Postnatal and Child Development Flashcards
what are the four sections of the developing brain at four weeks?
future forebrain (prosencephalon)
future midbrain (mesencephalon)
future hindbrain (rhombencephalon)
future spinal cord
what are the 3 flexures of the developing brain at four weeks?
cephalic flexure
pontine flexure
cervical flexure
what happens to the developing brain at 5 weeks?
reshaping of embryo into: telencephalon
diencephalon
pons
medulla
what happens to the developing brain at 8 weeks?
development of the ventricular system
hemisphere development
cerebellum development
What is the function of the prefrontal association cortex?
Executive function and concentration
In which cortex is their an abnormality resulting in ADHD?
prefrontal association area
The anterior section of grey matter of the spinal cord houses what type of neurones? how are these divided?
motor neurones
Flexors anterior, proximal medial, distal lateral, extensors posterior
The pyramidal tracts supply which nerves in the lateral corticospinal tract?
Sacral lumbar, thoracic and cervical
The extrapyramidal tracts are responsible for what?
Coordination of movements, regulation of posture and balance
When looking at primitive reflexes in small infants, what are the most important motor tracts to investigate?
Extrapyramidal
What are the 5 components of the reflex arc?
- Sensory receptor
- Sensory neurone
- Integrating centre
- Motor neurone
- Effector
What part of the spine do the sensory receptor stimulus move to the sensory neurones?
Dorsal
What is the morro reflex?
Babies neck suddenly extended and the arms abduct and then adduct
when should the morro reflex be present?
Develops around 28 to 32 weeks gestation and should disappear between three and six months
The persistence of primitive reflexes can be a sign of____
Impaired development
What occurs in the standing reflex?
Extension of lower extremities, hips slightly flexed
When is the standing reflex present?
Newborn at three months
What happens in the grasp reflex?
Object placed in the palm of the hand of the newborn and the fingers grasp very tightly
When should the grasp reflex stop being present?
6-9mnths
What is the parachute reflex?
Baby placed in forward tilting position and protects themselves with outstretched arms
When should the parachute reflex become present
Around 6-9 months
What is development?
Global impression of a child encompassing: growth, an increase in understanding, acquisition of new skills and more sophisticated responses and behaviour.
When is child development assessed?
Opportunistically and as part of programme of reviews
What are the four domains of child development assessment?
Gross motor skills
Fine motor skills
Social skills
Speech and language skills
What is assessed in the gross motor skills domain of child development?
Position, head lag, sitting, walking, running
What is assessed in the fine motor skills domain of child assessment?
Use of hands, grasp and fine pincer, bricks, crayon, puzzles
What is assessed in the social skills domain of child development?
Social interaction, stranger reaction, eating skills, dressing
What is assessed in the speech and language skills domain of child development?
Vocalisation, words, understanding, imaginative play
At what age do you expect to see babies starting to roll (sidelying)?
3months
and what age do you expect babies to start crawling?
8-9months
At what age do you expect babies to start cruising around furniture?
10 months
At what age would you expect to see a baby standing independently?
1 year
At what age would you expect an immature grip of pencil/ random scribble?
15-18 months
At what age do you expect a mature pincer grip?
10 months
what stage of gross motor development is the newborn expected to show?
Limited flexed, symmetrical posture, marked head lag on pulling up
What stage of vision and fine motor development is a baby expected to show at 6 weeks?
Follows object by turning head
At what age would you expect a child to be able to draw?
2 and a half years
What stage of hearing, speech and language is expected to be shown in the newborn?
Startles to loud noises
At what age would you expect a polysyllabic babble?
7-10 months
At what age do we expect a baby to sit without support?
7 months
At what age do we expect a baby to say 1-2- words and understand their own name?
1 year
At what age do we expect a baby to be able to say 6-10 words and point to 4 body parts?
15-18 months
BY what age would we expect smiling?
6 weeks
From what age do we expect drinking from a cup?
1 year
From what age do we expect starting to feed self with spoon?
15-18months
What are limit ages?
Traffic light system warning parents and healthcare professionals when a child has not reached a milestone
What patterns in development suggest abnormal development?
Slow but steady
Plateau
Regression
What is the limit age for head control?
4 months
what is the limit ag3 for sitting unsupported?
9 months
What is the limit age for standing independently?>
12 months
What is the limit age for walking independently?
18 months
Outline the five steps of gross motor development?
Acquisition of tone and head control,
primitive reflexes disappear,
locomotor patterns,
Standing walking and running,
Hopping, jumping and peddling
What abnormal motor development is associated with cerebral palsy?
Slowed developmental milestones
Hyperreflexia and hypertonia
Stiff limbs and asymmetry
Crossed legs
Poor coordination
What causes the hyperreflexia and hypertonia seen in abnormal motor development due to cerebral palsy?
Lack of inhibition by corticospinal neurons
What are the limit ages for vision and fine motor development?
Fixes and follows visually - 3 months
Reaches for objects - 6 months
Transfers objects - 9 months
Pincer grip - 10 months
What are the limit ages for hearing, speech and language development?
Polysyllabic babble - 7 months
Consonant babble - 10 months
Saying 6 words with meaning - 18 months
Joining words - 2 years
3-word sentences - 2 n a half years
What are the 4 steps for gross vision and fine motor development?
Visual alertness, fixing and following
Grasp reflex, hand regard
Voluntary grasping, pincer, points
Handles objects with both hands, transfers from hand to hand
Writing, cutting and dressing
What are the limit ages for social, emotional and behavioural development?
Smiles - 8 weeks
Fear of strangers - 10 months
Feeds self - 18 months
Symbolic play - 2 to 2 and a half years
Interactive play - 3 to 3 and a half years
Outline the six steps of gross social, behavioural and emotional development?
Smiling, socially responsive,
Separation anxiety
Self-help skills, feeding, toileting
Peer group relationships
Symbolic play
Social behaviour
Outline the five steps of gross hearing, speech and language development?
Sound recognition and vocalisation
Babbling
Single words, understands simple requests
Joining words and phrases
Simple and complex conversation
What are the three key components of the healthy child programme?
Screening
General examination and immunisation
Health education/ promotion
What are the prenatal causes of developmental impairments?
Nutrition e.g. folate for spinal cord
Drugs e.g. amino-glycosides can affects hearing
What are the perinatal causes of developmental impairments?
Delivery can be traumatic
Oxygen deprivation
What are the post natal causes of developmental impairments?
Trauma
Meningitis
Outline the approach to developmental assessment?
Ask, observe, task
When evaluating child development what do we consider in the history?
Parental concern
Birth history
Family history
Current skills and developmental history
When evaluating a child with abnormal development, what is included in the examination?
Developmental assessment and general and neurological examination
Morphology
Investigations - as appropriate
What four factors influence developmental delay?
Ill health
Lack of physical/ physiological stimuli
Sensory/ motor impairment - visual impairment can delay fine motor development
Reduced inherent potential
What are the 2 categories and their subcategories of developmental delay?
Global and specific
Specific : language, motor, sensory, cognitive
What are the five causes of global delay?
Chromosomal abnormalities
Metabolic
Antenatal and perinatal factors - infections, drugs, toxins, anoxia
Environmental-social issues
Chronic illness
What are the 8 causes of motor delay?
Cerebral palsy
Global delay - downs
Congenital dislocation hip
Social deprivation
Muscular dystrophy
Neural tube defects
Hydrocephalus
Corticospinal tract injury
What is the most common cause of motor delay?
Social deprivation
What are the six causes of language delay?
Hearing loss
Learning disability
Autism
Lack of stimulation
Impaired comprehension of language
Impaired speech production
List 4 commonly used assessment tools for child development?
Schedule of growing skills 2
Griffiths developmental scale
Bailey developmental scale
Denver developmental screening tests
