development and health supervision

Question 1

By what age should a baby have regained its birth weight?

Answer 1

2 wks

Question 2

How does infant weight usually change over the first 2 yrs?

Answer 2

Birth weight doubles by 4 months, triples by 12 months, and quadruples by 24 months

Question 3

How does infant length change?

Answer 3

increased by 50% at 1 yr, doubles by 4 yrs, and triples at 13 yrs of age; from age 2 to adolescence, height usually increases about 2 inches/yr

Question 4

How does head circumference change in the first 3 yrs of life?

Answer 4

• 5 cm growth during 0-3 months
• 4 cm growth during 3-6 months
• 2 cm at 6-9 months
• 1 cm growth between 9 and 12 months

Question 5

What are some causes of large head circumference?

Answer 5

Tay-sachs, maple syrup urine disease, neurofibromatosis, tuberous sclerosis, hydrocephalus, skeletal dysplasia, acromegaly, or intracranial hemorrhage

Question 6

What are causes of microcephaly?

Answer 6

fetal toxin exposure, trisomies, TORCH infections, cranial anatomic abnormalities, metabolic disorders, or neural tube defects

Question 7

By what age should primitive reflexes disappear?

Answer 7

6 months, though most are gone by 3 months

Question 8

What should I know about Hib vaccination?

Answer 8

4 shots, starting at 2 months. If a child is >5 years and unvaccinated, there is no need to vaccinate because of low risk of severe infection at this age. If a child is asplenic, Hib and pneumovaccine are indicated regardless of age

Question 9

milestones at 2 months

Answer 9

social smile, lifts head 45 degrees, eyes follow to midline, cooing

Question 10

milestones at 4 months

Answer 10

laugh, aware of caregiver, localizes sound, lifts head 90 degrees, eyes follow past midline. still cooing

Question 11

milestones at 6 months

Answer 11

differentiates parents from others, stranger anxiety. starts to roll over, holds self up with hands, sits. has rake grasp. babbles

Question 12

milestones at 9 months

Answer 12

interactive games and separation anxiety (9-15 mo), may crawl, pull to stand. has a grasp with thumb. may have 1 word

Question 13

milestones at 12 mo

Answer 13

separation anxiety, walks with help, pincer grasp, 2 block tower, 5-10 words

Question 14

milestones at 18 months

Answer 14

parallel play, walks well, walks backward, 4 block tower, uses cup or spoon. 10-50 word vocab and 2 word sentences

Question 15

2 yr milestones

Answer 15

dresses with help, runs, climbs stairs, 6 block tower. 3 word sentences, 50-75 words that are 50% intelligible

Question 16

3 yr milestones

Answer 16

magical thinking, climbs/descends stairs, 9 block tower, draws a circle. speech 75% intelligible to outsiders

Question 17

4 yr milestones

Answer 17

plays with others, hops on 1 foot, able to draw a cross, then a triangle
speaks 250+ words, 4 word sentences. by 4.5, 100% of speech is intelligible

Question 18

6 yr milestones

Answer 18

fantasy different from reality, skips, draws people, fluent speech