Peds - Development & Growth Flashcards
Birth length doubles by _____ and triples by _____
doubles at 4yoa; triples at 13yoa
Average child grows _____ in first year of life.
____ in the second
____ in the third
and _____ thereafter until puberty
10 inches (25cm)
5 inches (12.5cm)
3-4 inches (7.5 to 10cm)
2-3 inches per year after that until puberty (5-7.5cm)
Within first few days of life, newborn’s weight changes how?
10% of weight lost.
Birth weight
doubles by _____
triples by _____
Quadruples by _____
Between ages 2-9, weight increases by ____ per year
doubles by 4-5 months
triples by end of first year
quadruples by end of 2nd year
between 2-9yoa, +5lb (2.25kg) per year
At birth, the newborn head is ______ its total mature size whereas the rest of the body is _____ of its adult size
2/3 - 3/4
1/4
How many fontanelles are present at birth?
which ones?
6
anterior, posterior, 2 sphenoid, 2 mastoid
Anterior fontanelle closes by _____
posterior fontanelle closes by _____
10-14 months (can close by 3 and remain open until 18)
4 months (but may not be palpable at birth)
At birth, the average full-term infant has ____ ossification centers
which are?
five
distal end of the femur
proximal end of tibia
calcaneus
talus
cuboid
The ____ is the first bone to ossify in utero beginning when?
clavicle - during 5th fetal week.
Greatest changes in bone mass occur in girls at age _____ and boys at age _____
girls 12-15 years (slows significantly between 16-18)
boys 14-17 years (slows between 17-20)
Peak bone mass is reached in both sexes at ____ age
25-35 yoa
In neonates and infants, motor behavior is influenced by:
primitive reflexes as a result of immature CNS
During first 6-8 months, CNS matures, and primitive reflexes are suppressed.
_____ are the earliest markers of abnormal neurological maturation
obligatory or persistent primitive reflexes
Physiologic postural reflex responses
Reflex: Head righting
Stimulus:
Response:
Age of Emergence:
Clinical Significance:
Physiologic postural reflex responses
Reflex: head righting
Stimulus: visual & vestibular
Response: align face/head vertical, mouth horizontal
Age of Emergence: Prone 2 months, Supine 3-4 months
Clinical Significance: delays or absent in CNS immaturity or damage
Physiologic postural reflex responses
Reflex: Head and body righting
Stimulus:
Response:
Age of Emergence:
Clinical Significance:
Physiologic postural reflex responses
Reflex: head and body righting
Stimulus: tactile, vestibular, proprioceptive
Response: align body parts in anatomic position relative to each other and gravity
Age of Emergence: 4-6 months
Clinical Significance: delays or absent in CNS immaturity or damage
Physiologic postural reflex responses
Reflex: Protective extension tone or parachute reactions
Stimulus:
Response:
Age of Emergence:
Clinical Significance:
Physiologic postural reflex responses
Reflex:
Stimulus: displacement of COG outside supporting base in sitting, standing
Response: extension/abduction of lateral extremity toward displacement to prevent falling
Age of Emergence:
- sitting anterior: 5-7 months
- lateral 6-8 months
- posterior 7-8 months
- standing: 12-14 months
Clinical Significance: delays or absent in CNS immaturity or damage
Physiologic postural reflex responses
Reflex: equilibrium or tilting reactions
Stimulus:
Response:
Age of Emergence:
Clinical Significance:
Physiologic postural reflex responses
Reflex:
Stimulus: displacement of COG
Response: adjustment of tone and posture of trunk to maintain balance
Age of Emergence:
- sitting: 6-8 months
- standing: 12-14 months
Clinical Significance: delays or absent in CNS immaturity or damage
Developmental milestones can be grouped into 4 distinct areas of function:
- gross motor behavior
- fine motor, adaptive behavior
- language behavior
- personal-social behavior
As a newborn, name the 4 gross motor milestones met
- flexor tone predominates
- in prone, turns head to side
- automatic reflex walking
- rounded spine when held sitting
As a newborn, name the 3 fine motor milestones met
- hands fisted
- grasp reflex
- state dependent ability to fix and follow a bright object
As a newborn, name the 1 personal/social milestone met
habituation and some control of state
As a newborn, name the 2 speech/language milestones met
- cry
- state-dependent quieting and head turning to rattle or voice
As a newborn, name the cognitive state
- sensorimotor (0-24)
- reflex stage
At 4 months, name the 4 gross motor milestones met
- head midline
- head held when pulled to sit
- in prone position, lifts head to ninety degrees and lifts chest slightly
- turns to supine
at 4 months, name the 4 fine motor milestones met
- hands mostly open
- midline hand play
- crude palmar grasp
- fascinated by own face in mirror
at 4 months, name the personal/social milestone met
recognizes bottle
at 4 months, name the speech/language milestones met (4)
- turns to voice and bell consistently
- laughs/squeals
- responsive vocalization
- blows bubbles, “raspberries”
at what month does a circular reaction develop - the interesting result of an action motivates its repetition
4 months
at 7 months, name the 5 gross motor milestones met
- maintains sitting
- may lean on arms
- rolls to prone
- bears all weight, bounces when held erect
- cervical lordosis
at 7 months, name the 3 fine motor milestones met
- intermediate grasp
- transfers cube from hand to hand
- bands objects
at 7 months name the personal/social milestones met (4)
- Differentiates between familiar person and stranger
- holds bottle
- looks for dropped object
- talks to mirror image
at 7 months name the speech/language milestone met
uses single word and double consonant vowel combinations
At what time does the baby begin to differentiate mother and self -creating individualization.
at 5 months, gains a sense of belonging to a central person.
at 10 months, name the 5 gross motor milestones met
- creeps on all fours
- pivots in sitting
- stands momentarily, cruises
- slight bow leg
- increased lumbar lordosis, acute lumbosacral angulation
at 10 months, name the 2 fine motor milestones met
- pincer grasp, mature thumb to index grasp
- bangs 2 cubes held in hands
at 10 months, name the 3 social/personal milestones met
- plays peek-a-boo
- finger feeds
- chews with rotary movement
at 10 months, name the 5 speech/language milestones met
- shouts for attention
- imitates speech sounds
- waves bye-bye
- uses “mama” and “dada” with meaning
- Inhibits behavior to “no”
at what age can a child retrieve an object hidden from view?
10 months
at 14 months, name the 5 gross motor milestones met
- walks alone, arms in high guard or midguard
- wide base, excessive knee and hip flexion
- foot contact on entire side
- slight valgus of knees and feet
- pelvic tilt and rotation
at 14 months, name the 4 fine motor milestones met
- piles 2 cubes
- scribbles spontaneously
- holds crayon full length in palm
- casts objects
at 14 months, name the 2 personal/social milestones met
- uses spoon with overpronation and spilling
- removes a garment
at 14 months, name the speech and language milestones met (2)
- uses single words
- understands simple commands
what age?
Rapprochement phase, individualization, ambivalence behavior to mother. Stage of autonomy vs shame and doubt. pleasures in control of muscle and sphincter
14 months
at 18 months, name the 4 gross motor milestones met
- arms at low guard
- mature supporting base and heel strike
- seats self in chair
- walks backward
at 18 months, name the 4 fine motor milestones met
- emerging hand dominance
- crude release
- holds crayon butt end in palm
- dumps raisin from bottle spontaneously
at 2 years, name the 5 personal/social milestones met
- pulls on garment
- uses spoon well
- opens door turning knob
- feeds doll with bottle or spoon
- toilet training usually has begun
at 2 years name the 5 speech/language milestones met
- two-word phrases are common
- uses verbs
- refers to self by name
- uses me, mine
- follows simple directions
what age?
preoperational period - 2=7 years, able to evoke an object or event not present, object performance established, comprehends symbols
2 years
at 18 months, name the 3 personal/social milestones met
- imitates housework
- carries, hugs doll
- drinks neatly from cup
at 18 months, name the 4 speech and language milestones met
- points to named body part
- identifies 1 picture
3 says “no” - jargons
at what age?
capable of insight; problem solving by mental combinations, not physical groping
18 months
at 2 years of age, what 3 gross motor milestones are met
- begins running
- walks up and down stairs alone
- jumps on both feet in place
at 2 years of age, name the 6 fine motor milestones met
- hand dominance is usual
- builds 8-cube tower
- aligns cubes horizontally
- imitates vertical line
- places pencil shaft between thumb and fingers
- draws with arm and wrist action
at 3 yoa, name the 4 gross motor milestones met
- runs well
- pedals tricycle
- broad jumps
- walks up stairs alternating feet
at 3 yoa name the 4 fine motor milestones met
- imitates 3 cube bridge
- copies circle
- uses overhand throw iwth anteroposterior arm and motion
- catches with extended arms hugging against body
at 3 yoa name the 6 personal/social milestones met
- most children toilet trained day and night
- pours from pitcher
- unbutton; washes and dries hands and face
- parallel play
- can take turns
- can be reasoned with
at 3 yoa, name the 8 speech/language milestones met
- three word sentences are usual
- uses future tense
- asks who, what, where
- follows prepositional commands
- gives full name
- may stutter; eager
- identifies sex of self
- recognizes 3 colors
at what age, do children deal with their sexuality
age 3
at 4 yoa, name the 4 gross motor milestones met
- walks down stairs, alternating feet
- hops on 1 foot
- plantar arches developing
- sits up from supine position without rotating
at 4 yoa, name the 5 fine motor milestones met
- handles a pencil by finger and wrist action, like adults
- copies a cross
- draws a froglike person with head and extremities
- throws underhand
- cuts with scissors
at 4 yoa, name the 4 personal/social milestones met
- cooperative play - sharing and interacting
- imaginative make believe play
- dresses and undresses with supervision, distinguishing front and back of clothing and buttoning
4 does simple errands outside of the home.
at 4 yoa name the 5 speech/language milestones met
- gives connected account of experience
- asks why, when, how
- uses past tense, adjectives, adverbs
- knows opposite analogies
- repeats 4 digits
at 5 yoa, name the 2 gross motor milestones met
- skips, tiptoes
- balances 10 seconds on each foot
at 5 yoa name the 4 fine motor milestones met
- hand dominance expected
- draws man with head, body, extremities
- throws with diagonal arm and body rotation
- catches with hand
at 5 yoa, name the 6 personal/social milestones met
- creative play
- competitive team play
- uses fork for stabbing food
- brushes teeth
- self-sufficient in toileting
- dresses without supervision except tying shoelaces
at 5 yoa, name the 6 speech/language milestones met
- fluent speech
- misarticulation of some sounds may persist
- gives name, age, address
- defines concrete nouns - composition, classification, use
- follows 3 part commands
- number concept to 10
at 6 yoa, name the 2 gross motor milesotnes met
- rides bicycle
- roller skates
at 6 yoa, name the 2 fine motor milestones met
- prints alphabet; letter reversals still acceptable
- mature catch and throw of ball
at 6 yoa name the 4 personal/social milestones met
- teacher is important authority
- uses fork appropriately
- uses knife for spreading
- plays table games
at 6 yoa name the 2 speech/language milestones met
- shows mastery of grammar
- uses proper articulation
at 7 yoa name the gross motor milestone met
continuing refinement of skills
at 7 yoa, name the 3 personal/social milestones met
- eats with fork and knife
- combs hair
- is responsible for grooming