Pediatric Assessment Flashcards
Screening procedures
To identify children whose developmental levels are below normal for chronologic age and who therefore require further investigation
Denver Developmental Screening Test II
“Denver II” Widely used, standardized measures; Examiners must be specifically trained and certified in use of the tools; Interpretation of test; Recommendations/referrals
PDQ II: Prescreening Developmental Questionnaire
A parent-answered prescreen consisting of 91 questions from the Denver II, based on age of the child; The form may need to be read to parents and caregivers who are less educated; If findings indicate developmental delays or cautions, the Denver II is administered as soon as possible
newborn reflexes
rooting, suck, moro (startle), tonic neck, galant’s (trunk incurvation), palmar grasp, stepping, babinski
rooting reflex
gentle stroke cheek, newborn turns toward stimulus and opens the mouth; reflex disappears at 3-4 months but might last longer; absence indicates a neurological disorder
suck
place gloved finger in babys mouth; baby should vigorously suck; reflex may persist during infancy; week or absent reflex indicates development or neurological disorder
Moro (startle)
when the infant is startled or feels like he or she is falling ; sudden noise can stimulate it verifying the infant can hear; sit baby, support upper body and head w/ one hand, flex chest, suddenly let head and shoulders drop while releasing arms, arms and legs extend symmetrically, arms return to mid line with hands open and thumb and index form “c”; disappears 4-6 months; absence or weakness upper motor neuron lesions; asymmetrical w/ brachial plexus injury
tonic neck
turn the head to one side, arm and leg extend on side face is facing, contralateral arm and leg flex forming fender position, repeat by turning to other side and effect will reverse; strongest at 2 months and disappears at 6; if still present at 9 months then neurological damage and infant will not be able to support weight to crawl
galant’s (trunk incurvation)
place baby in ventral suspension; stroke skin on one side of back, trunk and hips should swing toward the side of stimulus; present 1st 4-6 weeks; absence - spinal cord lesions
palmar grasp
place finger in babys palm, infant fingers will firmly grasp finger; strongest between 1-2months; persistance after 3 months indicates neurological disorder
stepping
hold baby upright, allow sole to touch flat surface, legs and feet extend in a walking patter; reflex exists 1st 4-8 weeks of life and persists w/ neurological conditions
babinski
stroke one side of infants foot upward from the heel and across the ball of the foot, infant responds by hyperextending the toes, big toe flexes toward top of foot and other toes fan outward; last until child is walking; if persistence after 2 then associated with neurological damage
birth language skills
crying
1-2 month language skills
cooing
middle of first year language skills
babbling
8-10 months language skills
gestures such as showing and pointing
10-15 months language skills
uses first word, has receptive vocabulary of 50 words
18 months language skills
has expressive vocabulary of 50 words
18-24 months language skills
uses two-word utterances (telegraphic speech) such as “more milk”
2 years language skills
expressive vocabulary of 200 words
3-6 years language skills
learns 5-8 new words a day; works on syntax and meaning
6 years language skills
expressive vocabulary of 8,000-14,000 words; learns 22 new words per day
7 years language skills
begins to categorize words by parts of speech; learns comparatives (bigger, longer, etc.) and subjectives (“if you were the school principle…”)
6-12 years language skills
understands and uses more complex grammer; must be able to do this orally in order to read
