Toddler and Preschool Health Flashcards
Toddler definition
1-3 years
Preschool definition
4-5 years
Anthropometric measurements for toddlers
length, height, weight, head circumference up to 2 years
Anthropometric measurements for preschooler
height, weight, blood pressure starting at 3 years old, then each year
What laboratory tests are recommended for toddlers?
hematocrit (at 2 years or once between ages 1-5 unless otherwise indicated)
lead screening by 2 years-based on appropriateness from risk factors
What laboratory tests are indicated for preschoolers?
PPD for TB between 4-6 years if at risk
Cholesterol screening from 2-9 years–if family history
What is the toddler schedule for well child visits?
12, 15, 18, 24, 30, 36 months
When does the anterior fontanel close?
18 months
Chest and head are _____ until age 1.
equal in size
Which is larger, chest or head, by end of this preschool period?
chest grows 5 cm >head by end of this period
Discuss potential signs of cardiac issues in this age group.
Increased RR at rest or during sleep Eyelid or orbital edema squatting during play sleeping in knee-to-chest position exercise intolerance
Where is the point of maximal impulse (PMI)?
near the 4th intercostal space midclavicular line
Name gross motor skills for a 2 year old
up and down steps
kicks ball without falling
runs with wide gait
Name fine motor skills for a 2 year old
tower of 8 cubes
turns a doorknob
Describe language development of a 2 year old
up to a 50 word vocab
can follow 2-step commands
talks constantly
**2 words together by 2
Name gross motor skills of a 3 year old
hops at 3.5 years
rides a tricycle
Name fine motor skills of a 3 year old
copies a circle
builds a tower
Discuss language development of a 3 year old
up to a 900 word vocabulary
**3 words together by 3
Name gross motor skills of a 4 year old
up and down stairs with alternating feet
rides bicycle with training wheels
Name fine motor skills of a 4 year old
draws a person with 4 to 6 parts
tower of 10 blocks
Discuss language development for a 4 year old
can understand phrases and simple analogies
**4 words together by 4
Name gross motor skills of a 5 year old
skips
jumps rope
plays ball
Name fine motor skills of a 5 year old
copies a square
copies multiple shapes
prints letters
ties shoes
Discuss language development of a 5 year old
vocal greater than 2000 words
uses sentences regularly
knows at least 4 colors
**Five words together by 5
Discuss play in toddlers and preschoolers
onlooker and parallel play (Play by friends) in toddlers
associative, cooperative, dramatic, physical play (play with friends) in preschoolers
What is the Bayley scales?
gold standard for the diagnosis of developmental delays in infants/toddlers to 42 months of age
separate mental, motor, and behavioral rating scales
When should utensils be introduced?
introduce spoon between 15-17 months of age
When do nightmares begin?
Around age 3
When do night terrors begin?
Typically between 2-6 years–most outgrow as they get older.
When they wake up, do not know they were crying
When does physiologic and psychological readiness for toilet training begin?
Typically between 1.5 and 2.5 years
Average daytime control is typically achieved by 2
Average nighttime control lags behind by 1 year compared to daytime contorl
Name developmental warning signs of a 1 year old.
not imitating sounds
not pulling to standing
not indicating desires by point/gesture
Name developmental warning signs of a 18 month old.
no eye contact
does not feed self with spoon
Name developmental warning signs of a 2 year old.
is not walking up stairs
is not using 2-3 word phrases
is not noticing cars, animals
is initiating self-stimulating behaviors (rocking, flapping)
Name developmental warning signs of a 3 year old.
Is not aware of external environment cannot ride a tricycle does not follow simple direction continues baby talk does not imitate adult activities
Name developmental warning signs of a 4 year old.
does not listen to a story does not speak in sentences engages in head banging or rocking is not toilet trained does not draw a human figure
Name developmental warning signs of a 5 year old.
Magical thinking is still dominant
no impulse control
Discuss stuttering.
Occurs in 10% of children
More common in males
Maybe familial
Lasts for several weeks to 6 months but 50% of cases resolve spontaneously without intervention
When should you refer for stuttering?
Lasts >6 months
Child >6 years old
Child avoids speaking
What is autism?
Pervasive development disorder
Marked abnormal or impaired development in social interaction usually noted within first year of life
*language delay
What is asperger’s syndrome?
Pervasive development disorder
Severe and sustained impairment of social interaction
*No language delay, OCD tendencies
**Not in DSM-V
What is Rett’s disorder?
Pervasive development disorder
Neurogenerative developmental regression following a period of normal functioning through the first 5 months of age
*Has only been diagnosed in females
What is the etiology of Rett’s?
unknown
What is the clinical presentation of Rett’s?
lack of gain in developmental milestones CNS irritability and withdrawal symptoms Loss of skills previously mastered (speech and hand) Stereotypic hand movements Delayed head growth seizures scoliosis hypertonicity
What is childhood disintegrative disorder?
Pervasive developmental disorder
marked regression in a multiple areas of functioning following a period of at least 2 years of normal development
Onset of developmental delay must occur by what age to diagnose a Pervasive development disorder?
by age 3
DSM-IV-TR requires _ total behaviors from what 3 categories to diagnose a pervasive development disorder?
6 total behaviors from these 3 categories
motor
language
communication/social
Who are pervasive development disorders most common in and what is the prevalence?
most common in males (excepts Rett’s), but if occurs in females, more severe
2-5:10,000
What should visual acuity be by 5 years old?
20/30
