week 1-2 Flashcards
peds body is not mature until when? resp system until when?
2yrs, 8-9 yrs
speak to child first if:
school age or older
speak to parents first if:
younger than school age
confidentiality with adolecents
- ask private questions without mom and dad
- tell them you will not tell mom and dad unless they are hurting self or others
using an interpreter
- have to use a certified medical interpreter
communicating through play
-allows kids to say what they are trying to say
- let them play with the instruments
when to we screen for ASD? what is the tool for screening called?
18 and 24 mo. Mchat
cephalocaudel development
starts in utero- head to toe gross motor development
proximal to distal developemnt
fine motor development- shoulder control before grasp
mass to specific development
there is gross, fine, cognitive, speech and socio-emotional development reflective of mass to specific.
definite, predicitable sequence
- same sequence for EVERY child
- because of CNS development and myelination of the spinal cord.
rate/pace development
- factors that can effect the pace and rate of the development
- genetics, environment, birth order, parenting style,e language exposure (ex. bilingual houses will speak later), culture
stranger anxiety
6 mo
primitive reflexes in infants and when they disappear
Moro, sucking and rooting, palmar grasp, tonic neck, startle reflex (all 4 months), plantar grasp and Babinski (8-12 mo)
girls vs boys adolescent presentation of handling anxiety and depression
girls: internalizing behaviors like anxiety and depression
boys: externalizing behaviors like aggression
devo screening tools paperwork (2 types) and what the scores mean
ages and stages questioner: 0-6 years
black area means need a referral, gray area means have come back sooner than regular follow-up, and white means normal. (high literacy level- so be aware)
There is also Denver development screening tool that is not used as much and is not as accurate
young infant vs older infant
0-6 mo,06-12mo
erikson infant
trust vs mistrust
consistency will help the infant develop trust
reactive attachment disorder can be a product of mistrust (foster, orphans etc.)
pieget infant- 2 years
learns about environment through senses and motor activities
learn object permanence
fontenelle closes
2 month (posterior)
6 months wt
doubles of birth wt
6 months motor
rolls one way, chews and bites, head control
7 months motor
transfer from hand to hand,
rolls over completely
8 mo motor
sit without support
9 month. motor
crawl and pulls up to standing position
11 mo motor
creeps and cruises, cause and effect with dropping items
10 mo motor
pincer grasp
ant fontanelle closes and when to refer
12-18 mo
earlier then 12 mo or later than 18 mo would indicate neuro referral
12 mo wt and ht
triple birth wt. and double ht
vocalization at 6 mo
- begin imitating sounds/gestures
-lack voaclization could mean deafness
stranger anxiety
peaks at 7-8 mo
9 mo vocalization
understand simple verbal commands
ex: “no”
10 mo vocalization
say first work dada and mama, and will respond (stop action) when they hear no
when will a child search for an object that was hidden?
9 mo
12 mo vocalization/ attachment
- say 2 words besides mom and dad
- understand several words
- have a security blanket or stuffy
toddlers erikson
shame and doubt
want to do things for themselves
more in control of their bodies and environment
piaget- 2-7
egocentric (preoperational)
limited concept of time, see only their perspective
15 mo motor/physical
wide gait, pot bellies (lordosis), bowed legs
15 mo fine motor
use a cup, rotate a spoon, builds a tower of 2 cubes or blocks
18 mo motor/physical
ant font is closed, physiological anorexia, decreased growth needs. they will play with their food and not eat- it means they aren’t hungry. if they are hungry, they will eat.
can build a tower of 3-4 cubes
24 mo motor/physical
- chest circ exceeds head circ
- about 1/2 of adult ht.
- all systems except resp, endocrine and reproductive are mature
- ready for daytime bladder/bowel control
- unscrew lids
- open doorknobs
- can dress self simply
30 mo motor/physical
- have all teeth
- can jump with two feet
- builds tower of 8 cubes
- hold crayon with fingers rather than fist
15 mo senses/vocalization/ socialization
- interested in pictures
- uses pointing to ask for objects
- NEGATIVISTIC (says no even if that not the answer)
- give 2 options
- no reasoning
- will not share
18 mo senses/vocalization/ socialization
- says 10 or more words
- temper tantrums increasingly evident if tired, hungry, language delay (teach to ignore if no injurty to self)
- separation anxiety pearks
24 mo senses/vocalization/ socialization
- 300 words, uses pronouns, some sense of time,
- dawdles- take time and waste time
- ritualistic
30 mo senses/vocalization/ socialization
- states first and last name
knows sex - separates more easily from parent
erikson 3-5
initiative vs guilt
explore, imaginative
develop conscience morals
magical thinking
3 years motor/ physical
may have night time control of bowel and bladder
- go up stairs alternating feet
- completlyl feed self
-pour from bottle
- copies circle
- buttons/ unbottons things
4 years motor/ physical
walks down stairs using alternating feet
- skips/ hops on one foot
- copies a square
5 years motor/ physical
permentn teeth errupt
- handness is established (r sided is 90% of kids)
- ties shoes
- thwos and catches a ball
- uses scissors/ penicl will
- prints a few numbers, letter and words (first name)
3 years language/socialization
- BIG talkers
- talks when no one is listening
- constantly asks questions
- may stutter
able to share toys - animistic- give lifelike qualities to inanimant objects
about preschoolers fears
- NORMAL
- fears: dark, going to bed, monsters, being swallowed down the drain
- dont dismiss
- very real to the child
- HELPS: night light, no scary content intake, no news on
4 years language/socialization
-1500 word vocab
selfish, impatient, boastful, tattles
- likes to pretend/ dramatize
- imaginary playmates are common
-plays doctor or nurse
- magical thinking (thoughts cause events
- do’s and don’ts are important
- obey parents (not because they understand right and wrong)
- may run away from home
- strong identification with parent of opposite sex
5 years language/socialization
- 2100 word vocab
- names the coins and 4 or more colors
- less rebellious, more responsible, fewer fears
- needs occasional help with dress/hygiene
school age erikson
industry vs inferiority
want to produce and achieve
school age piaget
- concrete operation
can categorize and organize facts
inductive reasoning
cognative devo school age
6- concrete thinkers
12- start abstract
master language
physical growth school age
12 years- adult size brain
spine and leg straight
tonsils are largest at age 6
go through a growth spurt
increase fine motor ability
6 years activities
cheat to win, likes to color
deals with tension by grumbling/muttering, likes simple games
7 years activities
- can copy a diamond
- can use a table knife
-good at bedtime routine
-prefers play with same gender
8-9 years activities
- strict about rules
- likes school
curious about meaning of words - writes in cursive
- strong loyalty
10-12 activities
reads for enjoyment
- sometimes left at home alone for short times
- affectionate and respectful to parents
- judges acts by intent rather than consequenses
- begins to be capable of abstractions and deductive reasoning at 11.
bully triad
has to be all three to be considered bullying
- victim, bully and the bystanders
conversations for late school age child at home or visit
- screen time
bullying
assign chores
girls: periods
puberty in general and sexual activity
safety: helmets, seatbelts, online, home alone, accepting a dare
adolecents age
12-21
erikson adolecents
role confusion vs identity, concerned with who they are and how they look to others
piaget adolecents
formal operations, think abstractly, draw logical conclusions, can make and test hypothesis (deductive reasoning)
12-14 phyicial changes
- rapid physical changes
- max increase in ht means need for more sleep
- growth of pubic hair and underarm hair
- more oil (skin and hair), apocrine glad development and body odor
girls vs boys early adolecents
- girls are two years ahead of boys
- menses begins 11-14 years (average 12 1/2)
- breast buds means period is about 2 years away
boys testicles and penis grow
nocturnal emissions is normal
deepening of voice
growth of hair on face in boys
Tanner staging OR (SMR)
is 1-5
stage 1 is before puberty hits
stage 5 is complete development
mid-adolecents social changes
conflicts about independence with parents
parent child relationship is at a LOW point
self involved
very concerned about appearance and body
mid-adolescents cognitive changes
- think abstractly but not in all instances (still taking dares/risks)
- interest in intellectual things gain importance
late adolecents (17-21) physical boy vs girls
most gals are fully developed
males are still gaining wt, ht and muscle. growth ends for males at 18-20
late adolecents cognitive devo
more defined work habits
higher level of concern for the future
thoughts about ones own role in life
three developmental terms we assess on:
- developmental surveillance
- developmental screening
- developmental evaluation
developmental screening
using a standardized screening tool to recognize developmental delays
- ages and stages questionnaire (ASQ) sis commonly used. in infants/toddlers , the months of screening is done at 9,18, 24, 30 mo.
if Positive screen, devo evaluation is done
developmental surveillance
ongoing process of recognizing weather a child may be at risk for developmental delays
developmental evaluation
in-depth assessment involcing a formal peds devo tool.
typically done. by a specialist (speech patho), needs refferal
5 domains of development
- physical
- neurodevelopment maturation (gross/fine)
-cognitive development - language development
-socio-emotional developement
motor developmental concern: whats next?
increase tone: imaging needed/considered
decreased: labs should be drawn to check thyroid and creatinine kinase
should also be asking more in depth about activity within the past year: car accident, bike fall, etc.
notice a develpemntal delay and have assessed it/ documented it. whats next?
refer to developmental specialist for a developmental evaluation and then get the family connected to either early intervention or head start
early intervention
0-3 years
federally/state funded
speech/OT/PT and developmental
head start
3-5 years, after they expire from head start, school and
