Normal development

Question 1

Which children are considered “term”?

Answer 1

37-42 weeks of age

Question 2

Child growth phases? (3) and what leads them

Answer 2

• Infant (nutrient-led)
• Child (growth hormone)
• Pubertal (sex steroid)

Question 3

What’s Reference Nutrient Intake? And what’s different from Estimated Average Requirement?

Answer 3

RNI - sufficient for 97% of population (used since sufficient for everyone),
EAR - for 50% (average).

Question 4

Vit A sources? Intake above RNI?

Answer 4

Sources - cheese, eggs, yoghurt. Above RNI

Question 5

Vit C sources? Intake above RNI?

Answer 5

Sources - oranges, blackcurrants, potatoes. Above RNI.

Question 6

Vit D sources? Above RNI?

Answer 6

Sources - sunlight, small amounts from oily fish, eggs.

Intakes below RNI.

Question 7

Children activity guidelines - capable of walking under 5 y.o.?

Answer 7

At least 180 minutes per day, minimase sedentary periods (excluding sleeping)

Question 8

Activity guidelines - 5-18 years?

Answer 8

60minutes+ igorous/moderate activity per day,

3 days a week - vigorous activity.

Question 9

Direction of development?

Answer 9

Cephalocaudal (top to bottom)

Question 10

RED FLAGS FOR DEVELOPMENT (know them) (7)

Answer 10

Assymetry of movement,
Not reaching for objects by 6 months,
Unable to sit unsupported by 12 months,
Unable to walk by 18 months (check Creatine Kinase),
No speech by 18 motnsh,
Concerns re vision or hearing,
Loss of skills.

Question 11

What’s Global Developmental Delay?

Answer 11

Significant delay in 2+ of:

• gross/fine motor, speech/language,
• cognition, social/personal, ADL (activities of daily living)

Question 12

Medical screenings in Down syndrome?

Answer 12

Cardiac (40% will have, eg septoventricular defect),
Vision (accomodation, bifocal glasses)
Hearing (head shape)
Thyroid function (can put on weight)
Sleep related (eg sleep apnoea)

Question 13

Specific Developmental Delay - examples of Motor delays (3)

Answer 13

Duchene Muscular Dystrophy,
Cerebral palsy
Co-ordination disorders

Question 14

Example of language delays (1)

Answer 14

Specific language impairment

although Duchenne can be affected too

Question 15

Examples of sensory deficits and associated delay (2)

Answer 15

Oculocutaneous Albinism, Treacher-Collins,

Question 16

Examples of Developmental Deviations (1)

Answer 16

Autism Spectrum Disorder

Question 17

What is Gower’s Manoeuvre? Common in which dis?

Answer 17

If a child is given a task to quickly stand up and clap above head - they “climb” on legs to stand up. Commonly associated with Duchenne

Question 18

Autistic triad?

And 2 other features?

Answer 18

• Communication
• Social interaction
• Flexibility of thought/Imagination
  Other: restricted, repetitive behabiours, sensory defficulties

Question 19

Types of hearing impariment? (2)

Answer 19

• Sensorineural (one sets of frequency is lost)

- Conductive (all the frequencies are lower than should be - like in water).

Question 20

Primitive reflexes? (some of them lost) (5)

Answer 20

• Sucking and rooting
• Palmar and plantat grasp
• ATNR (assymetric tonic neck reflex)
• Moro (extend and flex back arms and grab - if you were falling, hold on!)
• Stepping and placing

Question 21

What does ATNR look like? When do you keep it instead of losing (example)?

Answer 21

One hand extended and leg too (the other one flexed at elbow and knee) - message of unstable surface.
Might keep in cerebral palsy (get it when you turn your head)

Question 22

What do palmar and plantar grasp look like?

Answer 22

Baby holding on to a rope with both hands and feet (also: hold my finger)

Question 23

What does parachute reflex look like? Primitive or not?

Answer 23

Not primitive.

Baby extends hands to protect from falling (sideways, or forwards or backwards)

Question 24

What’s the blood volume?

Answer 24

80 ml/kg (easiest to calculate)