Lecture 7: Developmental Issues for Infants and Toddlers Flashcards
Prenatal issues: Fetal Alcohol Syndrome (FAS)
- related to heavy alcohol use in first trimester
- growth retardation - low birth weight
- CNS abnormality - primarily cognitive and behavioral issues
- craniofacial anomalie; short nose, thin upper lip,
Fetal alcohol effects (FES) or Alcohol related neurodevelopmental disorder (ARND)
- milder CNS (cognitive and behavioral) involvement
- related to mild alcohol use throught pregnancy or heavy alcohol use late in pregnancy
FAS and FES can result in problems with
impulse control and decision making
Newborns exposed to drugs in utero will go through:
withdrawl
Cocaine use linked to
- prematurity
- LBW
- placental abruption - anoxia for fetus – CNS damange
- Neurobehavioral abnormalities - irritability, behavior issues
Ciggarettes linked to
LBW & prematurity
Prescription drugs linked to
thalidomide (cancer med) –> malformation of limb buds in embryonic stage
Prenatal issues - maternal infection/intrauterine infections
STORCH - require blood test for infection
S (STORCH)
Syphilis - Bacterial
-several internal organs affected (liver, spleen); hearing loss
T (STORCH)
Toxoplasmosis (parasite) - hearing vision & cognitive impairments
R (STORCH)
Rubella (virus)
vision and hearing loss/defecits, cognitive deficits, heart defects
STRORCH (C)
Cytomegalovirus (virus)
- 5-15% of fetuses exposed will present with some involvement, can include vision and hearing deficits, microcephaly, cognitive and motor impairments
- people with CMV may pass the virus in body fluids; saliva, urine, blood, tears, semen and breast milk
H (STORCH)
Herpes (virus)
-can involve CNS - cognitive deficit, seizures
handwashing lowers risk of maternal infection by
50-85%
prenatal issues - Zika virus
- related to aedes mosquito
- outbreaks in central and south america, 2016
- may cause microcephaly in new born
- damange to eye strucutre, visual cortex
prenatal issues - HIV
- transmitted to fetus through placenta or during birthing process (breast milk after birth)
- (in US) HIV+ women taaking medication - decreased risk of passing virus to fetus/baby
- virus impacts CNS - developmental delay
health professionals need to use universal precautions for blood borne pathogens until
known if an active infection is being carried
Prenatal issues - maternal diabetes
- babies born large for gestational age
- increased risk of brachial plexus injuries during birthing process because of size
- also see some long term, mild motor delays
Prenatal issues - malnutriton
- LBW and risk for infant mortality
- improved social efforts to increase prenatal medical care
- social support/services available to women who are pregnant for food and vitamins
folic acid supplementation
- decreased risk for spina bifida
- must be taking before pregnancy and in early months of pregnancy
mean age for maternal age
26.6
decreased age for maternal age
15-19
increased maternal age
over 40
increased maternal age increases risk for
genetic disorders (downs syndrome)
Teen pregnancy
- high risk pregnancy
- increased risk for LBW infant
- teen pregnancy dropped 7%; less sexually active & better use of birth control
APGAR score measured between
1 and 5 minutes
APGAR score measures:
HR, respiration, muscle tone, reflex irritability, color
- score each item as 0, 1, 2
- max score = 10
Normative scores at 1 min
0-2 = 6% of babies 3-7 = 24% of babies 8-10 = 70% babies
Low scores (0-3) after 5 min risk for
infant death, risk for CNS complication
Prematurity =
< 37 weeks gestation; normala gestation 38-40 weeks
In US avg. birth weight =
7.5pounds (5.8-8.13)
LBW =
< 1 lb at birth
Small for gestational age (SGA)
Weight < 10th% for GA
Large for gestational age (LGA)
Weight > 90th% for GA
Newborn eats __X/day
8-14
Newborn cries ___X/day
16hours/day
-crying is method of communicating needs, estabilghing caregiving relationships with parents
Infants - Erikson’s stage of development: Basic trust
- positive caregiving (touch, feeding, change diapers, etc) - TRUST
- inconsistent caregiving (babies cry not always answered, baby left hundry or lack of cuddling/soothing touch) –> mistrust
Functional task of infant: form __
relationships
Infant learning
Piaget’s sensorimotor stage
refer to table
Play is the work of children
Solitary play - 1st year
symbolic play - 12-18 mons
How do babies communcate their needs
- body language
- physiologic signals
- vocalizations
Expressive communcation: cooing
vowel sounds, breathy, soft sounds
expressive communcation - babbling
combine consonants & vowels
expressive communcation - jargon
uses intonation pattern, but not recognizeable words
___ words by 12 months
1-3 words
Receptive communication - listens to conversations
- turn taking
- attnetion span
- understands names and familar objects
Sudden infant death syndrome (SIDS)
- modifiable and non-modifiable risk factors
- non-modifiable: gender, # of previous pregnancies, racial/ethnic background
- modifiable: positioning, maternal smoking, breastfeeding
Back to sleep campagin
- babies should be placed in supine for sleeping
- parent should incorporate “tummy time” into day
Toddler 2-3 Erikson’s stage of development
Autonomy versus Shame/Doubt
Autonomy - learn to be independent, begin to control other people
-Terrible “two’s”
-shame/doubt - fail at independence - begin to experience self-doubt
Learning - Piaget’s Sensorimtor stage
Object performance - looking for things in direction they saw it go; will actively search for things
- trial and error - bang pots and pans > make noise
- functional use of objects - utensils
Onlooker play
watch others, but not participate
Symbolic play - complex, cooperative
assume roles (dress up)
parallel play
like to play side by side with another child, but not together
Movement in toddlers
running, climbing, etc
-refine a variety of motor tasks
communication (expressive) toddlers
- uses word combination
- simple sentences (2 years)
- 300-350 (2 years) nouns, verbs, pronouns
- 900+ words by 3 years
Receptive communication toddlers
- understands several words (no, come, dog)
- looks at named object
- follow simple commands - 18mons (stop, no)
What is child abuse and neglect?
-physical or mental injury
-sexual abuse
-negligent treatment
-maltreatment
(any child under 18 years old)
Physical therapists are ____
mandatory reporters
physical neglect
inappropriate diet, not kept clean, diaper rush due to not changing diaper
medical neglect
does not follow medical or mental health recommendations
educational neglect
child does not aattend school
emotional neglect
leaves child unattneded, permit child alcohol/drugs
physical abuse
- most often seen in infants and young children
- infants - shaken baby syndrome
- may also see fractures, bruises, burns
- 80% or perpetrators are parents - consider they are “disciplining”
sexual abuse
cana include explotaitn, molestation (contact, inappropriate touchingm or penetration (vagnial, oral, or anal) - seen most often in 7-10 year olds, but can be seen infants
emotional abuse
difficult to discern
-Impairs self-esteem
ADA - americans with disability act
- parents of disabeled children are protected from discrimination in hiring
- protects right to health insurnace
- access to public transportation and public buildings
