Normal development Flashcards
What is IQ?
o Intelligence quotient
o Measures Mental Age/Chronological age
What factors influence normal development in children?
o Genetic
o Nutritional
o Environmental
Which pair of twins have a higher correlation btw them: fraternal or identical?
Identical twins
What is the importance of environment in child development?
It sets the background in which genes can be expressed
How does malnutrition affect children?
Decreases the protein level in brain cells
Damage can be permanent if it affects kids before the age of 6 months
What is the biggest contributor to child mortality under the age of 5?
Infections –> due to increased susceptibility from malnutrition
What are developmental milestones?
Key stage when a new skill is developed
What is median age?
It is the age when half the population (50%) achieve a skill
What is the limit age?
It is the age by which a skill should have been acquired by 97.5% of the children
What are the factors that we need to know to assess development?
- normal milestones
- normal variations
- developmental age vs chronological age
What is the limit age for children to start walking?
18 months
What is developmental age?
It is the age at which they function emotionally, physically, cognitively and socially
How is the developmental age of a premature baby calculated?
Their milestones will be taken from their due date than their actual date of birth
By the age of 2 their developement will even out with their peers and their actual birth date can be used.
What is the median age for children to walk?
12 months
By what age do 75% of the children start walking?
13 months
What are the 5 principles of development?
- Continuous process
- Maturation of nervous system
- Sequence same but rate varies
- Cephalocaudal direction
- Generalised mass activity changing to more specific controlled movements
Which direction does growth begin in?
Cephalocaudally
What are the 4 areas into which development is divided?
Gross motor
Fine motor and vision
Language and hearing
Social behaviour and play
Are the sequences of growth same in children?
yes
What are the variants in the growth development in children?
Rate of development varies from one child to the other
What are the milestones for gross motor skills in children?
o Head control o Sitting balance o Crawling o Standing o Runs o Stairs – 2 feet/tread o Stairs – alternate feet o Hops
o Head control 3 months
o Sitting balance 6 months
o Crawling 9 months
o Standing 12 months
o Runs 18 months
o Stairs – 2 feet/tread 24 months
o Stairs – alternate feet 36 months
o Hops 48 months
What are primitve reflexes in children?
Primitive reflexes are reflexes originating from the CNS in babies but not neurologically intact adults
What are the major primitve reflexes in children?
Rooting and sucking Palmar and plantar grasp Moro ATNR (asymmetric Tonic Neck Reflex) Stepping and Placing
What is rooting and sucking reflex?
Rooting - Baby’s mouth stroked/ touched - the baby turns the head and opens his/her mouth to helps follows towards their mom and find the breast bottle to suck and feed
Sucking – if the roof of the baby’s mouth is touched - it opens its mouth and begins to suck, ready and helps in sucking milk
What is palmar and plantar grasp?
Palmar- grasp and close on anything that touches the palm of the baby
Plantar – if the sole of the feet of babies are touched -> they close around the object
What is moro/ startle reflex?
if they are startled by a loud noise or movement, the head falls back, the arms and legs extend out and reaches out to grab anything
What is ATNR?
Asymmetric Tonic Neck Reflex
to protect babies from rolling off, if their head turns to one side their hands also extend and turn out to that side
What are the stepping and placing relfexes?
the baby appears to step or dance when they are held upright with their feet on a solid surface
What is the importance of losing primitive reflexes?
o Helps to grow further fine skills
o Lose by around 3 months – 9 months
o If not -> poor motor ability, affect physical movement, psychomotor disturbances
What are parachute reflexes?
oDevelops at around 5-6 months (older infants)
oprevents the babies from falling over, not a primitive reflex
owhen the baby is held upright and the face falls forward (as in falling), the baby will extend their arms forward as if to break a fall
What is the safest position to put the baby to sleep?
On the baby’s back.
Why should babies not be put to sleep on their side or tummy?
As it can lead to Sudden Infant Death Syndrome (SIDS)
Is tummy time important for kids?
Yes, as it helps to keep them calm and out of distress
What is the limit age to walk independently?
18 months
if they don’t walk by then they should be taken to a specialist
What are the key milestones in fine mototr development and vision?
Hand regard in midline 3 months
Grasps toy - palmar 6 months
Scissor grasp 9 months
Pincer grasp 12 months
Tower of 3-4 bricks 18 months
Tower of 6-7/scribble 24 months
Tower of 9 bricks/copies circle 36 months
Draws simple man 48 months
How is the grip by 6 months?
palmar grasp
How is the grip by 9 months?
scissor grasp
How is the grip by 12 months?
fine pincer grasp
By what time do kids study their hands in the midline?
3 months
What are parents falsely reassured of when kids study their hands midline?
They think that their child’s vision is intact
What are the dangers associated with the age when pincer grip has been established?
Choking, as they can take everything with their hand and put it in their mouth
How does the digital pronate grip start?
from the palmar grasp
By what age are kids expected to start scribbling?
15 months
By what age are kids expected to draw a simple picture and copy pictures?
4 years (48 months)
What are the milestones in hearing and language?
- Vocalises 3 months
- Babbles 6 months
- Imitates sounds 9 months
- Knows name 12 months
- 2 body parts/5-20 words 18 months
- Simple instructions/50+ words 24 months
- Complex instructions/asks questions 36 months
- Can tell stories of experiences 48 months
By what age are kids expected to start vocalising?
3 months
By what age are kids expected to know their name?
12 months
• At which stage is hearing screened?
neonatal screening
When is higher frequency sometimes not heard?
o If they have sticky ears and hence can only hear low pitched sounds
What are the false leads to parents that their kids can hear them?
The kids might see a shadow, a daft of wind, perfume etc.. and might not be actually turning to the sound
How are communication skills developed?
Quite varied, and increased screen time leads to decreased development of the skills
How does having the tv on in the background affect the children’s language skills?
Decreases the interaction btw the parents are kids (decreased from 990 words/ hr to 110 word/ hr)
Can affect the kids comm skills
What is the major influencer about the cognitive developmental skills of a child?
How fast they communicate
What are kids usually able to do by 2 years?
Know about 50 words
join 2-3 words together
follow simple instructions
• What is a really important milestone that binds the relationship of a child and their parent?
social smile
By what median age why which a child is expected to have a social smile?
6 weeks
What is the significance of social smile?
Increased the bond btw the parents and kids
If they cant see it -> maybe it’s a visual problem. Should be immediately referred
What is the limit age for social smile in an infant?
8 weeks
What are the milestones in social behaviour and play?
o Social smile 6 weeks
o Pleasure on friendly handling 3 months
o Plays with feet/friendly with strangers 6 months
o Plays peek-a-boo/stranger awareness 9 months
o Drinks from cup/waves bye-bye 12 months
o Feeds with spoon 18 months
o Symbolic play/puts on some clothes 2 years
o Pretend interactive play/toilet-trained 3 years
o Understands turn-taking/dresses fully 4 years
Was the age to be toilet trained always 3 years?
No, was quite lesser before
Expected 18-19 months before (as the amenities and comforts ass with nappies weren’t there)
• Who do kids have a tendency to look at?
their mom’s face
How much activity should a toddler who can walk on its own do?
180 min (3 hours of moderate to intense activity)
How much activity should children btw 5 -18 years of age be doing?
60 min of activity every day
