Development

Question 1

Hearing testing in children

Answer 1

All newborns should be tested as part of the Newborn Hearing Screening Programme

Otoacoustic emission newborn (soft echo indicates a healthy cochlea)

Auditory brainstem response test if above is abnormal

pure tone audiometry done pre-school (>3 years)

As well as the above test there is a questionnaire for parents in the Personal Child Health Records - ‘Can your baby hear you?’

Question 2

Immunisation schedule

Answer 2

Question 3

Contraindications to vaccinations

Answer 3

Question 4

Consent in children (by age)

Answer 4

<16 may consent to tx if Gillick competent assessed (but cannot refuse tx if in their best interest)

16 - 18 = presumed competence to give consent to treatment

18+ = may consent to treatment or refuse treatment

‘Parents cannot override the competent consent of a young person to treatment that you consider is in their best interests. But you can rely on parental consent when a child lacks the capacity to consent.

Question 5

Contraceptives under 16 years of age (Fraser Guidelines)

Answer 5

These must all be fulfilled:

• young person understand professional advice
• the young person cannot be persuaded to inform their patents
• young person likely to begin, or continue having, SI with or without contraceptive tx
• unless the young person receives contraceptive tx, their physical/mental health or both, are likely to suffer
• the young person’s best interests require them to receive contraceptive advice or tx with or without parental consent

Question 6

Primitive Reflexes

Answer 6

Sucking and rooting = stimulate corner of mouth → baby will turn to source of stimulus

Palmar grasp = object place on baby’s hand → they will grasp it

Stepping = takes steps when held upright

Babinski, plantar reflex = toe curls in adults, goes up in children (myelination of long tracts are not complete)

Asymmetric tonic retroflex = arms stretched out when in recovery position, child looks at hands that is stretched out

Moro = drop baby, sudden abduction and adduction of the arms

Question 7

Developmental milestones summary

Answer 7

Question 8

Commonly used developmental assessment tools

Answer 8

Question 9

Routine developmental screening timetable

Answer 9

Question 10

Developmental warning signs

Answer 10

Question 11

Newborn examination

Answer 11

• Looks/skin
• Jaundice
• pallor
• cyanosis (peripheral and central)
• jitteriness
• tone
• head circumference
• eyes
• cleft lip and palate
• heart murmur
• recession
• femoral pulses
• hips
• genitalia
• hypospadias
• testes
• talipes
• familial illness
• delivery mode
• antenatal USS
• vaccination status

Question 12

• children below 0.4th centile for height should be reviewed by a paediatrician

Answer 12

• children below 0.4th centile for height should be reviewed by a paediatrician