Milestones Flashcards

1
Q

Infant Milestones: Height

A

Height:
1”/month x 6 mo
50% increase by 12 mo
Growth spurts

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2
Q

Infant Milestones: Weight

A

Weight:
gains 5-7 oz/week x 6 mo
DOUBLES birthweight x 6 mo
TRIPLES birthweight x 12 mo

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3
Q

Infant Milestones: Feeding

A

Birth- 6 mo
-human milk #1 choice

4-6 mo: introduce solid good (1 food every 4-7 days)

6 mo: Fe+ supplements for breastfed babies since milk depleted

12 mo: NO COW MILK or free water until this time. Test for anemia

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4
Q

Infant Milestones: Teething

A

1st 2 years of life:
age of child in months- 6 = # of teeth

-wipe teeth and guma w/ cloth after feeding, take to dentist at 1 y.o.

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5
Q

Infant Milestones: ADL

A

Sleep: place on back to sleep

Play: solitary, so play w/ them
NO interactive play can cause developmental delay

Injury Prevention:
Aspiration is #1 risk

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6
Q

Infant Milestones: Reflexes

A

Reflexes:
diminishes 3-4 mo, disappears 4-6 mo
Normal is symmetrical

Disappears at 2 mo:
stepping, placing, Galant’s reflex

Disappears at 3 mo:
rooting, sucking

Disappears at 4-6 mo:
fencing, moro, palmer grasp

Disappears at 9-12 mo:
plantar grasp, babinski reflex,

Parachute APPEARS and persists through life

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7
Q

Infant Milestones: Gross Motor

A

2 mo:
beginning head control

4 mo:
head control, grasp objects and bring to mouth

5 mo:
roll from front to back

6 mo:
back to front
crawl
COMPLETE HEAD CONTROL

7 mo:
sits/support w/ hands, transfer b/w hands

8 mo:
sits w/ no support
MUST BE ABLE TO CONTROL HEAD & STRAIGHTEN BACK TO SIT
pull to stand

9 mo:
creep

10:
prone to sit
stands alone (watch for hip dysplasia 11-12 mo)
walks w/ assistance

12 mo:
walks independently

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8
Q

Infant Milestones: Fine Motor

A

2 mo:
palmer grasp fades

4 mo:
grasps & brings to mouth

7 mo:
transfers b/w hands

8-10 mo:
crude pincer grasp

10-11 mo:
fine pincer grasp
remove objects from a container

12 mo:
build a tower of 2 blocks

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9
Q

Infant Milestones: Language

A

Birth:
responds to sounds
crying is 1st form of communication

2 mo:
vowel sounds

3-4 mo:
babbles and coos

6-7 mo:
belly laughs, talks to toys

8-9 mo:
mama, dada, “bye-bye”, “no”

11-12 mo:
SAYS 3-5 WORDS W MEANING
understands meaning of words and recognizes names of objects
knows name, jabbers

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10
Q

Infant Milestones: Psychosocial (Erikson)

A

Trust vs. Mistrust
food
water
love

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11
Q

Infant Milestones: Social

A

6-8 weeks: smiles responsively

4 mo: separation anxiety

6 mo: shows anger or fear

8 mo: stranger anxiety

9 mo:
smiles at self in mirror
plays peek-a-boo

10-12 mo:
quiets self
mood changes

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12
Q

Infant Milestones: Cognitive (Piaget)

A

Sensorimotor Phase:
Stage 1- REFLEXIVE (0-1 mo)
sucking, rooting, grasping

Stage 2- PRIMARY CIRCULAR RESPONSE (1-4 mo)
reflexes replaced w/ voluntary acts

Stage 3- 2ND CIRCULAR RESPONSE (4-8 mo)

  • repeats actions to prolong response)
  • imitates expressions of emotion or feeling

Stage 4- COORDINATION OF 2ND SCHEMAS

  • 6-8 mo
  • exploration
  • object permanence (plays peek-a-boo)
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13
Q

Infant Health Screening

A

1 mo:
length, weight, HC, vision + hearing, hereditary, metabolic

2,4, & 6 mo:
length, weight, HC, vision & hearing, developmental

9 mo:
length weight, HC vision & hearing, developmental, hemoglobin, lead

12 mo:
same as 9 mo, TB if at risk

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14
Q

Toddler (12-36 mo) Milestones: Height

A

3”/yr
Head circ 90% by 2 yrs
2 yrs = 1/2 adult height

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15
Q

Toddler Milestones: Weight

A

Gains 4-6 lbs/yr

birth weight quadrupled by 2.5 yrs

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16
Q

Toddler Milestones: Feeding

A

Develops food preferences
IMPROVES TASTE, SMELL, hearing, touch

Physiologic anorexia= fussy eater, decreased nutritional need

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17
Q

Toddler Milestones: Teething

A

Fluoride > 6 mo

low-cariogenic diet

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18
Q

Toddler Milestones: Body Image

A

Knows body parts by name
Recognize sexual difference by 2 yrs
Explores genitalia
Understands gender roles

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19
Q

Toddler Milestones: ADL

A

Skills:
feeding, playing, dressing, undressing self, strong willed, volatile behavior

Toilet Training:
able to stay dry for 2 hours, willing to please parents, curious about adult toilet habits, impatient w wet diapers

Injury Prevention:
MVC (car seats)

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20
Q

Toddler Milestones: Reflexes

A

18-24 mo:
voluntary sphincter control
MUST WALK & HAVE SPHINCTER CONTROL TO POTTY TRAIN
able to stay dry for 2 hours

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21
Q

Toddler Milestones: Gross Motor

A

12-13 mo: walks w wide stance

15 mo: walks well

2-2.5 yr: 
up and down stairs 
jump w/ both feet 
stand on one foot for 1-2 sec 
tiptoe 

3 yr:
stand on one foot
walk on tiptoe
climb stairs alternating feet

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22
Q

Toddler Milestones: Fine Motor

A

12-15 mo:
manual dexterity

18 mo:
throw ball overhand

2 yr:
build towers
removes clothing

3 yr:
draw circles

23
Q

Toddler Milestones: Language

A

1 yr: uses holophrases (1 word responses)
4 words

2 yr:
300 words
60-70% of speech is understandable

24
Q

Toddler Milestones: Psychosocial (Erikson)

A
Autonomy vs. Shame & Doubt 
Aquire sense of autonomy 
"NO!" 
Rituals= routine 
Understands predictable effect of behavior
Knows right & wrong by consequences
25
Q

Toddler Milestones: Social

A
Knows body parts by name 
Recognize sexual differences by 2 yrs old 
Explores genitalia 
Understands gender roles 
Plays house & dress up 
Differentiates self from mother 
Leaves but comes back 
Likes bye-bye rituals 
Parallel play
26
Q

Toddler Milestones: Cognitive (Piaget)

A

Sensorimotor (cont)
• Stage 5: Tertiary Circular Reactions
o 13-18 mo
o experiments to achieve unattainable goals.
o Aware of causal relationships.
o Learns spatial relationships.(get a stool to reach higher)
o Learns through imitation

•	Stage 6 Invention of New Mean through Mental combination
o	Ages 19-24 mo
o	Completes primitive thought process.
o	Complex mental operations
o	Limited awareness of time

Preconceptual Phase
• Begins at age 2
• Transitions from self to social
• “here & now”
• why?
• Animates= life like qualities to inanimate objects.
• Magical thinking= thinking can make it happen.
• No conservation of matter
• Irreversibility: can’t do things in reverse order.

27
Q

Toddler Milestones: Health Screening

A
  • Estuation tubes horizontal = OM
  • Tonsils large = tonsillitis; URI
15-18 months
•	Length
•	Weight
•	Vision
•	Developmental
2 years
•	Height 
•	Weight
•	BMI
•	Vision
•	Hearing
•	H&H
•	Lead level
•	UA
3 yr old
•	Height
•	Weight
•	BMI
•	Vision
•	Hearing
•	Language
•	Dental
•	H&H
•	Lead level
•	UA
28
Q

Preschool (3-5 yrs) Milestones: Height

A

Grows 2 ½ to 3 inches/ yr

29
Q

Preschool Milestones: Weight

A

5-7 lbs/yr
or
2-3 kg/yr

30
Q

Preschool Milestones: Feeding

A
Caloric Requirements:
•	90kcal/kg
•	~1800cal/24 hours
Fluid Requirements:
•	100 ml/kg
•	food fads
•	strong states common
•concern with childhood obesity.
31
Q

Preschool Milestones: Teething

A

Deciduous teething complete

32
Q

Preschool Milestones: Body Image

A
  • Aware of desirable appearance
  • Race identity
  • Poor body boundaries
  • (fears insides will leak out. Obsessed the Band-Aids.)
Sexuality:
•	forms strong attachment to parent of opposite sex.
•	Modest
•	Dresses up like mom or dad
•	Sexual exploration
•	Reproduction?
33
Q

Preschool Milestones: ADL

A

Sleep:
• Night terrors
• Consistent bedtime routine

Injury Prevention:
• Bike helmets

34
Q

Preschool Milestones: Gross Motor

A
3 years
•	RIDES A TRIKE
•	Run
•	Walk
•	Climb
•	Jump

4 years
• Skips & hops on 1 foot
• CATCHES BALL

5 years
• SKIPS ON ALTERNATE FEET
• Jumps rope
• Learns to skate & swim

35
Q

Preschool Milestones: Fine motor

A

3 years
• Tower 9-10 blocks.
• Copies circle

4 years
•	Uses scissors
•	Lace shoes
•	Copies square
•	3-part stick figure
5 years
•	ties shoelaces
•	uses pencil well
•	prints a few letters
•	9-part stick figure
36
Q

Preschool Milestones: Language

A

4-5 years
• 4-5 word sentences

6 years
• understands all parts of speech
• identify opposites

37
Q

Preschool Milestones: Psychosocial (Erikson)

A
Initiative vs Guilt
•	Feels accomplishment when succeeds
•	Feels guilt when thoughts differ from expected
•	Superego (conscious)
•	Learns wright from wrong/ moral
38
Q

Preschool Milestones: Social Milestones

A
  • Language skills develop
  • Individuation-separation process complete.
  • Overcomes stranger & separation anxiety

• Self-assertion

•	Wiling to please
•	Internalized values of family culture. 
•	May begin to challenge parents. 
Play:
•	Associative (plays with a friend)
•	Imitative
•	Imaginative
•	dramatic
39
Q

Preschool Milestones: Cognitive (Piaget)

A

Preoperational Phase
• Age 2 to 7 years
• 2 phases

Phase 1
Preconceptual phase:
• 2-4 yrs

Phase 2
Intuitive Thought Phase:
•	4-7 years
•	shifts from egocentric to social awareness
•	considers other’s viewpoints
•	Egocentricity still evident. 
•	Concept of causality
•	Concept of time incompletely understood
•	Magical thinking
40
Q

Preschool Milestones: Moral

A
  • Punishment & Obedience oriented
  • Can use simple instruments
  • Satisfies own needs
  • Concerned with justice & fairness
  • Misinterprets illness as punishment from God.
  • Development of conscience stronglylinked to spiritual development.
41
Q

Preschool Milestones: Health Screening

A
Body Changes:
•	Slender-loses belly
•	Graceful
•	Posture erect
•	Male/female similar in size. 
3-5 year olds
•	Height 
•	Weight
•	BMI
•	Vision
•	Hearing
•	Language
•	Dental
•	H&H
•	Lead level
•	UA
42
Q

School Age (6-12 yr) Milestones: Height

A

2 inches/yr

43
Q

School Age Milestones: Weight

A

5-7 lbs/yr
or
2-3 kg/yr

44
Q

School Age Milestones: Feeding

A

“Fast food” concerns.

45
Q

School Age Milestones: Teething

A

Begins with shedding of 1st deciduous teeth; ends at puberty with acquisition of final permanent teeth.

46
Q

School Age Milestones: Body Image

A

Prepubescence
*2 yrs prior puberty & ends with 13th birthday
• Ages 9-12
• Girls 2 yrs earlier than boys

Sex Education
Sex play normal
Formal sex education

47
Q

School Age Milestones: ADL

A

Play:
Physical skill
Intellectual ability
Fantasy

  • Forms groups
  • Rules & rituals
  • Sees need for rules in games.
  • team play
  • EGO Mastery

Sleep & Rest
*9 ½ hr/night
Ages 8-11 may resist going to bed

Ages 12 yrs less resistant to bedtimes.

Exercise
Sports
•	Must have sufficient physical & emotional maturity. 
•	Tanner Score
•	Generally likes competition 

Injury Prevention

  1. MVC
  2. Bike helmets
  3. Sport safety
48
Q

School Age: Psychsocial (Erikson)

A

Industry Vs Inferiority
Eager to do meaningful work.

Personal & interpersonal accomplishments.
Sense of independence

Peer approval

Relationships center around same-sex peers.

Feel inferior when unprepared to accomplish tasks.

49
Q

School Age: Social Milestones

A

Primary goal:
Independence from parents.

Parents:
Primary influence
*Personality
*Behavior
*Value system
50
Q

School Age: Cognitive (Piaget)

A

Concrete
Operational

Uses thought process to experience events & actions

Understanding of relationships between things & ideas.

Makes judgement based on reason.

51
Q

School Age Milestones: Kholberg

A

Has conscience & moral standard

6-7 years:
reward & punishment guide choices

> 7 years
able to judge an act by the intentions that prompted it.

Spiritual
Importance of peer group
Peers help child gain independence from parents.

Sex roles influenced by peer group.

52
Q

School Age Milestones: Health Screening

A
Body Changes:
•	Bladder capacity increases
•	Heart small in relation to body.
•	Immune system more effective
•	Bone ossification
Physical maturity doesn’t correlate with emotional & social maturity. 
6-10 yrs
•	Height
•	Weight
•	BMI
•	Vision
•	Hearing
•	Dental
11-12 Years
•	Height 
•	Weight
•	BMI
•	Vision
•	Hearing
•	Dental
•	Cholesterol screening
•	H&H
•	UA
•	STD
53
Q

BIG THINGS TO KNOW FROM PP INFANT

A

By one year: birth-weight should have tripled and height increased by 50%
Neurologic development progresses centrally to peripherally
3 months: Infants should be able to lift their head (no “head-lag”), clasp hands, coo
6 months: Infants should be able to roll over, reach for objects, turn to voices, babble, and possibly sit with support
9 months: Infants should have a neat pincer grasp (self-feed), indicate wants; have usually developed “stranger danger”
12 months: Infants should be able to stand, say 1-3 words
*Must correct for prematurity up until 24 months