Give developmental milestone for social, emotional and behavioural development for the following behaviours: - Smiling responsively - Scared of strangers - Symbolic play - Taking turns

- 6 weeks - 10 months - 18-24 months - 3-4 years

Give age for vision and fine motor skills for the following developmental milestone: - Follows moving objects by turning head - Palmar grasp - Hand transferring - Mature pincer grip

- 6 weeks - 4-6 months - 7 months - 10 months

Give age for vision and fine motor skills for the following developmental milestone: - Drawing with crayon - Block tower of 3 - Block tower of 8 - Block bridge

- 16-18 months - 18 months - 2.5 years - 3 years

Give age for gross motor development for the following developmental milestone: - Raises head to 45 degrees when prone - Sits without support - Crawling - Standing - Walking unsteadily

- 6-8 weeks - 6-8 months - 8-9 months - 10 months - 12 months

Give age for gross motor development for the following developmental milestone: - Running - Pedalling tricycle - Kicking a ball and hopping

- 2-3 years - 3-4 years - 4-5 years

Community Paediatrics Flashcards by Beth Elliott

Give developmental milestone for hearing, speech and language for the following ages:

Newborn
3-4 months
7 months
12 months

Newborn = startles to loud noises
3-4 months = coos/laughs/vocalises
7 months = Eye contact, responding to name
12 months = 2-3 words other than dada or mama

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Give developmental milestone for hearing, speech and language for the following ages:

20-24 months
2.5 - 3 years

20-24 months = joins 2+ words together

- 2.5-3 years = 3-4 word sentences

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Give developmental milestone for social, emotional and behavioural development for the following behaviours:

Smiling responsively
Scared of strangers
Symbolic play
Taking turns

6 weeks
10 months
18-24 months
3-4 years

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Give age for vision and fine motor skills for the following developmental milestone:

Follows moving objects by turning head
Palmar grasp
Hand transferring
Mature pincer grip

6 weeks
4-6 months
7 months
10 months

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Give age for vision and fine motor skills for the following developmental milestone:

Drawing with crayon
Block tower of 3
Block tower of 8
Block bridge

16-18 months
18 months
2.5 years
3 years

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Give age for gross motor development for the following developmental milestone:

Raises head to 45 degrees when prone
Sits without support
Crawling
Standing
Walking unsteadily

6-8 weeks
6-8 months
8-9 months
10 months
12 months

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Give age for gross motor development for the following developmental milestone:

Running
Pedalling tricycle
Kicking a ball and hopping

2-3 years
3-4 years
4-5 years

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At what age should you be worried if a child hasn’t done the following?

Standing
Walking unsteadily

12 months

- 18 months

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Give 3 differential diagnoses for motor delay

Cerebral Palsy
Duchenne Muscular Dystrophy
Downe’s Syndrome

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What is the triad of symptoms seen in ADHD?

Inattention (hard to follow instructions, can’t listen to small details, easily distracted)
Impulsivity (interrupting, can’t take turns, ‘on the go’)
Hyperactivity (restless, lots of talking)

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Give 2 other features of ADHD

Short temper

- Difficulty in forming good relationships

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Give 3 diagnostic criteria of ADHD

Has to be present in 2+ settings e.g. at home and at school
Has to impact on ADLs/functioning
Has to have been present for MORE THAN 6 months

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What are the screening tests for ADHD? (3)

Conner’s Tests
QB Test
Strengths and weaknesses

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Who is involved in the MDT management of a child with ADHD?

School/teachers
Community paediatrician
Educational Psychologist
?CAHMS

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What is the management for ADHD in UNDER 5s? (2)

ADHD focussed parent training course

- Only give meds if have second opinion/ as a last resort

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What is the management for ADHD in OVER 5s?

Conservative
- Parental education e.g. strategies/ support groups such as ADHD solutions
- Liaise with school
Medical
- Stimulants e.g. methylphenidate or lisdexamfetamine
- can have different preparations e.g. short vs long acting
- Atomoxetine is not preferred

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What baseline assessments do you need to do before commencing medications for ADHD?

Height and weight + plot a growth chart (meds can stunt growth)
Pulse and BP
CVS exam
ECG if indicated

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Define Autism Spectrum Disorder

A neurodevelopmental condition characterised by:

impairment in social interaction

communication

repetitive stereotyped behaviour, interests, and activities.

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What are the symptoms of ASD?

Usually evident before 2-3 years

Impaired social interaction - play alone, can’t regulate social interaction

Repetitive behaviours - stereotyping, stick to routines

+/- intellectual/language impairment

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What are 2 associated conditions with ASD?

ADHD

Epilepsy

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What are the aims of treatment in a child with ASD?

Decreased disability

Learning and development e.g. improved social skills, communication

Family help!

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Give 4 examples of non-pharmacological methods of managing a child with ASD

Parental education

ASD preschool program

Structured teaching method

Applied Behavioural analysis

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Give 3 pharmacological methods of managing a child with ASD

SSRIs can help to reduce stereotyped behaviour and anxiety

Antipsychotics can help to reduce anxiety, aggression and self-injury

Methylphenidate if ADHD is co-existing

Define cerebral palsy

a disorder of movement and posture due to a non-progressive lesion of the motor pathways in the developing brain.

What are the 3 groups of causes of cerebral palsy?

Antenatal - Congenital infections (TORCH), cerebral malformation Intrapartum: birth asphyxia Post natal: IVH, meningitis

How might cerebral palsy present?

abnormal tone early infancy delayed motor milestones abnormal gait (scissor) feeding difficultie.

Give three examples of potential co-existing conditions with cerebral palsy

Intellectual difficulties Epilepsy Squints

What are the 4 classifications of cerebral palsy?

spastic (70%): (hemiplegia, diplegia or quadriplegia) dyskinetic ataxic mixed

What are the pharmacological management options of cerebral palsy?

Diazepam Baclofen Botulinum toxin/surgery Anticonvulsants PEG

What are the features of patau syndrome? which trisomy is it?

13 Microcephalic, small eyes Cleft lip/palate Polydactyly Scalp lesions

What are the features of Edward's syndrome? which trisomy is it?

18 Micrognathia Low-set ears Rocker bottom feet Overlapping of fingers

What are the features of fragile X syndrome?

``` Learning difficulties Macrocephaly Long face Large ears Macro-orchidism ```

What are the features of Noonan syndrome?

Webbed neck Pectus excavatum Short stature Pulmonary stenosis

What are the features of Prader-Willi syndrome?

Hypotonia Hypogonadism Obesity

What are the 3 main referral points for developmental delay?

doesn't smile at 10 weeks cannot sit unsupported at 12 months cannot walk at 18 months

Give an example of a fine motor skill problem and what it may indicate

Hand preference by 12 months Cerebral palsy

What are 2 fine motor milestones for 3 months?

Reaches for objects Fixes and follows to 180 degrees

What are 2 fine motor milestones for 6 months?

Palmar grasp Can pass objects from one hand to the other

What is a fine motor milestone for 12 months?

Pincer grip

When should a child be able to build a brick tower of 6 blocks?

2 years

When should a child be able to copy a vertical line and a circle respectively?

vertical line = 2 years circle = 3 years

When should a baby gain head control?

3 months

When should a baby be able to sit without support?

7-8 months Refer if hasn't happened by 12

When should a baby be able to crawl and cruise respectively?

Crawl = 9 months Cruise = 12 months (/walk with a hand held)

Hone should a baby be able to walk unsupported?

13-15 months Refer if hasn't happened by 18

When should a baby be able to smile?

6 weeks Refer if hasn't happened by 10

When should a baby be able to laugh

3 months

When does a baby become shy around strangers?

9 months

When should a baby be able to play peek a boo and wave bye bye respectively?

PAB = 9 months BB = 12 months

When should a child be able to play with other children?

4 years

When should a baby be able to say mama and dada

9 months

When should a baby be able to respond to their name

12 months

When should a baby be able to combine 2 words

2 years

Give 4 clinical features of down's syndrome?

Face = protruding tongue, small low set ears, round face Single palmar crease Hypotonia Pronounced sandal gap

Give 3 congenital features of down's syndrome

Congenital heart defects (lots of them) Duodenal atresia Hirshprung's

Give 4 examples of later complications of down's syndrome

Learning difficulties Hypothyroidism Alzheimers Repeated respiratory infections (+ otitis media with effusion = ? hearing impairment)