Growth and Development Flashcards
What are the main childhood objectives?
Growth Develop/ achieve potential Optimal health Independence Safe Cared for Involved
What is development?
Gaining of functional skills throughout childhood.
Typically from birth to 5 years.
Cell growth, migration, connection, pruning and myelination occur.
Cognitive development begins.
What are the key developmental fields?
Gross motor - control go head, hold self up, walking etc.
Fine motor - grasping, holding objects, pincer, writing etc.
Social and self-help - feeding self, talking, facial expression etc.
Speech and language
Hearing and Vision
What are milestones?
Achievement of a key developmental skill for example smiling, walking, first words.
Refer if not achieved by limit age.
Correct for prematurity until 2years.
What are some factors that affect development?
Genetics
Environment
Positive early childhood experience
Developing brain is vulnerable to insults - antenatal, post natal, abuse and neglect.
What are some adverse environmental factors?
Antenatal - infections, toxins.
Postnatal - Infection, toxins, trauma, malnutrition, metabolic, maltreatment, maternal mental health issues.
Why do we assess development?
Reassurance/progress Early diagnosis and intervention Discuss positive stimulation/parenting strategies Provision of information Improving outcomes Genetic counselling Coexistent health issues
How is development assessed?
Child surveillance
Developmental screening/assessment
Parents/family are main assessors.
Health visitors, nursery, teachers, healthcare staff also play a role.
What are the red flags of development?
Loss of developmental skills
Parental/professional concern
Hearing loss
Persistent low muscle tone/floppiness
No speech by 18months
Asymmetry of movements/increased muscle tone.
Not walking by 18months/persistent toe walking
Occipitofrontal circumference disproportionate to parental.
Clinician uncertain
What are some features of Child Health Screening?
Based in Primary care
Main components - health promotion, developmental screening, immunisation.
Parental observations and concerns crucial
Record, advise and refer as appropriate.
What is in the child health programme?
New born exam and blood spot screening. New born hearing screening by 28 days Health visitor first visit 6-8week review 27-30month review Orthoptist vision screening at 4-5yrs
What conditions does the blood spot screening test for?
Phenlyketonuria PKU Congenital hypothyroidism CHT Cystic fibrosis CF Medium chain acyl-coA dehydrogenase deficiency MCADD Sickle Cell Disorder SCD Maple syrup urine disease Isovaleric academia (IVA) Glutaric acuduria type 1 GA1 Homocystinuria HCU
What is covered at the 6-8 week review?
Identifcation
Feeding - breast/bottle
Parental concerns about baby
Development - gross motor, hearing, communication, vision, social awareness.
Measurements - weight, OFC, length.
Examination - heart, hips, testes, genitalia, femoral pulses and eyes.
Sleeping position - supine, prone, side.
What is covered at the 27-30 month review?
Identification
Development - social behavioural, attention and emotion, communication, speech and language, gross and fine motor, vision and hearing.
Physical measurements - height and weight.
Diagnoses/other issues
What are some rules for immunisation in children?
Chronological age - do not correct prems.
No live vaccines in immunocompromised child e.g. MMR
Egg allergy is not a contraindication to MMR.
Postpone vaccines if unwell
