Physical milestones and failure to thrive Flashcards
What is development?
Increase in complexity of an organism due to maturation of the nervous system. It includes physical, functional, emotional, psychological and social development.
How does development occur?
Pattern of development constant and sequential, based on already acquired skills. Genetics and environment play a role
What are the areas of development?
Gross motor skills eg walking, sitting up and crawling
Fine motor skills and vision eg picking up objects
Hearing, speech and language
Social skills and behaviour
How is development assessed?
History from caregiver
Observing child for ability and quality of performance as well as considering ALL other areas of development.
How are the gross motor skills developed?
Cephalo-caudal progression where control of the body begins with keeping the head up and control of the upper limbs prior to the lower body
1) Hold head up
2) Sit up
3) Stand up
4) Walking
What are the milestones for gross motor skills?
6 weeks old they can hold their head up, at 6 months they will sit up.
50% of children walk by 1 years old with 90% walking by 14-15 months. 18 months and over is a cause of concern.
At 18m->2years old, running begins and tiptoeing. At 3 years old, they can walk like an adult.
What age is a concern for gross motor skills?
Threshold for concern is no walking by 18 months old, which is 2 standard deviations from the average. This may indicate neurological/muscular issue such as Duchenne’s, cerebral palsy or hip dislocation.
What is Cerebral Palsy?
Impairment of the brain’s motor function due to brain damage in pregnancy or infancy, leading to issues with posture and movement. It is the most common childhood physical disability.
How are fine motor skills developed?
Grabbing objects
Transferring between hands
Radial-palmer grasp (between thumb and all fingers) -> mature pincer grasp (between thumb and forefinger finger)
Scribbling from lines to distinguishable circles
What are the milestones for fine motor skills?
At 6 weeks tracking objects visually
6 months there is a palmar grasp with transfer between hands
9 months, there is object permanence
What are the hearing, speech and language skills?
Speech is producing sounds; language is the content of organisation of speech.
This requires Receiving input via the auditory cortex to make sense of the input in Wernicke’s area in the superior temporal gyrus of the brain.
Producing language uses Broca’s area in the frontal lobe using tongue muscles and palate to form words and
Which areas of the brain are involved in speech and language?
Wernicke’s area in the superior temporal lobe receives input from the auditory cortex to interpret speech into sensical words.
Broca’s area in the frontal lobe for producing speech via the motor cortex.
What are the milestones for hearing, speech and language skills?
6 wks: react to loud noise
6 ms: Babble and turn head to loud noises
By 1 years old, they should have an understanding of nouns
Why do speech delays occur?
Hearing loss
Mechanical issue with the palate or the muscles
Autism Spectral disorder
Environmental deprivation due to neglect/abuse and no talking interaction with the baby
What are the social and behavioural development?
Smiling at 6 weeks and waving, playing peek-a-boo, imaginative play and being able to independently dress
What are the psychological needs of a child?
Role models, opportunity to learn from experience, personal identity, independence
Who monitors child development?
Caregivers, Teachers, GPs, HEALTH VISITORS Physiotherapists, Speech and Language therapist
When does developmental surveillance occur?
4 appointments to identify developmental challenges:
Neonatal examination
6-8 week check by GP
1 year old check by health visitor
2-2.5 year old check by health visitor
