Growth and Development Flashcards

(72 cards)

1
Q

what happens in baby clinics

A

weighed
height taken (length lying down)
head circumference measure

check meeting milestones

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2
Q

jaw relationships at birth

A

Gum pads widely separated anteriorly - gap

Tongue resting on lower gum pad

Tongue in contact with lower lip
- Later, rest behinds teeth

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3
Q

sequence of eruption of primary teeth (basic)

A

From anterior to posterior

As a general rule mandibular tooth erupt before maxillary

Eruption begins at 6 months

Eruption of deciduous dentition is in most cases complete by 24 months of age

But wide variation

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4
Q

5 characteristics of primary dentition

A
Incisors upright 
Incisors spaced
Teeth are smaller
Reduced overjet 
More white in colour
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5
Q

5 areas in psychology of child development

A
Motor
Cognitive 
Perceptual 
Language 
Social
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6
Q

motor development in children

A

Predictability of early “motor milestones” suggests that it must be genetically programmed.

Completed in infancy

  • changes following the ability to walk are refinements.
  • Post 14 months

Eye-hand coordination gradually becomes more precise and elaborate with increasing experience.

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7
Q

4 stages in cognitive development in children

A

sensorimotor

preoperational thought

concrete operations

formal operations

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8
Q

sensorimotor stage of cognitive development in children

A

Until about 2 years, prime achievement is object permanence

  • Infant can think of things as permanent and still existing when out of sight
  • Can’t think of objects without actually having to see them
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9
Q

preoperational thought stage of cognitive development in children

A

2 to 7 years.

Allows child to predict outcomes of behaviour.
- Facilitated by language development.

Thought patterns are still egocentric
- unable to see another person’s point of view.

Unable to understand why areas and volumes remain unchanged even though their shape or position my change.

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10
Q

concrete operations stage of cognitive child development

A

7 to 11 years.

Able to apply logical reasoning and consider another person’s point of view.
- Important for dentist – see other perspectives explain to child e.g. how happy parent will be if they sit nicely

Thinking is rooted in concrete objects
difficult to think in a more abstract manner

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11
Q

formal operations stage in cognitive development of children

A

begins at 11 years

beginning of logical abstract thinking so that different possibilities for an action can be considered.

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12
Q

perceptual development of children

A

Difficult to know what babies are experiencing perceptually.
- Most research looks at eye movement.

Compared to an adult a 6 year old will cover less of an object, take in less information and become fixated on details.

Selective attention by 7 years.

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13
Q

language development of children holdbacks (2)

A

A lack of appropriate stimulation will retard a child’s learning, particularly language.
- No talking from parent to child – even though one sided, important as baby listening

A child needs language to be able to think about what she/he sees and hears.

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14
Q

1 year old understands

A

vocab of 20 words

  • simple phrases
  • relates object to word e.g. toy name
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15
Q

1 year old uses

A

2-3 words

  • repetitive babble
  • tuneful jargon
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16
Q

1 year old sounds

A

b
d
m

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17
Q

2 year old understands

A

simple commands

  • questions
  • joins in action songs e.g. incy wincy spider
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18
Q

2 year old uses

A

vocabulary of 100 words

puts 2 words together

echolalia (copies what you say)

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19
Q

2 year old sounds

A
p
t
k
g
n
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20
Q

3 tear old understands

A

prepositions (on, under etc)

functions of object

simple conversations

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21
Q

3 year old uses

A

4 word sentences

  • what, who, where
  • relates experiences
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22
Q

3 year old sounds

A

f
s
l

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23
Q

4 year old understands

A

colours

numbers

tenses

complex instructions

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24
Q

4 year old uses

A

long grammatical sentences

relates stories

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25
4 year old sounds
v z ch j
26
9 disorders of speech and language that can occur
Learning difficulties Cerebral palsy Autism Delayed speech and language development Head injury Acquired neurological disorders Non fluency Dysphonia Craniofacial disorder
27
what is needed for normal speech production
competent airway and articulators (lip, teeth, tongue etc)
28
normal speech production is classified by (3)
place manner voice
29
cleft type speech qualities
resonance articulation nasal emission
30
velopharyngeal incompetence (VPI)
unable to block off nasal passageway to rest of passageways unable to have normal speech
31
oro-nasal fistula
air goes up into nose from oral cavity so can't make some sounds unable to have normal speech
32
class III occlusion
protruding mandible can cause problem in producing dentate sounds unable to have normal speech
33
3 roles of cleft team
assessment diagnosis treatment as early as possible
34
different people in cleft team (multidisciplinary team)
Speech and Language Therapist Primary cleft surgeon Secondary cleft surgeon Orthodontist Paediatric dentist ENT surgeon Geneticist Nurse Psychologist
35
initial treatment of clefts
Feeding - Can’t be breast fed as unable to have suction from lips Early intervention Input modelling Articulation therapy
36
when would cleft lip surgery tend to be
3 months
37
secondary cleft surgery can be
Nasal revision Fistula closure -Secondary hole in palate due to surgery Pharyngoplasty Alveolar bone graft - At cleft site to allow permanent teeth to erupt Osteotomy
38
2 types of non cleft VPI
bifid uvula no uvula (both cases back of palate wrong so unable to have normal speech)
39
development of feeding skills of infant - pre 40 weeks (in utero)
28 weeks – non-nutritive sucking 34 weeks – nutritive sucking
40
development of feeding skills of infant - 0-3 months
Normal oral tone Rhythmical sucking Primitive reflexes - Gag - Rooting - Suck/swallow Semi-recline feeding position Liquid diet
41
development of feeding skills of infant - 4-6 months
Head control More control of suck/swallow Munching Move towards semi solid diet (UK not recommended to wean till 6 months) Starts babbling
42
development of feeding skills of infant - 7-9 months
Sitting feeding position Mashed consistency Finger food Upper lip involvement Chewing and bolus formation Bite reflex Mouthing
43
development of feeding skills of infant - 10-12 months
Lumpy food Sustained bite (continuous chewing) Active lip closure Chewing – lateralisation Cup drinking
44
development of feeding skills of infant - 24 months
a mature and integrate feeding pattern
45
when does baby start non-nutritive sucking
28 weeks in utero
46
when does the baby start nutritive sucking
34 weeks in utero
47
3 considerations to remember when communicating with children
develop natural skills over time environment conversation happening its a 2 way process - LISTEN
48
5 effects of family unit
behaviour contagion well-intentioned but improper preparation discuss dental treatment within hearing of the child -ensure they understand simultaneously or explain to them first enhancing the child’s anxiety threatening the child with dental treatment
49
assessment to be carried out when child pt comes to surgery
pain past dental history relevant past medical history social history level of understanding and potential co-operation level of anxiety
50
what is a knee-to-knee examination
for children under age of 3 not on dental chair held in patients lap and you kneel in front
51
3 areas to successful behaviour management
communication education interaction
52
things that frighten children
the unknown sight of the anaesthetic syringe sight, sound and sensation of the drill mutilation choking perceived expectation of ill-treatment/ trauma strangers - calm and friendly on initial visit
53
dental anxiety in children prevalence
16% of school-age children are afraid of the dentist and consequently avoid attending
54
children Vs adult dental anxiety
Children display their anxiety differently from adults - they are more irrational and less restrained. There is wide variation between individual children, this may be is largely genetically determined. Some children who refuse dental treatment have been shown to generally have difficulty adapting to change.
55
examples of manifestation of anxiety in children
``` Thumb-sucking Nail biting Nose picking Clumsiness Stuttering Stomach pain Need to go to the toilet Headache Dizziness Fidgeting No speech Clinging to parent Hiding ``` related to: age, sex, social class
56
influencing factors on whether child will suffer from dental anxiety
each child’s own psychological make-up understanding emotional development previous adverse dental/ medical experience - scarring memory attitude & previous experience of family/ peer-group the behaviour of the dentist
57
child interactions DO NOT
``` bribe coax shout bully threaten allow child to have all their own way ```
58
should you show empathy when tx child
yes create an environment in which the child feels safe - use a kind empathetic approach using directive guidance, and reinforcement to establish co-operation and obtain a rapport - allow the child some control (e.g. hand signal) question for feeling - are you alright? Are you OK? Are you getting tired? - show you understand their feeling – acknowledge but move on (know disliked but will benefit it)
59
good dentist to child communication
Improves the information obtained from the patient Enables the dentist to communicate information to the patient Increases the likelihood of patient compliance Decreases patient anxiety relate to what they know - films etc
60
breakdown of components of communication
verbal 5% para-linguitic 30% non-verbal 65%
61
verbal communication
This consists of the actual words the person uses. Try to avoid the use of jargon and specific terms that the patient might not understand - Children are not small adults. The approach and language used with them can be modified to match their abilities and understanding
62
dental language alternatives examples for children
Cotton Wool Roll’s= Tooth Pillow’s - Give one to touch and feel Topical Anaesthetic= Bubble gum or minty gel Probe= pointer/tooth counter Excavator= Tooth Spoon High Speed= Tooth Shower Slow Speed= “Mr Bumpy”, Tooth Scrubber Local Anaesthetic= Special Spray, Sleepy Juice Be careful if autistic – very literal, so don’t use anything that could scare them use analogies
63
paralinguistic communication
This refers to the tone of voice used by the individual. Loudness has been one aspect of paralinguistic communication that has been investigated in the dental field with children. - It was found issuing commands in a loud voice was more effective than using a normal voice
64
non-verbal communication
Includes a range of behaviours and environmental factors which we often interpret without conscious awareness - Facial expression - Gaze - Gesture - Bodily contact - Clothes - Spatial
65
dentist role in reducing child's anxiety
Preventing pain Being friendly & establish trust Working quickly Having a calm manner Giving moral support Being re-assuring about pain - Avoid using “pain”, “sharp” etc as this is all they will hear Empathy
66
dentist role in increasing fear in children
Ignoring or denying feelings Inappropriate reassurance - “Nearly done” avoid Coercing/Coaxing Humiliating Losing your patience with the patient
67
parents role in child's for dental visit
dentist should advise the parent how to prepare the child for the visit - a pre-appointment letter, - rehearsal (if wanted) supportive care prior to each stressful procedure can be beneficial to be not in room
68
beneficial for child for parent to be present?
Research suggests that the child's behaviour is unaffected by parental presence or absence The exception would appear to be children less than 4 years of age who have been shown to behave better with a parent present.
69
when would parents be excluded from surgery child is in
try to in most cases especially if: - Unable to refrain from competing with the dentist for their child's attention. - Unintentionally convey their own anxieties to their child through body language and words. Involving the parent in the planning stages and outlining their role as a passive but silent helper may provide a comforting presence (explain your behavior modifying technique so they are not shocked if you raise voice)
70
what is inclusive parent role in dentistry and when needed
Patient is incapable or unwilling to sit for examination - positioning the child in the lap of the parent permits the child to be in direct visual and physical contact with the parent (knee-to-knee) Opportunity exists for the parent to witness the behaviour the clinician must contend with
71
what is the link between pain and anxiety
Anxious subjects are more likely than non-anxious to report pain - This points to the psychological role in pain perception Anxiety, previous experience, expectation, anticipation, communication and control can influence pain perception
72
how to minimise pain and anxiety in child Tx
Care should be taken not to hurt any child Restorative care is usually carried out under local analgesia A painless technique of administering LA is of vital importance - Wand An introduction to topical and LA is an integral part of treatment (cotton wool roll)