A child's journey

Question 1

What are some notable developmental milestones?

Answer 1

Social smile
Sitting
Walking
First words

Question 2

When should inability to walk be referred?

Answer 2

Not walking by 18 months

Question 3

What are some important influences in development?

Answer 3

Genetics
Environment
Positive early childhood experience
Developing brain vulnerable to antenatal/postnatal insult and abuse/neglect

Question 4

What are some of the main antenatal infectious threats?

Answer 4

CMV
Rubella
Toxoplasmosis
VZV

Question 5

What are some big antenatal toxin threats?

Answer 5

Alcohol
Smoking
Anti-epileptics

Question 6

What are the main postnatal infectious threats?

Answer 6

Meningitis
Encephalitis
Sepsis

Question 7

What are the main postnatal toxin threats?

Answer 7

Solvents
Mercury
Lead

Question 8

When might a language delay be normal?

Answer 8

Multilingual families

Question 9

When is lack of speech development considered a red flag?

Answer 9

18 months
Especially if no other communication
Urgent referral for hearing test

Question 10

Is asymmetry of movements/increased muscle tone a significant sign?

Answer 10

Yes

Red flag

Question 11

Is low muscle tone/floppiness a red flag?

Answer 11

Yes

Question 12

Is hearing loss a red flag symptom?

Answer 12

Yes

Refer to audiology/ENT immediately

Question 13

Is vision concern always a red flag?

Answer 13

Yes

Question 14

What is the Healthy Child Programme?

Answer 14

UK child health screening
Overview of health and development
Based in primary care
Main concerns are health promotion, developmental screening, immunisation

Question 15

When is new-born hearing screening performed?

Answer 15

By day 28

Question 16

When is the orthoptist vision screening?

Answer 16

4-5 years

Question 17

What does the 6-8 week review address?

Answer 17

Feeding
Parental concerns
Development
Measurements
Examination
Sleeping position (supine, prone, side)

Question 18

What does the 27-30 month review address?

Answer 18

Development
Physical measurements
Diagnoses

Question 19

What are some developmental concerns at the 6-8 week review?

Answer 19

Gross motor
Hearing
Communication
Vision
Social awareness

Question 20

What are some developmental concerns at the 27-30 month review?

Answer 20

Social
Behavioural
Attention
Emotion
Communication
Speech
Gross and fine motor
Vision
Hearing

Question 21

Is egg allergy a contraindication to MMR?

Answer 21

No

Question 22

Could you use live vaccines (eg MMR) in immunocompromised children?

Answer 22

No

Question 23

What are the 3 key parameters for growth monitoring?

Answer 23

Weight
Length
Head circumference

Question 24

What are some maternal factors which may cause failure to thrive?

Answer 24

Poor lactation
Incorrectly prepared feeds
Unusual milk or other feeds
Inadequate care

Question 25

What are some infant risk factors for failure to thrive?

Answer 25

Prematurity Small for dates Oro palatal abnormalities (e.g. cleft palate) Neuromuscular disease (e.g. cerebral palsy) Genetic disorders

Question 26

What are some causes of excessive nutrient loss which may cause failure to thrive?

Answer 26

Gastro oesophageal reflux Pyloric stenosis Gastroenteritis (post-infectious phase) Malabsorption

Question 27

What are some causes of malabsorption?

Answer 27

``` Food allergy Persistent diarrhoea Coeliac disease Pancreatic insufficiency Short bowel syndrome ```

Question 28

What are some non-medical causes of failure to thrive?

Answer 28

``` Poverty Dysfunctional family interactions Lack of parental support Lack of parental education Neglect Emotional deprivation ```

Question 29

What are some conditions associated with failure to thrive?

Answer 29

``` GOR Coeliac Crohn's Chronic renal failure Cystic fibrosis Hypothyroidism Inborn errors of metabolism Neglect ```