Growth & Development Flashcards
What are the major phases of childhood?
<4wks = Neonate <12months = Infant <2yrs = Toddler <5yrs = Pre-schooler Primary Schooler Adolescent
What are the 5 key developmental fields?
Gross Motor Fine Motor Speech & Language Social Self-care
How do you do milestones with premature kids?
Correct for how premature they are up to 2yrs of age then stop correcting
What are the red flags of developmental delay?
- No social smile by 2 months
- Not sitting unsupported by 9 months
- Not walking by 18 months
- No words by 2 yrs
What are the steps of the Child Health Programme Scotland?
1) New born exam and blood spot screening
2) 28 days = newborn hearing screening
3) 2 wks = HV visits
4) 6-8wks = Review
5) 27-30 months = Review
6) 4-5yrs = Orthoptist screening
Reviews cover measurments, feeding, domains of development, exam and any parental concerns
What would stop us doing normal immunisations?
Not an egg allergy
Not if premature (do it by chronological age)
Do delay if unwell
Avoid live vaccines if immunocompromised
SEs of vaccines?
Mild Temp
Discomfort
Swelling
What do we use to monitor growth?
Weight
Length then height (after 2yrs)
Head Circumference
Whats the average growth measurments at birth?
3.3Kg, 50cm long and 35cm head
Whats the average growth measurments at 12 months?
10Kg, 75cm and 45cm head
What skills would you expect from a 3 month old
Gross motor –> hold head up, roll belly to back and begin to creep
Fine Motor –> reaches for & picks up toys with 1 hand
Speech –> “coo”, LOL
Social/safe care –> Taking to mouth, social smile & recognising mum
Hearing/Vision –> should be following objects with eyes and turning to sounds.
What skills would you expect from a 6 month old
Gross motor –> Roll back to belly and Sitting (without support by 8-9months!)
Fine Motor –> transfers across midline
Language –> Simple 2 syllable babble!, responds to name!
Social –> Recognises people + Stranger Awareness! & plays with simple objects
Self-care –> Feeds self
What skills would you expect from a 9 month old?
Gross Motor –> Crawls, pulls to stand
Fine motor –> Grasps with Finger/thumb!
Speech –> responds to “No” and uses certain sounds for things. ~understand simple words
Social –> Plays social games e.g. peekaboo & look for toys that fall out of sight!
/self care –> Can pick up a spoon by handle
What skills might you expect from a 1yr old?
Gross Motor –> stand without support, walks without help by 18 months! may run
Fine Motor –> stacks blocks
Speech –> Uses simple words! and responds to simple requests
Social –> Shared attention/points at thing’s of interest!
self care –> Drinks alone from glass/feeds self with spoon!
What skills might you expect from a 18month old?
Gross motor = runs, kicks ball, walks stairs
Fine motor = scribbles with crayon
Social –> Pretend play
Self care = May remove simple clothes
Speech = uses atleast 10 words, starts to make sentences by 21-24months!
What skills might you expect from a 2yr old?
Speech = 30-50words and sentences
Social = Play’s with kids & “helps” with household tasks
Gross Motor = plays on slides/ladders etc
Self-Care = Opens door and eventually dresses self
What skills might you expect from a 3yr old?
Gross Motor = Ride a Tricycle
Fine Motor = Draws circles!
Speech = Asks why, when how questions
Social = Gives directions to other kids
self care - toilet trained
What are the key developmental milestones?
Social smiling
Sitting
Walking
Words
At what age would you expect social smiling?
2 months
At what age would you expect sitting?
Unsupported by 9 months
At what age would you expect a child to walk?
Take first steps by 1yr (avg)
Be up to running by 2
Refer at 18 months if not walking unsupported
At what age do you expect the first words?
Cries when wet/hungry = 1 month
Coos when comfy = 3 months
2 syllable babble = 6 months
Certain words for certain things = 9months
Simple words = 1yr
Words together & basic sentences = 2+yrs
Sentences & 50+ words = 3yrs
Define Failure to Thrive?
Growing too slowly in form or function for the expected level at their age
What could cause failure to thrive?
Deficient intake
Increased demand
Increased nutrient loss
Non-organic causes
What might cause deficient intake in a baby?
Maybe mum’s got a problem e.g. poor lactation or incorrectly preparing feeds
Maybe baby can’t feed e.g. cleft palate or cerebral palsy
What could cause increased demand in a baby?
Heart disease Infection IBD Malignancy Lung Disease
What could cause increased loss of nutrients?
GORD
Gastroenteritis
Coeliac
What non organic things could cause FTT?
Low socioeconomic status
Neglect
Emotional Deprivation
Lack of parental support or education
How would you approach FTT?
After history and exam trial feeding the baby in hospital where you can observe the feeding, mums handling etc
How would we follow up FTT if hospital trial showed good intake?
If the baby starts to gain weight then the problem was something non-organic happening at home that doesn’t happen in hospital
If baby still isn’t gaining weight despite feeding well then theres an organic pathology e.g. GORD, IBD, Heart disease, inf, coeliac etc
How would we follow up FTT if hospital trial showed poor intake?
Organic cause
Feeding Disorder
Non-organic that should be able to spot while observing feeding etc
What Antenatal Factors could -vely influence baby’s development?
Infections e.g. CMV, rubella or VZV
Toxins e.g. Alc, smoking or anti-epileptics
What postnatal things could -vely affect baby’s development?
Brain infections Toxins e.g. lead Trauma e.g. head Malnutrition --> Iron, folate, vit D deficiency Metabolic --> Glc or Na derangement Maltreatment Maternal mental health
Whats the most important skill by 3.5yrs?
Follows a series of 3 simple instructions in order
What’s the most important skill of 4.5years?
Draws a person with 3 parts e.g. arms, head, eyes ,nose etc
