Peds Exam #2 Growth and Development Flashcards
Infant – Erickson’s developmental stage
(Trust vs Mistrust) - Caregivers responding to infant creates a sense of trust
Infant – Piaget’s developmental stage
(Sensorimotor) - Using senses/motor skills to learn about the world
Pigs (piaget) In (infant) motorboats (sensorimotor) get around the world faster
Toddler – Erikson’s developmental stage
(Autonomy vs shame & Doubt) - Achieves autonomy and self control; separates from the caregiver
“erik and todd have an auto shop and it’s a shame how expensive it is”
Toddler – Piaget’s developmental stage
(Sensorimotor & Preoperational)- Differentiates self from objects, increased object permanence; symbolic thought
“Pigs (piaget) are Terrible (toddlers) at looking looking around”
Preschooler – Erikson’s developmental stage
(Initiative vs Guilt) - Likes to please parents, initiates activities with others, makes up own activities
Preschooler – Piaget’s developmental stage
(Preoperational Substages)
Preconceptual – egocentric thinking & short attention span
Intuitive phases – classify objects; knows right from wrong
Preschooler – Kohlberg’s developmental stage
(Punishment - obedience orientation) - Determined good vs Bad dependent on the punishment
School Age – Erikson’s developmental stage
(Industry vs Inferiority) - Interested in how things are made, success on personal/social tasks, outside activities, peers, learning
schools are an industry and we are inferior to those who run it
School Age – Piaget’s developmental stage
(Concrete operational) - Learns by manipulating objects ; understands time, no abstract thinking
School Age – Kohlberg’s developmental stages
(Conventional)- Acts are wrong b/c you get punished; behavior is either right or wrong
Adolescent – Erikson’s developmental stages
(Identity vs Role Confusion/Diffusion) - Focus on body changes, Peer culture becomes primary
Adolescent – Piaget’s developmental stages
(Formal operation) - Greater abstract thinking; less egocentricity
Adolescent – Kohlberg’s development stages
(Post conventional Level III) - Adopts parental/societal morals; moves to internalized moral code
Negativism
Toddler is recognizing their individuality
Toddlers always saying “NO” is normal and is part of development
Egocentrism
Focus on self occurs as the toddler gains need to feel in control
This can lead to temper tantrums and/or power struggles
Regression
Toddler may want to go back to an earlier stage - may ask for bottle or pacifier they had previously given up
Separation is seeing oneself as separate from the __________
parent
Individuation is forming a sense of self and learning to control one’s environment - leading to __________ lability
emotional
When is the stepping reflex lost?
4-8 weeks
When is the sucking reflex lost?
2-5 months
When is the rooting reflex lost?
3 months
When is the Moro reflex lost?
4 months
When is the Asymmetric Tonic Neck reflex lost?
4 months
When is the Palmar Grasp reflex lost?
4-6 months
When is the Plantar Grasp reflex lost?
9 months
When is the Babinski reflex lost?
12 months
Neck keeps head in upright position when body is tilted; trunk will turn in the direction the head is turned when supine (Begins 4-6 months)
Neck righting
Protective extension w/ arms when held up in the air and moved forward. Infant reached forwards to catch self
Parachute (forward)
Protective extension w/ arms when tilted to side in a supported sitting position.
Parachute (sideways)
Protective extension w/ arms when tilted to backward.
Parachute (backward)
When can you begin to see Neck Righting?
4-6 months
When can you begin to see parachuting (forward)?
6-7 months
When can you begin to see parachuting (sideways)?
6 months
When can you begin to see parachuting (backwards)
8-10 months
Gross motor skill at 1 Month
Lifts and turns head when prone; head lag
Gross motor skill at 2 Months
Raises head and chest; improving head control
Gross motor skill at 3 Months
Raises head 45 degrees when prone; slight head lag
Gross motor skill at 4 Months
Lifts head and looks around, rolls prone to supine
Gross motor skill at 5 Months
Rolls supine to prone and back; sits upright with support
Gross motor skill at 6 Months
Tripod sits
Gross motor skill at 7 Months
Sits alone with hand support
Gross motor skill at 8 Months
Sits unsupported
Gross motor skill at 9 Months
Crawls, ,abdomen off floor
Gross motor skill at 10 Months
Pulls to a stand and cruises
Gross motor skill at 12 Months
Moves from sitting to standing; walks independently
Fine motor skill at 1 Months
Fists mostly clenched, involuntary hand movements
Fine motor skill at 3 Months
Holds hand in front of face, hands open
Fine motor skill at 4 Months
Bats at objects
Fine motor skill at 5 Months
Grasps rattle
Fine motor skill at 6 Months
Releases object in hand to take another
Fine motor skill at 7 Months
Transfers object from one hand to the other
Fine motor skill at 8 Months
Gross pincer grasp (Raking)
Fine motor skill at 9 Months
Bangs objects together
Fine motor skill at 10 Months
Fine pincer grasp, puts objects into container and takes them out
Fine motor skill at 11 Months
Offers objects to others and releases them
Fine motor skill at 12 Months
Feeds self with cup and spoon, makes simple marks on paper, pokes with index finger
Infant Developmental Warning Signs
- Arms and legs are ________ or ________
- Child cannot support ______ at 3-4months
- Child reaches with only one ______
- Child cannot sit with assistance at ____ months
- Child does not ______ by 12 months
- stiff or floppy
- head
- hand
- 6
- crawl
Toddler Gross Motor Skills
- Initial walking with _________ _____
- Later includes:
“toddler gait”
- Running, climbing, jumping, pushing/pulling toy, throwing ball, pedaling tricycle
Toddler Fine Motor Skills
Able to manage utensils, hold a crayon, string a bead, work a puzzle, use a touch screen
Increase in PHYSICAL size ; height, weight, head circumference is known as:
Growth
The sequential process by which infants and children gain various skills and function
Development
An increase in functionality of body systems or developmental skills is known as:
Maturation
Preschooler (3y) Fine Motor Skills:
- _______ self
- Builds a tower of ____blocks
- Screws/unscrews _____, ____, _______
Undresses self
9
lids, nuts bolts
Preschooler (5y) Fine Motor Skills:
- Undresses/ _______ self
- Prints some _______
- Feeds self well with ________
dresses
letters
utensils
Preschooler (3y) Gross Motor Skills:
- _____ well
- Pedals _______
- Climbs stairs with ____________ _____
- Bends over __________ __________
Climbs well
tricycle
alternate feet
without falling
Preschooler (5y) Gross Motor Skills:
- Stands on one foot for >___ seconds
- ______ and climbs well
- May ______
10
Swings
Skip
Motor warning signs (3y)
- ______ _______ often or has trouble with ______
- Drools or unclear _____
- Can’t work ______ toys
- Does not make ____ _______
Falls down, stairs
speech
simple
eye contact
Motor warning signs (5y)
- Does not show a variety of _________
- Extremes of __________
- Unusually __________ or inactive
- Cannot complete ______-______ activities
emotions
behavior
withdrawn
self care
School Age Gross motor Skills
- Coordination , _________, _________ improve
- _______ participation
- Older children may be awkward
rhythm, balance
sports
- 6-8y are at constant ______ - really enjoy ______ motor activities
motion
gross
8-10y are less _______-, high ________, graceful in muscular movements
restless
energy
10-12y are still _____ energy, can ____________ and _______ more. Increases strength and ___________
high
concentrate and focus
endurance
School Age Fine Motor
- ______ usage improves
- ______-_______ coordination improves
- Can write neatly, can print words, _____, and build _______
- Performs/takes pride in activities that require ________ and ______ motor skills (playing instruments)
hand
eye hand
sew, models
dexterity, fine
What kind of play do toddlers enjoy?
Parallel –> They usually play alongside each other instead of playing together
What kind of play do preschoolers enjoy?
Cooperative play –> usually really enjoy make believe and pretend
What kind of play do school age enjoy?
Cooperative –> sports
Solitary –> board, card, video games
What kind of play do adolescents enjoy?
Competitive play (sports)
Gross motor skills develop in what kind of fashion?
Cephalocaudal –> head to toe
** Head control > rolling> sitting> crawling> pulling to stand> walking
Fine motor skills develop in what kind of fashion?
Proximodistal –> center to periphery
** Infant will first bat with entire hand, then progress to gross grasping then fine fingertip grasping
What are some language concerns for an Infant?
No sounds/babbling by 4M
Does not laugh/squeal by 6M
Does not use words with meaning by 12M
What are some concerns with vision for infants?
Does not respond to loud noises
Crosses eye most of the time 6M
Does not track interesting object
Does not try to study interesting object
What is a hearing concern for infants?
Does not turn to locate sound at 4M
Toilet training
Negativism
Temper Tantrums
Thumb sucking/ Pacifiers
Sibling rivalry
Regression
Tooth and gum health
Weaning to cup
** These are all developmental concerns for what age group?**
Toddlers 1y-3y
What are some vision concerns in school age children?
-Eye rubbing/squinting
-Avoiding reading
-Frequent headaches
-Holding reading material close
-Problems with depth perception/ eye-hand coordination
-Lazy eye
What is the term that refers to the ability to understand what is being said or asked? This is the most common of the 3
Receptive language
What is the term that refers to the ability to communicate desires and feelings
Expressive
What is the term that refers to the repetition of words and phrases without understanding
Echolalia
What is the type of speech that only contains essential words to get the point across, much like a telegram.
** Instead of “I want a cookie and milk” the toddler will say “want cookie milk”
Telegraphic speech
What are some NB sensory assessment findings?
- Infants are near sighted
- They life faces and contrasting colors
- Hearing is intact at birth and screened before discharge
- Smell rapidly develops within an hour of birth
- Prefer the sound of human voices
- Touch is crucial for NB communication (calms infant)
What do growth charts assess?
They assess the adequate physical growth for a specific age
When does puberty begin in girls?
9-10 years
When does menarche begin?
9-15 years
When does puberty begin in boys?
10-11
What is the first sign of puberty development in girls?
Breast bud development
What is the first sign of puberty in boys?
Testicular and penis enlargement
What assessments are included in a well-visit?
-H&P assessment
-Developmental/behavioral assessment
-Sensory screening (vision/hearing)
-Appropriate at risk screening
-Immunizations
-Health Promotion/Anticipatory guidance
When should you go to the ped. provider during infancy?
Birth
1m
2m
4m
6m
9m
12m
If a 16 week old baby was born 3 weeks early, what would their adjusted age be?
13 weeks
Rear facing, center of back seat away from airbags is the car safety for:
Infants
Rear facing until 2y in back seat is the car safety for:
Toddlers
Back seat 4-8y forward facing booster seat using lap and shoulder belt is the care safety for:
school-age children
A 12y/o can sit in the front seat with her mom on the way to the bus stop to pick up her younger brother.
(TRUE OR FALSE)
FALSE – children younger than 13 years old should not ride in the front seat of a car
What kind of care focuses on maintaining highest quality of life while maintaining treatment and other needs?
* Children with life-threatening/progressive incurable conditions usually receive this kind of care
* Can be home, hospital, or hospice setting
Palliative care
What is the term where parents/pts can specify their wishes for care at the end of life
Limitations of care
Withholding CPR if child’s heart stops beating
Do Not Resuscitate
What is another form of a DNR
AND (Allowing Natural Death )
What is the term for parents’ reaction to a serious illness illness/event/ event in the child’s past continues to have long-term psychologically harmful side effects on the child and parents for many years
Vulnerable Child Syndrome
What are the risk factors for vulnerable child syndrome?
- Preterm birth
- Congenital Anomaly
- NB jaundice
Infant
-Heart ________ in size in the first year
-HR decreased from 120-140 to _____by 1Y
-BP increased from 60/40 to ___/___
-Peripheral capillaries are closer to the surface of the skin, making the NB and young infant more susceptible to ____ _____
-Thermoregulation becomes more effective as the child grows: peripheral capillaries constrict in response to cold and dilate in response to heat
doubles
100
100/50
heat loss
Infant
-Tongue is larger relative to oral cavity size for ______________
-Stomach capacity _________ as infant grows
-Consistency/frequency of ______ change over the first year of life based on intake
Breastfeeding
Increases
Stools
Infant
-Susceptible to __________
-Freq urination w low specific gravity (not concentrated until _________ mature)
-Lanugo/vernix may be present
-Acrocyanosis is ________decreases the in NB and decreased over first few days of life
-Skin is relatively _______ than that of adults with peripheral caps more superficial
dehydration
Glomeruli
normal
thinner
Infant
- Fetal hemoglobin present in _____amounts at birth
-After birth, fetal production almost ______ and _____ hemoglobin production begins and increases through the first 6m
-Maternal iron stores transferred to the fetus during the last 3m of gestation provide sufficient _____for the first few months of life
-Iron stores depleted by __-__ months
-Iron-fortified formula recommended for non ___-________ infants
-Iron supplementation is recommended for BF infants beginning at ___ months
large
ceases, adult
iron
4-6
Non-breastfed
4
Infant
-Infants are born with an ________ immune system
-Antibody production ________ gradually, maturing in early childhood
-Immunity during first 3-6m of life for antigens to which ________ was previously exposed
-_____________ provided addition protection through passive immunity
immature
increases
mother
Breastfeeding
Toddler
-Brain reaches about __% of size by 2
-Increased myelinization improves coordination, balance, and _________control
90
Sphincter
Toddler
-Alveoli increase in number until age __
-Trachea and airways are _____ compared to adult - tonsils and adenoids are _____relative to oral cavity
7
small
large
Toddler
- Stomach _______ in size
- Less frequent _____
- Bowel control achieved at end of toddlerhood
increases
stools
Toddler
- Bladder/kidney function reach adult function by ____-____m
- Urethra relatively ______
16-24m
short
Toddler
- Bones increase in ________
- Muscles _______
- ___________ and pot belly due to weak muscles - until 3Y
length
mature
Swayback
Preschooler
- Bladder/bowel control _______
-Resp. structures continue to grow in size; the number of _______ increase
-Eustachian tubes remain ______and straight
-HR decreases; BP increases; innocent heart ______may be heard
-Eruption of primary teeth complete by the beginning of preschool years
-Urethra remains _______
-Bones increase in length and muscles strengthen and mature
completed
alveoli
short
murmur
short
-Brain and skull grow very _______; cognitive processes mature
-RR ________and are diaphragmatic in nature
-HR decreased BP increased
-Immune system matures to adult level around 10y of age; fewer infections
-Deciduous teeth replaced by ________ teeth; fewer GI upsets; stomach capacity increases; caloric needs are _______ but appetite may increase
-Bladder capacity _________; prepubescence occurs
-Greater coordination and strength; muscle still immature and easily __________
slowly
decrease
permanent, lower
increases
injured
-Limit setting
-Negotiation
-Tech. to learn problem-solving
-Offer realistic choices
-Keep instructions simple
-Reinforce desirable behaviors
-Extinctions and negative for neg behavior time-outs
-Never spank younger than 18m – increased possibility of physical injury
These are discipline techniques for which age group?
Toddlers
-Children learn the natural and logical consequences of discipline
-Parents should teach children rules established by the family, values, and social rules of conduct
-Discipline should be consistent, applied fairly, and focus on the development of the child
-Acknowledgement of positive behaviors is more likely to encourage positive behaviors and promote development
These are discipline techniques for which age group?
School Age children
Warning signs of Autism
- Does not ________
-Lack of interest in joint attention
-____contact abnormalities
-Delayed ________ development
-Failure to develop symbolic imaginative play
-Losing language or _______skills at any age
imitate
eye
language
social
What are some benefits of breast feeding?
Best nutrition for infants
Health benefits for mom and infant
Heavily influenced by cultural expectations
Successful BF requires correct use of BF techniques
What are some contraindications to breastfeeding?
Infants with galactosemia
Maternal use of illicit drugs and few prescription meds
Maternal untreated active TB
Maternal HIV infection in developed countries
What are some risk factors for suicide in children?
Does not imitate
Lack of interest in joint attention
Eye contact abnormalities
Delayed language development
Failure to develop symbolic imaginative play
Losing language or social skills at any age
