Growth and Development

Question 1

What is a neonate defined as?

Answer 1

< 4 weeks old

Question 2

What is an infant defined as?

Answer 2

<12m/1year

Question 3

What is a toddler defined as?

Answer 3

1-2 years

Question 4

What is a definition of pre-school age?

Answer 4

2-5 years

Question 5

What are the 5 key developmental fields?

Answer 5

Gross Motor
Fine Motor
Social and Self Help
Speech and Language
Hearing and Vision

Question 6

What is a milestone defined as?

Answer 6

An achievement of key developmental skills

Question 7

What are some influencing factors in a child’s growth and development?

Answer 7

Genetics
Environment
Positive/Negative childhood experience

Question 8

What are some adverse environmental factors which can influence a child antenatal and postnatal?

Answer 8

Antenatal: Infection (Rubella, Toxoplasmosis)
and toxins (Infections, Toxins, Malnutrition (Iron, folate and Vit D), maltreatment and maternal health issues.

Question 9

What are some of the reasons we assess child development?

Answer 9

Reassurance 
Early diagnosis and intervention
Improving outcomes
Genetic counselling
Coexistent health issues

Question 10

What do we use to assess child development?

Answer 10

Healthy Child Programme (HCP) UK

Question 11

Name some of the red flags in child development

Answer 11

• No social smile by 2 months
• Not sitting unsupported by 9 months
• Not walking unsupported by 18 months
• No words by 2 years

Question 12

What does the child health programme include?

Answer 12

New born exam and blood spot screening.
New-born hearing screening (by day 28).
Health visitor first visit.
6-8 review (max 12W).
27-30 month review (Max 32m).
Orthoptist vision screening (4-5y).

Question 13

What happens in the 6-8w review?

Answer 13

Identification data
Feeding (Breast/bottle/both)
Parental concerns
Development of the 5 key skills.
Measurements
Examination (Heart, hips, testes, genitalia, femoral pulses and eyes)
Sleeping position (Supine, prone or side).

Question 14

What happens in the 27-30m review?

Answer 14

ID
Development of the 5 key stages.
Physical measurements
Diagnoses/other issues.

Question 15

At what age does the child get their first lot of immunisations?

Answer 15

6-8 weeks

Question 16

At what age does the child get their 2nd lot of immunizations?

Answer 16

12 wks

Question 17

No live vaccines if the child is immunocomprimised true or false?

Answer 17

True

Question 18

Egg allergy is a contraindication to MMR true or false?

Answer 18

False

Question 19

What are the 3 physical measurements which are key?

Answer 19

Weight (g/Kg).
Length (cm) or Height if >2y.
Head Circumference (cm).

Question 20

What is the definition of a ‘Centile’?

Answer 20

% divisions of the refernce population sampled.

Question 21

What is the definition of ‘50th Centile’?

Answer 21

If you take the average 100 healthy children 50 are above this point and 50 are below.
About half the kids in class are smaller

Question 22

What is the definition of the 0.4th centile?

Answer 22

If you take the average 1000 healthy children 4 are below this point 996 are above.

Question 23

What is the definition of Failure to Thrive ?

Answer 23

Child growing too slowly in form and usually in function at the expected rate for his or her age.

This is not a diagnosis but a description of a pattern.

Question 24

What are the maternal causes of FTT in early life?

Answer 24

Poor lactation
Incorrectly prepared feeds
Unusual milk or other feeds
Inadequate care

Question 25

What are the infant causes of FTT in early life?

Answer 25

Prematurity Small for dates Oro palatal abnormalities (e.g. cleft palate) Neuromuscular disease (e.g. cerebral palsy) Genetic disorders

Question 26

What are some of the metabolic causes of FTT in early life ?

Answer 26

``` Congenital lung disease Heart disease Liver disease Renal disease Infection Anemia Inborn errors of metabolism Cystic fibrosis Thyroid disease Crohn’s/ IBD Malignancy ```

Question 27

What are some of the nutrient loss causes of FTT ?

Answer 27

Gastro oesophageal reflux Pyloric stenosis Gastroenteritis (post-infectious phase) Malabsorption: ``` Food allergy Persistent diarrhoea Coeliac disease Pancreatic insuffiency Short bowel syndrome ```

Question 28

What are some of the non-medical causes of FTT in early life?

Answer 28

Poverty/ socio-economic status Dysfunctional family interactions (especially maternal depression or drug use) Difficult parent-child interactions Lack of parental support (eg, no friends, no extended family) Lack of preparation for parenting/ education Child neglect Emotional deprivation Poor feeding or feeding skills disorder