Physical milestones, FTT Flashcards
What is development in a child?
Increase in the complexity of the organism due to maturation of the nervous system.
What are the five domains of development?
Physical, Functional, Emotional, Psychological, Social.
What are key characteristics of developmental progression?
- Pattern is constant
- Skills acquired sequentially
- Later goals depend on earlier achievements
- Rate varies
- Influenced by genetics and environment
What are the four main developmental areas assessed?
Gross motor, Fine motor and vision, Hearing/speech/language, Social skills/behaviour.
How is development assessed?
Through history from caregivers, observation of the child, formal assessments, comparing with normal ranges, and assessing all areas.
What is meant by “accepted range” in development?
Typical variation seen in the population; e.g., 50% walk by 12 months.
What are developmental red flags?
- Regression
- No fixing and following
- No response to noise
- Abnormal tone
- No smile at 8 weeks
- Not holding objects at 5 months
- Early hand preference
- Not sitting at 12 months
- Not walking at 18 months
- Persistent toe walking
- Not pointing at objects at 2 years
Describe the cephalocaudal progression.
Development occurs from head to toe – e.g., head control → sitting → standing → walking.
What is the timeline for walking?
- 50% by 12 months
- 70% by 13 months
- 90% by 14–15 months
- 18 months = 2 SD from mean → late
List key fine motor milestones.
- Grabbing objects
- Hand-to-hand transfer
- Building blocks
- Radial-palmar grasp
- Mature pincer grasp
- Scribbling
What is the difference between speech and language?
Speech = physical sounds; Language = content and organization of communication.
Causes of speech delay?
Hearing loss
Mechanical issues (palate/muscles)
Global developmental delay
Environmental deprivation
Autism spectrum disorder
Examples of social/behavioral development?
Smiling, waving, peek-a-boo, stranger danger, pointing, imaginative play, dressing, toilet training.
Key ages for developmental checks in the UK?
- Neonatal exam
- 6–8 weeks (GP)
- 1 year (HV)
- 2–2.5 years (HV)
What are the types of developmental delay?
Isolated, global, regression.
Causes of developmental problems?
- Genetic syndromes (e.g., Trisomy 21)
- Cerebral malformations
- Congenital infections - Antenatal/perinatal/postnatal insults
- Abuse/deprivation
Define growth.
Increase in size or number of cells; measured via weight, height, head circumference.
What are the 4 phases of growth?
Fetal, infancy, pre-pubertal, pubertal.
What controls growth at different ages?
- <2 years → nutrition
- 2–12 years → growth hormone
- Puberty → growth hormone + sex steroids
Key growth milestones in infancy?
Week 1: lose up to 10% of birth weight
Week 2: regain birth weight
5 months: double birth weight
12 months: triple birth weight
Define FTT.
Suboptimal weight gain in infants/toddlers, often crossing 2 centiles downward on growth charts.
What is the usual first sign of FTT?
Falling weight on growth charts.
Causes of FTT (5 main categories)?
Inadequate intake
Inadequate retention
Malabsorption
Failure to utilize nutrients
Increased requirements
Key points in evaluating FTT?
Assess history
Check hearing/vision
Full developmental exam
Multidisciplinary input
Observe feeding & growth
What parameters are used in nutritional assessment?
Weight & height
Mid-upper arm circumference
Skinfold thickness
Dietary recall/diary
What is the BMI formula?
BMI = weight (kg) / height (m²)
Why can’t adult BMI ranges be used for children?
Children’s BMI varies with age; use age-specific centile charts (e.g., RCPCH charts).
Interpretation of short + overweight vs tall + overweight?
Short + overweight → think endocrine/genetic
Tall + overweight → think lifestyle/behaviour
What are some causes of short stature?
Constitutional delay
Genetic short stature
GH deficiency
Hypothyroidism
Steroid excess
Skeletal/chromosomal disorders
How is height velocity interpreted?
Normal: ~5 cm/year pre-pubertal
Influenced by nutrition, health, emotional environment, and hormones
BMI ranges?
Normal BMI 18.5-25
Underweight <18.5
Overweight 26-30
Obesity >30
