A Child's Journey: Growth, Development and Health Flashcards
(68 cards)
1
Q
Neonate is…
A
<4w
2
Q
Infant is …
A
12m/1yr
3
Q
Toddler is…
A
~1-2yr - usually on feet - toddle on feet
4
Q
5 Key Developmental Fields
A
Gross motor Fine motor Socail and self help Speech and language Hearing and vision
5
Q
How we get about is called
A
Gross motor
6
Q
What we do with our hands
A
Fine motor
7
Q
Whats a milestone?
A
Achievement of key development skills
8
Q
E.g.s of Milestones
A
Social smile, sitting, walking, first words
9
Q
What to do if not achieved milestones by limit age (2 SDs from mean)?
A
Refer
10
Q
milestones; correct for prematurity?
A
Yes until 2yrs
11
Q
Influencing Factors on development
A
Genetics (Family, race, gender) Environment Positive early childhood experience Developing brain vulnerable to insults Antenatal Post natal Abuse and neglect
12
Q
Antenatal adverse environmental factors for development
A
infections
toxins
13
Q
Postnatal adverse environmental factors for development
A
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
14
Q
What are the specific groups of kids that should be developmentally assessed
A
premature, syndromes, events
15
Q
Milestones : e.g. walking
early walkers…
A
9-10 months
16
Q
Milestones : e.g. walking
median age walkers…
A
12months
17
Q
refer if not walking by
A
18 months
18
Q
Problem if not smiling by
A
8wks
19
Q
RED FLAGS
…. of Development skills
A
loss
20
Q
RED FLAGS
Parental/ professional concern re….
A
vision
hearing loss
21
Q
RED FLAGS
tone…
A
Low - floppy
increased muscle tone
22
Q
RED FLAGS
no speech by
A
18 months
23
Q
RED FLAGS
type of walking
A
toe walking
24
Q
OFC stands for
A
Occipitofrontal circumference
25
RED FLAGS
| OFC >
99.6th centile
26
RED FLAGS
| OFC
0.4th centile
27
Expected Skills at 6 months
Sits steadily without support (by 8-9 months)
Transfers toy from one hand to the other.
Responds to name (turns and looks).
Reaches for familiar people.
Feeds self biscuits or similar food.
28
Expected Skills at 12 months
Walks without help. (By 18 months)
Stacks 2 or more blocks.
Uses “Mama” or “Dada” specifically for parents, or similar.
Shows shared attention/ pointing to things of interest.
Feeds self with spoon.
29
Expected Skills at 2 yrs
Climbs on play equipment
Scribbles with circular motion.
Has a vocabulary of at around 30-50 words.
“Helps” with simple household tasks.
Opens door by turning knob.
30
Expected skills at 3yrs
Rides on a tricycle, using pedals.
Draws or copies a complete circle.
Asks questions beginning with “Why? When? How?”
Gives directions to other children.
Toilet trained (but may need help with wiping etc.).
31
How do they communicate?
(Speech and Language)
32
What can they do for themselves?
Social and Self Help)
33
Main components of Child health programme (Scotland)
Health promotion
Developmental screening (including hearing)
Immunisation
34
Childs progress is reordered in the...
Red Book
35
Child health Programme involves:
```
New-born exam and blood spot screening*
New-born hearing screening (by Day 28)
Health Visitor First Visit
6-8w Review (Max 12w)
27-30 month Review (Max 32m)
Orthoptist vision screening (4-5y)
```
36
6-8w Review (GP and HV) involves...
Identification data (Name, address, GP)
Feeding (breast/ bottle/ both)
Parental concerns (appearance, hearing; eyes, sleeping, movement, illness, crying, weight)
Development
Measurements (Weight, OFC, Length)
Examination (heart, hips, testes, genitalia, femoral pulses and eyes (red reflex))
Sleeping position (supine, prone, side)
37
27-30m Review (HV)
Identification data (name, address, GP)
Development
Physical measurements (height and weight)
Diagnoses / other issues
38
Do you correct age for immunisations in prematures?
No
39
Growth Monitoring
| 3 key parameters
Weight (grams and Kgs)
Length (cm) or height (if >2y)
Head circumference (OFC) (cm)
40
birth weight
length
OFC
3.3kg
50cm
35cm
41
4 months weight
| length
6.6kg
| 60cm
42
12 months weight
length
OFC
10kg
75cm
45cm
43
3y weight
| lenght
15kg
| 95cm
44
A 'Centile' is...
% divisions of the reference population sampled
45
50th Centile means
```
“If you take the average 100 healthy children 50 are above this point and 50 are below”
“About half the kids in class are smaller…”
```
46
0.4th centile means
“If you take the average 1000 healthy children 4 are below this point 996 are above”
47
0.4th centile means
“If you take the average 1000 healthy children 4 are below this point 996 are above”
48
Failure to thrive (FTT) also known as
Weight Faltering
49
FTT is when a child grows too ... in .... and usually in ... at the expected rate for his or her age
slowly in form and usually in function at the expected rate for his or her age
50
In FTT there is a significantly low rate of
weight gain
| -crossing centile spaces
51
FTT is not a diagnosis but a...
description of a pattern
52
FTT means the SUPPLY of Energy and/or nutrients is
< DEMAND
| for Energy and nutrients
53
Causes of FTT in early life
| Deficient intake can be either
maternal or infant
54
Maternal causes for deficient intake in FTT
Poor lactation
Incorrectly prepared feeds
Unusual milk or other feeds
Inadequate care
55
Infant causes for deficient intake in FTT
Prematurity
Small for dates
Oro palatal abnormalities (e.g. cleft palate)
Neuromuscular disease (e.g. cerebral palsy)
Genetic disorders
56
Increased metabolic demands causes for FTT
```
Congenital lung disease
Heart disease
Liver disease
Renal disease
Infection
Anaemia
Inborn errors of metabolism
Cystic fibrosis
Thyroid disease
Crohn’s/ IBD
Malignancy
```
57
Excessive nutrient loss causes of FTT
```
Gastro oesophageal reflux
Pyloric stenosis
Gastroenteritis (post-infectious phase)
Malabsorption
Food allergy
Persistent diarrhoea
Coeliac disease
Pancreatic insuffiency
Short bowel syndrome
```
58
4 broad causes of FTT
Deficient intake
Increased Metabolic demands
Excessive nutrient loss
Non medical causes
59
Non medical causes of FTT
Poverty/ socio-economic status
Dysfunctional family interactions (especially maternal depression or drug use)
Difficult parent-child interactions
Lack of parental support (eg, no friends, no extended family)
Lack of preparation for parenting/ education
Child neglect
Emotional deprivation
Poor feeding or feeding skills disorder
60
History in FTT
Presenting symptoms
Dietary assessment
Birth/family/social
61
Physical exam FTT
Dysmorphic features
Anthropometry
Systems, Development
62
After physical exam in FTT what do you do?
Trial of feeding in Hospital
63
What is involved in a Trial of feeding in Hospital in FTT?
Observe feeding, mothers handling
Dietician / SALT assessment
Developmental assessment
64
What is a SALT?
speech and language therapist
65
FTT If child has good feeding intake in hospital assess...
Weight gain
66
FTT If child has good feeding intake in hospital and does gain weight condition is ...
Non organic
67
FTT If child has good feeding intake in hospital and does NOT gain weight condition is ...
Organic
| investigate accordingly
68
FTT If child has poor feeding intake in hospital causes are...
Organic cause
Feeding disorder
Non-Organic or mIxed
