Dev. milestones

Question 1

Milestones for ages

Answer 1

see P 71

Question 2

4 DDx for gross motor probs

Answer 2

1. CNS prob
2. PNS prob
3. metabolic conditions
4. genetics

Question 3

4 DDx for lang issues

Answer 3

1. structural/functional anaotmy
2. hearing impaired
3. pure language
4. pervasive dev. disorders

Question 4

4 cognitive DDx

Answer 4

global dev. delay

1. genetics
2. poor env.
3. prenatal/perinatal events leading to hypoxia
4. prenatal exposure

Question 5

2 DDx for emotional/social

Answer 5

1. PDD

2. poor env.

Question 6

mgmt for motor delays

Answer 6

1. poor correlation between cog. and motor

2. PT/OT ref

Question 7

mgmt for lang. delay

Answer 7

1. hearing assess
2. early local intervention service
3. SLP
4. nursery school
5. educate parents

Question 8

mgmt for cog.

Answer 8

thourough Hx
Ph exam including HC, neuro, dysmorphic features
hearing/vision assess
karyotype, lead levels

Question 9

mgmt for social/emot

Answer 9

• early intervention
• incr. contact with other children
• refer to therapeutic groups

Question 10

3 examples of dev. surveillance

Answer 10

1. rourke baby record
   - growth
   - nutrition
   - dev milestones
   - ant. guidance
2. nipissing
   - up to 6 years
   - part of enhanced 18month
3. greig health record
   - 6-17 years
   - height wwight
   - pyschosocial
   - nutrition
   - education
   - behav. and fam issues

Question 11

epi of ADHD

Answer 11

2-3x high in boys than girls

- girls more likely to get Dx with inattention

Question 12

ADHD def.

Answer 12

1. inattention (6 or more) and/or hyperactivity that is inconsistent with dev. level and impact function
2. Sx prior to 12
3. 2 or more settings
4. interferes
5. not due to another illness

Question 13

3 types

Answer 13

1. in attentive
2. hyperactive
3. combines

Question 14

risk for ADHD

Answer 14

1. genes are 75%

2. LBW, smoking in preg, severe early deprivation

Question 15

Phx for ADHD

Answer 15

useful for ruling out other issues

Question 16

invest. for ADHD

Answer 16

none usually

Question 17

MGMT of ADHD

Answer 17

• psychoed
• behavior therapies
  school aged
• first line stim. meds
• second non stim meds
• third behav. mgmt
  preschool
• first behav. mgmt
• second meds

DIET NOT helpful

Question 18

meds for ADHD

Answer 18

stim first line

• extended release associated with less use of street drugs
• should be used 365

Question 19

basic def. of ASD

Answer 19

• persistent impairment in reciprocal social interactions and restricted stereotyped patterns of behaviors, interests of activity
• present from early childhood
• language, motor signs, aversion to cuddling
• cog. varies

Question 20

risk factors for ASD (7)

Answer 20

1. male 4x
2. another child with autism
3. advanced parental age
4. genetic syndromes
5. early bilat. temp lesions
6. very LBW
7. NOT MMR

Question 21

4 signs to look out for ASD

Answer 21

1. loss of lang
2. lack of orienting to speech
3. concern about lang. comprehension
4. persistent mutism

Question 22

invest. for ASD

Answer 22

formal hearing test

Question 23

Dx of ASD

Answer 23

• DSM -V
• interdisc.
• one parent report measure and one behav . measure
• by 18 mos by exp. professionals

Question 24

mgmt of ASD

Answer 24

• early multi disc.
• structured learning
• SLP
• OT - sensory integration
• behav. mgmt
• meds and self injurious behavs.

Question 25

def. LD

Answer 25

discrepancy between cog. ability and academic performance

Question 26

3 main types

Answer 26

1. math 2. reading 3. reading expression

Question 27

what is done to manage LD

Answer 27

IEP that is written and worked on

Question 28

def. bullying

Answer 28

use of power or aggression to cause distress or control

Question 29

indicators of bullying

Answer 29

- physical Sx - depression/anxiety - poor school perf. - little concern for others - extra money or posessions

Question 30

indicators of victims

Answer 30

- - physical Sx - depression/anxiety - school refusal - drop in school motivation - lost items/money - injuroes - threats to hurt self or others

Question 31

mgmt of bullying

Answer 31

comprehensive strategies that encompass the school, fam.m and community

Question 32

Sleep requirments by age

Answer 32

newborn - 16 6-1year - 14 toddlers - 10-13 preschool - 10-12

Question 33

how a newborn should sleep

Answer 33

on back in crib with flat surface and no pillows/blankets

Question 34

def. sleep terrors

Answer 34

first thrid of night - extreme autonomic reg. - no recall

Question 35

nightmares

Answer 35

last third of REM sleep - milder - very common - vivid recall

Question 36

BEARS screen for sleep

Answer 36

``` Bedtime problems Excess daytime sleepyness Awake during the night Regularity and duration of sleep Snoring ```

Question 37

signs of readyness to toilet train

Answer 37

- can follow simple instructions - diaper dry ofr 2-3 hours at a time - BMs regular and somewhat predicatable - uncomfortable in soiled diapers - recognized need to go - can walk to bathroom and pull up pants - stable on potty - motivated

Question 38

4 stages of car seats

Answer 38

1. rear face 2. forward face 3. booster 4. seat belt

Question 39

def. colic

Answer 39

paroxysms of fussiness, irritability or crying - 3 hrs or more per day 3 days per week - no fail to thrive

Question 40

epi and mgmt of colic

Answer 40

peaks at 6 weeks and better by 4 mos - might help to pacify - no evidence for meds or diet