Growth & Development Flashcards
1
Q
When does average newborn regain birthweight?
A
3rd week
2
Q
When does birthweight double?
A
5 months
Triples - 1 yr
3
Q
When does birthweight triple?
A
1 year
Doubles - 5 mo
4
Q
Infant younger than 3 weeks who hasn’t regained birthweight…
A
Reassure and re-evaluate in 1 week
5
Q
Average infant height (50%)?
A
50cm
6
Q
Birth length 50% increase from birth, age…?
A
1 yr
Doubled - 4 yr
Tripled - 13 yr
7
Q
Birth length is doubled by…?
A
4 yr
50% - 1 yr
Tripled - 13 yr
8
Q
Birth length is tripled by…?
A
13 yr
50% - 1 yr
Doubled - 4 yr
9
Q
Growth rate first year of life?
A
20 cm/year
10
Q
Birth size reflection of?
A
Maternal factors and in utero conditions (vs. genetic growth potential)
Infant can cross percentiles in 1st 12-18 months as genetic, hormonal, and environmental factors overcome maternal ones
11
Q
When are you half your adult height?
A
2 yr
12
Q
When do you worry about abnormality of growth?
A
Shifts across 2+ percentile lines on growth curve after 2
13
Q
What has significant effect on linear growth velocity?
A
Chronic diseases
14
Q
Normal head circumference at birth for full term newborn?
A
35cm
15
Q
Normal head growth for first 6 months?
A
~1 cm/month
16
Q
Normal head growth from 6-12 months?
A
~1/2 cm/month
17
Q
Head circumference above 98 percentile for age?
A
Macrocephaly
18
Q
Infant with increasing head circumference, but normal development… Next step?
A
Measure parents’ heads - Normal familial macrocephaly
19
Q
Is hydrocephaly present at birth?
A
Can be, doesn’t have to be
20
Q
Signs of hydrocephaly (6)
A
- Irritability
- lethargy
- poor appetite
- PERSISTENT vomiting
- bulging fontanelle
- neurological findings in infant with rapidly enlarging head (upward gaze)
21
Q
Normal development, no signs increased ICP, parents with big heads
A
Macrocephaly
22
Q
Irritability, vomiting, bulging fontanelle, impaired upward gaze
A
Hydrocephaly
- Irritability
- lethargy
- poor appetite
- PERSISTENT vomiting
- bulging fontanelle
- neurological findings in infant with rapidly enlarging head (upward gaze)
23
Q
Which is scary… Large anterior fontanelle v. Bulging fontanelle?
A
Bulging… associated with increased ICP
24
Q
Is a bulging fontanelle associated with papilledema?
A
No (bulging fontanelle is chronic, not acute like papilledema)
25
Weight drop first, then decreased length, spares head circumference. Cause?
Inadequate calorie intake
26
Short stature with normal or elevated weight. Disorder type?
Endocrine disorders
27
Microcephaly + Dysmorphic features
Chromosomal abnormalities
28
Weight and height decrease together. Disease type?
Chronic medical conditions
29
Head circumference below 5th percentile for age
Microcephaly
30
Acquired Microcephaly
Head circumference, weight and height changes?
Occurs in infants who had normal head circumference at birth
If **head circumference decreases** while **weight and height stay the same**, has to be a cause
31
A physical sign that a child is receiving inadequate nutrition for optimal growth and development.
**_Failure to thrive (FTT)_**
* Lack of appropriate weight gain.
* Irritability.
* Easily fatigued.
* Excessive sleepiness.
* Lack of age-appropriate social response (i.e., smile)
* Does not make vocal sounds.
* Delayed motor development.
* Learning and behavior difficulties later in childhood.
32
Weight below 5th percentile for age
FTT
33
Weight that drops 2 major percentile channels
FTT
34
Weight less than 80% of ideal weight for age
FTT
35
Weight below 5th percentile on the weight-for-length curve
FTT
36
Which kids have specific growth charts? (3)
Down, Turner, William's
Don't call growth abnormal unless comparing to the specific chart
37
When is it normal for kids to change % up to 2 channels up or down? (age range)
Between birth and 2
38
Consideration in FTT...?
New caretaker, improper mixing of formula
39
First thing to check with FTT?
**Evaluate diet** first
Then look at mother/child interaction (feeding technique). Most cases from _non-organic causes_.
Labs/tests are not first step!
40
4 categories of organic causes of FTT?
1. Chronic renal failure
2. Thyroid and other metabolic disorders
3. Disorders leading to inadequate absorption
4. Disorders leading to inadequate utilization
\*Something in history will suggest these causative factors
41
Throw ball while standing?
18 months
42
Throw overhand?
24 months
43
When can you stop factoring in prematurity for milestones?
2 years
44
28 week GA infant, now 16 months old... Corrected age?
13 months Corrected Age
Current Chronological Age – (40 weeks – Gestational Age at birth) = Corrected Age
* Example: 16-month old toddler who was born at 28 weeks gestation.
* 16 months Chronological Age – (40 weeks - 28 weeks Gestational Age at birth) = Corrected Age
* 16 months – 3 months = 13 months Corrected Age
45
Can follow mom around room through 180 degree arc (eye follow object to midline). Age?
2 months (2 Sides)
46
Lift head and chest while prone. Age?
2 months (#2 rolling up)
47
Coo. Age?
2 months (two rhymes with coo)
48
Scratches/grabs clothes. Age?
4 months
49
Clutch/hold rattle. Age?
4 months (Looks like rattle)
50
Put objects deliberately in mouth. Age?
4 months
51
Sit up. Age?
6 months
“Six up”
52
Transfer cube from one hand to other. Age?
6 months
53
Crawl on bellies. Age?
6 months
54
Walk with hand held. Age?
12 months (1 year old can walk with one hand held)
55
Point. Age?
12 months ("Need 1 finger 2 point")
56
Say one word besides mama and dada. Age?
12 months
57
Walks fast, falls occasionally, walks upstairs with hand held, climbs into and sits in chair. Age?
18 months
58
Feed themselves. Age?
18 months
59
How many cubes at 18 months?
2-3
60
How many cubes at 24 months?
4-6
61
How many cubes at 36 months?
8
62
6-cube tower. Age?
2 years
63
Walk up stairs with alternating feet. Age?
3 years
64
Ride a tricycle. Age?
3 years (3 wheels for 3 years)
65
Hop 3 times. Age?
3 years
66
Identify opposites. Age?
4 years
67
Draw 4 body parts. Age?
4 years
68
Rule of 4's (6 items) - Age 4
1. **Count** to 4
2. Recite a 4-word **sentence**
3. Identify 4 primary **colors**
4. Draw a 4-part **rectangle/cross**
5. Build a **gate** out of blocks (4 looks like a gate)
6. Strangers **understand 4/4** of what they say
69
Tie a knot. Age?
5 years
70
Correctly grab a pencil. Age?
5 years
71
Print letters. Age?
5 years
72
Draw a square. Age?
5 years
73
Walk backward heel-to-toe. Age?
5 years (avoids school by walking backwards)
74
Draw circle. Age?
3 years
75
Draw cross. Age?
4 years
76
Draw square. Age?
5 years
77
Draw triangle. Age?
6 years
78
Draw diamond. Age?
7 years
79
Worry with lack of visual attention/fixation. Age?
2 months
80
Worry with lack of visual tracking. Age?
4 months
81
Worry with lack of steady head control while sitting. Age?
4 months
82
Worry with failure to turn to sound or voice. Age?
6 months
83
Worry with lack of smile or joyful expressions. Age?
6 months
84
Worry with inability to sit. Age?
9 months
85
Worry with lack of reciprocal vocalizations, smiles, or other facial expressions. Age?
9 months
86
Worry with failure to respond to name when called. Age?
12 months
87
Worry with absence of babbling. Age?
12 months
88
Worry with inability to walk independently. Age?
18 months
89
Worry with lack of simple pretend play. Age?
18 months
90
Worry with lack of language/gestures. Age?
18 months
91
Worry with lack of 2-word meaningful phrases. Age?
24 months
92
Worry with loss of previously acquired speech or social skills. Age?
Any age
93
50% intelligible speech. Age?
2 years
94
75% intelligible speech. Age?
3 years
95
100% intelligible speech. Age?
4 years
96
Stuttering can be normal until what age?
Mx?
3 or 4 years (often disappears once vocab increases)
-Normal/reassure
97
When do you refer for stuttering? (4)
1. Persistence beyond preschool age
2. Persists for more than 6-8 weeks
3. Marked parental concern
4. Associated symptoms like facial tics
98
Can serious language delays be explained by bilingual home, second child with siblings, or parents speaking for child?
No
99
First thing to do with language delay?
Hearing test
100
History of TORCH infection, hyperbilirubinemia, or meningitis + language delay. Mx?
Hearing evaluation
101
What impacts language and emotional development as well as ability to read?
Chronic hearing loss (including loss due to chronic otitis media)
102
Hearing loss that starts after what age has less of an impact than if it occurs before?
5 years
103
Most important intervention for language development in infant with congenital hearing loss?
**Family involvement** (including non-verbal communication)
\*Family use of verbal and nonverbal communication has been shown to have the most positive impact on language acquisition in children with hearing loss
\*This is more important than specific formal interventions
104
Goal of early intervention with developmental delay?
Provide services to aid in developmental progress (speech therapy, occupational therapy, physical therapy)
105
What outlines guidelines for education of children in U.S. who have developmental delays or other problems that may interfere with learning?
Individuals with disabilities education act (IDEA)
106
Part C of IDEA covers what?
Early intervention services for kids under 3
\*Goal is for kids to reach developmental potential and improve cognitive outcome
\*Programs must be family based and culturally relevant
107
Does Feingold diet show benefit in managing ADHD or learning disabilities?
No
**Feingold diet**: eliminates artificial food colors, flavorings, sweeteners, preservatives, and some salicylates intended to reduce or eliminate ADHD symptoms in certain children.
108
Is restricting sugar beneficial for managing/treating ADHD or behavioral disorders?
No, but don't use sugar/candy as reward for good behavior
109
Mega vitamin therapy increases incidence of what?
Increases disruptive behavior (no role with managing learning disabilities or behavioral problems)
110
Solutions for autism and other developmental disorders that have not been proven to be effective? (4)
1. Sensory integration therapy
2. eye exercises
3. chelation therapy
4. hyperbaric O2 chambers
111
Systematic monitoring "structured surveillance" of a child's development using standardized screening tools has been proven to identify delays in children much more often than physician questioning and observation alone "unstructured surveillance"
Yup
112
When do you use universal post-partum mood disorder screening?
First year after birth
113
When do you do general structured developmental screening? (4)
9, 18, and 24 or 30 months
114
When do you do autism specific screening? (2)
18 and 24 months
115
When do you do social emotional screening?
Whenever a screening instrument is abnormal
116
Average newborn loses up to what % of birthweight?
10%
117
What has been proven to identify delays in children much more often than physician questioning and observation alone?
Systematic monitoring: "Structured surveillance"
118
When do you do kindergarten readiness screening?
4 years
119
What should be done at every health supervision visit from ages 5-18?
Social-emotional/mental health/psychosocial function screening
120
What do you do at every health supervision visit throughout adolescence?
Substance abuse-specific screening
121
Name 2 general developmental screens
1. Ages and stages questionnaire (ASQ)
2. Parents' evaluation of developmental status (PEDS)
122
Name a specialized developmental screen
Modified checklist for autism in toddlers (MCHAT)
123
Name 3 mental health/behavior screens
1. Pediatric symptoms checklist (PSC)
2. Connors 3
3. Vanderbilt scales
124
3 ways development can go astray?
1. Delay in development
2. Deviation in order of skills acquisition or an atypical pattern of development
3. Dissociation where different areas of development advance at different rates
-**3Ds of developmental deviation**
