Postnatal and Child Development Flashcards

1
Q

At what point does the brain develop ventricles, aqueducts?

A

8 wks

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2
Q

What is the brain like by term?

A

Fully developed:

  • Cortex
  • Ventricular system
  • Aqueducts
  • Cerebellum
  • Pons
  • Medulla
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3
Q

Which part of the brain is affected in people with ADHD?

A

Frontal lobe

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4
Q

Which part of the brain is responsible for the motor neurons?

A

Anterior part of grey matter

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5
Q

What are the primitive reflexes?

A
  • Moro reflex
  • Standing reflex
  • Grasp reflex
  • Protective reflex
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6
Q

What is the moro reflex?

A

The baby’s neck is suddenly extended causing the arms to abduct then adduct

  • develops ~28 weeks gestation
  • disappears ~3-6 months
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7
Q

What could persistence of the moro reflex be indicative of?

A

Impaired development

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8
Q

What is the standing reflex?

A

Extension of lower extremities and hips slightly flexed slightly behind the shoulders and head free to turn
- present from 3 months

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9
Q

What is the grasp reflex?

A

The object placed in the palm of hand and finger grasp very tightly
Stroking on the side or lateral part of fingers causes them to open again
Develops ~ 6-9 months

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10
Q

What is the protective reflex?

A

~6-9 months

Outstretched arms

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11
Q

What is development?

A

Global impression of child encompassing: growth, increase in understanding, acquiring new skills & more sophisticated responses & behaviour
Endows child with increasingly complex skills in order to function in society

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12
Q

Who can be aware of development?

A
  • Parents
  • Doctors
  • Teachers
  • Nursery nurses
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13
Q

When can awareness of development occur?

A
  • Opportunistically

- Part of planned programme reviews

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14
Q

What are the 4 domains of child development?

A
  • Gross motor skills
  • Fine motor skills
  • Speech & Language skills
  • Social skills
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15
Q

What is in gross motor skills?

A
  • Position
  • Head lag
  • Sitting
  • Walking
  • Running
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16
Q

What is looked at in fine motor skills?

A
  • Use of hands
  • Grasp and fine pincer
  • Bricks
  • Crayon
  • Puzzles
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17
Q

What is looked at in speech and language skills?

A
  • Vocalisation
  • Words
  • Undertsanding
  • Imaginative play
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18
Q

What would you look at in social skills?

A
  • Social interaction
  • Stranger reaction
  • Eating skills
  • Dressing
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19
Q

What would you see in a newborn who was pulled up from lying down?

A

Marked head lag on pulling up

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20
Q

What would you expect to see in a baby who is 6-8 weeks?

A

raise head to 45 degrees in prone

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21
Q

What would you expect to see in a baby who is 6-8 months in terms of sitting?

A

Sitting without support

  • 6 months - round back
  • 8 months - straight back
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22
Q

At what age do babies begin to roll?

A

3-5 months

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23
Q

At what age would you expect a baby to be able to sit?

A

6 months

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24
Q

At what age would you expect babies to be able to crawl?

A

8-9 months

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25
Q

At what age would you expect babies to be able to cruise around furniture?

A

10 months

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26
Q

At what age would you expect babies to be able to walk unsteadily, broad gait, hands apart?

A

12 mnths

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27
Q

At what age would you expect babies to be able to walk steadily?

A

15 months

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28
Q

What are the ways babies can go from sitting to walking?

A

immobile -> commando crawl -> walking
immobile -> crawling on all 4s -> walking
immobile -> bottom-shuffling -> walking

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29
Q

At what age would you expect babies to be able to follow moving objects?

A

6 weeks

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30
Q

At what age would you expect babies to reach out for toys?

A

4 months

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31
Q

At what age would you expect a palmar grasp?

A

~4-6 months

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32
Q

At what age would you expect a baby to transfer objects from one hand to another?

A

~7 months

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33
Q

At what age would you expect a baby to do a mature pincer grip?

A

10 months

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34
Q

At what age would you expect a baby to make marks with a crayon?

A

16-18mnths

35
Q

At what age would you expect a baby to startle to loud noises?

A

Newborn

36
Q

At what age would you expect a baby to vocalise alone or laugh/coo when spoken to?

A

3-4months

37
Q

At what age would you expect a baby to vocalise alone or laugh/coo when spoken to?

A

3-4 months

38
Q

At what age would you expect a baby to turn to soft sounds out of sight?

A

7 months

39
Q

At what age would you expect a baby to use sounds indiscriminately?

A

~7 months

40
Q

At what age would you expect a baby to use sounds discriminately?

A

~10 months

41
Q

At what age would expect a baby to use 2-3 words other than mama or dada?

A

12 months

42
Q

At what age would you expect 6-10 words and showing 2 parts of the body?

A

18 months

43
Q

At what age would you expect to use 2 or more words to make simple phrases?

A

20-24 months

44
Q

At what age would you expect constant talking in 3-4 word sentences?

A

2.5-3 years

45
Q

At what age would you expect a baby to hold a spoon and get food safely to the mouth?

A

18 months

46
Q

At what age would you expect symbolic play?

A

18-24 months

47
Q

At what age would you expect responsive smiles?

A

6 weeks

48
Q

At what age would you expect to put food in mouth?

A

6-8 months

49
Q

At what age would you expect waving bye-bye and playing peek-a-boo?

A

10-12 months

50
Q

At what age would you expect drinking from a cup with two hands?

A

12 months

encouraged to get rid of bottles at this age as it may affect speech development

Prolonged bottle usage particularly with juices can cause dental carries

51
Q

At what age would you expect dry by day and pulling off some clothing?

A

2 years

52
Q

At what age would you expect parallel play, interactive play evolving & taking turns?

A

2.5-3 years

53
Q

What is the limit age for head control?

A

4 months

54
Q

What is the limit age for fixing and following visually?

A

3 months

55
Q

What are the limit ages for polysyllabic babble?

A

7 months

56
Q

What is the limit age for smiles?

A

8 wks

57
Q

Who should be carrying out assessments and monitoring?

A
  • Parents
  • Doctors
  • Nursery nurses
  • Teaches
58
Q

What are the 4 key programme activities?

A
  • Screening
  • Immunisation
  • Child health reviews
  • Health promotion
59
Q

What are factors which affect the developing human at any time in the life cycle?

A
  • Prenatal
    Nutrition
    Folate
    Iron
  • Perinatal
    Delivery itself - trauma? O2 deprivation?
    Drugs used - aminoglycosides
  • Postnatal
    Trauma
    Meningitis
60
Q

How do we evaluate a child with abnormal development?

A
History 
- Parental concern 
- Birth history 
- FH 
PMH 
- developmental history 
- Current skills 
Examination 
- Developmental assessment & general & neurological 
- Any appropriate investigations
61
Q

What is the general approach to developmental assessment?

A

Ask, observe, task

62
Q

What do you need to assess?

A
  • Milestones proceeding age
  • Expected milestones for age
  • Next important milestones
63
Q

What factors could lead to delayed development?

A
  • Ill health
  • Lack of physical/psychological stimula
  • Reduced inherent potential
  • Sensory/motor impairment
64
Q

What are the types of developmental delay?

A
Global
Specific 
- Language
- Motor
- Sensory 
- Cognitive
65
Q

What is global delay?

A

Delay in all 4 domains

66
Q

What are the causes of global delay?

A
  • Chromosomal abnormalities - Down’s, Fragile X
  • Metabolic - hypothyroidism - inborn metabolic errors
  • Antenatal & perinatal factors - infection, drugs, toxins, anoxia, trauma, folate deficiemcy
  • Environmental-social issues
  • Chronic illness
67
Q

What could cause motor delay?

A
  • Cerebral palsy
  • Global delay - Down’s
  • Social deprivation
  • Congenital dislocation (hip)
  • Muscular dystrophy - Duchenne’s
  • Neural tube defects - spina bifida
  • Hydrocephalus
68
Q

What could cause language delay?

A
  • Hearing loss
  • Learning disability
  • ASD
  • Lack of stimulation
  • Impaired comprehension of language - developmental dysphasia
  • Impaired speech production
69
Q

What are the commonly used assessment tools?

A
  • standardised tests
  • schedule of growing skills
  • Griffiths developmental scale
  • Bailey developmental scale
  • Denver developmental screening tests
70
Q

What is the upper limit for sitting unsupported?

A

9 months

71
Q

What is the upper limit for standing independently?

A

12 months

72
Q

What is the upper limit for walking independently?

A

18 months

73
Q

What is the limit age for reaching for objects?

A

6 months

74
Q

What is the limit age for transferring?

A

9 months

75
Q

What is the limit age for pincer grip?

A

12 months

76
Q

What is the limit age for fear of strangers?

A

10 months

77
Q

What is the limit age for feeding self/spoon?

A

18 months

78
Q

What is the limit age for symbolic play?

A

2-2.5 years

79
Q

What is the limit age for interactive play?

A

3-3.5 years

80
Q

What is the limit age for constant babble?

A

10 months

81
Q

What is the limit age for saying 6 words with meaning ?

A

18 months

82
Q

What is the limit age for joining words?

A

2 years

83
Q

What is the limit age for 3-word sentences?

A

2.5 years