wk7: BV - Intro to Paediatrics

Question 1

Outline the physical developmental stage for a child of 0-6 months (5)

Answer 1

suck and grasp reflex
needs to be held
rapid growth
can follow and focus
lots of sleep

Question 2

Outline the intellectual developmental stage for a child of 0-6 months (2)

Answer 2

vocalises

udnerstands that can cry for response

Question 3

Outline the emotional developmental stage for a child of 0-6 months (2)

Answer 3

attached to parents/caregivr

comforts self with thumb pacifier

Question 4

Outline the social developmental stage for a child of 0-6 months (2)

Answer 4

recognises parents/care giver

smiles when they arrive

Question 5

Outline the physical, intellectual, emotional and social developmental stage for a child of 6-18 months

Answer 5

Physical: feed self, sits, stands, walks, stack 2+ blocks
Intellect: 1-2 words, mama, dada, points, curious about environment
Emotional: hugs parents, separation anxiety, shows emotions but can’t identify
Social: games, peek a boo, extends attachment to others, some independence

Question 6

Outline the physical, intellectual, emotional and social developmental stage for a child of 18 months-3 years

Answer 6

Physical: bladder + bowel control, climb stairs, hold crayons, draw circle, better hand eye coordination
Intellectual: drawing, sentences being to be understood half the time
Emotional: verbally express feelings, separation anxiety better
Social: plays with children, tests boundaries

Question 7

Outline the physical, intellectual, emotional and social developmental stage for a child of 3-6 years

Answer 7

Physical: hop on one foot, skip and dance, draw square and some letters
Intellect: complete puzzle, completely understandable when speaking, has likes + dislikes, engage in discussion
Emotional: can identify happy and sad, imitates parents and caregiver, can feel overwhelmed by emotions
Social: dresses and undresses self, enjoys RPGs, follows rules

Question 8

Outline the physical, intellectual, emotional and social developmental stage for a child of 6-12 years

Answer 8

Physical: energetic, increased appetite, height and weight growth
Intellect: verbal, asks fact oriented questions, understands past, present, future
Emotional: more defined personality, guided primarily by school and family
Social: enjoys playing and working with others, same sex play with peers, learns to achieve and compete

Question 9

Outline the physical, intellectual, emotional and social developmental stage for a child of 12-18 years

Answer 9

Physical: growth spurts, puberty
Intellect: able to think and reason and think abstractly and use imagination
Emotional: independence needs exerted, mood swings
Social: part time work, social activities with peer gropus, conflict with parents

Question 10

At what average age do kids develop:

• social smile
• speak single words
• speak six or more words

Answer 10

6 weeks
12-15 months
12-20 months

Question 11

At what average age do kids develop:

• crawls
• walks holding on
• turns pages
• jumps on spot

Answer 11

6-9 months
7-13 months
2 years
20-30 months

Question 12

What does PEDS stand for? is it effective? How does it work?

Answer 12

Parent evaluation of developmental status. It is effective. Uses a score form

Question 13

How is the examination of a child different? List 5 points

Answer 13

Parents concerned - emotional + protective
Like having 2 patients: parent and child
Children tire + bore easily
Children want to please you so may tell you what they think you want to hear
Children and parents will KNOW if you don’t genuinely care

Question 14

What methods can you use to assist in child exam? (6)

Answer 14

Body language/non-verbal cues/expression
Be creative in approach (e.g. get onto floor with child and watch excursions, let parent be part of assessment, play with child)
Can’t always stick to a script
Never spend too long on any test
Don’t show any disappointment (if child doesn’t understand move onto next thing quickly)
Be genuinely intersted

Question 15

What rough percentage of children under 16 years coming into your clinic have:

• Hyperopia
• Strabismus
• Myopia
• Accomm-vergence

Answer 15

hyperopia: 45%
strabismus: 30%
myopia: 9%
accomm-vergence: 30%

Question 16

Name one effective way of ensuring all necessary information is communicated to you by parent/guardian

Answer 16

Questionnaire to complete before entering consulting room

Question 17

What should a questionnaire include? (7)

Answer 17

1. demographics: DOB, address, etc
2. PC: parental concerns, school concerns, child’s concerns
3. Oc., family, health hx
4. Developmental + educational hx
5. Prev tx: e.g. VT, surgery, medications
6. Adjunct surveys: PEDS, CISS
7. Find out if other professionals have been involved in child’s care

Question 18

What is the problem with testing vision in children under 2 years old?

Answer 18

unlikely to get reliable subjective response

Question 19

What clinical tests would you use on a child under 3 years? (8)

Answer 19

Cover test
Hirschberg test
Bruckner's 
Oc. Motility
Look at eye-hand coordintion _ fixation picking up toys during play
Refractive/accommodative tests: Ret and Near ret
Pupil reactions
Internal examination

Question 20

What more clinical tests would you use on a child from 3 to 6 years? (5)

Answer 20

Vision: lea symbols
Colour vision+stereo: can try, but not likely until school age
Binocular vision: worth 4 dot, prism doubling, phorias can evaluate by school age
Accommodation-convergence evaluation: from school age
Slit lamp ,tonometry