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Spring 2021 Pediatric Primary Care > Intro to Peds: Growth and Development > Flashcards

Intro to Peds: Growth and Development Flashcards

1
Q

Objectives

A
  • Understand the concept of growth and development
  • Understand growth and development stages
  • Recognize abnormal vs. normal growth and development
  • Develop an understanding of causes for impaired growth and development
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2
Q

Growth

= The process of ____ maturation

  • Results in increase in size of ____
  • It is ______ changes in the body which are measured
  • It is part of the developmental process but does not ____ throughout life
  • It stops with physical _____
  • Growth may or may not bring ______
A

Physical maturation

  • Body
  • Quantitative
  • does not continue
  • Physical maturity
  • may or may not bring development
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3
Q

Development

= the process of f_____ and phys_____ maturation of the individual

  • It is a progressive increase in s_____ and capacity to f_____
  • Related to maturation and myelination of the _____ system
  • It is a ______ change
  • Development is possible _____ growth
  • Incorporates: C_____, L_____, S____/E_____, M______
A

functional and physiological maturation

  • skills, function
  • nervous system
  • qualitative
  • without growth is possible
  • Cognitive, Language, Social/Emotional, Motor
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4
Q

Principles of Growth and Development

  • Development is a ______ process from conception to maturity
  • The sequence of development is the ____ for all children
  • But the _____ of development varies from child to child
  • (2) Directions
  • G_____ to Sp_____
A
  • continuous
  • same sequence
  • rate differs
  • Cephalocaudal, Proximodistal
  • General to Specific
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5
Q

Cephalocaudal Direction

From ____ to _____

A

Head to Tail

This means that improvement in structure and function comes first in the head region, then in the truk and last in the leg region

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6
Q

Proximodistal Direction

From _____ to _____ direction

A

Center (Midline) to Periphery

Development proceeds from near to far - outward from central axis of the body toward the extremities

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7
Q

General to Specific

  • Start broad and go narrow
  • For example
    • Hold objects with ___ hands
    • Then ___ hand
    • Picks things up using r____ motion, then ____ grasp
    • Hold pencil with ___ then ___ grip
    • Draws ____, then ____, then __, then _____
A
  • Both
  • One
  • racking, pincer
  • fist, pencil
  • circle, square, X, letters
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8
Q

Developmental Age Periods

  1. Infancy
    • Neonate =
    • Infancy =
  2. Early Childhood
    • Toddler =
    • Preschool
  3. Middle Childhood
    • School age =
  4. Late Childhood
    • Early Adolescence
    • Middle Adolescence
    • Late Adolescence
A
  1. Infancy
    • Birth-1 month
    • 1 month to a year
  2. Early Childhood
    • 1-3
    • 3-6
  3. Middle Childhood
    • 6-11
  4. Late Childhood
    • 12-14
    • 15-17
    • 18-20
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9
Q

Attachment Theory

Explains how the parent and child relationship =

  • Infants are born biologically pre-programmed to form attachments with others for ______
A

Emerges and influences subsequent development (developed by john bowl)

  • survival
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10
Q

Stages of Attachment

  1. Pre-attachment: Birth to 6 weeks =
  2. Indiscriminate: 6 weeks to 7 months =
  3. Discriminate: 7+ months =
  4. Multiple: 10+ Months =
A
  1. Baby shows no particular attachment to specific caregiver
  2. Infant begins to show preference for primary and secondary caregivers
  3. Infant shows strong attachment to one specific caregiver
  4. Growing bonds with other caregivers
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11
Q

Piaget’s Stages of Development

  1. 0-2 yo The child begins to interact with the environment =
  2. 2-6/7 yo The begins to represent the world symbolically =
  3. 7-11/12 yo The child learns rules such as conservation =
  4. 12-Adulthood The adolescent can transcend the concrete situation and think about the future =
A
  1. Sensorimotor Stage
  2. Preoperational Stage
  3. Concrete Operational Stage
  4. Formal Operational Stage
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12
Q

Erickson’s Psychosocial Stages of Development

  1. Birth to 18 months =
  2. Early Childhood (2-3y) =
  3. Preschool (3-5y) =
  4. School Age (6-11y) =
  5. Adolescence (12-18y) =
  6. Young Adulthood (19-40y) =
  7. Middle Adulthood (40-65y) =
  8. Maturity (65-death) =
A
  1. Trust vs. Mistrust
  2. Autonomy vs. Shame and Doubt
  3. Initiative vs. Guild
  4. Industry vs. Inferiority
  5. Identity vs. Role Confusion
  6. Intimicy vs. Isolation
  7. Generativity vs. Stagnation
  8. Ego Integrity vs. Despair
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13
Q

Attachment Type

  1. Caregiver reacts quickly and positively to child’s needs, responsive to child’s needs
  2. Responds to child inconsistently
  3. Abusive or neglectful, responds in frightening, or frightened ways
  4. Unresponsive, uncaring, dismissive
A
  1. Secure
  2. Insecure ambivalent
  3. Insecure disorganized
  4. Insecure avoidant
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14
Q

**MOST IMPORTANT**

=

A

Caregivers suspicion that child is not seeing, hearing, moving limbs, or taking notice like other children of the same age is to be taken very seriously and investigate appropriately

Listen to caregivers/parents/guardians

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15
Q

Developmental Milestones

  • Social/Emotional
  • Motor fine/gross (vision)
  • Language-receptive/expressive (hearing)
  • Cognitive
  • Each category has a specific _____ of developmental stages
  • Understanding the pr______/pattern of development for each category is important in identifying _____ development
A
  • pattern
  • progression, abnormal
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16
Q

Gross Motor

= All muscle movement that does not involve (1)

  • _____ over, S____, W____, R____, Th____ overhand, St_____, Riding a _____
  • Gross motor starts from the ___ to ___ (cephalocaudal) bc this is how _____ of the nerves occurs
  • Lift ____-neck (2 mths)
  • ____ over using arms (front to back 4 mths)
  • ____ -using knees (9 mths)
  • ____-goal of first year of life
A

eye hand coordination

  • Roll over, Sitting, Walking, Running, Throwing, Stairs, bike
  • head to toe, myelination
  • head
  • roll
  • crawl
  • walk
17
Q

Gross Motor Pics

  1. Fetal Posture =
  2. Holds Chin up =
  3. Holds Chest up =
  4. Sits when supported =
  5. Sits alone =
  6. Stands holding furniture =
  7. Crawls =
  8. Walks if led =
  9. Stands alone =
  10. Walks alone =
A
  1. newborn
  2. 1m
  3. 2m
  4. 4m
  5. 7m
  6. 9m
  7. 10m
  8. 11m
  9. 11m
  10. 12m
18
Q

Key Gross Motor Development Milestones

  1. 3m = ___ holding
  2. 5m = ____ over
  3. 6m = ___ with own support
  4. 8m = Sitting ____ support
  5. 9m = ____ holding on (with support)
  6. 12m = Creep well, stand ____ support
  7. 15m = Walks alone, creeps _____
  8. 18m = ____
  9. 2 yr = Walks up and ___ stairs
  10. 3 yr = Rides _____
  11. 4 yr = ___ on one foot, _____ feet going downstairs
A
  1. neck
  2. rolls
  3. sits
  4. sits without support
  5. standing
  6. without
  7. upstairs
  8. runs
  9. up and downstairs
  10. tricycle
  11. hops, alternate
19
Q

Abnormal Gross Motor

  • Able to roll over before __ m (maybe due to ___ limbs)
  • Poor head ____ at 5mths
  • Unable to ___ at least tripod at at __ m (unassisted by 9 mths)
  • Unable to ____ 15-18m
  • Persistent ____ walking after age 3
  • Fixed _____ preference before the age of 18m (may indicate muscle ____ of the non-preferred hand)
A
  • 3, stiff
  • control
  • sit, 6m
  • walk
  • toe
  • hand, weakness
20
Q

Fine Motor

Movements of ___/___ _______

  • Fixating and f_____ an object, across midline
  • R_____ for an object
  • P____ up items - first with raking motion then with pincer grasp
  • Block s_______
  • Vision = able to _____ objects with their eyes
  • Then they will ____ for things around 3 mths
  • Around 4mths, they will pick things up and put them in their ____
  • At the same time they will t_____ from one hand to another
  • Will be able to ____ things with their hands to pick things up
  • Goal is to develop ____ graps by one year
A

eye/hand coordination

  • following
  • Reaching
  • Picking
  • Stacking
  • track
  • reach
  • mouth
  • transfer
  • rake
  • pincer

Take into consideration vision

21
Q

Key Fine Motor Developmental Milestones

  1. 4m = reaching out for objects with ____ hands
  2. 6m = reaching out for objects with ____ hand
  3. 9m = ______ pincer grasps
  4. 12m = Pincer grasp _____
  5. 15m = Imitates sc_____, tower of __ blocks
  6. 18m = Sc____, tower of __ blocks
  7. 2yr = Tower of __ blocks, v____ and c_____ stroke
  8. 3yr = Tower of __ blocks, copies c_____
  9. 4yr = Copies c____, br___ with blocks
  10. 5 yr = Copies t_____, g____ with blocks
A
  1. both
  2. one
  3. immature
  4. mature
  5. imitates scribbling, 2
  6. scribbles, 3
  7. 6, vertical and circular
  8. 9, circle
  9. cross, bridge
  10. triangle, gate
22
Q

Pencil Grip

As your child develops a better pencil grasp, the writing process becomes easier

Typical progression of preschool development of pencil grasp

  • 1-1.5yrs = ____ Grasp
  • 2-3 yrs = _____ Grasp
  • 3.5-4 yrs = _____ Grasp
  • 4.5-7 yrs = _____ Grasp
A
  • Cylindrical
  • Digital
  • Modified Tripod Grasp
  • Tripod Grasp
23
Q

Abnormal Fine Motor

  • Doesn’t _____ hands by 2 mths
  • Hands that are persistently ____ at 3 mths
  • Unable to ____ from hand to hand by 1 yr
  • Abnormal ____ grip or grasp by age 15 mths
  • At risk for motor delays children with
    • problems of tone, p____, c_____
    • j___ and ligament abnormalities
    • In_____ disabilities, multiple disabilities
    • Problems with ____ (gross motor skill)
    • V____ impairment (fine motor skill)
A
  • notice
  • fisted
  • transfer
  • pincer
  • At risk for motor delays
    • power, coordination (usually a problem with muscle tone)
    • joint
    • Intellectual
    • balance
    • visual
24
Q

Language

  • Expressive; word development speech (___ center of brain)
    • Delayed to ______ difficulty
  • Receptive: does the child understand what is being said (____)
    • Receptive deficits are ____ concerning - implies a ____ problem
  • Language
    • First we need to make sure they can ____
    • Responds to parent’s ____
    • C___’s Babbles
    • R____ sounds
    • Develops words
      • __-__ words by one year
      • 2 yrs - __ word sentences
      • 3 yrs - __ word sentences
A
  • Broca
    • mechanical
  • Wernicke
    • more concerning, cognitive
  • Language
    • hear
    • voice
    • Coo’s
    • Repeats
      • 1-2 words by 1 yr
      • 2
      • 3
25
Q

Language Development

  • 0-3 mths = _____
  • 4-6 mths = making sounds, r____, yelling, growling, ____ sounds, ooo, aaa, eee
  • 6-11 mths = b_____, babababa, dadada
  • 12-18 mths = first ____ with strings of nonsense, b, m, d, n
  • 18-24 mths, words develop, legible, put __ words together
  • 24-36 mths = ____ growth of language
A
  • cooing
  • raspberries, vowels
  • babbling
  • words
  • 2 words
  • rapid growth
26
Q

Language Development

  1. 1m = ____ to sound
  2. 3m = C____ (musical vowel sounds)
  3. 4m = L____ loud
  4. 6m = M___syllables (ba, da, pa) sound
  5. 9m = B__syllables (mama, baba, dada) sound
  6. 12m = _-_ words with meaning
  7. 18m = _-__ words vocab
  8. 2 yr = __-__ word sentences, uses pro____ “I”, “Me”, “you”
  9. 3 yr = Asks _____
  10. 4 yr = Says s___ or poem, tells st____
  11. 5 yr = Asks m____ of words
A
  1. Alerts
  2. Coos
  3. Laughs
  4. Monosyllables
  5. Bisyllables
  6. 1-2 words
  7. 8-10 words
  8. 2-3 word sentences, pronouns
  9. question
  10. songs, stories
  11. asks meaning
27
Q

Abnormal Language

  • Does not respond to ____ sounds
  • Does not ____at the sound of your voice by 2 mths
  • Absence of b____ at 6 mths
  • __legible words at 18-24 mths
  • L___ of words by 2 yrs
A
  • loud
  • smile
  • babbling
  • Illegible
  • Lack
  • May want hearing test: If not responding to large dog barks, no smile to familiar voice etc*
  • Lack of words by 2 -> speech value*
28
Q

Social

Social/Emotional - How does the child ____ with other people

  • _____ back when smiled to (social smile at 6 weeks of age)
  • Responds to parents ______
  • Makes eye ____
  • C___
  • Distinguishes parents from _____
  • P____

Abnormal Social Development

  • Does not engage in ____ situations
  • Plays a_____
  • F_____ on one object
  • Does not recognize social c____
  • Language is very c______ (no imagination)
A

interact

  • Smiles
  • voice
  • contact
  • coos
  • strangers
  • peekaboo
  • social
  • alone
  • fixates
  • cues
  • concrete
29
Q

Key Social and Adaptive Milestones

  1. 2m = Social S_____
  2. 3m = Recognizes ______
  3. 6m = Recognizes _____, stranger anxiety
  4. 9m = ____ “bye bye”
  5. 12m = Comes when _____, plays simple ball game
  6. 15m = J_____
  7. 18m = C____ parents in tasks
  8. 2yr = Asks for f___, drink, t____
  9. 3yr = Sh____ toys, knows full name and gender
  10. 4yr = Plays cooperatively in a ____, goes to toilet ____
  11. 5yr = Helps in _____ tasks, dr____, and undressing
A
  1. smile
  2. mother
  3. stranger
  4. waves
  5. called
  6. jargon
  7. copies parents tasks
  8. food, toilet
  9. shares
  10. group, alone
  11. household, dressing
30
Q

Premature Infants

  • Full term is considered __ weeks
  • Premature is any delivery prior to __ weeks
  • Chronological age =
  • Corrected age =
A
  • 40
  • 37
  • Age from date of delivery (birthdate)
  • Corrects for prematurity (adjusted age)
31
Q

How to Calculate Corrected Age

  • Chronological Age = weeks/mths, Premature = Corrected age
    • Example: 6mth old born 2.5mths early
    • What is the corrected age?
  • If a baby is born early, the _____ system has not developed or matured to the same degree as a baby born at term
  • You want to track development based on _____ age
A
  • 3.5 mths corrected age
  • neurological
  • corrected
32
Q

How Long is Corrected age used?

  • Catch up by __-__ yrs of age or
  • Multiply weeks of prematurity by x__
    • 6 wks premature x10 would be __wks or 15 mths
  • So by the age of 15 mth for an infant born 6 weeks early; he or she should be caught up developmentally to same age (non-premature) peers
A
  • 2-2.5 yrs
  • x10
    • 60wks
33
Q

Key Points

  • For premature infants, must factor in _____ age
  • Anytime a milestone is met and then lost is a reason for evaluation/_____
  • Listen to ______ when they say they are concerned
A
  • corrected
  • concern
  • parents
34
Q

**Tips for Remembering Milestones**

  1. Goal is to walk at __ mth
  2. Halfway there able to __ at 6mth

At 9mths you are crawling/cruising

  1. 2mths: lift ___ 45 degrees
  2. 4mths: ____ over (front to back first, then back to front, easier if you can push off with hands)
  3. 6mths: ___ (halfway to goal, halfway through year, “sit at six”)
  4. 9mths: c____, s____ (halfway between sitting and goal)
  5. 12mths: ____ (the goal)
  6. 15mths: walks ____
  7. 18mths: ____ object over hand
  8. 2yrs: up and down _____ (one foot at a time); run
  9. 3yrs: _____ (3 wheels, 3 yrs), jump in place
  10. 4yrs: up and down stairs ____ feet; balance on 1 foot for 4 seconds (legs look like a 4 when on 1 foot), hop
  11. 5yrs: ____ (5 looks like an “S”kips)
A
  1. 12
  2. sit at 6mth
  3. head
  4. rolls
  5. sit
  6. crawls, stands
  7. walk
  8. walks well
  9. throws
  10. stairs
  11. tricycle
  12. alternating, hop
  13. Skips

Spring 2021 Pediatric Primary Care (6 decks)

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