Normal development and milestones Flashcards
When does the anterior fontanelle usually close?
10-24 months
Later if premature
When does the posterior fontanelle usually close?
2 months
What is the normal diameter of the anterior fontenelle in the first 6 months of life?
3-6cm
What is the normal diameter of the posterior fontanelle?
1-1.5cm
What is the definition of IUGR?
Alteration of normal foetal growth characterised by an estimated foetal weight below the 10th percentile
What is the asymmetrical tonic neck reflex and when does it resolve?
The infant’s head is turned to one side → extension of the infant’s ipsilateral arm and leg, with flexion of the contralateral arm and leg (fencing posture)
3-4 months
What is the stepping reflex and when does it usually resolve?
Holding the infant in an upright position and lowering him/her to bring the feet in contact with the examining table → stepping motion
2 months
What is the moro reflex and when does it usually resolve?
The startle reflex
3-6 months
What is the plantar grasp reflex and when does it usually resolve?
The infant’s foot is stroked from the toe to the heel → plantar flexion (curling in) of the infant’s toes
3 months
What is the galant reflex and when does it usually resolve?
Stroke the paravertebral region → ipsilateral rotation of the hip
4-6 months
What is the palmar grasp reflex and when does it usually resolve?
The infant’s palm is stroked horizontally → closure of it’s palm
3-6 months
What are the three feeding reflexes?
- Rooting reflex ( the cheek of the infant is stroked → the infant turns its head to the ipsilateral side and opens its mouth)
- Sucking reflex (the roof of the infant’s mouth is touched with a finger → infant starts to suck the finger)
- Snout reflex (light pressure or tapping is applied on an infant’s closed lips of (midline) → puckering of lips)
What is the glabellar tap reflex and when does it usually resolve?
The root of the nose (glabella) is tapped → blinking with each tap
4-6 months
When does the Babinski reflex usually resolve in children?
12 months
The absence of the plantar and palmar reflex at birth may suggest what?
Cerebral palsy
At what age should children start focusing on faces?
2 weeks
At what age should children begin smiling?
8 weeks
At what age should children be turning their heads towards sounds and making coos and gurgling sounds?
8 weeks
What what age should children be holding their head up and beginning to push when lying on their tummy?
8 weeks
What what age should children be responding to their name?
6 months
At what age should children be able to roll over in both directions and sit without support?
6 months
At what age should children be saying “mama”, “dada” and exclamations like “uh-oh!”?
12 months
At what age should children say several single words?
18 months
At what age should children be able to say and shake head “no”?
18 months
At what age should childen have sentences of 2-4 words?
2 years
For how long should infants be exclusively breastfed?
6 months
When should solids be introduced to infants?
6 months
When do infants begin toilet training?
18 months - 2 years
When should infants be fully toilet trained by (dry by night)?
3-4 years
By what age should birth weight have doubed?
4-5 months
At what age should birth weight have tripled?
A year
When do neonates regain weight lost after birth?
10-14 days
Up to what age is it legally required that children use a booster seat in the car?
7
What is echolalia?
Repetition of speech
May be a feature of ASD
What is infantile colic?
Excessively unsettledness or crying (>3 hours/day > 3 days a week)
The child is otherwise well and thriving with no identifiable medical problem
What is the difference between a cognitive impairment and a learning difficulty?
Cognitive impairment - generalised, often with an IQ < 70
Learning difficulty - specific to one area and a normal IQ
Terms are sometimes used interchangably
What IQ range represents a mild cognitive impairment?
50-70
What is dyslexia?
Specific learning difficulty with reading
Usually associated writing difficulty (dysgraphia), especially spelling
What is dyscalculia?
Impaired arithmetic skills
Specific laguage impairment is highly comorbid with which condition, which is often diagnosed later in childhood?
Dyslexia
What are your differentials for developmental regresssion?
Autism spectrum disorder
Neurodegenerative disorders e.g. Rett’s syndrome
Inborn errors of metabolism
Structural brain disease
Infectious diseases
Psychiatric disease
Seizure disorders e.g., Lennoz-Gastaut
Trauma/injurt
Sensory deficits
Psychosocial
What is the definition of overweight and obese in children?
Overweight: > 85th centile
Obese: > 95th centile
What is the definition of an underweight child?
< 5th centile
What is the definition of nocturnal enuresis?
Urinary incontinence during sleep in children 5 and over
At what age are children able to sit unsupported?
6 months - curved back
9 months - straight back
When do a child’s first teeth usually appear?
6-12 months
Incisors (front 4)
What are the two types of breath holding spells?
- Blue (cyanotic breath holding)
- Pale spells (pallid breath holding)
* Pallid: due to slow HR, may mimic a seizure*
What are some of the milestones you would expect a 12 month old to have achieved?
Stand and walk holding on
Pull to standing
Pick up objects using pincer grip, grasp pencil
2 clear words
Shake head “no”
Babble frequently when alone
Point at wanted objects
Wave “bye”
What are some of the milestones you would expect an 18 month old to have achieved?
Stand and walk alone well
Bend or crouch to pick up an object
Push a pram/cart
Walk backwards
Kick ball
Stack 2-3 blocks into a tower
Scribble with a pencil
4-8 clear words
Follow single instruction
Shows sense of self; says “no” or “mine”
Drink from a cup
Points to body parts, clothing and objects
Helps with dressing
Completes simple puzzles e.g., one or two shapes in holes
Plays correctly with toys e.g., making an airplane fly
What are some of the milestones you would expect a 2 year old to have achieved?
Run
Throw a ball
Walk up and down steps, holding on
Jump
Scribble in circles with a crayon/pencil
20-50 clear words
2-3 word sentences
Names pictures and objects when asked
Follows two-step commands
Shows interest in books and stories
Uses a spoon
Early imaginative play
What are some of the milestones you would expect a 6 month old to have achieved?
Lift head and chest of ground when lying down
Roll over side to side
Sit up with support
Stand with support
Reach for objects
Transfer objects from hand to hand
Laugh
Search for sound by turning head
Drink from cup with adult holding it
What are some of the milestones you would expect a 3 month old to have achieved?
Lift head when lying on tummy
Head control when sitting
Kick
Follow objects with eyes
Tries to make sounds
Laugh
Responds to sound
Smiles
Active, visual interest in the world and people
At what age can children wave?
9 months
At what age do children start using a pincer grip?
9 months
At what age can children start breathing through their mouth?
6 months
At what age do you refer a child who cannot sit without support?
12 months
At what age do you refer a child who cannot walk unaided?
18 months
