ICL 18.3: Life Transitions Flashcards
what are the 3 types of normal growth?
- neonatal growth
2. infant growth
what is normal neonatal growth?
- average birth weight of 7 lb 8 oz
- weight loss up to 10% that is then regained by 7-14 days of age
- 15-30 gram weight gain per day for the first month of life (0.5-1 oz)
- higher caloric requirement: 80-120 kcal/kg/day
- average birth length of 20 inches
why do babies lose a lot of weight in the first couple days of life?
a baby is born and if they’re breastfeeding, the mothers milk doesn’t come in right away –> all the baby is getting is colostrum which is thick and nutrient packed but not a lot of water so there’s water weight loss
also when babies are born, they’re a little water logged and they lose some of it in the first couple days
how can you increase a neonates caloric intake per day?
increase total volume that they’re eating
could be difficult for a small baby because they’re gonna feed till they’re full then stop
so really the only way you can do it is to increase the amount of calories in the milk by adding formula
what % body weight can a newborn be expected to lose in the first few days of life?
10%
how old is a neonate?
first 28 days of life is considered a neonate
what is the normal growth of an infant?
- double birth weight by 4 months
- triple their birth weight by 12 months
- grow 10 inches in the first year
a baby born at 3 kg birth weight should be about how much at one year of age?
9 kg
they should be triple their birth weight at 1 year
what is the normal growth of a kid?
- percentiles are important
- mark a growth chart at every visit
- monitor for inconsistencies and changes in growth; remember to remeasure first if you get a weird measurement!
by what age should a child born prematurely catch up to peers in terms of growth?
2 years
what are the primitive reflexes that are part of normal child development?
- moro
- babinski
- rooting
- suckling
- grasp
- galant
- stepping
these are only suspected to be here for a certain amount of time till mature neural reflexes are formed
what are the 5 monitored domains of development?
- language
- fine motor
- gross motor
- cognitive
- personal/social
what is the Moro reflex? when does it go away?
when a baby is startled, there arms go out to the side
you want it to be symmetric, so both arms go out
you elicit this by holding the baby and letting the head dip back so the baby gets scared and their arms will go out
it should be there till 4 months old; it goes away once babies can bring hands to midline on purpose
what is the babinski reflex?
you want to stoke the lateral foot and the toes will go up
if you stroke the middle of the foot the toes will curl down because that’s activating the grasp reflex
in adults the toes should curl down
what is the rooting reflex?
when you stroke the babies cheek or the side of their mouth, they’ll open their mouth and turn towards it
this is what’s helping them to find food!
what is the sucking reflex?
if you put a finger or bottle in their mouth they should immediately clamp down a suck
what is the grasp reflex?
they should automatically grab something that is placed in their hand or foot
what are the primitive reflexes that are part of normal child development?
- moro
- babinski
- rooting
- suckling
- grasp
- galant
- stepping
these are only expected to be here for a certain amount of time till mature neural reflexes are formed
what is the stepping reflex?
hold baby under their armpits and let their feet touch the table and they’ll lift it so that it looks like their trying to talk even though it’s just a reflex!
once they can actually put weight on their legs they shouldn’t have this reflex anymore
what is the stepping reflex?
hold baby under their armpits and let their feet touch the table and they’ll lift it so that it looks like their trying to talk even though it’s just a reflex!
once they can actually put weight on their legs they shouldn’t have this reflex anymore
which of the following is NOT a developmental domain that is monitored?
A. hearing
B. language
C. motor skills
D. personal and social skills
A. hearing
language, fine motor skills, gross motor skills, personal/social skills, cognitive are what we monitor
which of the following is NOT a developmental domain that is monitored?
A. hearing
B. language
C. motor skills
D. personal and social skills
A. hearing
language, fine motor skills, gross motor skills, personal/social skills, cognitive are what we monitor
when do you screen for developmental domain delays?
all domains should be screened at 9, 18 and 30 months
you need to have developmental surveillance and you need a skilled observer to do this
when do you screen for developmental domain delays?
all developmental domains should be screened at 9, 18 and 30 months by using the ASQ or PEDS tool
you need to have developmental surveillance and you need a skilled observer to do this
when do you screen for autism?
24 and 30 months
use the standardized tool of the MCHAT-R
when do you screen for developmental domain delays?
all developmental domains should be screened at 9, 18 and 30 months by using the ASQ or PEDS tool
you need to have developmental surveillance and you need a skilled observer to do this aka you and also ask the caregivers!
when do you screen for developmental domain delays?
all developmental domains should be screened at 9, 18 and 30 months by using the ASQ or PEDS tool
we have set screening because up to 20% of developmental delays can be missed!
you need to have developmental surveillance and you need a skilled observer to do this aka you and also ask the caregivers!
when do you screen for developmental domain delays?
all developmental domains should be screened at 9, 18 and 30 months by using the ASQ or PEDS tool
we have set screening because up to 20% of developmental delays can be missed!
there is a quick questionnaire you give to parents and if they’re in the white zone, they’re good to go – if they’re in the grey zone give some suggestions for improvement – if they’re in the black zone then they need a full workup for whatever domain it is
you need to have developmental surveillance and you need a skilled observer to do this aka you and also ask the caregivers!
when do you screen for autism?
24 and 30 months
use the standardized tool of the MCHAT-R –> only accurate till 36 months
what is a developmental diagnostic assessment?
full test of all the developmental domains
can take up to 2.5 hrs
not done by normal pediatrician, go to a specialist
can also be used to monitor intervention success
what do you do when there is a speech delay?
hearing evaluation
what do you do when there is a motor delay?
PT/OT evaluation
what do you do when there is a cognitive delay?
developmental assessment
what do you do when there is a person/social delay?
developmental assessment
what is Help Me Grow?
early intervention program in Ohio
birth-3 years old
Head Start takes over at 3-5 years old then schools take over
what is global developmental delay?
delay in all 5 developmental domains
what is prematurity? how do you manage them?
gestational age vs. chronological age
they need early intervention regardless of development!
monitor with serial developmental assessments
NICU follow-up clinics for 2 years
which toxin exposures in utero lead to developmental delays?
- opiates
- fetal alcohol syndrome
- prescription drugs like antiepileptics
- lead
- lack of physical/emotional stimuli
T/F: if a child is born prematurely you should wait to start developmental assessments until 9 months
false
you should start them immediately! early intervention is key!!
which antiepileptic drug if taken during pregnancy is associated with neurodevelopment delay?
A. levetiracetam
B. carbamazepine
C. valproic acid
D. phenytoin
C. valproic acid
the others are teratogenic too but not specifically for neurodevelopmental delays
what are the developmental milestones between birth and 5 years old?
2 months: lifts head/chest when prone, eyes track past the midline, alerts to sound and smiles, recognizes parent
4 months: rolls front to back, grasps a rattle, laughs and is soothed by parents voice, orients head to direction of a voice
6 months: sits with little or no support, reaches with one hand and transfers objects, babbles and develops stranger anxiety, feeds self
9 months: pulls to stand, developing immature pincer grams and bangs two objects together, says mama/dada indiscriminately and waves bye, plays tester games like pattie cake
12 months: stands/walks alone, fine pincer grasp, one word and follows one step commands with a gesture, points to desired object
15 months: stoops and recovers, scribbles in imitation, uses 4-5 words, uses spoon and cup and turns pages in a book
18 months: runs well, builds a tower of 3 cubes, points to 1-3 body parts, helps in the house
if a child can sit unsupported, roll in both directions, bangs toys together and says baba, how old are they?
9 months
you’re seeing a 12 month old for her well baby check up. she can say 2 words, take a few steps unsupported, has a fine pincer grasp and has developed stranger anxiety, in which domain is there a developmental delay?
no delays! she’s doing great!
