Development Flashcards
(119 cards)
1
Q
What factors influence normal development?
A
- genetic
- nutritional
- environmental
2
Q
Define median age
A
‘age when 50% of the population achieve a skill’
3
Q
Define limit age
A
‘age when skill should have been acquired by 97.5% of children’
4
Q
Describe gross motor development within the first 6 weeks of life
A
Head control in vertical
5
Q
Describe gross motor development within the first 3 months of life
A
No head lag on pulling to sit
6
Q
Describe gross motor development within the first 6 months of life
A
Sits unsupported, weight bears on legs
7
Q
Describe gross motor development within the first 9 months of life
A
Crawls, holds onto furniture to stand and reaches on
8
Q
Describe gross motor development within the first 12 months of life
A
Pulls to standing, walks
9
Q
Describe gross motor development within the first 18 months of life
A
Runs, climbs onto adult chair
10
Q
Describe gross motor development by 2 years of age
A
Climbs stairs with two feet/step, sits and steers trike
11
Q
Describe gross motor development by 3 years of age
A
Climbs stairs using alternate feet, jumps off bottom step
12
Q
Describe gross motor development by 4 years of age
A
Hops and climbs ladders
13
Q
Name five primitive reflexes
A
Sucking and Rooting Palmar and Plantar grasp ATNR Moro Stepping and Placing
14
Q
Describe the fine motor and vision development at 6 weeks
A
Follow torch with eyes
15
Q
Describe the fine motor and vision development at 3 months
A
Hand regard in midline
16
Q
Describe the fine motor and vision development at 6 months
A
Grasps toys, hand in hand
17
Q
Describe the fine motor and vision development at 9 months
A
Scissor grip, points with index finger
18
Q
Describe the fine motor and vision development at 12 months
A
Pincer grasp, bangs toys together
19
Q
Describe the fine motor and vision development at 18 months
A
Tower of 3-4 bricks
20
Q
Describe the fine motor and vision development at 2 years
A
Tower of 6-7 bricks, scribbles
21
Q
Describe the fine motor and vision development at 3 years
A
Tower of 9 bricks, copies circle
22
Q
Describe the fine motor and vision development at 4 years
A
Threads beads, draws simple man
23
Q
Describe hearing and language development at 6 weeks
A
Stills to voice
24
Q
Describe hearing and language development at 3 months
A
Starts to vocalise
25
Describe hearing and language development at 6 months
Babbles, screams when annoyed
26
Describe hearing and language development at 9 months
Imitates sounds, localises sound
27
Describe hearing and language development at 12 months
Knows and turns to name, many vowels and consonants
28
Describe hearing and language development at 18 months
5-20 words
29
Describe hearing and language development at 2 years
Simple instructions, 50+ words
30
Describe hearing and language development at 3 years
Asks questions, complex instructions, nursery rhymes
31
Describe hearing and language development at 4 years
Tells stories, counts to 20
32
Describe social and play development at 6 weeks
Social smile
33
Describe social and play development at 3 months
Pleasure on friendly handling
34
Describe social and play development at 6 months
Plays with feet, friendly with strangers
35
Describe social and play development at 9 months
Plays peek-a-boo, distinguishes strangers
36
Describe social and play development at 12 months
Drinks from a cup, waves bye bye
37
Describe social and play development at 18 months
Feeds with a spoon
38
Describe social and play development at 2 years
Puts on some clothes, symbolic play
39
Describe social and play development at 3 years
Toilet trained, washes hands, pretend interactive play
40
Describe social and play development at 4 years
Dresses and undresses, washes/dried hands, understands taking turns
41
Define developmental delay
Failure to attain appropriate developmental milestones for child's correct chronological age
42
Name three types of abnormal development
- delay (global/specific)
- deviation (autism)
- regression (Rett's syndrome, metabolic disorders)
43
What is Rett's Syndrome?
Genetic condition where children develop normally in first year and then plateau before losing developmental skills
44
States seven red flags for abnormal development
1. Asymmetry of movement
2. Not reaching for objects by 6 months
3. Unable to sit supported by 12 months
4. Unable to walk by 18 months
5. No speech by 18 months
6. Concerns re. vision or hearing
7. Loss of skills
45
What is global developmental delay?
```
Significant delay in 2 or more;
gross/fine motor
speech/language
cognition
social/personal
ADL
```
46
What does Down's syndrome screening consist of?
- cardiac
- vision
- hearing
- thyroid (annual)
- sleep related breathing disorders
- growth/development charts
- genetic
47
What is the genetic defect in Down's syndrome?
trisomy 21
48
What is the IQ range of a mild learning disability?
IQ 50-70
49
What is the IQ range of a severe learning disability?
IQ <50
50
What are specific developmental delays?
Delay in one of the subsections for development
51
State three motor delays
- duchenne muscular dystrophy
- cerebral palsy
- co-ordination disorders
52
Name a language delay
Specific language impairment
53
Name two sensory delays
Oculocutaneous albinism
| Treacher-Collins
54
Name a developmental deviation
Autism Spectrum disorders
55
Describe Duchenne Muscular Dystrophy
X-linked recessive disorder which impacts all muscles and often presents with speech delay. Ultimately life limiting, patients have calf pseudohypertrophy but muscles have no increased tone. Lordosis is common.
56
How is DMD investigated and what is the clinical test?
Measure CK - very high
| Gower's manoeuvre shows pelvic girdle weakness
57
What is cerebral palsy?
Group of disorders of development of movement/posture due to - disturbances to the foetus in utero/during delivery or insult after birth leading to neurological ischaemia and loss of inhibitory messages
58
What type is most cerebral palsy?
Spastic
59
Name the three types of spastic cerebral palsy
- hemiplegic (arm and leg on one side)
- diplegic (both legs)
- quadriplegic (both arms and legs)
60
Name some conditions associated with cerebral palsy
- mobility problems
- learning difficulties
- epilepsy
- visual/hearing impairment
- communication problems
- feeding/sleep problems
61
What does an MRI of cerebral palsy show?
Loss of white matter around ventricles
62
Describe oculocutaneous albinism
Autosomal recessive disease affecting the pigment in hair/skin/eyes
63
What do people with oculocutaneous albinism look like?
Very pale skin, light coloured hair and red eyes
64
What eye problems can present in oculocutaneous albinism?
astigmatism
| nystagmus
65
What is hydrocephalus?
Build up of fluid on the brain which can cause serious problems including visual impairment
66
What will an MRI of hydrocephalus look like?
Enlarged ventricles
67
What causes hydrocephalus?
Spina bifida, mumps, rubella in utero
68
How is hydrocephalus treated?
Ventriculoperitoneal shunt
69
What is a middle ear effusion?
Build up of secretions behind the ear drum leads to conductive hearing loss - separation of air and bone conduction
70
Other than conductive what is the other type of hearing loss?
Sensorineural - equal air and bone conduction
71
How is an ear effusion treated?
Temporary grommets to drain fluid and keep eardrum open
72
In terms of the CNS what do genes determine?
- the correct sequence of brain development from conception to neuronal proliferation, migration and reorganisation
- development of dendritic and axonal interconnections
- development of synapses, receptors and neurotransmitters
73
Other than genes what is another key factor in CNS development?
Environment
74
What contributes to the intrauterine environment?
- maternal health and disease
- insults which may be continuous throughout pregnancy (alcohol, CMV, rubella)
- placental function/nutrition
75
Give an example of a maternal disease that can impact the intrauterine environment
Maternal PKU - phenylalanine levels must be controlled otherwise excess may impact foetal brain development
76
What is the extrauterine environment made of?
- physical factors (nutrition, environmental toxins)
- emotional and social factors (neglect, lack of stimulation)
- exposure to drugs, alcohol and other substances
77
When is the embryonic period?
Conception - week 8
78
Name the two layers the embryo starts as
Epiblast and hypoblast
79
After the formation of the epiblast and hypoblast what happens?
Streak develops with a primitive node
80
What are the opposite ends of the embryo called?
Rostral (top)
| Caudal (bottom)
81
What determines the way the cells migrate?
Nodal signalling
82
What layer do the cells migrate within?
Mesoderm
83
Name the three layers that form during gastrulation
ectoderm - skin, nails, hair & neural tissue
mesoderm - muscle, bone, cartilage, vasculature
endoderm - gut and respiratory system
84
What is the first well defined neural structure and when does it form?
Neural tube between 20-27 days
85
Explain the formation of the neural tube
1. Neuronal progenitor cells form a neuronal plate
2. Plate develops a groove
2. Plate folds on itself to form a tube
86
What is derived from the neural tube?
Brain (rostral tube) and spinal cord (caudal tube)
87
What happens to the inside of the tube?
It is lined with neuronal progenitors to form the ventricular zone
88
What does the the hollow centre become?
Ventricular system and the central channel is the spinal cord
89
Name the three brain vesicles at the start of development
- prosencephalon
- mesencephalon
- rhombencephalon
90
What does the prosencephalon divide into?
Telencephalon and Diencephalon
91
What does the telencephalon become?
Cerebrum
92
What does the diencephalon become?
Eye cup
| Thalamus/hypothalamus/epithalamus
93
What does the mesencephalon become?
Midbrain
94
Where do the pons and cerebellum originate from?
Mesencephalon
95
What does the myelencephalon become?
Medulla Oblongata
96
How is the neocortex formation regulated?
Variable concentrations of signalling molecules decide where the cells will go and what they will do
97
Name two genes that encode for chemical which are distributed in the brain?
Emx2 and Pax6
98
Describe the concentrations of Emx2 and Pax6 at the front and back of the brain
Front - low emx2 and high pax6
| Back - low pax6 and high emx2
99
What neurons are formed when there is a low emx2 and high pax6?
Motor neurons
100
What neutrons form when there is a low pax6 and high emx2?
Visual cortex neurons
101
When is the foetal period?
Week 9 to term
102
What happens to the neural tube during the foetal period?
Out pouching of the neural tube and brain. Brain is originally lissencephalic (smooth) but gradually it develops folds
103
Name the structures that form in the foetal period
Sulci - grooves
| gyri - ridges
104
Why are sulci and gyri required?
To accommodate the proliferating neuronal populations
105
How do neurons migrate?
- Somal translocation
- Radial glial glial guide
- Tangential migration
106
What is the function of axons?
Transmit signals from the neuron, develops a synapse when it reaches another neuron
107
What is the function of dendrites?
Gather information and transmit to neutrons often arranged in a 'tree like' formation around the neuron to put in lots of information
108
What is the key CNS process that occurs after birth?
Myelination
109
How does myelination occur?
Oligodendrocyte progenitor cells develop processes which wrap around axons to form myelin sheaths to insulate the neuron and increase conduction
110
What is a key factor in CNS development postnatally?
Experience - stimulation and input
111
What changes occur in adolescence?
Synapses are eliminated, there is an increase in white matter volume and a change in neurotransmitter systems
112
After puberty how do the specific hormones cause different responses in boys and girls?
Girls - oestrogen makes them more prone to stress
| Boys - androgens makes then more resilient
113
Name the condition where the neural tube does not close at the top end
Anencephaly (babies don't survive)
114
Name the condition where the caudal tube does not close
Spina bifida
115
Name the condition where the vesicles fail to form, what are the three types?
Holoprosencephaly
| - lobar, semilobar, alobar
116
What are the three types of myelination disorders?
Hypomyelination - does not myelinate fully
Dysmyelination - myelinated incorrectly
Demyelination - myelinates and then loses myelin
117
Name an example of a myelination disorder
Pelizaeus Merzbacher Disease
118
Describe Pelizaeus Merzbacher Disease
PLP1 gene codes for a protein which is in myelin responsible for main functions of the sheath
119
How does Pelizaeus Merzbacher Disease present?
nystagmus, hypotonia, cognitive impairment progresses to spasticity and ataxia
