Milestones Flashcards
At what age would you expect a child to be:
- chest up in prone
- keeps head steady when held in a sitting position
2 months
At what age would you expect a child to be:
- opens and closes hands
- hands unfisted 50% of the time
2 months
At what age would you expect a child to be:
- opens mouth at site of food or bottle
2 months
At what age would you expect a child to be:
- able to recognize mother
2 months
At what age would you expect a child to be:
- reciprocal smiling
- makes sounds that show happiness or upset
2 months
At what age would you expect a child to be:
- coos
- social smile
2 months
Social smile at 6 weeks
At what age would you expect a child to be:
- sits with trunk support
- no head lag when pulled to sit
- rolls front to back
4 months
At what age would you expect a child to be:
- reaches
- plays with fingers in midline
- holds hands open
4 months
At what age would you expect a child to be:
- briefly holds on to bottle
4 months
At what age would you expect a child to be:
- mouths objects
4 months
At what age would you expect a child to be:
- smiles spontaneously
- stops crying at parents voice
4 months
At what age would you expect a child to be:
- orients head in direction of voice
4 months
At what age would you expect a child to be:
- laughs out loud
4 months
At what age would you expect a child to be:
- sits momentarily propped on hands
- pivots in prone on belly
- rolls in both directions
6 months
At what age would you expect a child to be:
- transfers hand to hand
- bangs objects on surface
6 months
At what age would you expect a child to be:
- places hands on bottle
6 months
At what age would you expect a child to be:
- removes cloth on face
6 months
At what age would you expect a child to be:
- recognizes familiar faces
- stranger danger
6 months
At what age would you expect a child to be:
- stops momentarily to “no”
- gestures “up”
6 months
At what age would you expect a child to be:
- babbles with vowels
6 months
At what age would you expect a child to be:
- pulls to stand
- crawls
9 months
At what age would you expect a child to be:
- bangs two blocks together
- lets go of objects intentionally
9 months
At what age would you expect a child to be:
- bites, chews cookie
9 months
At what age would you expect a child to be:
- plays peek a boo (object permanence)
9 months
At what age would you expect a child to be:
- separation anxiety
- waves “bye bye” and shakes head “no”
9 months
At what age would you expect a child to be:
- follows directions with gestures
9 months
At what age would you expect a child to be:
- imitates sounds
- says “mama” and “dada” non-specifically
9 months
At what age would you expect a child to be:
- some independent steps
- stands without support
12 months
At what age would you expect a child to be:
- holds crayon and makes mark
- fine pincer grasp of pellet
- drops object in cup
12 months
At what age would you expect a child to be:
- finger feeds
12 months
At what age would you expect a child to be:
- follows one step commands without gestures
12 months
At what age would you expect a child to be:
- points in order to get desired object (proto-imperative pointing)
- uses “mama” or “dada” specifically
12 months
At what age would you expect a child to be:
- carries a ball while walking
- throws a ball standing
18 months
At what age would you expect a child to be:
- scribbles
18 months
At what age would you expect a child to be:
- moves around house without adult
- uses spoon
18 months
At what age would you expect a child to be:
- matches pairs of objects
- knows ordinary objects
- proto-declarative pointing!!!!
18 months
At what age would you expect a child to be:
- passes M-CHAT
- engages in pretend play
- throws temper tantrums
18 months
At what age would you expect a child to be:
- points to self
- points to 2-3 objects when named
18 months
At what age would you expect a child to be:
- 10 to 25 word vocab
- identifies 1+ body part
- names at least 5 familiar objects
- says and shakes head “no”
18 months
At what age would you expect a child to be:
- walks downstairs holding onto rail
- kicks a ball
- jumps off ground with 2 feet
24 months
At what age would you expect a child to be:
- draws line
- stacks object
24 months
At what age would you expect a child to be:
- sucks through straw
- pulls off pants
24 months
At what age would you expect a child to be:
- sorts objects
24 months
At what age would you expect a child to be:
- engages in parallel play
- shows defiance
24 months
At what age would you expect a child to be:
- follows 2 step commands
24 months
At what age would you expect a child to be:
- uses 2-word sentences (noun + verb)
- uses 50 words
- uses words that are 50% understandable to strangers
24 months
At what age would you expect a child to be:
- balances on one foot for 3 seconds
- pedals tricycle
- climbs on/off chair or couch
3 yo
At what age would you expect a child to be:
- cuts with scissors side to side
- strings small beads
- copies circle
3 yo
At what age would you expect a child to be:
- puts on shoes
- capable of toilet training
- unbottons
3 yo
At what age would you expect a child to be:
- knows own gender and age
- understands opposites
3 yo
At what age would you expect a child to be:
- imaginary play
- takes turns
- shows concern
- fears emerge
3 yo
At what age would you expect a child to be:
- understands action words and simple propositions
3 yo
At what age would you expect a child to be:
- uses 3 word sentences
- uses words that are 75% understandable to strangers
3 yo
At what age would you expect a child to be:
- hops
- climbs stairs with alternating feet
- balances on one foot for 4 seconds
4 yo
At what age would you expect a child to be:
- draws a simple cross
- writes part of first name
- uses scissors well
4 yo
At what age would you expect a child to be:
- goes to toilet alone
- uses fork well
- buttons
4 yo
At what age would you expect a child to be:
- can give amounts less than 5
- names some colors and numbers
- plays board/card games
4 yo
At what age would you expect a child to be:
- enjoys doing new things
- enjoys playing with other children
4 yo
At what age would you expect a child to be:
- understands same and different
- follows 3 step demands
4 yo
At what age would you expect a child to be:
- sings songs
- uses 4-word sentences
- says first and last name
- uses words that are 100% understandable to strangers
4 yo
At what age would you expect a child to be:
- balances on one foot for 10 seconds or more
- skips
- somersault
- jumps backward
5 yo
At what age would you expect a child to be:
- copies squares
- writes first name
5 yo
At what age would you expect a child to be:
- independent dressing
5 yo
At what age would you expect a child to be:
- counts to 10 or more
- can print some letters/numbers
5 yo
At what age would you expect a child to be:
- knows right and left on self
- understands adjectives
- likes to rhyme
5 yo
At what age would you expect a child to be:
- defines simple words
- uses future tense
- says address
- responds to why questions
5 yo
What’s important to remember pertaining to childhood development?
Sequence of development is the same in all children but RATE varies
Standard developmental screening is recommended at what age?
9, 18, and 24 or 30 months of age AND at every well child visit.
What tools are used to assess childhood development?
SWYC - Survey of Wellbeing in Young Children
ASQ - Ages and Stages Questionnaire
PEDS - Parent’s Evaluation of Developmental Status
MCHAT:
- what is it?
- at what age is it used?
- which questions should be answered “no”?
- what is it? Modified Checklist for Autism in Toddlers
- at what age is it used? 16-30 months
- which questions should be answered “no”?
If the child ever seems oversensitive to noise (e.g., plugging ears)
If the child makes unusual finger movements near his/her face
If the caregivers have ever wondered if the child is deaf.
To have cerebral palsy, what must happen?
Insult to the brain MUST occur prior to age three.
May occur in PRENATAL, perinatal, or postnatal period
What would make you most concerned for the diagnosis of autism?
Regression in some children
Develop an assessment and plan for a child with delayed milestones
Refer to a developmental pediatrician
Refer to early intervention (or the local school district)
Order any labs deemed appropriate
Educate the family
Describe a way a mother may be able to enhance her child’s development.
Appropriate prenatal care - DHA, flu shot, Prenatal vitamins, staying healthy, rest
Which age group has shorter periods of sleep throughout the day and night and sleeps 12-18 hours?
Newborns
Which age group has 1 afternoon nap, switching from crib to bed?
1-3 yo
Which age group sleeps 9-10 hours total and drops the nap?
3-5 yo
Under what circumstances is a sleep study warranted?
Symptoms suggestive of physiologic sleep disorder (eg OSA, PLMD)
Behavioral insomnia unresponsive to therapy
A child presents with sleep problems. You dx them with OSA. What is the first line treatment?
Tonsillectomy and Adenoidectomy
What symptoms of OSA would warrant a T&A without needing to do a sleep study?
Nighttime symptoms: snoring
Daytime symptoms: hyperactivity, attention and learning problems, day time sleepiness
Big tonsils
Which patient population should have a sleep study, regardless of symptoms?
Those with Down Syndrome
Should be done by 4 yo
Which patient population should have a sleep study at time of diagnosis?
Those with achondroplasia
At risk for OSA, hypoventilation (restrictive lung physiology), and CSA (compression of medulla from foramen magnum stenosis)
Which patient population should have a sleep study prior to initiation of Growth Hormone therapy?
Those with Prader-Willi syndrome
List the criteria for restless leg syndrome?
Urge to move the legs at night & Occur more often at night
Worse during rest
Improved with movement
What is the first line treatment for restless leg syndrome?
Supplemental iron - goal ferritin 50 to 100
Lifestyle (adequate sleep, physical activity)
Symptoms of narcolepsy
Excessive daytime sleepiness
Cataplexy (tongue thrusting) - sudden, brief loss of voluntary muscle tone triggered by strong emotions such as laughter
Paralysis
Hallucinations
Tx for narcolepsy
Excessive daytime sleepiness:
- Stimulants (Methylphenidate derivatives, Provigil)
Cataplexy:
- SSRIs (Fluoxetine, Venlafaxine)
- TCAs (triptyline, pramine)
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