Paediatric development Flashcards
Development : Gross motor - 3 months
”High Leaping Rabbits Swiftly Climb White Walls, Squirrels Run Through Secret Holes”
- High (0-3 months) - Head support, lifting and turning head
- Leaping (4-6 months): Lifts legs when lying on back- Grasps at feet
- Rabbit : Rolls front to back
- Swiftly (7-9 months): Sits without support, straight back and can pull to sitting
- Climb (9 months): Crawling
- White (12 months) - Walks with one hand held, cruises
- Walls ( 13-15 months) - Walks unsupported
- Squirrels (18 months) : Squats to pick up town
- Run (2 years) : Runs + Rails used going up and down stars
- Through secret (3 years) : Tricycle riden + Stairs without rails
- Holes (4 years) : Hops on 1 leg
Development : Feeding
”Hungry Chicks Savor Fresh Kiwis”
1. 6 months : Hand on bottle
2. 12 - 15 months : Cup to drink and uses spoon
3. 2 years : Spoon competent and doesn’t spill with cup
4. 3 years : Fork and Spoon used
5. 5 years : Knife and Fork used
Development : Dressing
Helpful Unicorns Support Independent Buttoning
1. 12-15 months : Helps getting dressed/undressed
2. 18 months : Undresses shoes and hat but cannot replace
3. 2 years : Shoes and hat can be put back on
4. 4 years : Independent dressing/undressing except for buttons and laces
Development : Play
Playful Bears Adore Naughty Fun
1. 9 months : ‘Peek-a-boo’
2. 12 months : ‘Bye-Bye’ wave
3. 18 months : Alone playing
4. 2 years : Near to other children playing
5. 4 years : Friends! Plays with other children
Development : social
”Samantha Likes Engaging in Social Moments”
1. 6 weeks : Smiles
2. 3 months : Laughs
3. 6 months : Extroverted / Not shy
4. 9 months :
* Shy
* Takes everything into mouth
Development : Language
”Quiet Toddlers Sound Serene; Do Sush! Moms, and Dads Know Names. 2 to 6, go to bed! Two words and points parts , Vocabulary Jumps. Tiny Explorers Ask: ‘Why, When, How?’
- 3 months : Quietens to parents voice, Turns towards sound
- 6 months : Double Syllable
- 9 months : Says Mama and dada, understands ‘No’
- 12 months : Knows and responds to name
- 12-15 months : 2-6 words, understands simple commands
- 2 years : Combine two words, Points to part of the body
- 21/2 Years : Vocabulary of 200 words
- 3 years : Short sentences, asks what and who
- 4 years : asks why, when how
Development : Objects
”Fixate, Palmar Grasp, Scissor Squash, Pincer Pinch, Spoon Scoop.
- 8 weeks: Fixes their eyes on an object 30 centimetres in front of them and makes an attempt to follow it. They show a preference for a face rather than an inanimate object.
- 6 months: Palmar grasp of objects (wraps thumb and fingers around the object).
- 9 months: Scissor grasp of objects (squashes it between thumb and forefinger).
- 12 months: Pincer grasp (with the tip of the thumb and forefinger).
- 14-18 months: They can clumsily use a spoon to bring food from a bowl to their mouth.
Development : Drawing
”Scribble vertically then horizontally create a cross, Try!”
* 12 months: Holds crayon and scribbles randomly
* 2 years: Copies vertical line
* 2.5 years: Copies horizontal line
* 3 years: Copies circle
* 4 years: Copies cross and square
* 5 years: Copies triangle
Development : Bricks
**12 months plus two months tower of 2
Wait another 4 months for a tower of 4
Keep adding 4 every 6 months
3 years : 3 block train/bridge then step to 4
- 14 months: Tower of 2 bricks
- 18 month/s/: Tower of 4 bricks
- 2 years: Tower of 8 bricks
- 2.5 years: Tower of 12 bricks
- 3 years: Can build a 3 block bridge or train
- 4 years: Can build steps
Red flag symptoms : Fine + Gross motor
Fine motor :
Unable to hold an object at 5 months
Hand preference before 12 months
Gross motor : Unable to sit unsupported by 12 months, Unable to stand by 18 months, unable to walk independently at 2 years
Red flag symptoms : Language and social
Language : No words at 18 months
Social : No smiling at 10 weeks, No interest in others at 18 months
Global development delay : Causes
Slow development in all developmental domains
1. Down’s syndrome
2. Fragile X syndrome
Gross/Fine motor delay : Causes
- Cerebral palsy
- Visual impairment
- Muscular dystrophy
Language delay : Causes
Hearing impairment
Autism/Learning disability
Cerebral palsy
Failure to thrive : Definition
Faltering growth in children as they fall in weight across centile spaces
Failure to thrive : Causes
1 . **Inadequate nutritional intake **
* Maternal malabsorption
2 . Difficulty feeling
* Abnormal facial structure : Cerebral palsy, cleft lip
* Pyloric stenosis
3 . Malsorption
* Intolerence/Allergy : Coeliac’s disease, Cow’s milk intolerance
* GI disease : Cystic fibrosis, IBD
* T1DM
4 . Increased energy requirements
* Hyperthyroidism
* Chronic disease : Congential HF, Cystic fibrosis
* Infection
Short stature : Definition
Short stature is defined as a height more than 2 standard deviations below the average for their age and sex. This is the same as being below the 2nd centile.
Short stature : Causes
- Familial short stature
- Constitutional delay in growth and development : short stature in childhood but growth spurt during puberty lasts longer - reaching predicted adult height
- Malnutrition
- Chronic diseases, such as coeliac disease, inflammatory bowel disease or congenital heart disease
- Endocrine disorders, such as hypothyroidism
- Genetic conditions, such as Down syndrome
- Skeletal dysplasias, such as achondroplasia
Vaccination schedule - < 5 years old
‘Babies get protecting against many!
Babies : BCG if risk factors
Get (first jabs) :
1 . 2 months : 6-1 vaccine (1) + Rota virus + Men B(1)
2 . 3 months : 6-1 vaccine(2)+ Rota virus(2) + PVC(1)
Protecting (boosters)
3 . 4 months : 6-1 vaccine(3) + Men B(2)
Against many (lots of jabs)
4 . 1 year : HiB/MenC + MMR(1) + PCV (2) + MenB(3)
5 . 3-4 years : 4 in 1 pre-school booster + MMR
Vaccination schedule - > 5 years old
- 12-13 years : HPV vaccination
- 13-18 years : 3 in 1 (think 13) teenage booster + Meningitis ACWY
What are the component of the 6in1 vaccine vs 4in1
- ‘6-1 vaccine’ : diphtheria + tetanus + whooping cough + polio + Hib + hepatitis B
- ‘4-in-1 pre-school booster’ diphtheria + tetanus + whooping cough + polio
Neonatal blood spot screening
Neonatal blood spot screening (previously called the Guthrie test or ‘heel-prick test’) is performed at 5-9 days of life
Conditions screened for;
* Congenital hypothyroidism
* Cystic fibrosis
* Sickle cell disease
* phenylketonuria
* medium chain acyl-CoA dehydrogenase deficiency (MCADD)
* maple syrup urine disease (MSUD)
* isovaleric acidaemia (IVA)
* glutaric aciduria type 1 (GA1)
* homocystinuria (pyridoxine unresponsive) (HCU)
