Normal Pediatric Development Flashcards
What is development?
The biological, psychological and social processes that begin in utero and continue over a lifespan
Children’s health is the extent to which a child is able to do … (3 things).
- Develop & realize their potential
- Satisfy their needs
- Develop capacities
What is a developmental milestone?
What are the various categories (lines) in which development is assessed?
Growth
Motor
Language
Cognitive
Social
What is considered during neonatal development?
Gestational age at birth
Birth weight
Head circumference
In utero exposures (i.e. EtOH)
Preterm birth
- Defined as delivery prior to _____ completed weeks of gestation
- Is the leading cause of infant _____&______
- How is preterm birth related to risk for severe morbidity?
- Preterm births affect ____% of all pregnancies
- Preterm infants are at greater risk for what 3 things?
- 37
- mortality and morbidity
- the more premature they are the more at risk they are (inverse relationship)
- 10
- (1) Death in 1st year of life (2) emotional, behavioral, and learning problems (3) physical and intellectual disabilities
Preterm births are steadily increasing by small increments year to year due largely to an increase in _____ terms births, which is birth between 34 - 37 weeks.
Late preterm
Preterm births disproportionately affect what 2 demographics?
Hispanic women
Non-hispanic black women
What is the average term infant weight?
What is a low birth weight?
What is a very low birth weight?
What is an extremely low birth weight?
What classifies a neonate as small for gestational age?
What classifies a neonate as large for gestational age?
3500 grams
< 2500 grams
< 1500 grams
< 1000 grams
< 10th percentile
> 90th percentile
What are some reasons that a neonate might be born small for their gestational age?
Because they did not achieve full in utero growth potential (growth restriction)
- Multiple gestation (multiple babies delivered in same pregnancy)
- Maternal factors (malnutrition, medical conditions)
- Problems delivering nutrients (placental abnormalities)
- Congenital infection
Infants who are at risk for large for gestational age are at risk for perinatal morbidity and long term _________
Metabolic complications
What is the average head circumference?
What is microcephaly?
What is macrocephaly?
35cm +/- 2cm
< 33cm
> 37cm
Microcephaly can be caused by what 4 things?
Genetic
Infectious
Toxic
Metabolic
Macrocephaly can be caused by what 4 things?
Excess brain parenchyma
Excess CSF
Excess bone
Increased intracranial pressure
Alcohol is a teratogen that causes _______ CNS effects at all stages of gestation
irreversible
FASD can affect what aspects of fetal development?
Physical, behavioral, cognitive
What are 3 telling facial signs of FASD?
What is the Fetal Origins Hypothesis or the Barker hypothesis?
Alterations in embryonic nutrition and endocrine status during gestation can result in developmental adaptations that produce permament changes in structural, physiological, metabolic and epigenetic changes thereby predisposing their children to cardiovascular, metabolic and endocrine diseases as adults
What are the goals of newborn screening programs?
To detect disorders that are threatening to life or long-term health before they become symptomatic
Neonatal screening varies from state to state.
True/false
True
Birth weight _____ in the first 4-5 months
Birth weight _____ in the first 12 months
Length increases by _____ in the first 12 months
Doubles
Triples
50%
Brain mass ____ in the first 12 months.
This increase in brain mass is due to what?
Doubles
Growth of existing neurons, myelination of axons and proliferation of glial cells
Functional brain development and performance are dependent on what?
Use!
Neurons reach a constant number by _______ in gestation.
Synaptic density ______ during the first 2 years of life.
Synaptic density ____ until puberty and this is called “______”
28 weeks
Steeply rises
Declines, synaptic pruning
Why is the density of synapses front loaded in life?
Because the large surplus of synapses is needed in phases of life with large plastic changes
What is a critical period?
Developmental phases during which a certain skill, behavior, or mental capacity is normally acquired. After this period, neuroplasticity is lower and the probability of raeching a normal level of perception or behavior declines.
What gross and fine motor development milestones would you expect in an infant?
Infant movement develops in what direction?
Cephalo-caudal & proximodistal pattern
What gross developmental milestones would you expect for a toddler?
What fine motor developmental milestones would you expect in a toddler?
What is a unique developmental milestone that occurs in toddlers?
Toilet training, ages 2 - 4
What gross and fine motor developmental milestones are expected in early childhood?
What are night terrors
What gross and fine motor developmental milestones are expected in middle childhood?
When do most of the neural connections for langauge develop?
Within the first year of life
What language milestones do you expect for an infant?
What language developmental milestones would you expect for toddlers?
What language developmental milestones would be expected in early childhood?
When do most neural connections for higher cognitive function develop?
Between ages 1 - 3
What is a key developmental milestone for an infant?
Object permanence - know an object exists even if not in field of vision
What are important cognitive developmental milestones for toddlers?
Egocentrism
Symbolic play
Parallel play (toddlers play near each other but not with each other)
What are important cognitive developmental milestones in early childhood?
Imaginative play
Associate play (group activity/cooperation)
Learn by imitation
Learn to share
What are important cognitive developmental milestones of middle childhood?
Conservation - ability to consider more than one characteristic of an object simultaneously
Elimination of egocentrism - ability to view things from another’s perspective
What is an important social developmental milestone in an infant?
Attachment - relationship between infant and primary caregiver that provides infant with sense of safety, security, and comfort
Social smile - selectively recognizes mother and smiles in response
Stranger anxiety
Separation anxiety
What impact do abuse and neglect have on infant attachment?
They prevent formation of attachments with negative consequences for future personality development and ability to form relationships
Secure vs. insecure attachment is powerful predictor of what later in life?
Social and emotional development
What important social developmental milestones are expected for a toddler?
Social referencing - look to caregiver for emotional cues
Joint attention - understanding of others’ behavior
Gender identity - sense of being male or female is estabilshed by age 3
Separates easily from parents
What are important social developmental milestones in early childhood?
Moral development - motivated primarily by desire to avoid punishment
More task autonomy
What are important social developmental milestones in middle childhood?
Moral development - internalization of values and principles
Social cognition - person’s sense of self relative to others
Develop empathy
When is the best time to perform elective surgery on a child?
School aged children - they cope relatively well with hospitalization
