Growth Development and Health

Question 1

How old is:

1. a neonate
2. an infant
3. a toddler
4. pre-school age

Answer 1

1. Neonate = <4wks
2. Infant = <1yr
3. Toddler = 1-2yrs
4. Pre-school = 2-5yrs

Question 2

What are some of the general factors which can influence development?

Answer 2

Genetics
Environment
Positive early childhood experience

Question 3

List some antenatal adverse environment factors which can impact development.

Answer 3

Infections- Rubella, toxoplasmosis
Toxins- alcohol, smoking, anti-epileptics

Question 4

List some postnatal adverse environment factors which can impact development.

Answer 4

Infections- meningitis, encephalitis
Toxins- mercury, lead
Trauma
Malnutrition
Metabolic- hypoglycaemia, hper/hponatraemia
Maltreatment e.g. domestic violence

Question 5

Five key developmental fields?

Answer 5

Gross motor
Fine motor
Speech and language
Hearing and vision
Social and self help

Question 6

How are some of the basic ways development is assessed?

Answer 6

Looking at the child- what are they doing with their hands, how do they move their body around, how do they communicate?

Using play- bricks, crayons, tea sets, picture books

Question 7

At how many months if a child isn’t walking, should it cause some concern?

Answer 7

18 months

Question 8

List the developmental red flags.

Don’t get overwhelmed..

Answer 8

Loss of developmental skills
Parental/ professional concern re. vision (simultaneous referral to paediatric ophthalmology)
Hearing loss (simultaneous referral for audiology/ ENT)
Persistent low muscle tone/ floppiness
No speech by 18 months, esp if no other communication (simultaneous referral for urgent hearing test)
Asymmetry of movements/ increased muscle tone
Not walking by 18m/ Persistent toe walking
OFC > 99.6th / < 0.4th / crossed two centiles/ disproportionate to parental OFC
Clinician uncertain/ thinks that development may be disordered

Question 9

Which test is done at birth to screen for serious disorders?

Answer 9

Heel prick test

Question 10

When does a new-born hearing screening occur?

Answer 10

By Day 28

Question 11

When do babies get reviewed?

Answer 11

6-8wks
27-30 month

Question 12

What is done in 6-8wk review?

Answer 12

Feeding- breast/bottle
Parental concerns
Development- eyes following etc
Measurements- weight, length
Examination- head to toe, heart, hips, testes, genitalia, femoral pulses, eyes (red reflex)

Question 13

What is done in 27-30month check?

Answer 13

Development- social communication development
Height and weight
Any other health concerns

Question 14

Which type of vaccines are avoided if the child is immunocompromised?

Answer 14

Live vaccines

Question 15

How is growth measured in children?

Answer 15

Weight
Length or height (if >2y)
Head circumference

Question 16

What is meant by a centile/

Answer 16

% divisions of the reference population sampled

e.g.
50th centile- if you take 100 healthy children, 50 are above, 50 are below
0.4th centile- if you take the average 1000 healthy children, 4 are below this point, 996 are above

Question 17

What are some of the maternal causes of failure to thrive due to insufficient intake?

Answer 17

Poor lactation
Incorrectly prepared feeds
Inadequate care

Question 18

What are some of the infant causes for failure to thrive due to insufficient intake?

Answer 18

Prematurity
Small for dates
Oro palatal abnormalities e.g. cleft plate
Neuromuscular disease
Genetic disorders

Question 19

What are some of the non-medical causes of failure to thrive?

Answer 19

Poverty/socio-economic status
Lack of parental support
Lack of education
Child neglect
Abuse