BRS2 Flashcards
(92 cards)
1
Q
developmental quotient
A
developmental age/chronologic age x 100
2
Q
Developmental quotient > 85%
A
normal
3
Q
Developmental quotient < 70%
A
abnormal
4
Q
Developmental quotient 70-85%
A
close follow-up warranted
5
Q
developmental domains (4)
A
motor, language, social and cognitive
6
Q
gross motor milestone at birth
A
turns head to side
7
Q
gross motor milestone at 2 months
A
lifts head when lying prone, head lag when pulled from supine position
8
Q
gross motor milestone at 4 months
A
rolls over, no head lag when pulled from supine position, pushes chest up with arms
gross motor milestone at birth
9
Q
gross motor milestone at 6 months
A
sits alone, leads with head when pulled from supine position
10
Q
gross motor milestone at 9 months
A
pulls to stand, cruises
11
Q
gross motor milestone at 12 months
A
walks
12
Q
infants with CNS damage have ___ primitive reflexes and ____ postural reactions
A
stronger and more sustained primitive reflexes
delayed development of postural reflexes
13
Q
primitive reflex
A
these develop during gestation and are present at birth. usually disappear between 3-6 months of age.
14
Q
postural reactions
A
not present at birth- they are acquired.
15
Q
4 primitive reflexes
A
moro, hand grasp, atonic neck reflex, rooting
16
Q
moro reflex
A
abduction and extension of arms with trunk extension. then adduction of upper extremities. present at birth, gone by 4 months
17
Q
hand grasp reflex
A
grasp anything placed in palm. present at birth, gone by 1-3 months
18
Q
atonic neck reflex
A
head turned to Left- arms extend on left (E for same) and flex on the right (opposite side). present at 2-4 weeks and gone by 6 months
19
Q
rooting reflex
A
turn head toward same side as stimulus when corner of mouth is stimulated. present at birth and gone by 6 months.
20
Q
2 postural reactions
A
head righting and parachute
21
Q
head righting
A
ability to keep head vertical despite body being tilted. appears at 4-6 months and persists
22
Q
parachute
A
outstretched arms and legs when body is moved head first in down direction. seen at 8-9 months and persists
23
Q
fine motor milestone at birth
A
hands kept tightly fisted
24
Q
fine motor milestone at 3-4 months
A
brings hands together at midline and then to mouth
25
fine motor milestone at 4-5 months
reaches for objects
26
fine motor milestone at 6-7 months
rakes objects with whole hand, transfers objects from hand to hand
27
fine motor milestone at 9 months
uses immature pincer
28
fine motor milestone at 12 months
uses mature pincer (using tip of index finger)
29
earliest sign of neuromotor delay
persistent fisting beyond 3 months of age
30
early hand dominance (before 18 months)
sign of weakness of opposite extremity
31
which is better- receptive or expressive language
receptive is always more advanced than expressive
32
language vs. speech
language is ability to communicate with symptoms (writing, signing, speaking etc.)
speech is the vocal expression of language.
33
when is optimal language acquisition
first 2 yrs of life
34
language milestone at birth
attunes to human voice, developes recognition of parents voice
35
language milestone at 2-3 months
cooing, musical sounds (ooh, agh)
36
language milestone at 6 months
babbling like da da da ba ba ba
37
language milestone at 9-12 months
jargoning. mixed consonants, inflection. uses terms like mama, dada (non specific)
38
language milestone at 12 months
1-3 words. mama and dada specific
39
language milestone at 18 months
20-50 words. beginning to use 2 word phrases
40
language milestone at 2 yrs
2 word sentences like "mommy come" 25-50 % speech should be intelligible
41
language milestone at 3 yrs
three word sentences. more than 75% of speech should make sense
42
pre-speech period
0-10 months. cooing and babbling
43
naming period
10-18 months. infant understanding people have names and objects have labels
44
word combination period
18-24 months. early word combinations. telegraphic- no prepositions, pronouns. combine words 6-8 months after first word
45
differential for language impairment
hearing loss, global delay, environmental deprivation, pervasive developmental disorder like autism
46
how to determine cognitive or intelligence in an infant
language is the single best indicator of intellectual potential. gross motor skills correlate poorly with cognitive potential
47
when does functional play begin
at about 1 yr of age. child puts a toy telephone to their ear
48
when does imaginative play begin
24-30 months. use blocks to build a castle or a stick as a fork
49
when does concrete thinking develop
interpret things literally. preschool and early elementary years
50
abstract thinking develops
in adolescent years
51
when and what is object permanence
develops about 9 months. concept that mom still exists even if she isn't in the room. can lead to separation anxiety- common between 6-18 months.
52
cause and effect behavior
at 9-15 months. dropping something makes it fall to the floor. actions cause things to happen
53
magical thinking
normal state of mind during preschool toddler years. child assumes inanimate objects are alive and have feelings
54
predictor of verbal intelligence
language development
55
predictor of non verbal intelligence
problem solving skills
56
3 social milestones
attachment, sense of self, social play
57
attachment
bonding with a primary caregiver. begins at birth. need empathy within first 3 yrs of life
58
a sense of self and independence
separation and individualization begins about 15 months
59
social play
toddlers exhibit parallel play during the first 2 yrs of life. learn to play together and share by about 3.
60
definition cerebral palsy
static and non progressive encephalopathies caused by injury to the developing brain. motor function is primarily effected. injury can be prenatal or perinatal. patients have increasing tone or spasticity, hypotonia, asymetric reflexes, abnormal issues with disappearing innate reflexes and appearing of postural responses
61
2 types of cerebral palsy
spastic and non spastic
62
spastic diplegia
weakness usually in the lower extremities more. early rolling over, increased muscle tone. scissoring is common. common in prematurity
63
spastic hemiplegia
unilateral spastic motor weakness, usually upper extremity is involved. early hand preference, attempts at grasping always on same side and fisting. absent pincer on one side. seen with perinatal vascular insults, post natal trauma
64
spastic quadriplegia
motor involvement of head, neck and all 4 limbs involved. seizures, scoliosis, facial weakness, Gi reflux etc. CNS infections, trauma, malformations, hypoxic ischemic encephalopoathy
65
non spastic cerebral palsy= athetoid CP
extrapyramidal. athetoid movements. hypotonia. arms more than legs. oral involvement may be prominent drooling, problems with speech. often in full term infant with hypoxia ischemic encephalopathy, kernicturus leading to basal ganglia damage
66
mental retardation definition
significantly subaverage general intellectual functioning with deficits in adative behavior like self care, social skills, work and leisure. manifested before 18 yrs of age.
67
learning disabilities definition
significant discrepency between a child's academic achievement and the level expected on the basis of age and intelligence. most commonly idiopathic. can be caused by CNS damage.
68
pervasive developmental disorder (PDD)
spectrum of developmental disabilities affects multiple developmental areas, especially behavior and learning with a wide range of severity.
69
prototypical PDD
autism. more common in boys
70
difference between autism and aspergers
asperger has a qualitative impairment in peer relationships and social interactions but no clinically significant language delay. language in aspergers may actually be advanced.
71
ADHD
poor selective attention, difficulty focusing or distractibility. hyperactivity may or may not be part of this.
72
what medications can be used for ADHD
stimulants are first line treatments- improve attention, impulsivity and hyperactivity. examples are methylphenidate (ritalin) and amphetamines like adderall.
73
neurotransmitter issue with ADHD
lower levels of dopamine and norepi. stimulants increase these and improve symptoms
74
non stimulant drugs for ADHD
second line therapy. tricyclics, and adrenergic agents like clonidine. clonidine is especially helpful at bedtime and can be used with a stimulant
75
when do you need to identify a hearing problem by
hopefully before 6 months to prevent delayed langugae skills and academic and behavior problems
76
most common cause of hearing issues in kids
genetics. autosomal recessive.
77
labs to check in hearing loss child
genetic evaluation, creatinine level (because of associated kidney disease in things like Alport syndrome), viral serologies for infections, CT of inner ear if still unclear.
78
primary cause of blindness in children worldwide
trachoma infection. other causes include retinopathy of prematurity and congenital cataracts
79
colic definition
crying that lasts more than 3 hours per day and occurs more than 3 days per week. normal crying should be about 2 hours per day at 2 weeks and increases to 3 hours per day at 3 months. begins at 2-4 weeks of age and resolves by 3-4 months. typically more irritable in the afternoon early evening.
80
enuresis
urinary incontinence beyond the age at which kids are capable of continence. can be primary (never continent) or secondary (following a period of continence)
81
causes of enuresis (genetic)
strong familial tendency for nocturnal primary enuresis. gene on chromosome 13
82
sleeping through the night
this is sleeping more than 5 hours straight after midnight for a 4 week period. this is seen in 50% of infants at 3 months
83
trained night waking
this is abnormal. occurs between 4-8 months. infant does not resettle without parental intervention during normal night stirrings and awakenings. treatment is establishing a routine and placing infant in bed while drowsy but awake.
84
nightmares
common after 3 yrs. can occur as early as 6 months. occur during REM sleep and are normal
85
night terrors
seen at 3-5 yrs of age. ocur 90-120 minutes into sleep and NON REM stage 4 sleep.
86
appetite after 1 yr of age
it actually may decrease and this is normal
87
temper tantrums
expressions of emotions like anger that are beyond the child's ability to control. common between 1-3 yrs. usually from frustration or fatigue. more if there is poor motor skills or expressive language.
88
breath holding spells
benign episodes in which children hold their breath long enough to cause parental concern. spells are involuntary in nature, harmless, and always stop by themselves. can start at 6-18 months and disappear by 5 yrs. iron has been shown to help.
89
cause of a cyanotic breath holding spell
usually from frustration and anger. child cries and becomes cyanotic. can become unconscious and have a seizure
90
cause of a pallid breath holding spell
unexpected event that is frightening. hyper vasovagal response. child becomes pale or limp
91
normal age of bowel and bladder control
bowel control by 29 months of age. range is 16-48 months. average bladder control by 32 months with a range of 18-60 months.
92
how long should a time out be?
1 minute per year of age (max of 5 minutes).
