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Physiology & Science: Human Growth > Normal psychomotor development > Flashcards

Normal psychomotor development Flashcards

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1
Q

What is psychomotor development?

A

The progressive attainment of skills that involve both mental and muscular activity

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2
Q

What are the 2 prominent stages of psychomotor development?

A
  1. Formation of neural tube
  2. Development of prosencephalon
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3
Q

Describe primary neurulation

A
  • Process by which neural tube folds
  • ~3-4 weeks of gestation
  • NS begins in dorsal aspect of embryo as a plate of tissue
  • 2 lateral folds develop either side of neural plate
  • Then fold over and form neural crest
  • Epidermis forms, covering neural tube, which is now discrete
  • Occurs caudally
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4
Q

Disturbances in primary neurulation can lead to errors in neural tube development. What is anencephaly?

A
  • Failure of anterior end of neural tube to fold
  • Meninges + skull don’t form, most common type involves forebrain
  • Hypothalamus + brain in contact with amniotic fluid
  • 75% stillborn, rest die in neonatal period
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5
Q

What is myelomeningocele?

A
  • Post tube defect, caudal part doesn’t close
  • Worst type of spina bifida
  • Lumbo-sacral commonly affected, sometimes thoracic lesions
  • Can get hydrocephalus higher up
  • Paralysis of legs as well
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6
Q

What is holoprosecephaly?

A
  • Prosencephalon doesn’t split as it should
  • Remains as one sphere
  • Result in facial defects
  • No cleavage in the middle - single ventricle in middle
  • Happens ~5-6 wks gestation
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7
Q

What 4 events occur in the CNS after the neural tube has formed and cleavage/midline formation has occured?

A
  • Neuronal proliferation
  • Neuronal migration
  • Neuronal organisation
  • Myelination

These processes happen from second month of gestation right up until adult life

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8
Q

When is brain growth quickest?

A
  • Grows quickly before birth
  • Continues to grow quickly till 1 years of age
  • Starts to level off by 2 years of age (75% of adult weight)
  • Further development in puberty
  • Declines as we get older
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9
Q

When do synapses achieve maximum density?

A

at 6-12 months after birth

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10
Q

What is neurodevelopment like at birth?

A
  • Cerebral cortex primitive
  • Neurons poorly connected
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11
Q

What is meant by the physical growth of the nervous system?

A

Myelination of nerves and an increase in number of connections between cells. Myelination progresses: nervous control of various functions improve, continues throughout childhood.

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12
Q

What is meant by ‘biological influences’ on development?

A
  • Inherited characteristics eg. cognitive potential and temperament
  • Antenatal + perinatal history
  • General health
  • Vision + hearing (sensory systems)
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13
Q

What is meant by ‘environmental influences’ on development?

A
  • Opportunities such as sensitive and supportive parenting + education
  • Threats such as social + economic deprivation
  • Experience and encouragement
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14
Q

What are 5 characteristics of development?

A
  • Innate
  • Incremental
  • Progressive
  • Responsive to stimuli
  • Interdependent
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15
Q

What is meant by developmental milestones?

A

The age at which major skills that are crucial to a child’s progress in each of the 4 spheres of development are achieved

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16
Q

What are the 8 areas of child development?

A
  • Gross motor skills
  • Fine motor skills
  • Language comprehension
  • Expressive language
  • Hearing
  • Vision
  • Behaviour + emotional development
  • Social skills

*grouped in pairs, all relate with each other

17
Q

What gross motor skills do newborns posess?

A

Reflex head turn; moves head side to side

18
Q

At what age can/should a baby do the following:

  • roll back to front
  • crawl
  • cruises
  • walks
  • runs/kicks a ball
  • walk up + down stairs
  • skips
A
  • 5 months: roll back to front
  • 7-8 months: crawls/sits well
  • 10-11 months: cruises
  • 12 months: walks
  • 18 months: runs/kicks a ball
  • 2 yrs: can walk up + down stairs (1 step at a time)
  • 5 yrs: skips
19
Q

Most babies follow the sequence of gross motor skills but a small number of children will for example bottom-shuffle instead of crawl - is this normal?

A

Yes, there is a 9% incidence of bottom shuffling in comparison to crawl/stand/walk being 83%.

Bottom shuffling is inherited and if a child is a bottom-shuffler, they tend to walk alone slightly later but it is a normal pattern.

20
Q

Describe the fine motor/adaptive skills of a baby at certain points

A
  • 1 m: tracks horizontally to midline
  • 3 m: unfisted for >50% of time; tracks 180 degrees; visual threat
  • 5 m: ‘rakes’ at bright object
  • 6 m: transfers object from 1 hand to other
  • 7 m: 3 finger pincer grip
  • 9 m: fine/neat pincer grip
  • 14 m: tower of 2 cubes, scribbles spontaneously
  • 18 m: tower of 4 cubes
  • 2 yr: copies line
  • 3 yr: copies circle
  • 6 yr: copies triangle
21
Q

Give examples of primitive reflexes - when do they last till?

A
  • Moro reflex
  • Rooting
  • Sucking
  • Grasp
  • Stepping
  • ATNR (asymmetrical tonic neck reflex/fencing reflex)

Primitive reflexes begin to diminish at about 6 months as postural reflexes take hold as well as definitive motor actions

22
Q

Describe at what ages babies acquire language skills

A
  • newborn: alerts to bell
  • 2 m: cooing; searches w eyes for sound
  • 4 m: turn head to sound; laughs
  • 6 m: babbles
  • 8 m: mama/dada nonspecific
  • 9 m: understands “no”
  • 12 m: mama/dada specific, 3-5word vocab
  • 16 m: can point to several body parts
  • 2 yr: 50 word vocab, 2 word sentences
  • 2.5 yr: gives first + last names; uses plurals
  • 3 yr: 250 word vocab, intelligble speech 75% time to strangers
23
Q

Describe at what ages babies acquire personal/social skills

A
  • newborn: regards face
  • 6wk: spontaneous social smile
  • 6 m: discriminates social smile
  • 7 m: stranger anxiety, peek-a-boo
  • 12 m: drinks from cup
  • 15-18 m: uses spoon, spills
  • 2 yr: washes + dries hands
  • 3 yr: uses spoon well, buttons
  • 4 yr: washes + dries face; engages in cooperative play
  • 5 yr: dresses without assistance
24
Q

What would you be worried about if a baby wasn’t smiling at 6-8weeks?

A
  • Vision problems
25
Q

What is meant by developmental scales being ‘interdependent’?

A
  • Eg. fine motor skills are dependent on gross motor skills coming beforehand
  • Gross motor skills dependent on vision
  • Social skills dependent on vision
  • Hearing skills dependent on gross motor skills
26
Q

What is developmental delay?

A

Failure to acquire a particular developmental skill at an age when 95% of peers have done so

27
Q

What are the 2 types of developmental delay?

A
  • Global delay
  • Specific delay
28
Q

What is global delay and causes for this?

A
  • Delay in 2 or more areas of development
  • Widespread problem of brain structure:
    • Genetic
    • Asphyxial
    • Infective
    • Trauma
  • Widespread problem of sensory input:
    • Severe neglect
29
Q

What is specific delay? Examples?

A
  • To do with 1 specific part of brain eg. speech delay, some blindness
  • Defect of effector units eg. myopathies, neuropathies
  • Defect of sensory organs eg. blindness, deafness
30
Q

How often are babies screened?

A
  1. Newborn - every baby has it
  2. 6 weeks - done by GP
  3. 6-9 months - by health visitor
  4. 18 months - by health visitor
  5. 3 years - just before school
31
Q

How would you assess the development of a child?

A
  • Detailed developmental assessment
  • Take thorough history from parents
  • Watch them play in clinic room with toys
  • Griffith’s developmental scores
32
Q

What do you look for when looking for causes of developmental delay?

A
  • Chromosomes eg. down syndrome
  • Genetic referral
  • MRI brain
  • Audiology - correct w hearing aids/implants
  • Opthalmology
  • Thyroid function

Physiology & Science: Human Growth (9 decks)

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