Growth & Development Flashcards
What is the healthy child programme?
Universal preventive evidence-based programme that begins in pregnancy and continues through childhood of growth and developmental reviews, screening, immunisations, health promotion and parenting support i.e. red book of parent held child health record (PHCHR)
What do the babies skull fontanelles close?
Posterior: 2-3mths
Anterior: 18mths
When is a baby classed as premature?
Born at ~37 weeks of gestation
What is bonding?
Caregiver’s emotional relationship with baby - encourages attachment but is NOT the same as attachment
What are interactions?
Bi-directly to and fro of exchanges between baby and I
What is the root reflex?
Baby turns mouth towards stimulus until 4 months of age
What region of the brain matures almost completely post-natally?
Orbitofrontal region
What developmental milestone occurs by 4 months?
Posture and large movements: head control where neonates show minimal control of neck flexors and when pulled to sitting position head lags behind the arms/shoulder disappears and infant can support his/her head
What are the most important years of a babies life?
The first 2 years as the brain is most adaptable
What are experience-dependent mechanisms?
Unique experiences of each baby produce distinctive wiring of brain enabling child to adapt to specific features of environment that they inhabit - DEPENDENT on primary caregiver (dyad relationship) acting as an external psychological regulator
What are primitive reflexes?
Reflexes that appear and disappear (integrate) in a predictable sequence as infant matures indicating typical motor development reflecting many developing and neural factors such as underlying myelination of higher cortical pathways allowing for voluntary movement control
What usually happens to a babies weight after birth?
Lose weight and usually regain it by 2 weeks of age
What are the main domains that securely attached infants have optimal functioning in?
Emotional Social Behavioural adjustment School achievement Peer-related social status
What milestones should be met by 9 months?
- Posture and large movements: sit alone for 10-15 mins on floor, progresses on floor by rolling/squirming and attempts to crawl
- Fine motor: inferior pincer grip
- Jargon: babble and intonational sounds
- Social behaviour/play: clearly distinguishes strangers from familiars
What is the cephalocaudal and centrifugal principles?
General pattern of physical and functional development whereby:
- Cephalocaudal: developments follow head-to-toe progression
- Centrifugal: development follows proximal to distal direction
What is emotional regulation?
Process by which levels of +ve and -ve emotions are kept within bounds so they are registered as not overwhelming and parents must aid this - self-regulation provides foundation of ones ability to function in society w/o they will lose it easily
When observing the parent-infant interaction what 3 dimensions must you bare in mind?
- Engagement: over-intrusiveness OR unengagement (e.g. in post-natal depression)
- Predictability: consistency in meeting babies needs will make baby cry when in need but if not, they will not cry as much
- Genuineness: true/genuine OR false/deceptive affect where baby and mum are either in sync or not
What is crossing a centile line? When is this a worry?
When a baby crosses through a centile line on the centile chart - if a baby falls through/across 2, this is classed as failure to thrive and they must be referred
What is the asymmetrical tonic neck reflex?
When head is turned to one side, the ipsilateral arm/leg will extend whilst contralateral extremities are in flexion but baby should be able to overcome it and move out of this posture usually lasting 3/4 months
What fine motor developmental milestones should be met at 2 years of age?
Scribbles on his/her own Imitates vertical/circular strokes Turns over container to pour out contents Builds tower of 6 blocks or more Begins to sort by shapes and colours Begins make-believe play
What are developmental milestones?
Median ages at which children develop specific behaviours and abilities
What is the grasp reflex?
Palmer grasp reflex where baby grasps stimulus until 4-6 months for hands but 6-12 months for toes - gradually replaced by voluntary activity of reaching/grasping with hand
What is growth?
Dynamic process in which increasing cell size and number and various tissues result in a physical increase in size of body as a whole
What social and emotional developmental milestones should be met at 2 years of age?
Imitates behaviour of others esp. adults and older children
More aware of him/herself as separate from others
Demonstrates increasing independence
Begins to show defiant behaviour
What posture and large movement milestones should be met by 12 months?
Pulls to standing
Walks around furniture
May stand alone for a few moments or walk alone
When babies are experiencing prolonged and frequent episodes of unregulated stress, what can happen?
High levels of cortisol which disrupt developing brain by:
- Stops development of new neural connections and pathways
- Fewer cortisol receptors produced in hippocampus so it is less able to negatively feedback to hypothalamus so cortisol is constantly producing and stress system is always on so it is overactive
This makes the baby a high reactor to stress or in long-term underactive
What determines the quality of interactions?
Emotional tone
Rhythm
Matchedness
Interactive repair
What are receptive and expressive skills?
Receptive: ability to comprehend communication
Expressive skills: ability to produce communication
What are the 2 processes that occur to increase the weight of babies brain?
Myelination
Synaptogenesis (depends on experience-dependent mechanisms)
Why are babies born earlier than other species?
Brain is immature so babies are less independent as otherwise the head would be too big to navigate the birth canal so brain must grow a lot after birth with the help of parenting
What are the purposes of health and developmental reviews?
Assess growth/development
Detect abnormalities
Assess family strengths, needs and risks
Give mothers/fathers opportunity to discuss concerns and aspirations
What is Kohlberg’s moral development stages?
- Preconvention level where judgements are based on self-interest occurring in primary/junior school through obedience/punishment, individualism, instrumentalism and exchange
- Conventional where judgements based on traditional family values and social expectations occurring in adolescence through gaining approval and law/order
- Post-conventional level where judgements are based on more abstract and personal ethical principles occurring sometimes not even in adulthood through social contract and principled conscience
What is the national child measurement programme (NCMP)?
Nationally mandated public health programme that provides data for child excess weight indicators in Public Health Outcomes Framework as part of the governments approach to tackling child obesity - height and weight taken in school at 4-5 years now
What is the moro reflex?
Reflex initiated due to sudden loss of support where baby spreads arms out (abduction), pulling arms in (adduction) and crying usually lasting up to 4/5 months
What is Piaget’s stage model of cognitive development?
- Sensorimotor (birth-2yrs): `knowledge limited to sensory perceptions and motor activities - ‘object permanence’ achievement made when infant knows as object exists when it is hidden e.g. of mental representation/schema of object
- Pre-operational (2-7yrs): child learns language and thinks symbolically
- Concrete operational (7-11yrs): better understanding of mental operations, thinks logically about concrete events and begin to conserve number, mass and weight
- Formal operational (12yrs-adult): develop ability to think about abstract concepts e.g. logical though, deductive reasoning and systematic planning
What are the trunk control milestones?
- Sit with assistance at 6 months
2. Sit unaided at 9 months
When must growth charts be adjusted?
Prematurity
Down’s syndrome and other common conditions
What are the 4 physical parameters of growth?
Weight
Length (0-2yrs) and then height (2yrs+)
Head circumference = occipito-frontal circumference (OFC)
When developmental delay is identified, what must be done?
3 domains must be included alongside physical exam to obtain a developmental history:
- Perinatal
- Family
- Environment
What gross motor developmental milestones should be met at 2 years of age?
Walks alone
Climbs onto/down from furniture unassisted
Walks up/down stairs holding on to support
Begins to run
Walks into large ball when trying to kick it
Squats with complete steadiness
Throws a small ball overhead
Stands on tiptoe
What are the 2 types of failure to thrive?
- Organic: bodily causes e.g. pyloric stenosis
2. Non-organic: neglect where mum is not feeding baby as much as they should be
List 5 diseases infants are immunised against.
Mumps Measles Rubella Haemophilis influenza B Hepatitis B Meningitis B Rotavirus
What is the outdated developmental domains that are not used anymore but are essentially the same as ages and stages questionnaire?
Sheriden: birth to five years
What self-regulation issues exist?
Externalising: small stimulus and will lose it (often little boys)
Internalising: quiet behaviour where they get quite lost
What is the body proportion of a baby at birth?
Head is disproportionately large comprising 1/4th of body’s total length compared to 6% in an adult
What is the Lewis and Brooks-Gunn Rouge Test?
Self awareness/sense of self where if a dot is placed on the babies head or nose they will recognise themselves in the mirror at 18 months of age
When are mirror neurons activated?
When one person sees another doing a specific action
What are standard centile charts?
Shows where baby is compared with others over time in terms of growth parameters and includes 9 (0.4th, 2nd, 9th, 25th, 50th, 75th, 91st, 98th and 99.6th) - different for boys and girls
How is height measured in a child?
Shoeless with heels and back touching the wall standing against a stadiometer
How should language develop?
2-3mths: coo or musical sounds
6mths: babbling (consonant sounds with vowel sounds e.g. “da-da”)
9-12mths: jargon e.g. babble and intonational sounds
What is a centile space?
Distance between each centile line
What is Ericsson’s model of psychosocial development?
- Trust vs Mistrust (birth-1yr): dependant on quality of caregiver to meet needs and as a result feeling safe and secure or if not mistrust
- Autonomy vs Shame/Doubt (early childhood): greater sense of personal control is gained and parents must let children do this to develop autonomy, security and confidence or if not shame/doubt
- Initiative vs Guilty (pre-school): children who begin to assert power/control through play and socialising feel capable and able to lead others or if not guilt
- Industry vs Inferiority (5-11yrs): children encouraged and commended by parents and teachers feel competent and belief or if not doubt
- Identity vs Confusion (teens): proper encouragement and reinforcement through personal exploration will give a strong sense of self, independence and control but if not confusion
- Intimacy vs Isolation (early adulthood): enduring and secure personal relationships formed if successful or if not isolation
- Generatively vs Stagnation
- Integrity vs Despair
What are the gross motor milestones?
- Prone-to-supine (front to back) rolling over by 3-4 months
- Supine-to-prone (back to front) rolling over by 5-6 months
What speech and language developmental milestones should be met at 2 years of age?
50 plus words and telegraphic speech appears (2-word sentences) and now asks what?
What are the fine motor developmental milestones (ONLY LEARN KEY ONES)?
- Reflex hand grasp disappears at 1 month and turns into voluntary grasp
- At 2-3months baby can bring both hands to midline and hold an object in either hand if placed
- At 4-5 months, use hand like a rake and palmar grasp
- At 5-7 months baby can use hands independently to transfer objects across midline
- At 9 months, inferior pincer grasp
- At 18 months, tower of 2
- At 24 months, tower of 6
- At 38 months, bridge
- At 15 months scribbles spontaneously/imitates
- At 24 months imitates vertical or circular strokes
- At 36 months, copies circle
- At 48 months copies cross
What are experience-expectant mechanisms?
Brain growth takes place when brain is primed to receive particular classes of external information in order to build basic skills in the most flexible way e.g. visual cortex expects to be exposed to light and patterned visual info needing this for normal development
What is attachment?
Bio-behavioural mechanism activated by anxiety, in which the primary goal is to reduce this stress and to restore feelings of security referring to babys emotional bond with caregiver - promotes infants safety/survival but has a key role in dyadic regulation of effect where the parent and baby jointly regulate infant’s stress and emotions promoting optional functioning across all developmental domains
What are the different age categories in childhood?
Baby: 0-1yrs Infant: 0-2yrs Childhood: 2-10yrs Early adolescence: 11-13yrs Middle adolescence: 14-17yrs Late adolescence: 18-21yrs
When does the infant experience the first true emotional psycho-physiological reaction based on subjective experience?
3 months - beginning of turn taking and shared positive affect between dyad
How is body length measured in a baby?
Baby placed in recumbent position and measured from crown to heel
What are the 4 categories of attachment?
A. Insecure/avoidant (A): minimal expression of emotions due to parents not readily comforting them when they need
B. Secure: protective and positive where infant is happy and explorative as needs are being met efficiently and consistently
C. Insecure-resistant/ambivalent: attention-seeking, low distress threshold and confidence because not sure if needs will be met at right time
D. Disorganised: depressed, angry and non-responsive as infant cannot be soothed by caregiver as they have too many emotional issues of own so attachment system remains in overdrive
What is the developmental sequence of complex gross motor patterns?
Improving balanced and coordination: Walking Running Jumping on 2 feet Hopping Skipping
