Milestones Flashcards
Infant Milestones: Height
Height:
1”/month x 6 mo
50% increase by 12 mo
Growth spurts
Infant Milestones: Weight
Weight:
gains 5-7 oz/week x 6 mo
DOUBLES birthweight x 6 mo
TRIPLES birthweight x 12 mo
Infant Milestones: Feeding
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
Infant Milestones: Teething
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.
Infant Milestones: ADL
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
Infant Milestones: Reflexes
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
Infant Milestones: Gross Motor
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
Infant Milestones: Fine Motor
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
Infant Milestones: Language
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
Infant Milestones: Psychosocial (Erikson)
Trust vs. Mistrust
food
water
love
Infant Milestones: Social
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
Infant Milestones: Cognitive (Piaget)
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)
Infant Health Screening
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
Toddler (12-36 mo) Milestones: Height
3”/yr
Head circ 90% by 2 yrs
2 yrs = 1/2 adult height
Toddler Milestones: Weight
Gains 4-6 lbs/yr
birth weight quadrupled by 2.5 yrs
Toddler Milestones: Feeding
Develops food preferences
IMPROVES TASTE, SMELL, hearing, touch
Physiologic anorexia= fussy eater, decreased nutritional need
Toddler Milestones: Teething
Fluoride > 6 mo
low-cariogenic diet
Toddler Milestones: Body Image
Knows body parts by name
Recognize sexual difference by 2 yrs
Explores genitalia
Understands gender roles
Toddler Milestones: ADL
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)
Toddler Milestones: Reflexes
18-24 mo:
voluntary sphincter control
MUST WALK & HAVE SPHINCTER CONTROL TO POTTY TRAIN
able to stay dry for 2 hours
Toddler Milestones: Gross Motor
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
Toddler Milestones: Fine Motor
12-15 mo:
manual dexterity
18 mo:
throw ball overhand
2 yr:
build towers
removes clothing
3 yr:
draw circles
Toddler Milestones: Language
1 yr: uses holophrases (1 word responses)
4 words
2 yr:
300 words
60-70% of speech is understandable
Toddler Milestones: Psychosocial (Erikson)
Autonomy vs. Shame & Doubt Aquire sense of autonomy "NO!" Rituals= routine Understands predictable effect of behavior Knows right & wrong by consequences
Toddler Milestones: Social
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
Toddler Milestones: Cognitive (Piaget)
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.
Toddler Milestones: Health Screening
- 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
Preschool (3-5 yrs) Milestones: Height
Grows 2 ½ to 3 inches/ yr
Preschool Milestones: Weight
5-7 lbs/yr
or
2-3 kg/yr
Preschool Milestones: Feeding
Caloric Requirements: • 90kcal/kg • ~1800cal/24 hours Fluid Requirements: • 100 ml/kg • food fads • strong states common •concern with childhood obesity.
Preschool Milestones: Teething
Deciduous teething complete
Preschool Milestones: Body Image
- 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?
Preschool Milestones: ADL
Sleep:
• Night terrors
• Consistent bedtime routine
Injury Prevention:
• Bike helmets
Preschool Milestones: Gross Motor
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
Preschool Milestones: Fine motor
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
Preschool Milestones: Language
4-5 years
• 4-5 word sentences
6 years
• understands all parts of speech
• identify opposites
Preschool Milestones: Psychosocial (Erikson)
Initiative vs Guilt • Feels accomplishment when succeeds • Feels guilt when thoughts differ from expected • Superego (conscious) • Learns wright from wrong/ moral
Preschool Milestones: Social Milestones
- 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
Preschool Milestones: Cognitive (Piaget)
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
Preschool Milestones: Moral
- 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.
Preschool Milestones: Health Screening
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
School Age (6-12 yr) Milestones: Height
2 inches/yr
School Age Milestones: Weight
5-7 lbs/yr
or
2-3 kg/yr
School Age Milestones: Feeding
“Fast food” concerns.
School Age Milestones: Teething
Begins with shedding of 1st deciduous teeth; ends at puberty with acquisition of final permanent teeth.
School Age Milestones: Body Image
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
School Age Milestones: ADL
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
- MVC
- Bike helmets
- Sport safety
School Age: Psychsocial (Erikson)
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.
School Age: Social Milestones
Primary goal:
Independence from parents.
Parents: Primary influence *Personality *Behavior *Value system
School Age: Cognitive (Piaget)
Concrete
Operational
Uses thought process to experience events & actions
Understanding of relationships between things & ideas.
Makes judgement based on reason.
School Age Milestones: Kholberg
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.
School Age Milestones: Health Screening
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
BIG THINGS TO KNOW FROM PP INFANT
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
