Peds Flashcards
what is the CDC’s reccomendation on which growth chart to use
WHO growth charts up to 2
CDC/NCHS from 2-19
four growth parameters to measure
head circumference
length
weight
BMI
what is OFC in regards to pediatric growth measurements
what is the concern if it is large
what is the concern if it is small
occipital-frontal circumference
hydrocephalus
poss poor brain development
when is the period of most rapid head growth
0-2 months
what are the two main periods of increasing length
infant and adolescence
how much does length increase in the first year
by four years
by 13years
on average how much does high increase between age 2 and teenage years
50%
2x
3x
2” per year
how to estimate adult heigh based on height at age 2
take the height and double it
estimate adult height based on parents height for boys
girls
boys: Mom height + 13 + Dad height/2 +-5
girls: mom height + dad height - 13/2 +-5
T/F childten may up to 10% of their birth weight
what would you expect to happen at week 2
true
they shuld have gained their weight back
how much weight should a baby gain
15-30 (.5-1 oz) everyday
how long should a baby get back to birth weight after birth
when should they have doubled their weight
tripled
quadrupled
2 weeks
4 months
1 year
2 years
how much weight should a child gain between age 2 and adolescence
5lbs
calculating ideal birth weight for men
for women
what are the flaws
110 for 5’ then 5 lbs every inch
100 for 5’ then 5lbs for every inch
only works for people >5ft tall, estimates too low for women, usually for calculating doses and assessing severity of anorexia
T/F gross motor development progresses from the bottom up
false, it progresses from the head down
what is the rationale for using the WHO growth charts until age 2 then the CDC charts after
breastfed infants regardless of background are generally the same
after age 2 the diet and health care availible in the US will cause us to have larger children
differentiate length vs height
length is laying down
height it standing
where do boys hit their highest growth velocity
girls
what accounts for this difference
14
12
girls growth plates fuse faster during their growth spurt, boys stay open longer and allow for more gradual growth before the growth spurt
why add 13 or minus 13 from the parental heights when calculating height
it takes into account the genetic potential the mother had or the growth the father experienced before the growth spurt
12 month old presents with mom for Well Child Visit.
Mom concerned that baby is smaller than his 9 month old cousin.
Mom is worried she is not feeding him well enough. He drinks 30 ounces of whole milk per day with 3 meals and 3 snacks.
Mom’s height: 5’2 (157cm)
She is the tallest girl in her family, but the men in her family are close to 6 foot tall
Dad’s height: 5’4” (162cm)
He has siblings that are shorter than him
should they be concerned
no, there is a strong possiblity based on CDC charts that the child will just be short
BMI standard for peds
underweight <5%
healthy 5-84%
overweight 85-94%
obese >95%
what is more important for pediatric growth before 4 years, TH or GH
after 4
TH before 4, GH after 4
when should head leg go away in an infant
between two months and 6 months they should have the strength and recognition to tuck their chin
categorize these from top to bottom
1 month no head up
2 months about 45 deg
4 months head up and rolling
how do most kids learn to roll over
front to back accidently as they look around and fall over
gross motor development milestones
rolling
sitting
crawling
4 months
6 months
9 months
gross motor development milestones
cruising
walking
walking backward
running
10-11 months
12 months
15 months
18 months
gross motor development milestones
running
jumping & climbing stairs (2 feet)
tricycle & climbing stairs (alternating feet)
18 months
2 years
3 years
gross motor development milestones
hops on 1 foot, go down stairs alternating feet
jumps over things
4 years
5 years
fine motor development milestones
2 months
3 months
4 months
follow past midline
follow 180 deg
reach with two hands
fine motor development milestones
6 months
9 months
12 months
transfer object and raking
immature pincher
matuer pincer
describe the evolution in fine motor skills in terms of grasping
6 months they should rake
9 months they should do an inferior pincher grasp
12 months the should do a fine pincher grasp
describe these from top to bottom
rake, thumbs aducted, proximal and distal thumb joints flexed, happens at 6 months
inferior grasp between the thumb and the index finger beginning opposition, 9 months
fine pincher between fingertips, 12 months
fine motor milestones
15-18 months
use a spoon and cup
2 block tower
scribbles
fine motor milestones
2 years
3
4
6 block tower
draw circle, clothes off
draw a cross
fine motor milestones
4.5
5
draw square, clothes on, buttons, catch ball
tie shoes
language development milestones
2 months
4 months
6 months
smile
laugh
babble
language development milestones
9 months
12 months
15 months
wave bye
jargoning (intonation), performing 1 step commands with gesture
1 step commands
language development milestones
18 months
2 years
know 5 body parts
2 word sentances, “what”, 50 word vocab
language development milestones
3 years
4 years
5 years
3 word sentances, why, temporal orientation, 250 words
4 colors, songs or poems from memory
print first name
describe 2/4, 3/4, 4/4 as it relates to language development
2 yeasr should be 50% intelligible language
3 years is 75%
4 years is 100% intelligible
social development milestones
1
2
6 months
regards face
recognize parents
likes looking around
social development milestones
6
8
12 months
strangers
expoloring+pat a cake
imitation, comes when called
social development milestones
15-18 months
independent
copies parents (18months)
protoIMPERATIVE vs protoDECLARATIVE
at 15 months they can’t speak but they can point to what they want (imperitive)
18 months can point something out as interesting (declaritive)
when is autism evident in toddlers
15-18 months, they can’t speak but they can interact by pointing and should want to do that
may also point with a thumb instead of forefinger
social development milestones
2
3
4 years
parallel play
group play, sharing, taking turns
associate gender specific categories, competition
why is sharing difficult to learn at age 3
because children lack empathy to understand that not everything is theirs
when is a newborn hearing screen done
when should it be repeated
when should signs of hearing loss be assessed
at discharge
at age 4
with each visit
signs that infants can hear
at 0-2 months
startle response and blink to sudden noise
calming down with soothing voice or music
signs that infants can hear
2-3 months
change in body movements in response to sound
change in facial expression to familiar sounds
signs that infants can hear
3-4 months
turning eyes and head to sound
signs that infants can hear
6-7 months
turning to listen to voices and conversation
around when will children begin to show imagination
3-5 years
incidence in hearing loss in babies
when is intervention most crucial
2-4 out of 1000 babies
intervention is critical before 6 years
T/F babies have excellent vision
false, very poor 20/400 in black and white with a fixed focal length of 12 inches
when do infants develop full color vision
7 months
goals of a well child check
assess growth and development
identify problems to provide education and early intervention
teach parents childcare and parent care
describe these pictures in terms of infant development
at four months a baby will lay on its back and grasp something at th midline
at 6 months a baby can sit up, listen, see, hear
at 1 year they can stand, talk, and pincer grasp
6 topics for a well child visit
- Interval history since last appointment
- Parent concerns
- Child care
- Review medical history
- Review medications / allergies
- Sleep issues
- Dietary issues
- Family risk factors
- Nutrition evaluation
- Anticipatory guidance (aka stuff you teach the parents)
- Immunizations
- Screening labs if indicated
- Developmental and Mental Health
- Fine motor / Gross motor
- Hearing
- Vision
- Dental
pateitn presents tolerating solid food, brings feet to her mouth, being distracted by a mirror and pats her image
which of the following developmental milestones are most typical for in infant whose age is what
A) 2 months
B) 4
C) 6
D) 9
E) 12
c, 6 months. tolerating solid food, placing feet in mouth, and reaching for a mirror while patting the image are all typical 6 onths milestones
6 month old girl presents with mom for Well Child Visit.
Mom states that baby is eating well.
Baby has social smile and is cooing.
On physical exam baby has head lag. Not able to push up on hands. Has not started rolling over yet. Can not keep head steady when held in sitting position.
Growth chart demonstrates less than optimal growth
why might this be considered normal
if the baby is premature, comparisions to growth and development are made to their gestational age until2 years
baby presents saying hi to receptionist, asking for juice, tries to give her doll a drink, knows her mouth, imitates mother, and knows mama
what age would you expect this child to be
18 months
patient presents able tos tand, take a few steps independently, and uses a two finger grasp
what age would you expect this patient to be
12 months
what is preferred method of infant nutrition
breast feeding up to 6 months, try to main tain for 12 months
when is formula used
if breastfeeding isn’t possible or desired
two contraindications for breastfeeding
infants with classic galactosemia (galactose 1-phosphate uridyltransferase deficiency)
mother who have HIV
how often should a baby be breastfed
8-12 x in 24 hours in the first month
7-9x 1-2 months
6-8x 2-12 months
how do you know if a baby is breastfeeding well
are they gaining weight
content/active/alert
wet or dirty diapers regularly
how much formula should be given when using formula
2-2.5 oz per lbs in 24 hours
2-3 oz ever 3 hours
4-6 every 3-4 hours
max 32oz at 24 hours before eating solid foods
when should babies be tranisitioned to solid food
indications a child is ready for solids
4-6 months
does the baby hold up their head, open their mouth at the sight of food, at least double their body weight from birth
reccomdations for infant cereal
baby food
start with 1-2 teaspons of a single grain cereal mixed with breast milk, formula, or water, then advance to 1-2 table spoons twice daily
give a new food each day, start with 1 tsp working up to a full jar
when should a baby start eating finger foods
7-8 months, or when they can sit up and bring objects to their mouth
how long should fruit juice be withheld
whats the maximum amount of fruit juice
should it be put into a bottle
1 year
4oz/day max up to half the daily reccs for fruit
no, only from a cup
reasons parents should avoid juice
cavities
malnutrition
short stature
perioral rash
diarrhea
GI symptoms
when should the transition to cup and utensil feeding happen
as soon as possible
when should toddlers transition from breast milk/whole mile to low fat milk
2
T/F abnormal flucuations in appetite are abnormal
false, they are normal and should be expected
why can iron and zinc defiency be an issue in pediatrics
because meat is a major source of both and kids don’t necessarily like the taste/texture of them
T/F parents should fed children snack food if they won’t eat normal food
false, don’t let them eat food with no nutritional value just to get them calories
what is the calorie need of toddlers
how much of that is fat
1000, half from fat
why is fiber very important for toddler nutrition
prevention of constipation
questions to ask during a nutritional interview
who buys and makes food
who does feedings
are they on a consistent schedule
aer you offering good portions
do you eat out
key issues for school aged nutrition
getting enough fruit, veggies, calcium, vit d
avoiding junk food
developing a healthy body image
guidlines for school aged nutrition
consume 3 meals with 2-3 snacks as dicated by appetite, growth, activity
limit grazing
avoid automatic eating
avoid junk food
favor fresh foods
big change between school age kids vs toddlers
decrease from 50 to 35% total cals from fat
45-65% carbs less than 10% simple sugar
causes of pediatric malnutrition
inadequate intake from eating disorders or limited access
celiac disease
crohns
chonic liver disease
conditions sequelae to pediatric malnutrition
illness
stunted growth
hyperactivity
aggression
anxiety
mental disabilities
pellegra
risk factor
solution
a niacin deficiency
maize based diet
foods rich in protein and whole grains
beri-beri
risks
solution
thiamin deficiency
polished rice or other cereal diet
whole or parboiled rice, legumes, protein sources
what nutritional factor will cause a vitamin A deficiency
how can it be resolved
a diet without enough fresh fruit
dark orange fuirt and veggies, yellow corn, dark green veggies
scurvy
risks
solution
vitamin C defiency
diet without fresh fruit and a low fat intake
more fruit, veggies, liver, animal milk
T/F you can have an obese child who is malnourished
true
failure to thrive
decline in weight curse by two percentile channels from a previously established rate
typical pattern for failure to thrive
decreased weight with normal height and head circumference, progressing to height and head slowing
treatment for failure to thrive
correct underlying cause (usualyl inadequate intake)
look at social environment for poor eating or learned behavior
BMI in pediatrics is based on the number or their percentile
percentile
what demographics are most likely to be obese
hispanic boys and black females
potential complications of childhood obesity
HTN
dyslipidemia
DMII
sleep apnea
mental health problems
orthro issue
what is the probability that pediatric obestity will progress into adulthood
20% at 4 years
80% at adolescence
risk factors for childhood obesity
genetics
behaviors
environment
two ways to gather infromation that will help early recognition of high-risk patterns of weight gain
dietary history
activity log
measurements and observations to help dectect pediatric obesity
plot trend on ht, wt, bmi
blood pressure
note on adiposity
labs
what is acnthosis nigricans indicative of
high levels of insulin
lab tests for obese childten based on BMI 84-94th percentile with and without risk factors (FHx, HTN, high lipd levels, tobacco)
what if BMI is +95th
fasting lipids
fasting lipids with AST, ALT, fasting glucose
same as the ones with risk factors
treatment for childhood obesity
eat less do more
staged approach to treating obesity
prevention plus
structured weight management
comprehensive multidisciplinary
tertiary care intervention
differentiate between stages of obesity treatment (prevention plus, structured management, comprehensive multidisciplinary, tertiary care)
counselling with emphasis on lifestyle changes
meal planning, exercise, behavior goals with dietician or therapist
multidisciplinary team with weekly meetings
mutlidisciplinary team that might involve medications or surgery
what is the maximum amount of weight loss reccomended for BMI over 95th percentile before age 11
lose 1 lb per month
pharmacotherapy treatment for obese children
orlistat (lipase inhibitor) approved for >12 yrs old
AAP reccomendation for TV
no tv before 2, max 2 hrs after 2
indications for bariatric surgery of obesity
severely obese adolscents who are mature with a BMI over 50 or over 40 with comorbid conditions
AND
failed a structured weight loss program for six months
AND
are psychologically ready for major lifestyle changes
contributing factors of teenage smoking
low SSE
use or approval from peers/siblings/parents
availabilty and price
no parental support
low self esteem
5 A’s for smoking cessation
ask
advise
assess
assist
arrange
three parts of pubertal cognitive development
change in secondary sex characteristics and development of reproductive ability
cognitive recognition of the previous
moral determination of right and wrong in shade of grey
progression of cognitive ability associated with adolescents
formal operational thought (development of logic, deduction, planning)
use of abstract thought to consider possible outcomes and consequences
increased self awareness
PSYCH primary care providers screen for socio-emotional problems
Parent child interaction: how are things going with your parents
school: how are things in school
youth: how are things with friends
casa: how are things at home
happiness: how would you describe your modd
what demographics have increased risk of depression
teenage girls and minorities
pharmacotheraputic treatment of depression in adolescents
SSRIs are useful and 30% of patients don’t remit after initial treatment
second and third line treatments are available
third line treatment should involve referral
how long should depression be treated with SSRIs
why is it important to have adherence
6-12 months
relapse is more common with patients who stop taking drugs once symptoms remit
why would SSRI treatment be considered for longer than 6-12 months
if the depression episode includes psychosis, suicidal behavior or ideation, functional impairment, resistance to treatment, previous failure to reduce medication
what is the leading cause of morbidity/mortality in adolescents
MVA, frequently involving alcohol or texting
possible explanations why suicide rates are increasing
increased drug and alcohol abuse
depression
family/social disorganization
access to firearms
social media
what is the lag time in SSRI treatment
4-6 weeks before there is an appreciable effect
T/F there is no evidence that screening for suicidal ideation in teens reduces suicides
true, suicidal patterns can be identified but there is little effect on outcomes
general screening questions for suicide
depression
substance abuse
hx of violence, victimization, or witnessing violence
Suicide-Screening Questionare questions
- In the past few weeks, have you wished you were dead?
- In the past few weeks, have you felt that you or your family would be better off if you were dead?
- In the past week, have you been having thoughts about killing yourself?
- Have you ever tried to kill yourself?
questions to ask if you think there is a suicide risk
content, nature, chronicity of thoughts
planning
details of the plan
once suicidal ideation with planning has been identified what is the goal
work with family to address safety issues
removing access to means
constant monitoring
when would you put a patient on a 24 hour hold
when would you refer to psych
if there is imminent risk of suicide
if there is a plan but not imminent risk of suicide
lab tests for suicide attempts
toxicology screen
pregnancy test
drug and alcohol screen
test for medical conditions that can lead to psychiatric disorders (thyroid, SLE, IBS)
what is the standard of care for suicide attempts
other options?
hospitalization, though it is not proven to prevent future suicide
outpatient treatment for low risk pts with intensive home therapy
pharmacotherapy for suicide
no proven treatment, SSRIs might be used during initial therapy or if underlying psych disorders are present
what can we do to prevent suicide
recognize disrders
screen
anticipatory guidance on drug use, firearms etc
be tehre
reduce stigma of mental healt conditions
T/F school and community based suicide prevention programs are effective
false, there is some evidence for school based support
what percent of high school students exercise for 60 minutes daily
35%
what makes breast milk superior nutritionally to formula
contains a species specific amount of fat, sugar, and minerals
antibodies
changes to adapt to what the baby needs
how many women start breast feeding
how many continue breast feeding until 6 months
81%
50%
short term maternal benefits of breastfeeding
less postpartum bleeding
easier postpartum weight loss
delays ovulation
allows for mother/infant bonding
long term maternal benefits of breastfeeding
reduced risk of breast and ovarian cancer
decreased risk of CV disease, HTN, hyperlipidemia
decreased risk of DM II
infant benefits of breast feeding
decreased rate of ear infections, respiratory illness, allergies, diarrhea, childhood obesity, SIDS
what is the economic benefit of breast feeding
saves $1200/yr on formula
lower healthcare issues due to fewer illnesses
the five steps of lactation physiology
mammaogenesis
lactogenesis
galactokinesis
galactopoiesis
involution
mammogenesis
development of breasts to a functional state
lactogenesis
stages
synthesis and secretion of milk from the breast alveoli
Stage I: colosutrum production starting at week 16
Stage II: sharp increase in production due to decreased progesterone after delivery of the placenta
galactokinesis
galactopoiesis
ejection of milk
maintenance of lactation
involution
regression and atrophy post lactation
types of breast milk
colostrum: late pregnancy until 4 days after delivery (antibodies)
transitional milk: day 4-10, lower in protein than colostrum
mature: produced from day 1o through completion of breastfeeding
describe the positive feedback mechanism that regulates milk production
sensory stimulus of suckling triggers a release of prolaction from the anterior pituitary and oxytocin from the posterior pituitary
function of prolactin in breastfeeding
oxytocin
increases milk production
stimulates let down from the breast
why is breastfeeding preventative for uterine bleeding postpartum
it causes smooth muscle contraction and involution of the uterus
T/F the decrease in ovulation from breastfeeding can be considered contraceptive
false, there is still a change to get pregnant
what is the best way to maximize milk production
infant feeding or pumping (not as effective)
do exercise or contraception have an effect on lactation
little if any
ways to decrease milk production
stress (inhibits milk let down)
smoking
supplementation with formula
engorgment
signs of hunger to indicate breastfeeding should start
increased alertness
mouthing or rooting
bringing hands to mouth
crying is the last one
signs of satiety after breast feeding
relaxation of arms and elgs
eyes close
falling asleep
T/F breast milk is lacking in vitamin D
true
tips on how to initiate a latch
bring baby to breast
infant facing mother
wide gape for nipple and areola
lower lip out
full cheeks
tongue extended
typical breastfeeding schedule during the first week
wake every four hours to feed
follow urine and stool
common issues with breast feeding
inadequate milk supply (most common reason for termination)
nipple or breast pain
breast infections (mastitis/yeast)
maternal medication use
special psych risk for post partum women who are having difficulty breast feeding
postpartum depression
reasons for inadequate milk production
insufficient breast development (rare)
previous breast surgery (augmentation or reduction)
delay in progression to stage II lactogenesis
maternal drugs that decrease milk production
issues with breast reduction that can decrease milk production
interruption of ducts
decreased blood flow
nerve damage that decreases reflex arc
factors that can delay progression to stage II lactogenesis
materanl pre-pregnancy obesity
gestational hyertension/preeclampsia
PCOS
retained placenta fragments
pituitary insufficiency (sheehans syndrome)
drugs that can decrease milk production
decongestants, antihistamines
problems that can least to milk extraction issues
insufficient nursing and poor feeding schedule
problems with latch
ankyloglossia
ankyloglossia
baby born with a short frenulum that limits tongue extension
when should you be concerned a baby was not getting fed enough
weight loss beyond 3 days of life
weight loss of >7% of birth weight
failure to regain birthweight by day 10 of life
sheehands syndrome
a loss of pituitary function from episodes of extremely high blood pressure
Risks of insufficent feeding
dehydration
elevated bilirubin
re-hospitalizxation
acute renal failure -> shock, sz
when should supplemental feeding be considered
dehydration
<3 stools/day
loss of 7% birth weight
limited maternal milk supply
galactogogues
two types
medications that can increase milk supply
reglan, fenugreek
what is the dosing schedule for reglan for breastmilk production
is it proven successful
how long should the course be
10mg/8hrs
limited evidence, some anecdotal
limit to 1-3 weeks unless it works really wel
what is the issue with fenugreek supplmentation for breast feeding
it can help increase production but it isn’t welll proven
causes of nipple and breast pain
breast pump use
nipple vasoconstriction from reynauds
engorgment
plugged duct
nipple issues
how to treat reynauds associated with breastfeeding
warm the whole body
treatment for engorgement related to breast feeding
empty breast, pump if needed, check latch, take nsaids
treatment for a plugged duct related to breastfeeding
check latch
warm compress
expression
analgesics
nupple issues with breastfeeding
nipple or breast infections
dermatitis or psoriasis
inverted nipples
overall management of breast and nipple pain from breast feeding
get a good latch
be aware that is is normal
nurse on the unaffected side first
avoid excess moisture/air dry
masitis
incidence
causes
organism
local inflammation of the breast that causes fever, myalgia, pain, firmness
5-10%
ineffective feeding/incomplete emptying, plugged ducts, nipple damage
usually from staph
treatment of mastitis
nsaids, cold compressess
continue breast feeding
ABx
treatment of non-severe, low risk MRSA mastitis
dicloxacillin
keflex
clindamycin
treatment of non-severe, moderate MRSA mastitis
trimetoprim-sulfamethoxazole
clindamycin
treatment of severe mastitis
inpatient IV vancomycin
what usually preceeds a breast abscess
symptoms
evaluation
treatment
usually preceded by mastitis
breast pain, fever, myalgias, fluctuant, tender mass
evaluate by ultrasound, treat with I&D
symptoms of yeast infection in the breast
pain out of proportion with findings on exam
history of infant oral or diaper candidal infection
maternal vaginal yeast
shiny, flaky nipple skin
treatment of nipple yeat infections
topical antifungal
combination of antifungal
gentian violet
maternal fluconazole
infant nystatin
contraindications of breastfeeding
infant with galactosemia
HIV+
human T cell lymphotrophic virus
active TB
cytotoxic chemo
illicit drugs/alcohol
galactosemia
symptoms
inborn error of metablism that leads to accumulation of galactose
failure to thrive, liver dysfunction, mental retardation
reccomendations for HIV breastfeeding
formula in developed countries
breastfeeding in poor countries
common diseases that are NOT contraindications for breastfeeding
HepB (if the infant is immunized at delivery)
HepC
maternal fever
chorioamnioitis
materanl CMV if the baby is term and mother hasnt converted
indications to pump and bottle feed
materanl varicella, occuring 5 days before throigh 2 days after
active herpes on the nipple
active H1N1 flue
what is the best way to support breastfeeding after birth
skin to skin contact increases breastfeeding by 42.6 days
barriers to breastfeeding
african americans
adolescent, <25 years
single mothers
smokers
less than high school education
participation in WIC
early return to work
unwatnted pregnancy
when is it ok the start breastfeeding after general anesthesia
when the mother is alert
how long after drinking should breastfeeding be allowed
2 hours after a single drink
what is fetal alcohol specturm disorder
the rangle of effects that can occur in an individual who is exposd to alcohol during the nine month prenatal period before birth
common features of fetal alcohol syndrome
craniofacial dysmortpholgy
growth deficits
neurological abnormalities or deficits
T/F prenatal alcohol is the leading cause of birth defects and development disabilities
T/F alcohol causes worse neurobehavioral effects than other drugs
true to both
fetal alcohol syndrome
mental, physiolofgical, neurological, and behavior birth defects caused solely by expsoure to alcohol during pregnancy
T/F animal studies show that continous drinking is more damaging than binge drinking
false, other way around
pathophysiology of FASD
alcohol quickly crosses the placenta
the fetal liver lacks alcohol dehydrogenase or gluthiaone to break down alcohol
amniotic sac holds alcohol
what are the effects of ethanol/acetaldehyde in FASD
disrupt cell differentiation
DNA and protein synthesis
inhibition of cell migration
altered fat/protein/carb metabolism
decrease movement of amino acids, protein, folic acid, minerals across the placenta
CDC criteria for diagnosis of FAS.
how amany are needed for diagnosis
facial dysmorphia
growth deficits
CNS abnormalities or behavior deficits
all three
facial dysmorphia related to FAS
smooth philitrum
thin vermilion border
small palpebral fissures
micrognathia
epicanthal folds
minor ear abnormalities
growth deficits related to FAS
prenatal or post natal and or weight below 10th percetile at one point in time adjusted for age, sex, race
CNS or neurobehavior deficits related to FAS
head circumference below 10th percentile
clinically significant brain abnormalities observed through imaging
abnormalities in function skills of the CNS
T/F you have to have confirmed prenatal alcohol use to make a diagnosis of FAS
false
abnormalities of functional skills of the CNS related to FAS
decreased cognition
motor delays
ADHD
social skill issues
language problems
others
clinically significant brain abnormalities associated with FAS
changes in the corpus callosum, cerebellum, basal ganglia
cognitive difficulties for a person with FASD
taking and retaining infrmation (sensory integration)
recollection
using informaiton in a specific situation
primary disabilities related to FASD
lower IQ
impaired abilites in reading or math
lower level of adaptive functioning
commonly diagnosed with ADHD
sensory integration issues with FASD
strategies to overcome
overly sensitive to stimulus, problems with kinesthetic awareness, loss of social cue recogition
simplifiy environment, take steps to avoid sensory triggers, OT/PT interventions
memory issues with FASD
information recall (learning, test taking, directions)
putting things from memory in sequential order
strategies to avoid memory issues associated with FASD
provide direction one rule at time
review rules regularly
repetition
typically difficulties with information processing with FASD
may feign understanding
poor judgement in decision making
don’t ask questions because they want to fit in
examples of executive functioning issues associated with FASD
repeatedly break rules
doesn’t learn from mistakes
issues with time and money
susceptible to peer pressure
stragegies to deal with executive functioning in FASD
use short term consequences
establish achievable goals
provide skill training that uses role play
secondary disabilities associated with FAS/FASD
mental health issues
school issues
trouble with the law
inappropriate sexual behavior
substance abuse
preventing secondary disabilities associated woith FAS/FASD
get early diagnosis and help
family education
increase supervision in adolescence and early adulthood
proactive adult support and mental health services
myths about alcohol and FASD
less than one drink a day is ok
drinking late in pregnancy is ok
drinking is good for breastfeeding
the health benefits of red wine make it ok
FASD is curable
T/F studies show that low to moderate drinking does not cause FAS/FASD
true, but many disorders might not be come evident until after age 5
