A Child's Journey Flashcards
what are the Recognised phases of childhood?
- Neonate (<4w)
- Infant (<12m/1y)
- Toddler (~1-2y)
- Pre-school (~2-5y)
- School age
- Teenager/ Adolescent
What are the main childhood objectives?
- To grow
- To develop and achieve their potential
- To attain optimal health
- To develop independence
- To be safe
- To be cared for
- To be involved
what is development?
- Gaining functional skills throughout childhood
- A gradual yet rapid process
- Cell growth, migration, connection, pruning, and myelination (Use it or lose it)
- Sequence of events in each domain
- School - Cognitive and thought development (early skills become more refined)
when does development occur?
- Typically birth to 5y (but brains develop in utero)
- Fairly consistent pattern but rate will vary
Getting Wired up…
What is happening in the brain in fascinating
Born with connections and up until 2 forms billions of connections
Use it or Lose it….
Then there’s a pruning back process at 15
what are the key development fields?
4 main key areas
2 parts of motor separate
Hearing and vision may not get listed separately
All these areas do interact and overlap with each other
evolution of childs level of physical development
evolution of childs level of mental and social development
Understand the sequence
It’s a progression of skills over a period of time
when thinking about a childs development, what are important things you need to think about?
What has come before? What is coming next?
- Think of the sequence within each domain
- If what you see is normal - Chances are what follows will be normal
- If what you see is abnormal - What came before and what comes after may well be abnormal
what are Milestones?
- Achievement of key development skills
- Social smile, sitting, walking, first words
- Variation of what is normal
when should a child be refered if milestones are not met?
- Refer if not achieved by limit age (2 SDs from mean)
- Correct for prematurity until 2y (born early, should be caught up by 2 years old)
- Example: Walking
- Some may walk at 9-10 months
- 50% by 12m (median age)
- Refer if not walking by 18m (limit age)
- Beware bottom shufflers and commando crawlers
Why is Development Important?
- Learning functional skills for later life (often things you take for granted)
- Hone skills in a safe environment
- Allow our brain’s genetic potential to be fully realised
- Equip us with tools needed to function as older children and adults
- Many are completely automatic
Critical for who you become when you are older
what are influencing factors of development?
- Genetics (Family, race, gender)
- Environment
- Positive early childhood experience
- Developing brain vulnerable to insults - Antenatal, Post natal, Abuse and neglect
Adverse Environmental Factors affecting development:
what are some Antenatal factors?
Infections (CMV, Rubella, Toxoplasmosis, VZV)
Toxins (Alcohol, Smoking, Anti-epileptics)
Adverse Environmental Factors affecting development:
what are some Postnatal factors?
Infection (Meningitis, encephalitis)
Toxins (solvents mercury, lead)
Trauma (Head injuries)
Malnutrition (iron, folate, vit D)
Metabolic (Hypoglycaemia, hyper + hyponatraemia)
Maltreatment/under stimulation/domestic violence
Maternal mental health issues
Developmental Assessment- Why?
- Reassurance and showing progress
- Early diagnosis and intervention
- Discuss positive stimulation/parenting strategies
- Provision of information
- Improving outcomes (pre-school years critical)
- Genetic counselling
- Coexistent health issues
Developmental Assessment - how are patients assessed?
- Child surveillance v.s. developmental screening v.s. developmental assessment
- Specific groups (premature, syndromes, events)
Surveillance being the process by which all children are kept under review. developmental screening is the points at which kids get seen at set ages And there’s that snapshot to take a look at where they’re at. And developmental assessment is more a more detailed process where there’s maybe a few issues flagged up at screening, and then you have a more detailed assessment looking at a wider range of skill sets
Developmental Assessment - Who are the assessors?
Parents and wider family
Health visitors, nursery, teachers
GPs, A+E, FYs, STs, students
Paediatricians and community paediatricians
Reference charts vs. WHO Standard charts
whats the difference?
A growth reference simply describes the growth of a sample of individuals, whereas a standard describes the growth of a ‘healthy’ population and suggests an aspirational model. WHO growth charts are growth standards
Taking info and putting it on growth chart to see where they fit into the rest of the population
Population derived references
Useful reference values to remember for weight, length and OFC
Unlikely to get asked in exams
What age does your head circumference double by? - it doesnt
Failure to thrive (FTT)/ Weight Faltering - what is it?
- Child growing too slowly in form and usually in function at the expected rate for his or her age
- Significantly low rate of weight gain - Crossing centile spaces
- Not a diagnosis but a description of a pattern
summary of how to deal with a child who has failure to thrive
Diet part of history is most important
