Child Development Flashcards

1
Q

Developmental Screening

A

-Birth hearing screening
-Hip screening
-Routine neonatal examination and 6-8 weeks checks
-HV screening at attendance for immunisations/weighing
-ASQ – Ages and Stages Questionnaire
-ASQ SE – Ages and Stages Questionnaire(Social and Emotional)

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2
Q

What are developmental milestones?

A

Developmental milestones must be considered in regards to their ‘median age of acquisition’ (when half of a standard population of children achieve that level) and the ‘limit age’ by which they should have been achieved. Limit ages are generally considered to be two standard deviations from the mean age of acquisition. If the skill is not achieved by this age, more detailed assessment, investigation or intervention may be required. For instance, when considering the milestone of walking – the median age is 12 months, with a limit age of 18 months.

Developmental milestones are acquired in a serial manner – one after the other – and their achievement follows a similar pattern between children.

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3
Q

Functional areas of developmental milestones

A

Gross motor
Vision and fine motor
Hearing, speech and language
Social, emotional and behavioural

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4
Q

Gross motor development milestones

A

-New-born
=Limbs flexed, symmetrical pattern
=Marked head lag on pulling up

-6-8 weeks
=Raises head to 45 degrees in prone (tummy-time)

-6-8 months
=Sits without support (initially with a round back, then eventually with a straight back by 8 months)
=Lying on abdomen arms extended, lying on back lifts and grasps feet, pulls self to sitting, held sitting back straight, rolls front to back
=Limit age: months

-8-9 months
=Pulls to standing
=Crawling

-10 months
=Stands independently
=Cruises around furniture

-12 months
=Walks unsteadily- a broad gait, with hands apart, walks with one held hand
=Limit age: 18 months

-15 months
=Walks steadily (refer at 18 months)

-2.5 years
=Runs and jumps

-3 years
=Ride tricycle using pedals, walks up stairs without holding onto rail

-4 years
=Hops on one leg

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5
Q

Vision and fine motor development milestones

A

-3 months
=Reaches for object
=Holds rattle briefly if given to hand
=Visually alert, particularly human faces
=Fixes and follows to 180 degrees

-6 weeks
=Follows moving object or face by turning the head (fixing and following)
=Holds in palmar grasp
=Pass objects from one hand to another
=Visually insatiable, looking around in every direction
=Limit age: 3 months

-4 months
=Reaches out for toys
=Limit age: 6 months

-4-6 months
=Palmar grasp

-7 months
=Transfers toys from one hand to another
=Limit age: 9 months

-10 months
=Mature pincer grip
=Points with finger
=Limit age: 12 months

-16-18 months
=Makes marks with crayons

-14 months-4 years (brick building)
=Tower of three – 18 months
=Tower of six – 2 years
=Tower of eight or a train with four bricks – 2.5 years
=Bridge (from a model) – 3 years
=Steps (after demonstration) – 4 years

-2-5 years (pencil skills- drawing without seeing how it is done, can copy 6 months earlier)
=Line – 2 years
=Circle – 3 years
=Cross – 3.5 years
=Square – 4 years
=Triangle – 5 years

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6
Q

Hearing, speech and language development milestones

A

-New-born
=Startles to loud noises

-3 – 4 months
=Vocalises alone or when spoken to, coos and laughs “aa, aa”
=Quietens to parents voice
=Turns towards sound
=Squeals

-7 months
=Turns to soft sounds out of sight
=Polysyllabic babble (“babababa, lalalalala”)

-7 – 10 months
=Sounds used indiscriminately at 7 months
=Sounds used discriminately to parents at 10 months “Dada, Mama”

-12 months
=Two to three words other than ‘Dada’ or ‘Mama’
=Understands name “Drink”
=Knows and responds to own name

-18 months
=6-10 words
=Is able to show two parts of the body “Where is your nose?” – Baby will point

-20 – 24 months
=Joins two or more words to make simple phrases “Give me teddy”

-2.5 – 3 years
=Talks constantly in 3 – 4-word sentences
=Understands 2 joined commands “Push me fast Daddy”
=Vocab 200 words

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7
Q

Social, emotional and behavioural development milestones

A

-6 weeks
=Smiles responsively
=Limit age: 8/10 weeks

-6 – 8 months
=Puts food in their mouth, 6 months not shy

-10 – 12 months
=Waves bye-bye, plays peek-a-boo, 9 months shy

-12 months
=Drinks from a cup with two hands

-18 months
=Holds spoon and gets food safely to mouth

-18 – 24 months
=Symbolic play
=Limit age: 2 – 2.5 years

-2 years
=Toilet training: dry by day
=Pulls off some clothing

-2.5 – 3 years
=Parallel play
=Interactive play evolving
=Takes turns

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8
Q

Neonate

A

-Palmar and plantar grasp
-Rooting
-Sucking
-Swallowing
-Moro reflex
-Asymmetric tonic neck reflex fencing posture)
-Galant (trunk incurvation) reflex

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9
Q

Sitting infant

A

6-1yr
-Sit without support
-Object permanence
-Transfer object
-Casting
-Crawling
-Drink from sipping cup
-Cruising

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9
Q

Lying infant

A

1-6 months
-Responsive smile
-Responds to sound
-Hands to mouth
-Feet to mouth
-Hand regard

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10
Q

Toddler

A

1-2 years
-6 single words
-50 single words
-Two word phrases
-Walk unaided
-Use spoon
-Jump on 2 feet

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11
Q

Pre-school child

A

-Use cutlery
-Speak in short sentences
-Drink from open cup
-Pedal a tricycle
-Put on trousers and jumper
-Shows hand preference (earlier than 18 months, red flag for pathology)

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12
Q

School aged children

A

-Write own name
-Buttons and zips
-Count to 10
-Brush teeth independently
-Cycle a two wheeled bike
-Wash own hair

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13
Q

What is Global Developmental Delay

A

-Evidence of significant delay in 2 or more domains

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14
Q

Boy late walking

A

-Duchenne’s MD consideration
-Screen by checking CK
-Confirm by genetics looking for dystrophin gene mutations
-X linked recessive
-rarely manifesting in female carriers
-Refer to neurology

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15
Q

Overview of GDD in Down’s syndrome

A

-Global developmental delay expected but make sure no additional treatable problems like CSOM
-MDT, consider congenital cardiac, duodenal atresia, cataracts,
-Annual hearing tests, thyroid function screening, developmental review and support
-Risks of leukaemias, coeliac, puberty and weight management, learning disability, ASD

16
Q

Red flags in developmental delay

A

-Boys with delayed walking
-Hand preference <8 months
-Regression/ loss of skill
-Delayed speech aged 18-2yrs
-Abnormal clinical signs associated faltering growth
-Dysmorphism

17
Q

Differential diagnosis of GDD

A

-Autism Spectrum Disorder (ASD):
=Characterised by impairments in social interaction and communication alongside restricted interests and repetitive behaviours.
-Cerebral Palsy:
=A group of permanent movement disorders appearing in early childhood due to abnormal brain development or damage.
-Fragile X Syndrome:
=A genetic condition causing intellectual disability, behavioural challenges and various physical characteristics.
-Down Syndrome:
=A chromosomal disorder leading to intellectual disability and characteristic facial features.
-Fetal Alcohol Spectrum Disorders (FASDs):
=A range of effects that can occur in an individual exposed to alcohol before birth.

-Rett syndrome
-Metabolic disorders

18
Q

Examples of GDD problems

A

-Referral points
=Doesn’t smile at 10 weeks
=Cannot sit unsupported at 12 months
=Cannot walk at 18 months

-Fine motor skill problems
=Hand preference before 12 months is abnormal and may indicate cerebral palsy

-Gross motor problems
=Most common causes of problems: variant of normal, cerebral palsy and neuromuscular disorders (e.g. Duchenne muscular dystrophy)

-Speech and language problems
=Always check hearing
=Other causes include environmental deprivation and general development delay

19
Q

Gross Motor Delay

A

Cerebral palsy
Ataxia
Myopathy
Spina bifida
Visual impairment

20
Q

Fine Motor Delay

A

Dyspraxia
Cerebral palsy
Muscular dystrophy
Visual impairment
Congenital ataxia (rare)

21
Q

Language Delay

A

Specific social circumstances, for example exposure to multiple languages or siblings that do all the talking
Hearing impairment
Learning disability
Neglect
Autism
Cerebral palsy

Management of language delay involves a referral to speech and language, audiology and the health visitor. Referral to safeguarding is required if neglect is a concern.

22
Q

Personal and Social Delay

A

Emotional and social neglect
Parenting issues
Autism