Unit 2: Things to memorize Flashcards
Routine vaccines for 4-6 years?
“Very DIM between 4-6 pm”
Varicella, Dtap, IPV, MMR
Routine vaccines for 11-12 yr
“Tada, Human Men”
Tdap, HPV, Meningococcal
Routine vaccine 16 yr
“Men get boosted”
Meningococcal
When is HPV routinely given? How many doses?
HPV is given at 11-12 yr (earliest is age 9) 2 doses (6-12 months apart)
IF 15 + for 1st dose; give 1st now, 2nd at 1-2mo, 3rd at 6 months (HPV “Vee” is a pattern like Hep B “Bee”)
Catch up vaccine is recommended through age 18 if not adequately vaccinated
When is Varicella routinely given? How many doses?
1st dose: 12-15 months
2nd dose: 4-6 years
2 doses; (at least 3 months apart)
Side note: if the kid is 13 +, the doses can be 4 weeks apart (not months)
When is Tdap routinely given?
Age 11-12 years (don’t confuse with DTap)
Tdap should be given between 27-36 weeks in every pregnancy (NO REQUIRED INTERVAL)
When is Hep A routinely given? How many doses?
1st dose: Given between 12-18 months 2nd dose (at least 6 months later)
When is Hep B routinely given? How many doses?
Birth, 2mo, 6mo
3 doses
**Catch up schedule should be 1st dose now, 2nd dose in 1-2 months, 3rd dose in 6mo (pattern same as routine)
When is Meningococcal routinely given? How many doses?
11-12 years
booster given at 16-18 years (“Men get boosted”)
When is influenzae routinely given? What is the minimum age? Who gets 2 doses?
Minimum age = 6 months
If age 6mo - 8 yrs for 1st time dose: they get 2 doses, (4 weeks apart)
Then, 1 dose annually
Can influenza vaccine be given if the patient has an egg allergy?
Yes, if their egg allergy reaction = hives
If other reaction = give in medical setting under supervision to watch for severe reaction
BMI percentage for underweight?
<5% percentile
BMI percentage for overweight?
85-95th percentile
BMI percentage for obese?
95th percentile or greater
Reminder:
Vaccine at 2 months
2 B DR HIP
Hep B, Dtap, RV, HiB, IPV, PCV
Reminder:
Vaccine at 4 months
4 DR HIP
Dtap, RV, HiB, IPV, PCV
Reminder:
Vaccine at 6months
B DR HIP In 6 mo
Hep B, Dtap, RV, HiB, IPV, PCV and Influenza
Reminder:
Vaccine at 12-15 mo
Very MAD HP
Varicella, MMR, Hep A, Dtap, HiB, PCV
Reminder:
Vaccine at 4-6 years
Very DIM from 4-6 pm
Varicella, Dtap, IPV, MMR
When do you start screening for obesity annually?
2 years
When do you screen females for scoliosis? Males?
Females: Age 10 AND 12
Males: between age 13-14 (once)
When do you start screening for depression?
Age 12 yr with screening tool PHQ2 or others
Screen annually from age 12
When do you start screening for substance abuse? Tobacco?
Start screening for both at 11 years, then yearly
Screen for substance abuse using CRAFFT tool
Age when concrete operations begin?
6 years (early school years)(6 bags of concrete)
Also seen in early adolescence, Age 10-13
Age when abstract thinking begins?
Age 7-11 (middle childhood)
Also seen in middle adolescence, Age 14-16
When does idealism begin?
Usually late adolescence, around age 17
What ages are vision screenings done?
years 3, 4, 5, 6, 8, 10, 12, 15
What ages are hearing screenings done?
years 5, 6, 8, 10, then 11-14, 15-17, and 18-21
When is routine Dyslipidemia screening?
between age 9-11 and 17-21
When should HIV screening be done?
Age 15-18
Screen for cervical dysplasia at what age?
Age 21
How often do you measure height, weight, BMI, and blood pressure?
Yearly
BMI from age 2, BP from age 3
True or False:
All of the below are assessed/completed yearly:
History, developmental surveillance, psychosocial/behavioral assessment, physical exam, immunizations, anticipatory guidance
True
History, developmental surveillance, psychosocial/behavioral assessment, physical exam, immunizations, anticipatory guidance should all be completed or assessed at every annual visit
What is enuresis?
in ages >5y
2x/week for 3 months
repeated urination in clothes or bed at night;
What is encopresis?
repeated passage of stool into inappropriate places (ie underwear); every month x 3 months
Age greater than 4y
**Assess for pathology related to constipation (usual cause)
What age should read 1 syllable words and know when it is morning or afternoon?
age 6-7
What age should be able to copy a triangle and draw a 12 detail person?
age 6-7
What age should be able to skip smoothly and catch a ball?
Age 5-6
What age should be able to copy a + already drawn and draw and 8 detail person?
Age 5-6
T or F: a 5-6 year old should have good motor ability, but is likely to have little awareness of dangers
True
What age should be able to count by 2s and 5s and also add/subtract 1-digit numbers?
Age 7-8
What age can tie their shoes and know what day of the week it is?
Age 7-8
Are hearing or vision screenings done at age 7?
Nope. Age 6 and 8
What age copies a diamond and draws a person with 16 details?
Age 7-8
What age learns borrowing and carrying in addition and subtraction?
Age 8-9
By what age should a child know the month, date, and year and be able to recite all the months in order?
Age 9-10
What age should build a sentence when given 3 words?
Age 9-10
What age learns simple multiplication?
Age 9-10
What age should do multiplication and simple division?
Age 10-12
What age should do long division and be able to add, subtract, and reduce fractions?
Age 12-15
Which vaccine should not be given if the patient has a serious allergy to yeast?
Hep B
B is for bread
What are contraindications to the varicella vaccine?
immunocompromised patients, pregnancy
live virus
True or false: Meningococcal vaccine is contraindicated if the patient has an allergy to latex
True
Should HPV vaccine be given to a pregnant patient?
No
A lateral curvature of the spine greater than 10 degrees of deviation from straight.
Scoliosis
True or False:
Pulmonary impairment is usually NOT seen with a Cobb angle less than 35
True, impairment seen over 40 degrees
*Cobb Angle is a measurement for quantifying spine curvature (magnitude) of scoliosis. It describes max side to side distance of curvature
An exaggerated front to back, forward rounding curve of the upper, thoracic spine.
kyphosis
Normal thoracic curve is 20-45 degrees. HIGHER than 45 = pathological
What is BEARS pneumonic used for? What do the letters stand for?
Screening for sleep problems.
B- bedtime resistance E-Excessive daytime sleepiness A- Awakening during the night R- regularity and duration of sleep S- sleep disordered breathing
What is the first line treatment for pediatric insomnia?
Sleep hygiene education and cognitive behavioral therapy
S/S: snoring, morning headaches, dry mouth, daytime sleepiness - consider what diagnosis?
Sleep-disordered breathing / Obstructive sleep apnea
ADHD has been found to be associated with what sleep disorder?
Obstructive sleep apnea (inattention type)
What disorder is associated with the triad of symptoms:
impulsivity, inattention, and hyperactivity
ADHD
True or False: nightmares are usually self limiting and require little treatment
True
Nightmares are usually self-limited and require little treatment. They are associated with stress, trauma, anxiety, sleep deprivation, and medications
T or F: It is recommended that quality and quantity of sleep be screened at every well child visit.
True
(pg. 81 Hays) Parents will often not bring up sleep and sleep problems have a big impact on the patient and health
What must the patient have to be diagnosed with intellectual disability ?
IQ less than 70
adaptive skills more than 2 deviations below the mean
(cognitive AND adaptive deficits)
what age can report their age & knows right and left hand?
5-6y
what age has a “concept of 10?” (i.e. may count 10 items or recite from memory)
5-6y
what age can describe their favorite tv program in some detail?
5-6y
what age does simple chores at home? (taking out garbage, drying silverware)
5-6y
what age goes to school unattended or meets the school bus?
5-6y
what age copies a triangle?
6-7y
what age defines words by USE? (what is an orange? TO EAT)
6-7y
what age shows NO MORE evidence of sound substitution? (fr when they mean thr)
7-8y (Theven to eight)(trying to come up w something to remember)
what age reads Durrell paragraph #1?
7-8y
what age defines words BETTER than by use? (what is an orange? A FRUIT)
8-9y
what age can give an appropriate answer to moral based questions?
8-9y
what age reads Durrell paragraph #2?
8-9y
what age reads Durrell paragraph #3?
9-10y
what age is learning simple multiplication?
9-10y
what age reads Durrell paragraph #5?
10-12y
what age reads Durrell paragraph #7?
12-15y
at what age do children reach adult proficiency of language?
7-8y
at what age do children have approximately 2560 words & create 6-7 word sentences?
6y
thinking. early childhood: 5-7 PER HAY
- concrete operations typically begin after 6y
- magical thinking diminishes
- reality of cause-effect is better understood
- fantasy & imagination are still strong
thinking. middle childhood: 7-11 PER HAY
*abstract thinking begins
idealism thinking begins what age?
ADD IF YOU KNOW
most common type of scoliosis? who is most affected?
idiopathic. adolescent girls during a growth spurt from ages 10-18 (10-12 most often & can be earlier)
congenital scoliosis?
at birth
syndromatic scoliosis?
associated w a known syndrome
neuromuscular scoliosis?
associated w a neuro or muscular disease
scoliosis is classified by what?
anatomical position of deformity = thoracic or lumbar
cobb angle definition
- *describes the maximum distance of side-to-side curvature
* *quantitifes the curve magnitude
severe scoliosis can cause?
lung function impairment & possible death from cor pulmonale
causes of kyphosis?
- congenital & developmental most common
* others = trauma, degenerative (old ladies)
EARLY CHILDHOOD (5-7Y) functions to know when child starts kindergarten (per montgomery ppt)
- separation-individualization
- begins relating to peers
- sensorimotor coordination (pencil & paper tasks & sports)
- cognitively focus on one task/problem at a time
EARLY CHILDHOOD (5-7y) functions present in first grade (per montgomery ppt)
- numbers, letters, words, begins writing
- begins CONCRETE operations w 1+ variable
- can order, #, & classify
- begins cause-effect relationships
- play can include fantasy & imagination
MIDDLE CHILDHOOD (7-11) functions per montgomery ppt
- importance of school & peer group interactions
- 7yo strives for achievement in school & acceptance by peers
- academics intensify in auditory & visual complexity
- MORE ABSTRACT
- learning disabilities may become apparent
- developmental status hard to ID in this age due to complexity of milestones
TEMPERAMENT is ______ influenced and ______ over time. p 73-4 HAY
*GENETICALLY influenced behavioral disposition that is STABLE over time
sleep disorders can be classified as?
primary & secondary
insomnia types?
onset or maintenance of sleep
parasomnias include?
NREM & REM disorders
*night terrors, sleep walking, sleep talking, nightmares
RLS/PLMD sleep disorders
- restless leg syndrome
* periodic limb movemend disorder
most common neurodevelopmental disorder?
ADD/ADHD
triad of symptoms of ADD/ADHD
- impulsivity
- inattention
- hyperactivity
BOOK: be familiar w ADHD criteria on p. 86 HAY (up to but not including mgmt)
just read up table 3-3 on pg 86
what category is ASD grouped under in the DSM?
pervasive developmental disorders
ASD development levels:
- level 1 = support
- level 2 = substantial support
- level 3 = very substantial support
ASD stats
- approx 1 in 59 (hay)
- approx 1 in 68 (montgomery ppt)
MALE DOMINANT
themes of intellectual disorder (ID)
*significant delays in development of language, motor skills, attention, abstract reasoning, visual-spatial skills, academic or vocational achievements
dx of ID requires what two dx criteria?
- adaptive skills MORE THAN two standard deviations below the mean
- IQ < 70
cognitive function tends to predict?
academic success
adaptive function tends to predict?
level of independence in ADLs
eval for ID should include:
complete fam hx, H&P, screening for co-occuring conditions, hearing & vision exam, neuroimaging, genetic eval, thyroid testing
BMI 25-29.9 =
overweight
BMI > 30 =
obese
BMI = 18.5- <25
healthy
BMI < 18.5
underweight
which BMI measurement is more important in children ?
PERCENTILES. bc BMI is compared to gender & age. range alone is not properly indicative.
healthy BMI percentile
5-85th percentile
girls usually begin pubertal growth spurt _____ before boys
2y
SMR 1 =
prepuberty
SMR 2 =
*pubic hair sparse, fine, NONpigmented, downy
SMR 3 =
*hair becomes pigmented & curly, increases in amount
SMR 4 =
adult in texture but limited in area
appearance of pubic hair typically precedes axillary hair by _____
more than 1y
what is first sign of puberty in FEMALES
*growth spurt
SMR 2 in FEMALES
breast buds begin
8-13y
pubic hair: sparse, fine, NONpigmented, downy
SMR 3 in FEMALES
breast & areola enlarge & ELEVATE
menarche may begin
pubic hair: coarse & curly, pigmented, increased amount
SMR 4 in FEMALES
nipple & areola form separate (secondary) mound, protruding from breast
pubic hair: adult like but limited area
SMR 5 in FEMALES
areola rejoins breast contour and development is complete
12.5-18.5y
menarche usually occurs?
during SMR 3 or 2y after breast budding
range 9-15y
SMR 2 in MALES
testes increase in size & scrotum reddens/thickens
pubic hair: straight at base
SMR 2 in MALES
testes increase in size & scrotum reddens/thickens
*10-13.5y
pubic hair: straight hair @ base
SMR 3 in MALES
penis lengthens (first ejaculate usually in this phase) pubic hair: coarse, dark, curly
SMR 4 in MALES
penis widens/enlarges in overall size. scrotal skin becomes pigmented
pubic hair: full but limited in area
SMR 5 in MALES
“development is complete”
developmental passage from childhood to adulthood includes 4 steps
1) completing puberty & somatic growth
2) developing socially, emotionally, & cognitively. moving from concrete to abstract thinking
3) establishing an independent identity & independence from family
4) preparing for a career/vocation
3 leading causes of death ages 15-19
1) MVAs (52%)
2) Suicide (20%)
3) homicide (15.6%)
ask about violence/abuse as it can lead to….
unintentional injury
AAP recc’s depression screen for youth _____+yo using the ____ tool
12, PHQ2
gateway substances =
tobacco, alcohol
clues to possible substance abuse =
truancy, failing grades, problematic interpersonal relationships, delinquency, depressive affect, chest pains, HA,
adolescent SUD screening tools include
1) Brief screener for Tobacco, alcohol & other drugs (BSTAD)
2) screening to brief intervention (S2BI)
* *both ask questions about frequency of past year use & triage them into levels 1-3 of substance use disorder
AAP stance on pharmacologic screening?
OPPOSED. YOU MAY NOT TEST A CHILD JUST BC THEIR PARENT WANTS YOU TO
five “A’s” for tobacco cessation
Ask about tobacco use Advise to quit Assess willingness/motivation Assist in quit attempt Arrange for f/u
nicotine dependence can occur in as little as?
4w
nicotine specific pharm tx for smoking cessation in teens?
nicotine gum & patch are approved & recc’d
pill pharm tx for smoking cessation?
XR bupoprion, clonidine, nortriptyline can decrease relapse rates up to 5x
drug prevention: primary
focus on preventing initiation (DARE)
drug prevention: secondary
prevent progression of use (alateen)
drug prevention: tertiary
targeted @ current users. aim is prevent morbid consequences of SUD (drive a drunk teen home)
a depressed teenager is at greater risk for:
drug & alcohol abuse academic failure STIs pregnancy suicide
osgood-schlatter includes ______ onset of ______ related _______ knee pain. swelling & pain over the _________ with progressive ______ of ________
p. 860 in HAY
essentials =
*insidious onset of activity-related anterior knee pain in adolescents
*swelling & pain over tibial tubercle
*progressive fragmentation of tibial tubercle apophysis (growth plate)
osgood schlatter is caused ______ traction on _______ that occurs during ______ & _____ sports
recurrent traction on tibial tubercle apophysis (growth plate) that occurs in jumping & running sports
microfractures & fragmentation of the tibial tubercle ST osgood-schlatter occur during times of ______
rapid growth
osgood schlatter is most common at what ages?
pre-teen & adolescent
girls 11-13
boys 12-15
osgood schlatter pain is exacerbated by activities using the
eccentric quads
osgood schlatter radiographs demonstrate
fragmentation or irregular ossification of the tibial tubercle
osgod schlatter resolves when?
spontaneously as the athlete reaches skeletal maturity
treatment for osgood schlatter?
NSAIDS. PT. stretch hammies. ice after workout.
HEADSS assessment for adolescents
Home Education/employment Activities Drugs Sexuality Suicide/depression
goals of adolescent screening
1) deter adols from participating in behaviors that jeapordize health
2) detect physical, emotional, and behavioral problems early & intervene promptly
3) reinforce & encourage behaviors that promote healthy living
4) provide immunization against infectious diseases
cervical cancer screening per AAP
per USPSTF = 21
testicular cancer screening per AAP
if pt has hernia, varicocele, or epididymitis
BP screening per AAP
yearly starting at 3y
lipid screening per AAP
- 9-11: fasting lipids or non-fasting LDL & total
- 18-21: fasting lipids or non-fasting LDL & total
(can test 12-17 if they have risk factors)
obesity screening per AAP
yearly
diabetes screening per AAP
10+ w 2+ risk factors screen q2y
scoliosis screening per AAP
females: 10 AND 12
males: ONCE @ 13-14
anemia screening per AAP
yearly; ask about diet. screen those w rf’s
depression screening per AAP
12+ w PHQ2 or other tools
substance use screening per AAP
11+ w CRAFFT screening tool
tobacco screening per AAP
11+
STI screening per AAP
sexually active females
HIV screening per AAP
once btwn ages 15-18
syphillis screening per AAP
no recc’s
motivational interviewing
counseling style that guides pts toward behavior change by helping to resolve ambivalence. effective in adolescents
transition to adult care depends on three components
provider readiness, family readiness, youth readiness
10-13. early adolescence: cognitive development. HAY pg 114
- growing capacity for abstract thought
- interested in present, limited thought of future
- intellectual interests expand
- deeper moral thinking
14-16. middle adolescence: cognitive development
- continued growth of capacity for abstract thought
- greater capacity for setting goals
- interest in moral reasoning
- thinking about meaning of life
early adolescence = 10-13: social/emotional development
- struggle w sense of identity
- worries about being normal, feels awkward
- realize parents arent perfect, increased conflict w parents
- desire for independence
- tendency to return to childish behavior when stressed
- moodiness
- rule & limit testing
- greater interest in privacy
TENLEY is almost 13. Shes moody, she just wants to be left alone to feel awkward in peace. Shes fighting with her parents and testing the rules. Shes just trying to find her identity.
middle adolescence: 14-16: social/emotional development
- intense self-involvement
- continued adjustment to changing body & worries about being normal
- distance from parents, drive for independence
- peers gain importance
- feelings of love & passion
FOURTEENA only cares about two things: herself & her friends. sometimes she drives around town to get away from her parents. she loves a boy but is worried she’s too weird.
fragile X syndrome
most common inherited cause of ID
present w: developmental delays, social anxiety, hyperactivity, difficult behavior in early childhood
fragile X syndrome in males
- gaze aversion, preservative language, hand biting, significant hypersensitivity to environmental stimuli
- may meet criteria for ASD (makes sense given above)
- macroorchidism (big balls)
- elongated facial features (big face)
fragile X syndrome is commonly associated w what conditions
seizures, strabismus, otitis media, GERD, mitral valve prolapse, hip dislocation
fragile X syndrome in girls
*elongated thin face, prominent ears, promoinent jaw & forehead, joint hyperextensibility BUT girls may be less effected since they have another X chromosome
fragile X syndrome mgmt
testing for family carriers treat symptoms (adhd, aggression, moodiness)
fetal alcohol syndrome
can range from learning disabilities to severe ID
features associated w FASD
- facial anomalies: short palpebral fissures, thin upper lip, smooth philtrum
- poor prenatal or postnatal growth
- CNS abnormalities like poor brain growth
- neurobehavioral impairment
- major congenital cardiac, skeletal, renal, ocular, or auditory malformations or dysplasias
________ procedures are the leading source of opioid prescriptions to youth
dental
most popular supplement abuse in teens
anabolic-androgenic steroids, steroid hormone precursors, creatine, human growth hormone, diuretics, protein supplements
CAGE questionairre
Feel the need to Cut down? Annoyance if asked about it? Guilt related to consumption of substance Eye-opener, needs it in the morning
**2+ highly suggestive of substance abuse
stages of change
- precontemplation
- contemplation
- determination
- action
- maintenance
- relapse
nutrition for children 2y +
1) 3 meals/day
2) variety
3) <35% calories from fat
4) cholesterol <100-300
5) carbs 45-65% (<10% from simple sugars)
6) limit grazing, eating while distracted, soft drinks, other sugary beverages
7) limit sodium by limiting processed foods & added salt
8) lean meats, poultry, fish, skim or low fat milk, veggie oils, fruits & veggies
severe obesity range
99th percentile+
Stage 1 HTN in kids:
greater than 95th-99th percentile + 12mm Hg
stage 2 HTN in kids:
greater than the 99th percentile + 12mm Hg
kids w HTN should have what labs done
CBC, serum nitrogen, creatinine, electrolytes, lipids, glucose, urinalysis, renal ultrasound
minimal acceptable visual acuity ages 3-5
20/40
minimal acceptable visual acuity ages 6+
20/30
drowning is _____ leading COD in kids 5-19
third
AAP screen time reccs for 5yo
1h/day
medical home traits
1) accessible
2) family centered
3) continuous
4) comprehensive
5) coordinated
6) compassionate
7) culturally effective
growth deficiency def
child greater than 6m has not grown for 3 consecutive months
PHQ-2:
two question questionairre. if pt scores >1+ then admin the PHQ-9
PHQ-9:
9 question questionairre. 1-4 = minimal 5-9 = mild 10-14 = moderate 15-19 = moderate severe 20-27 = severe IF PT ANSWERS YES TO #9 THEY MUST HAVE FURTHER ASSESSMENT (#9 is a suicide question)
Which stage of adolescence is interested in the present, worried about being normal, and has more interest in privacy?
Early adolescence , age 10-13
Which stage of adolescence sets goals, thinks about the meaning of life and has deeper moral thinking? They also have a drive for independence and thinks peers are very important
Middle adolescence, age 14-16
Which stage of adolescence thinks through ideas, has concerns for the future, is more emotionally stable, and has greater concern for other people?
Late adolescence, age 17 +
subtypes of ADHD disorder
- hyperactive-impulsive
- inattentive
- combined
subtypes of ADHD disorder
- hyperactive-impulsive
- inattentive
- combined (most common)
normal hearing definition kids >5y
can hear 500, 1000, 2000 and 4000hz frequencies at 0-20 decibels. if need volume over 20 decibels. indicates hearing loss. refer.
when to refer kids >5y for hearing issues
any child requiring volume greater than 20 decibels in order to hear 500, 1000, 2000, and 4000hz frequencies
when to refer kids for vision issues
- 3-5y if vision <20/40
- 6+y if vision <20/30
- anyone with a two-line discrepancy between eyes (even if the scores are still passing)
- children w fam hx amblyopia, strabismus, retinoblastoma, retinal degeneration
- children w down syndrome
memory trick for ages 5-6 development
FIVEL plays ball on a team of 10 other self-proclaimed 5-6 year olds. He is number 8. He can catch with his left AND right hand. Sometimes he skips bases bc he’s dreaming of his favorite TV show. At home, he is a fearless but good boy; helps with simple chores, and even catches the bus by himself.
(ages 5-6)(catches ball)(concept of ten)(tells age)(8 detail person)(knows left from right)(skips smoothly)(describes fav tv show in some detail)(not aware of danger)(simple chores)(catches bus or goes to school unattended)
memory trick for ages 6-7 development
SIX in the morning is too early. Why are you awake drawing a triangle, the number 12, and random 1-syllable words???? This is of no use to anyone!
(ages 6-7)(knows morning & afternoon)(draws a triangle, a 12 detail person)(can read 1-syllable words)(knows words by their use)
memory trick for ages 7-8 development
SEVERINA laces up her diamond dance shoes and counts by 2’s and 5’s. It is Wednesday which means she has dance class with 16 other little girls. Her homework today is to read 1 paragraph & practice single digit addition & subtraction.
(ages 7-8)(can tie shoes)(can draw diamond)(can count by 2’s & 5’s)(knows day of week)(16 detail person)(Durrell paragraph 1, can add & subtract 1-digit numbers)
memory trick for ages 8-9 development
EIGHT minutes is all it took the overly useful children to read 2 paragraphs and answer the moral based
questions. Give or take a few seconds. You can borrow the book, I’ll carry it for you.
(ages 8-9)(defines words by more than use)(Durrell paragraph 2)(can appropriately answer moral questions)(addition & subtraction)(is learning borrowing & carrying)
memory trick ages 9-10 development
3 x 3 is NINE. today is september, 9th, 2020.
(simple multiplication) (makes a sentence w three words) (reads durrell paragraph 3) (ages 9-10) (knows months of year & today’s date)
memory trick ages 10-12 development
TENLEY does her multiplication & division tables 5 times a day
(ages 10-12)(multiplication & simple division)(durrell paragraph 5)
memory trick ages 12-15 development
TWELVE problems of math homework. You must add & subtract fractions & then reduce them to their lowest form. 7 questions will be long division.
(ages 12-15)(add/subtract fractions & reduce)(durrell paragraph 7)(long division)
temperament is an _______ psychological attribute that is expressed as a response to an _____ stimulus
temperament is an INDEPENDENT psychological attribute that is expressed as a response to an EXTERNAL stimulus
temperament is:
the style in which the child interacts w its environment