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PEDS Shelf (mine) > Growth & Development > Flashcards

Growth & Development Flashcards

1
Q

When does average newborn regain birthweight?

A

3rd week

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2
Q

When does birthweight double?

A

5 months

Triples - 1 yr

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3
Q

When does birthweight triple?

A

1 year

Doubles - 5 mo

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4
Q

Infant younger than 3 weeks who hasn’t regained birthweight…

A

Reassure and re-evaluate in 1 week

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5
Q

Average infant height (50%)?

A

50cm

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6
Q

Birth length 50% increase from birth, age…?

A

1 yr

Doubled - 4 yr

Tripled - 13 yr

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7
Q

Birth length is doubled by…?

A

4 yr

50% - 1 yr

Tripled - 13 yr

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8
Q

Birth length is tripled by…?

A

13 yr

50% - 1 yr

Doubled - 4 yr

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9
Q

Growth rate first year of life?

A

20 cm/year

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10
Q

Birth size reflection of?

A

Maternal factors and in utero conditions (vs. genetic growth potential)

Infant can cross percentiles in 1st 12-18 months as genetic, hormonal, and environmental factors overcome maternal ones

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11
Q

When are you half your adult height?

A

2 yr

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12
Q

When do you worry about abnormality of growth?

A

Shifts across 2+ percentile lines on growth curve after 2

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13
Q

What has significant effect on linear growth velocity?

A

Chronic diseases

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14
Q

Normal head circumference at birth for full term newborn?

A

35cm

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15
Q

Normal head growth for first 6 months?

A

~1 cm/month

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16
Q

Normal head growth from 6-12 months?

A

~1/2 cm/month

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17
Q

Head circumference above 98 percentile for age?

A

Macrocephaly

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18
Q

Infant with increasing head circumference, but normal development… Next step?

A

Measure parents’ heads - Normal familial macrocephaly

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19
Q

Is hydrocephaly present at birth?

A

Can be, doesn’t have to be

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20
Q

Signs of hydrocephaly (6)

A
  1. Irritability
  2. lethargy
  3. poor appetite
  4. PERSISTENT vomiting
  5. bulging fontanelle
  6. neurological findings in infant with rapidly enlarging head (upward gaze)
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21
Q

Normal development, no signs increased ICP, parents with big heads

A

Macrocephaly

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22
Q

Irritability, vomiting, bulging fontanelle, impaired upward gaze

A

Hydrocephaly

  1. Irritability
  2. lethargy
  3. poor appetite
  4. PERSISTENT vomiting
  5. bulging fontanelle
  6. neurological findings in infant with rapidly enlarging head (upward gaze)
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23
Q

Which is scary… Large anterior fontanelle v. Bulging fontanelle?

A

Bulging… associated with increased ICP

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24
Q

Is a bulging fontanelle associated with papilledema?

A

No (bulging fontanelle is chronic, not acute like papilledema)

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25
Q

Weight drop first, then decreased length, spares head circumference. Cause?

A

Inadequate calorie intake

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26
Q

Short stature with normal or elevated weight. Disorder type?

A

Endocrine disorders

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27
Q

Microcephaly + Dysmorphic features

A

Chromosomal abnormalities

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28
Q

Weight and height decrease together. Disease type?

A

Chronic medical conditions

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29
Q

Head circumference below 5th percentile for age

A

Microcephaly

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30
Q

Acquired Microcephaly

Head circumference, weight and height changes?

A

Occurs in infants who had normal head circumference at birth

If head circumference decreases while weight and height stay the same, has to be a cause

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31
Q

A physical sign that a child is receiving inadequate nutrition for optimal growth and development.

A

Failure to thrive (FTT)

  • Lack of appropriate weight gain.
  • Irritability.
  • Easily fatigued.
  • Excessive sleepiness.
  • Lack of age-appropriate social response (i.e., smile)
  • Does not make vocal sounds.
  • Delayed motor development.
  • Learning and behavior difficulties later in childhood.
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32
Q

Weight below 5th percentile for age

A

FTT

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33
Q

Weight that drops 2 major percentile channels

A

FTT

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34
Q

Weight less than 80% of ideal weight for age

A

FTT

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35
Q

Weight below 5th percentile on the weight-for-length curve

A

FTT

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36
Q

Which kids have specific growth charts? (3)

A

Down, Turner, William’s

Don’t call growth abnormal unless comparing to the specific chart

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37
Q

When is it normal for kids to change % up to 2 channels up or down? (age range)

A

Between birth and 2

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38
Q

Consideration in FTT…?

A

New caretaker, improper mixing of formula

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39
Q

First thing to check with FTT?

A

Evaluate diet first

Then look at mother/child interaction (feeding technique). Most cases from non-organic causes.

Labs/tests are not first step!

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40
Q

4 categories of organic causes of FTT?

A
  1. Chronic renal failure
  2. Thyroid and other metabolic disorders
  3. Disorders leading to inadequate absorption
  4. Disorders leading to inadequate utilization

*Something in history will suggest these causative factors

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41
Q

Throw ball while standing?

A

18 months

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42
Q

Throw overhand?

A

24 months

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43
Q

When can you stop factoring in prematurity for milestones?

A

2 years

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44
Q

28 week GA infant, now 16 months old… Corrected age?

A

13 months Corrected Age

Current Chronological Age – (40 weeks – Gestational Age at birth) = Corrected Age

  • Example: 16-month old toddler who was born at 28 weeks gestation.
  • 16 months Chronological Age – (40 weeks - 28 weeks Gestational Age at birth) = Corrected Age
  • 16 months – 3 months = 13 months Corrected Age
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45
Q

Can follow mom around room through 180 degree arc (eye follow object to midline). Age?

A

2 months (2 Sides)

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46
Q

Lift head and chest while prone. Age?

A

2 months (#2 rolling up)

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47
Q

Coo. Age?

A

2 months (two rhymes with coo)

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48
Q

Scratches/grabs clothes. Age?

A

4 months

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49
Q

Clutch/hold rattle. Age?

A

4 months (Looks like rattle)

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50
Q

Put objects deliberately in mouth. Age?

A

4 months

51
Q

Sit up. Age?

A

6 months

“Six up”

52
Q

Transfer cube from one hand to other. Age?

A

6 months

53
Q

Crawl on bellies. Age?

A

6 months

54
Q

Walk with hand held. Age?

A

12 months (1 year old can walk with one hand held)

55
Q

Point. Age?

A

12 months (“Need 1 finger 2 point”)

56
Q

Say one word besides mama and dada. Age?

A

12 months

57
Q

Walks fast, falls occasionally, walks upstairs with hand held, climbs into and sits in chair. Age?

A

18 months

58
Q

Feed themselves. Age?

A

18 months

59
Q

How many cubes at 18 months?

A

2-3

60
Q

How many cubes at 24 months?

A

4-6

61
Q

How many cubes at 36 months?

A

8

62
Q

6-cube tower. Age?

A

2 years

63
Q

Walk up stairs with alternating feet. Age?

A

3 years

64
Q

Ride a tricycle. Age?

A

3 years (3 wheels for 3 years)

65
Q

Hop 3 times. Age?

A

3 years

66
Q

Identify opposites. Age?

A

4 years

67
Q

Draw 4 body parts. Age?

A

4 years

68
Q

Rule of 4’s (6 items) - Age 4

A
  1. Count to 4
  2. Recite a 4-word sentence
  3. Identify 4 primary colors
  4. Draw a 4-part rectangle/cross
  5. Build a gate out of blocks (4 looks like a gate)
  6. Strangers understand 4/4 of what they say
69
Q

Tie a knot. Age?

A

5 years

70
Q

Correctly grab a pencil. Age?

A

5 years

71
Q

Print letters. Age?

A

5 years

72
Q

Draw a square. Age?

A

5 years

73
Q

Walk backward heel-to-toe. Age?

A

5 years (avoids school by walking backwards)

74
Q

Draw circle. Age?

A

3 years

75
Q

Draw cross. Age?

A

4 years

76
Q

Draw square. Age?

A

5 years

77
Q

Draw triangle. Age?

A

6 years

78
Q

Draw diamond. Age?

A

7 years

79
Q

Worry with lack of visual attention/fixation. Age?

A

2 months

80
Q

Worry with lack of visual tracking. Age?

A

4 months

81
Q

Worry with lack of steady head control while sitting. Age?

A

4 months

82
Q

Worry with failure to turn to sound or voice. Age?

A

6 months

83
Q

Worry with lack of smile or joyful expressions. Age?

A

6 months

84
Q

Worry with inability to sit. Age?

A

9 months

85
Q

Worry with lack of reciprocal vocalizations, smiles, or other facial expressions. Age?

A

9 months

86
Q

Worry with failure to respond to name when called. Age?

A

12 months

87
Q

Worry with absence of babbling. Age?

A

12 months

88
Q

Worry with inability to walk independently. Age?

A

18 months

89
Q

Worry with lack of simple pretend play. Age?

A

18 months

90
Q

Worry with lack of language/gestures. Age?

A

18 months

91
Q

Worry with lack of 2-word meaningful phrases. Age?

A

24 months

92
Q

Worry with loss of previously acquired speech or social skills. Age?

A

Any age

93
Q

50% intelligible speech. Age?

A

2 years

94
Q

75% intelligible speech. Age?

A

3 years

95
Q

100% intelligible speech. Age?

A

4 years

96
Q

Stuttering can be normal until what age?

Mx?

A

3 or 4 years (often disappears once vocab increases)

-Normal/reassure

97
Q

When do you refer for stuttering? (4)

A
  1. Persistence beyond preschool age
  2. Persists for more than 6-8 weeks
  3. Marked parental concern
  4. Associated symptoms like facial tics
98
Q

Can serious language delays be explained by bilingual home, second child with siblings, or parents speaking for child?

A

No

99
Q

First thing to do with language delay?

A

Hearing test

100
Q

History of TORCH infection, hyperbilirubinemia, or meningitis + language delay. Mx?

A

Hearing evaluation

101
Q

What impacts language and emotional development as well as ability to read?

A

Chronic hearing loss (including loss due to chronic otitis media)

102
Q

Hearing loss that starts after what age has less of an impact than if it occurs before?

A

5 years

103
Q

Most important intervention for language development in infant with congenital hearing loss?

A

Family involvement (including non-verbal communication)

*Family use of verbal and nonverbal communication has been shown to have the most positive impact on language acquisition in children with hearing loss
*This is more important than specific formal interventions

104
Q

Goal of early intervention with developmental delay?

A

Provide services to aid in developmental progress (speech therapy, occupational therapy, physical therapy)

105
Q

What outlines guidelines for education of children in U.S. who have developmental delays or other problems that may interfere with learning?

A

Individuals with disabilities education act (IDEA)

106
Q

Part C of IDEA covers what?

A

Early intervention services for kids under 3

*Goal is for kids to reach developmental potential and improve cognitive outcome
*Programs must be family based and culturally relevant

107
Q

Does Feingold diet show benefit in managing ADHD or learning disabilities?

A

No

Feingold diet: eliminates artificial food colors, flavorings, sweeteners, preservatives, and some salicylates intended to reduce or eliminate ADHD symptoms in certain children.

108
Q

Is restricting sugar beneficial for managing/treating ADHD or behavioral disorders?

A

No, but don’t use sugar/candy as reward for good behavior

109
Q

Mega vitamin therapy increases incidence of what?

A

Increases disruptive behavior (no role with managing learning disabilities or behavioral problems)

110
Q

Solutions for autism and other developmental disorders that have not been proven to be effective? (4)

A
  1. Sensory integration therapy
  2. eye exercises
  3. chelation therapy
  4. hyperbaric O2 chambers
111
Q

Systematic monitoring “structured surveillance” of a child’s development using standardized screening tools has been proven to identify delays in children much more often than physician questioning and observation alone “unstructured surveillance”

A

Yup

112
Q

When do you use universal post-partum mood disorder screening?

A

First year after birth

113
Q

When do you do general structured developmental screening? (4)

A

9, 18, and 24 or 30 months

114
Q

When do you do autism specific screening? (2)

A

18 and 24 months

115
Q

When do you do social emotional screening?

A

Whenever a screening instrument is abnormal

116
Q

Average newborn loses up to what % of birthweight?

A

10%

117
Q

What has been proven to identify delays in children much more often than physician questioning and observation alone?

A

Systematic monitoring: “Structured surveillance”

118
Q

When do you do kindergarten readiness screening?

A

4 years

119
Q

What should be done at every health supervision visit from ages 5-18?

A

Social-emotional/mental health/psychosocial function screening

120
Q

What do you do at every health supervision visit throughout adolescence?

A

Substance abuse-specific screening

121
Q

Name 2 general developmental screens

A
  1. Ages and stages questionnaire (ASQ)
  2. Parents’ evaluation of developmental status (PEDS)
122
Q

Name a specialized developmental screen

A

Modified checklist for autism in toddlers (MCHAT)

123
Q

Name 3 mental health/behavior screens

A
  1. Pediatric symptoms checklist (PSC)
  2. Connors 3
  3. Vanderbilt scales
124
Q

3 ways development can go astray?

A
  1. Delay in development
  2. Deviation in order of skills acquisition or an atypical pattern of development
  3. Dissociation where different areas of development advance at different rates

-3Ds of developmental deviation

PEDS Shelf (mine) (3 decks)

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