Development Flashcards by Hannah Gibson

Moro, rooting + grasp reflex - what is it, when does it appear + when does it go?

Moro = sudden extension of head causes symmetrical extension then flexion of hands, present at birth, disappears 3-4 months

Rooting = turns head towards a stroke of the cheek. Present at birth, disappears at 4 months

Grasp = flexion of fingers when object is in palm

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Tonic neck reflex, labyrinthine righting + postural support reflex - when does it appear + when does it leave?

Tonic neck = lying supine, infant adopts outstretched arm to side which head turns

Present at 1 month, integrated by 4 months

Labyrinthine righting = head moves in opposite direction to which body is tilted

Present at birth, integrates within a few months

Postural support/ stepping = when upright, legs take weight and bounce

Present at birth, disappears at 5-6 months

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Lateral propping + parachute reflex

Lateral propping = when sitting, arm extends on side to which child falls

Parachute = when upside down, arms extend

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6 week developmental milestones

Head lag, head in line when held

Fixes + follows object through 90’

Startles to loud noise, cries/ coos

Smiles

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6 months developmental milestones

Sits without support, rolls front to back, grasps feet

Transfers objects between hands, mouths

Turns to voice, babbles

Finger feeds, laughs, holds bottle

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1 year developmental milestones

Stands independently, cruises around

Pincer grip, bangs cubes

1-2 words, understands name

Drinks from cup, waves, empties cupboards

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15 months developmental milestones

Broad based gate, pushes wheeled toy

Palmer grasp of pencil, random scribble , builds tower of 2, follows toy pulled 3m away

2-6 words, understands simple commands

Feeds self with spoon, can help dressing, indicates wants without crying

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2 years developmental milestones

Kicks ball, climbs furniture

Circular scribble, tower of 6, turns pages

50+ words, joins 2 words, 2 step request understood

Won’t share, plays near but not with others

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Red flag ages for smiling, not rolling over, unable to sit unsupported

Smiling = 6 weeks Not rolling over = 6 months Unable to sit unsupported = 9 months

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Red flag ages for being unable to crawl or walk

Crawling = 12 months Walking = 18 months

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Types of squint

Concomintant Paralytic

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What is a concomintant squint?

Refractive error - treat with glasses Common with neurodevelopmental delay Squinting eye turns inwards (convergent) Squint is constant in all directions of gaze

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What is a paralytic squint?

Varies with gaze direction due to paralysis of motor nerves (LR6 SO4) Possibility of SOL

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RF for squints

Low birth weight Preterms Neuromuscular disorders Brain or eye tumours Infections

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How to diagnose squints

Corneal light reflex test - if light reflection is in different positions Cover test - when fixing eye is covered, squinting eye moves to take up fixation

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ASD S+S

Impaired social interaction Speech + language disorder Imposition of routines with ritualistic + repetitive behaviour

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Genetic causes of blindness

Cataracts Albinism Retinal dystrophy Retinoblastoma

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Antenatal + perinatal causes of blindness

Congenital infection Retinopathy of prematurity Cerebral damage Optic nerve hypoplasia

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Postnatal causes of blindness

Infection JIA Vit A deficiency

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Types of deafness

Sensorineural = lesion in cochlea or auditory nerve, present at birth Conductive = abnormalities of ear canal or middle ear, usually due to OME

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Causes of sensorineural hearing loss

Genetic Congenital infection (Rubella) Preterm HIE Hyperbilirubinaemia Drugs: aminoglycosides, furosemide

Causes of conductive hearing loss

OME Eustachian tube dysfunction: DS, cleft palate, Pierre Robin sequence

What is fragile X?

X linked recessive disorder Learning difficulty Macrocephaly Macro-orchidism Long face, large ears, prominent mandible, broad forehead Mitral valve prolapse, joint laxity, autism, ADHD

Management of ADHD

Stimulants: methylphenidate or dexamphetamine

12 week training scheme

SE of methylpenidate

Reduced appetite Slowed growth Insomnia Stomach pains

Rooting + stepping reflex

Rooting = head turns to stimulus when touched near mouth Stepping = stepping movements when held vertically

What is Angelman's syndrome?

Developmental regression, epilepsy Due to deletion of maternally inherited CH15

When can honey be introduced and why?

12 months due to risk of botulism

When are children able to draw a X and a box?

4 years

Gross motor milestones (6-8 weeks, 8 months, 9 months, 10 months, 12 months, 15 months)

6-8 weeks = raises head 45’ when prone 6-8 months = sits without support 8-9 months = crawls 10 months – cruising 12 months = walks 15 months = walks steadily

Language milestones for 3-4 months, 7-10 months, 12 months, 18 months, 2 years, 3 years

3-4 months = vocalises alone, laughs 7-10 months = first words 12 months – 2-3 words 18 months – 6-10 words. Shows body parts 2 years = simple phrases 3 years = talks in 3-4 word sentences

Fine motor + vision milestones (6 weeks, 4 months, 6 months, 7 months, 10 months, 18 months, towers + drawing ages)

6 weeks = follows moving object 4 months = reaches out for toys 4-6 months = palmar grasp 7 months = transfers toys between hands 10 months = pincer grip 18 months = marks with crayon 3 block tower = 18 months 6 block tower = 24 months 8 block tower = 2.5 years Line = 2 years Circle = 3 years Cross = 3.5 years Square = 4 years Triangle = 5 years

Social milestones (6 weeks, 8 months, 10 months, 12 months, 18mths, 24mths, 2 years, 3 years)

6 weeks = smiles 6-8 mths = food in mouth 10-12 = waves bye, plays peek a boo 12 months = drinks from cup with 2 hands 18 mths = holds spoon + gets food into mouth 18-24 mths = symbolic play 2 years = dry by day 3 = parallel play, takes turns

What age can children build towers of 3, 6 + 9?

3 = 18 months 6 = 2 years 9 = 3 years

When can a child copy + draw shapes?

Copy 6 months before they can draw

What is the cutoff for acceptable weight loss in the first 7 days?

10%

When can a child hop on one leg?

4 years

What is the definition of delayed puberty?

Lack of onset of development of secondary sexual characteristics by 13 in girls + 14 in boys

What is the average weight of a 1 year old?

10kg

How many hours does a newborn sleep?

16 hours

When to children get hand preferences?

18 months

What is fetal anti-convulsant syndrome?

Defects occurring from mother taking anti-convulsants during pregnancy NTD, heart defects, orofacial + urogenital defects

Which drugs cause craniofacial abnormalities in newborns?

ACEi, alcohol, carbamazepine, valproate, warfarin

What do you give in grey baby syndrome?

Chloramphenicol

3 month milestones

Hands to midline, fixes + follows through 180' No head lag, lifts chest + head when prone Turns to sound Social smile

9 month milestones

Points with index finger, early pincer, looks for fallen toy Sits unsupported for 15 mins, rolls back to front, pulls to stand Understands 'no' + 'bye', says 'mama' + 'dad' Stranger anxiety, finger feeds

18 month milestones

Tower of 3 bricks, linear scribble, hand preference Walks well, walks upstairs with hand held, runs 6-20 words, points to body parts Feeds independantly, symbolic play, indicates toilet needs

2.5 years milestones

Tower of 7, tripod grip, picks up tiny objects with eye covered Runs well, walks upstairs 2 feet to a step, steers pedal cycle 200+ words, echolalia, questionning Feeds self skilfully, pulls down pants, role play

3 years milestones

tower of 9, copies brick train + bridge, copies circle, cuts with scissors Walks upstairs, throws ball, stands on 1 leg momentarily 3-4 word sentences, counts to 10, knows name + sex Uses knife + fork, dry by day, separates from mother easily

4 year milestones

Tower of 10, copies square, matches 4 primary colours Hops, stands on 1 fot for 3-5s Speech grammatically correct, knows full name + address, counts to 20 Shares toys, dry by day + night, uses toilet alone

5 year milestones

Copies triangle, builds steps of 3 Runs up and down stairs, catches ball, skips Fluent speech, defines words Chooses friends, washes + dries hands, comforts in distress