Growth Devt Flashcards
Holds Head steady while sitting
Two months
Developmental implications : I know some more Visual interaction
Pulls to sit with no head lag
3 months
: for muscle tone
Brings hands together in midline
3’months
Self discovery of hands
Asymmetric tonic reflex Gone
4 months
Can inspect hands in midline
Sita without support
6 mos
Increasing exploration
Rolls back to stomach
6.5 months
Truncal flexion risk of falls
Walks alone
12 months
Exploration control of proximity to parents
Runs
16 months
Supervision more difficult
Grasps rattle
Fine motor 3.5 months old
Object used
Reaches for objects
Find motor
Four months
Visual motor coordination
Palmar grasp gone
4 months
Voluntary release
Fine motor
Transverse object hand to hand
5.5 months
Fine motor comparison of objects
Thumb finger grasp
Fine Motor
Eight months
Able to explore small objects
Turns pages in book
Fine motor
12 months
Increasing autonomy during book time
Scribbles
Fine motor
13 months
Visual motor coordination
Build tower of two cubes
15 months
Fine motor
Uses objects in coordination
Builds tower of six cubes
22 months
Fine motor
Requires visual, gross, and fine motor coordination
Communication and language
Smiles in response to face or voice
1.5 months
More active social participant
Communication and language
Monosyllabic Babble
Six months
Experimentation with sound tactile sense
Inhibits to “no”
Communication and language
7 months
Nonverbal response to tone
Communication and language
Follows one – step command with gesture
7
Nonverbal communication
Communication and language
Says mama or dada
10 months
expressive language
Communication and language
Points to objects
10 months
Interactive communication
Communication and language
Speaks first real word
12 months
Beginning of labeling
Follows one step commands without gesture
10 months
Verbal receptive language
Speaks 4 to 6 words
15 months
Acquisition of object and personal names
Speaks 10 to 15 words
18 months
Speaks two word sentences like “ Mommy shoe”
19 months
Beginning grammatization
corresponds with 50 – word vocabulary
Tip: mommy nike (sounds like 19) shoe
Cognitive
Stares momentarily at spot where object disappeared
Two months
Lack of object permanence
Cognitive
Stares at own hand
4 months
Self discovery cause-and-effect
Bangs two cubes
8 months
Active comparison of objects
Uncovers toy after seeing it hidden
8 months
Object permanence
Egocentric symbolic play ( pretends drinking from cup)
12 months
Beginning symbolic thought
Uses stick to reach toy
17 months
Able to link actions to solve problems
Pretend to play with Doll
(E.g. Gives doll bottle)
17 months
Symbolic thought
Patterns of behavior
Prone: Lies in flexed attitude: turns head from side to side : head sags on ventral suspension
Neonatal period or first four weeks
Patterns of behavior
Supine: generally flex and a little stiff
Neonatal period / 1st 4 weeks
Patterns of behavior
VIsual: May fixate face on light in line of vision; doll’s eye movement on turning of the body
Reflex: Moro’s reflex active; Stepping and placing reflexes; grasp reflex active
Neonatal period / 1st 4 weeks
Patterns of behavior
Prone: legs more extended, holds chin up, turns head; Head lifted momentarily to plane of body and ventral suspension
1 month
Patterns of behavior
Supine: Tonic neck posture predominates; Supple and relaxed; Head lags when pulled to sitting position
1 month old
Patterns of behavior
Visual: Watches person, follows moving object
1 month
Patterns of behavior
Social: Body movements in cadence with voice of other in social contact; beginning to smile
1 month
Patterns of behavior
Prone: Raise his head slightly farther, Head sustained on body in ventral suspension
2 months
Patterns of behavior
Visual: follows Moving object at 180°
2 months
Patterns of behavior
Social: Smiles on social contact; listen to voice and coos
2 months
Patterns of behavior
Prone: Lifted head and chest with arms extended; Head ABOVE plane of body on Ventral suspension
3 months
Patterns of behavior
Supine: Tonic neck posture predominates; reaches toward and misses objects; waves at toy
3 months
Patterns of behavior
Sitting: Head lag partially compensated wwhen pulled to sitting position; early head control with Bobbing motion; back rounded
3 months
Patterns of behavior
Reflex: Typical Moro reflex has not persisted; Makes defensive movements or selective withdrawal reactions
3 months
Patterns of behavior
Social: sustained social contact, listens to music; says “aah, ngaah’
3 montths
Patterns of behavior
Prone: Lifts head and chest, with head in approximately vertical axis, legs extended
4 mon ths
Patterns of behavior
Supine: symmetric posture predominates, hands in midline, reaches objects and put to mouth
4 months
Patterns of behavior
Sitting: No head lag when pulled to sitting position: Head steady tipped forward enjoys sitting with full truncal support
4 months
Patterns of behavior
Standing: when held erect, pushes with feet
4 months
Patterns of behavior
Adaptive: sees raisin, but makes no move to reach for it
4 month
Patterns of behavior
Social: laughs out loud; may show displeasure if social contact is broken; excited at sight of food.
4 months
Patterns of behavior
Prone: Rolls over; pivots; Crawls or creep crawls
7months
Patterns of behavior
Supine: Lifts head; Rolls over; Squirms
7 months
Patterns of behavior
Sitting: Sits briefly with support of pelvis; leans forward on hands; back rounded
7 months
Patterns of behavior
Standing: May support most of the weight; Bounces actively
7 months
Patterns of behavior
Adaptive: reaches out for and grasps large object; transfers objects from hand to hand; radial palm /raking grasp
7 monts
Patterns of behavior
Language: Forms polysyllabic words
Social: Prefers mother: babbles, enjoys mirror, responds to changes in emotional content of social contact,
7 months
Patterns of behavior
Sitting: Sits up alone and indefinitely without support with back straight
10 months
Patterns of behavior
Standing: Pulls to standing position: Cruises or walks holding onto furniture
10 months
Patterns of behavior
Standing: pulls to standing position; cruises or walks holding onto furniture
10 months
Patterns of behavior
Motor: creeps or crawls
1o months
Patterns of behavior
Adaptive: GRasps objects with thumb and finger; pokes at things with forefinger, picks up pellet with assisted pincer movement. Uncovers hidden toy; attempts to retrieve dropped object, releases object grasped by other person
SOcial: responbds to sound of name, plays peek a boo or pat a cake, waves bye bye
Language: repetitive consonant sounds (“mama, dada”)
10 months
PAtterns of behavior
Motor: Walks with one hand held; Rises independently; Takes several steps
Adaptive: Picks up raisin with an assistant pincer movement of forefinger and thumb; Releases object to another person on request or gesture
Language: says a few words besides mama and dada
Social: play simple ballgame; makes postural adjustment to dressing
At 1 year
Age When patient achieve state regulation and regular sleep wake cycles
Weight is doubled
4 months
Total sleep requirements at 3 to 4 months old
Approximately 14 to 16 hours a day with about nine to 10 hour concentrated at night and 2 naps in day
Age when patient starts to socially “ hatching”: Babies become interested in the wider world
4 months
What are the primary emotions of an infant by four months old (6)
Anger
joy
interest
fear
disgust
surprise
By first year, Birth weight is _______
Length is_______
Heads circumference is_______
By first year, Birth weight is TRIPLED
Length isINCREASED BY 50%
Heads circumference INCREASED BY10CM/4INCHES
Average time duration babies cry with peak at six weeks old
Two hours per day
Definition of Colic: “ the rule of 3 “
Begins at second or third week of life
Lasts about 3hours per day
Occurs 3 days per week
Lasts for more than 3 weeks
Resolves in 3 to 4 months old
Treatment: reassurance
Some studies have found differences in fecal microflora between babies with excessive crying and controls. If the baby appears to have gastrointestinal symptoms, what we can advise to breast-feeding mothers?
Breastfeeding Mothers may try elimination of milk beans and cruciferous vegetables in their diet.
In allergic families, mother may try stricter elimination of food allergens like milk eggs we eat nuts soy and fish but the nutritional status should be monitored
How do you describe early walking?
Infants initially toddle with a wide base gait,
with the knees bent,
and the arms flex at the elbow.
The entire torso rotates with each stride
The toes may point out or and the feet strike on the floor flat
Patterns of behavior 1-5 years old
Motor: walks alone, crawls up stairs
Adaptive: makes tower of 3 cubes; makes a line with crayon, inserts raisin in a bottle
Language: jargon, follows simple commands, may name a familiar objectm responds to his/her name
Social: indicates some desires or needs by pointing. Hugs parents
15 months
Motor:Runs stiffly; sits on small chair; walks up stairs with 1 hand held; explores drawers and wastebaskets
18 months
Adaptive:Makes tower of 4 cubes; imitates scribbling; imitates vertical stroke; dumps raisin from bottle
18 months
Language:10 words (average); names pictures; identifies 1 or more parts of body
Social:Feeds self; seeks help when in trouble; may complain when wet or soiled; kisses parent with pucker
18 months
Motor:Runs well, walks up and down stairs, 1 step at a time; opens doors; climbs on furniture; jumps
24 months
Adaptive:Makes tower of 7 cubes (6 at 21 mo); scribbles in circular pattern; imitates horizontal stroke; folds paper once imitatively
24 months
Language:Puts 3 words together (subject, verb, object)
Social:Handles spoon well; often tells about immediate experiences; helps to undress; listens to stories when shown pictures
24 months
Motor:Goes up stairs alternating feet
Adaptive:Makes tower of 9 cubes; makes vertical and horizontal strokes, but generally will not join them to make cross; imitates circular stroke, forming closed figure
Language:Refers to self by pronoun “I”; knows full name
Social:Helps put things away; pretends in play
30 months
Motor:Rides tricycle; stands momentarily on 1 foot
Adaptive:Makes tower of 10 cubes; imitates construction of “bridge” of 3 cubes; copies circle; imitates cross
Language:Knows age and sex; counts 3 objects correctly; repeats 3 numbers or a sentence of 6 syllables; most of speech intelligible to strangers
Social:Plays simple games (in “parallel” with other children); helps in dressing (unbuttons clothing and puts on shoes); washes hands
36 months/ 3 years
Motor:Hops on 1 foot; throws ball overhand; uses scissors to cut out pictures; climbs well
48 months / 4 years
Adaptive:Copies bridge from model; imitates construction of “gate” of 5 cubes; copies cross and square; draws man with 2-4 parts besides head; identifies longer of 2 lines
48 months/4 years
Language:Counts 4 pennies accurately; tells story
48 months / 4 years
Social:Plays with several children, with beginning of social interaction and role-playing; goes to toilet alone
48 months/ 4 years
Motor: skips
60 months/ 5 years
Adaptive:Draws triangle from copy; names heavier of 2 weights
60 months/ 5 years
Language:Names 4 colors; repeats sentence of 10 syllables; counts 10 pennies correctly
60 months/ 5 years
Social:Dresses and undresses; asks questions about meaning of words; engages in domestic role-playing
60 months/ 5 years
Object permanence
Start of separation anxiety
Uses transitional object which functions as a symbol of the absent parent (ex. Security blanket)
Self conscious awareness
The very beginning of the foundation of conscience
Weakness on internalized inhibitions
12-24 months
Growth velocity from 12 to 24 months
10cm/year
Growth a velocity from 24 to 36 months
8cm/year
Growth velocity during childhood three years above
6cm/year
Slowly decelerates before pubertal onset
Height typically doesnt cross percentile lines
Growth velocity adolescence
Siigmoid shaped growth
Adolescent growth spurt
Accounts 15% of adult height
Girls 8cm/yr
Boys: 10cm/yr
Age where birthweight quadruples
2.5 years
All primary teeth have errupted
3 years
Sleeping hours of preschool children
11-13hrs/day
Visual acuity at three years old and four years old
3 years: 20/30
4 years:20/20
Establishment of handedness
3 years
AT what age children can use
Past tense?
Future tense?
Past: 4 years
Future: 5 years
Piaget’s stage of development wherein It is characterized by magical thinking, egocentrism,and thinking that is dominated by perception and not abstraction
There is dominance of perception over logic
Preoperational stage (pre school)
Gender identification
3 years
When do we need to consider tantrums as a concern
If tantrums lasted for more than 15 minutes and occurs more than three times a day
It may reflect underlying medical emotional developmental or social problems
Conscience
6 years
Start of replacement from temporary to permanent teeth
Six years old
Rate of replacement of adult teeth
Around 4 teeth per year
9 y/o: around 8 permanent incisors and 4 adult molars
Premolars erupt by 11-12 y/o
Piaget stage wherein Children increasingly apply rules based on observable phenomena, factor in multiple dimensions, and points of view and interpret their perceptions using physical laws
Concrete (logical) operations (school age children)
What are the five “R”s of early education?
- reading as a daily family activity’
- Rhyming playing and cuddling together
- Routines and regular times for meals play and sleep
- Rewards through praise for success
- Reciprocal nurturing relationships
It is defined as achievement of height velocity that is LESS than expected for a child’s age and sex or a DOWNWARD crossing of MORE THAN 2 percentile lines for height on the growth chart
Growth failure
Defined as growing either BELOW expected genetic potential Are growing below -2 SD For age and sex
Short stature
Give normal common causes of Decreased growth and short stature
Familiar short stature
Constitutional delay
Delayed puberty
Give nutrition and gastrointestinal condition that causes decreased growth in short stature
Malnutrition
Celiac disease
Inflammatory bowel disease
Genetic condition that causes decreased growth and short stature
Turner syndrome
Prader– Willi syndrome
22Q deletion syndrome
Trisomy 21
Skeletal dysplasias
Endocrine conditions psychosocial causes renal conditions and medication’s that are common causes of decreased growth and short stature
Endocrine: hypothyroidism, growth hormone deficiency, poorly controlled diabetes mellitus, Poorly controlled diabetes insipidus, metabolic bone disease like rickets and hypophosphatasia ,and glucocorticoid excess
Psychosocial causes
Medications: Glucocorticoids, inappropriate sex steroid exposure, antiepileptic medication’s
Common causes of increased growth and tall stature
Variation of normal:
Constitutional tall stature
Familial growth stature
Endocrine:
GH excess’
Precocious puberty
CAH
Obesity
Genetic
Marfan
Kleinfelter
Sotos
What x-ray is requested to check skeletal bone age
Left hand and wrist
What is the interpretation if the skeletal bone age is delayed compared to chronological age?
Suggestive of catch-up potential for linear growth
( may pag asa pa tumangkad)
What laboratory tests are useful in assessment of growth
Metabolic panel
CBC with PC
CRP
Erythrocyte sedimentation rate
TSH, thyroxine
Celiac panel
Insulin like growth factor (IGF-1 and IGF-BP3)
Xray of left hand and wrist
Karyotyping (for syndromes)
Gonadotropins (LH, FSH, Testosterone, estradiol)
Urinalysis (for renal fxn, RTA, etc)
When (age) it is considered delayed tooth eruption and what are the possible causes
Delayed tooth eruption if no tooth beyond 13 months
Possible causes: Congenital or genetic disorders
endocrine disorders like hypothyroidism hypoparathyroidism
Familial conditions
idiopathic conditions
