Milestones, Screening & Vaccinations

Question 1

What are the different components of child health surveillance?

Answer 1

• childhood screening
  
  • assess developmental progress
• immunisations
• delivering universal health promotion activities
  
  • childsmile
• early interventions to address needs
  
  • medical or developmental issues identified
  • earlier intervention more effective

Question 2

What is involved in screening?

Answer 2

• checking milestones
• checking vaccinations
• delivering health promotion
  
  • regular dental attendance for routine check ups
• targeted supervision
  
  • interventions to risk groups
  • refer concerns to paediatric team

Question 3

What screening is carried out in school entry?

Answer 3

• personal, social and emotional development
• physical development
• communication skills
  • hearing and vision assessments

Question 4

What are the developmental milestones at 1 month?

Answer 4

• able to raise head when lying on tummy
• pays attention to faces in direct line of vision
• moves arms and legs in energetic manner
• likes to be held and rocked

Question 5

What are the developmental milestones at 2 months?

Answer 5

• smiles and coos
• rolls onto side from back
• grunts and sighs

Question 6

What are the developmental milestones at 3 months?

Answer 6

• vision more established, eyes follow moving object
• able to hold head erect
• grasp objects when placed in hand
• babbles

Question 7

What are the developmental milestones at 4 months?

Answer 7

• holding for extended period of time
• laughs out loud
• sits supported for short periods
• recognises familiar faces and feeding (mum or bottle)

Question 8

What are the developmental milestones at 5 months?

Answer 8

• reaches for and holds objects
• stands firmly when held
• stretches arms to be picked up
• likes peek-a-boo

Question 9

What are the developmental milestones at 6 months?

Answer 9

• turns from back to stomach
• turns towards sound
• sits with some support
• reaches for objects out of reach
• listens to own voice
• crows and squeals
• grasps objects and brings them to mouth
• holds/sucks/bites and begins chewing
  • can be painful as teeth are coming through

Question 10

What are the developmental milestones at 7 months

Answer 10

• transfer object from one hand to other
• sit for a few minutes without support
• pats and smiles at image in mirror, recognition
• creeps (pulls body with arms and legs kicking)
• shy with strangers

Question 11

What are the developmental milestones at 8 months

Answer 11

• sits steady for around 5 minutes
• crawls on hands and knees
• grasps with thumb and first two fingers (pincer grasp)
• likes to be near parent, particularly at night

Question 12

What are the developmental milestones at 9 months?

Answer 12

• says mama and dada in context
• responds to name
• can stand for short times
• can hit two objects together
• copies sounds

Question 13

What are the developmental milestones at 10 months

Answer 13

• pulls self up at side of crib or playpen
• drinks from cup
  • has likely drunk from trainer cup earlier

Question 14

What are the developmental milestones at 11 months?

Answer 14

• walk holding onto furniture (cruising)
  
  • injuries to teeth increase due to falls
• find object placed under other object

Question 15

What are the developmental milestones at 12 months?

Answer 15

• waves bye
• walks with one hand held
• two words beside each other
• enjoys some solid foods
  • must be careful as can influence gut allergies
  • some degree of solids as child not satisfied with milk alone

Question 16

What are the developmental milestones at 15 months?

Answer 16

• walks by self more confidently, stops creeping
• shows desires by pointing and gesturing
• scribbles on paper after shown
• begins using spoon
• cooperates with dressing

Question 17

What are the developmental milestones at 18 months?

Answer 17

• build a three block tower
• likes climbing and taking things apart
• say 6 words
• tries to put on shoes
• drinks from cup held in both hands
• likes to help parent

Question 18

What are the developmental milestones at 2 years?

Answer 18

• able to run
• walks up and down stairs using alternate feet
• says about 50 words
• sometimes used two word sentences
• points to objects in a book, interacts with stories

Question 19

What are the developmental milestones at 3 years

Answer 19

• can repeat two numbers in a row
• knows their gender
• dresses self except for buttoning
• can copy a circle
• can follow 2 commands of on, under or behind
• jumps with both feet off the ground
• can build 9 block tower

Question 20

What are the developmental milestones at 4 years?

Answer 20

• can repeat a simple 6 word sentence
• can wash hands and face without help
• can copy a cross
• can stand on one foot
• can catch a tossed ball

Question 21

What are the developmental milestones at 5 years?

Answer 21

• can follow three commands
• can copy a square
• can skip

Question 22

Why are childhood vaccinations performed?

Answer 22

• to prevent certain infectious diseases where the risk of vaccination is lower than the risks from disease
• to reduce or eliminate infectious diseases from the community by reducing the number of susceptible vector

Question 23

What vaccinations are available for children?

Answer 23

• diphtheria
• tetanus
• HIB
• typhoid
• polio
• BCG
• pertussis
• rota virus
• pneumococcus
• HPV
• measles
• mumps
• rubella
• hepatitis A
• hepatitis B
• meningitis B & C
• varicella
• influenza
• covid-19
• all are appropriate for children
• some are given to all children

Question 24

What recent changes have been implemented to UK vaccines

Answer 24

• polio vaccine
  
  • was previously given orally
  • now inactivated form
  • polio like symptoms no longer experienced
• meningitis vaccine
  
  • haemophilus influenza B (HIB)
  • meningococcal B
  • routinely given

Question 25

What information does the UK routine immunisation schedule provide?

Answer 25

• when the immunisation is to be administered
• what the vaccine is
• what the site of injection is

Question 26

What should be considered when a child is found to be non-compliant with the immunisation schedule?

Answer 26

• determine whether they are not being administered due to medical reasons
• if not determine why
• may raise concerns around other areas, potentially suggests neglect

Question 27

When is the BCG vaccine given for high risk children?

Answer 27

• can be given shortly after birth
• high risk
  • children looked after by grandparents who have traveled from countries where there is endemic tuberculosis
  • family member with active tuberculosis

Question 28

Why may childhood immunisation be refused?

Answer 28

• religious or philosophical grounds
• think they are stopping a painful assault on the child
• feel that benefits do not outweigh the risks

Question 29

What should be done when childhood immunisation is refused?

Answer 29

• determine whether refusal puts the child at extreme personal risk
  
  • neglect
• determine whether refusal puts others at risk sufficient to warrant intervention on public health grounds