg
length = 50cm
OFC = 35cm

Question 16

what are some of the non-organic causes of failure to thrive?

Answer 16

deficient intake;
maternal:
- poor lactation
- unusual milk
- incorrectly prepared 
- inadequate care 

infant:

• prematurity
• small for dates

poverty 
lack of parental support 
dysfunctional family 
neglect 
emotional deprivation
poor feeding skills

Question 17

what are the organic causes of failure to thrive?

Answer 17

increase metabolic demand;

• anaemia
• congenital lung disease
• heart, kidney, liver disease
• cystic fibrosis
• thyroid disease

decrease absorption;

• malabsorption i.e. pancreatic insufficiency, coeliac, short bowel syndrome
• gastroeosophageal reflux
• pyloric stenosis
• gastroenteritis

Question 18

at what age should an infant double their birth weight by?

Answer 18

by 4 months they should have doubled their birth weight

Question 19

what is involved in the developmental screening in the child health programme?

Answer 19

new born exam and blood spot screening 
new born hearing screening (by day 28)
health visitor review
review at 6-8 weeks
review at 27-30 weeks 
ophthalmic vision screening at 4/5 years

Question 20

who is involved in the developmental assessment of a child?

Answer 20

health visitor
school teacher, nursery
parent and family
GP, nurse, paediatrician etc

Question 21

what would stop a child from getting their vaccinations?

Answer 21

if they were getting a live vaccine (such as MMR) and they were ill (immunocompromised)

Question 22

what vaccine are children still allowed to get if they are ill?

Answer 22

HIV

Question 23

what are the common side effects from vaccinations?

Answer 23

swelling
discomfort
mild temperature