Milestones from Power Point

Question 1

Growth: Who Needs Further Eval?

Answer 1

Variations beyond two standard deviations for age

Children above the 95th percentile or below the 5th percentile are indications for more detailed evaluation

Reduced growth velocity, shown by a drop in height percentile on a growth curve

Drop >2 quartiles in 6 months

Weight for length <5th percentile

Head circumference above the 95th percentile or below the 5th percentile

Question 2

The Newborn: Gestational Age

Answer 2

Gestational Age

Preterm: <34 weeks
Late Preterm: 34-36 weeks
Term: 37-42 weeks
Postterm: >42 weeks

Risks
Preterm/late preterm: many including respiratory, cardiovascular and neurodevelopmental

Postterm: Increased risk for mortality/morbidity related to asphyxia and meconium aspiration

Question 3

Newborn Growth: Weight

Answer 3

Birth Weight
Extremely Low Birth weight (ELBW): <1000g
Very Low Birth Weight (VLBW): <1500g
Low Birth Weight (LBW): <2500g
Normal: >/= 2500g

Newborn Classifications
Small for gestational age (SGA) <10th percentile
Appropriate for gestational age (AGA) 10-90th percentile
Large for gestational age (LGA) >90th percentile

Question 4

Newborn: Development

Answer 4

Use all 5 senses
Differences in temperaments, personalities, behavior and learning
Interact dynamically with caregivers

Habituation: Ability to selectively and progressively shut out negative stimuli (e.g., a repetitive sound)

Attachment: A reciprocal, dynamic process of interacting and bonding with the caregiver

State regulation: Ability to modulate the level of arousal in response to different degrees of stimulation (e.g., self-consoling)

Perception: Ability to regard faces, turn to voices, quiet in presence of singing, track colorful objects, respond to touch, and recognize familiar scents

Question 5

Infant: Growth and Development

Answer 5

By one year: birth-weight should have tripled and height increased by 50%
Neurologic development progresses centrally to peripherally

3 months: Infants should be able to lift their head (no “head-lag”), clasp hands, coo

6 months: Infants should be able to roll over, reach for objects, turn to voices, babble, and possibly sit with support

9 months: Infants should have a neat pincer grasp (self-feed), indicate wants; have usually developed “stranger danger”

12 months: Infants should be able to stand, say 1-3 words

Question 6

Early Childhood (1-4 yr): Growth

Answer 6

After infancy, the rate of physical growth slows by approximately half

Preschool years, children grow 3.5 inches and gain 4 pounds on average

Chubby, clumsy toddlers transform into leaner, more muscular preschoolers.

Question 7

Early Childhood (1-4): Development

Answer 7

Almost all children walk by 15 months, run well by 2 years, and pedal a tricycle and jump by 4 years

Toddlers move from sensorimotor learning (through touching and looking) to symbolic thinking, solving simple problems, remembering songs, and engaging in imitative play

18 month-old: 10-20 words; 2yo: 2-3 word sentences; 3yo: converses well; 4yo: complex sentences

Drive for independence
Impulsive and have poor self-regulation, temper tantrums
Preoperational: Without sustained, logical thought process

Question 8

Middle Childhood (5-10): Growth and Dev

Answer 8

Grow steadily but more slowly

Strength and coordination improve dramatically with more participation in activities

Concrete operational: capable of limited logic and more complex learning
Remain rooted in the present with little ability to understand consequences or abstractions
School, family, and environment greatly influence learning
A major developmental task is self-efficacy
Language is more complex
more independent
Guilt and self-esteem emerge
Clear sense of wrong and right

Question 9

Adolescents: Growth and Dev

Answer 9

Puberty begins on average at age 10 years in girls and 11 years in boys

On average, girls end pubertal development with a growth spurt by age 14 years and boys by age 16 years

The age of onset and duration of puberty vary widely, although the stages follow the same sequence in all adolescents

Concrete to formal operational thinking: acquiring an ability to reason logically and abstractly and to consider future implications of current actions
Wide variability in cognitive development
Recent evidence shows that brain development probably continues well into the twenties
Transition from family-dominated influences to increasing autonomy and peer influence
The struggle for identity, independence, and eventually intimacy leads to stress, health-related problems, and often, high-risk behaviors