Normal development and milestones

Question 1

When does the anterior fontanelle usually close?

Answer 1

10-24 months

Later if premature

Question 2

When does the posterior fontanelle usually close?

Answer 2

2 months

Question 3

What is the normal diameter of the anterior fontenelle in the first 6 months of life?

Answer 3

3-6cm

Question 5

What is the normal diameter of the posterior fontanelle?

Answer 5

1-1.5cm

Question 6

What is the definition of IUGR?

Answer 6

Alteration of normal foetal growth characterised by an estimated foetal weight below the 10th percentile

Question 7

What is the asymmetrical tonic neck reflex and when does it resolve?

Answer 7

The infant’s head is turned to one side → extension of the infant’s ipsilateral arm and leg, with flexion of the contralateral arm and leg (fencing posture)

3-4 months

Question 8

What is the stepping reflex and when does it usually resolve?

Answer 8

Holding the infant in an upright position and lowering him/her to bring the feet in contact with the examining table → stepping motion

2 months

Question 10

What is the moro reflex and when does it usually resolve?

Answer 10

The startle reflex

3-6 months

Question 11

What is the plantar grasp reflex and when does it usually resolve?

Answer 11

The infant’s foot is stroked from the toe to the heel → plantar flexion (curling in) of the infant’s toes

3 months

Question 12

What is the galant reflex and when does it usually resolve?

Answer 12

Stroke the paravertebral region → ipsilateral rotation of the hip

4-6 months

Question 13

What is the palmar grasp reflex and when does it usually resolve?

Answer 13

The infant’s palm is stroked horizontally → closure of it’s palm

3-6 months

Question 15

What are the three feeding reflexes?

Answer 15

1. Rooting reflex ( the cheek of the infant is stroked → the infant turns its head to the ipsilateral side and opens its mouth)
2. Sucking reflex (the roof of the infant’s mouth is touched with a finger → infant starts to suck the finger)
3. Snout reflex (light pressure or tapping is applied on an infant’s closed lips of (midline) → puckering of lips)

Question 17

What is the glabellar tap reflex and when does it usually resolve?

Answer 17

The root of the nose (glabella) is tapped → blinking with each tap

4-6 months

Question 18

When does the Babinski reflex usually resolve in children?

Answer 18

12 months

Question 19

The absence of the plantar and palmar reflex at birth may suggest what?

Answer 19

Cerebral palsy

Question 20

At what age should children start focusing on faces?

Answer 20

2 weeks

Question 21

At what age should children begin smiling?

Answer 21

8 weeks

Question 22

At what age should children be turning their heads towards sounds and making coos and gurgling sounds?

Answer 22

8 weeks

Question 23

What what age should children be holding their head up and beginning to push when lying on their tummy?

Answer 23

8 weeks

Question 24

What what age should children be responding to their name?

Answer 24

6 months

Question 25

At what age should children be able to roll over in both directions and sit without support?

Answer 25

6 months

Question 26

At what age should children be saying “mama”, “dada” and exclamations like “uh-oh!”?

Answer 26

12 months

Question 27

At what age should children say several single words?

Answer 27

18 months

Question 28

At what age should children be able to say and shake head “no”?

Answer 28

18 months

Question 29

At what age should childen have sentences of 2-4 words?

Answer 29

2 years

Question 30

For how long should infants be exclusively breastfed?

Answer 30

6 months

Question 31

When should solids be introduced to infants?

Answer 31

6 months

Question 32

When do infants begin toilet training?

Answer 32

18 months - 2 years

Question 33

When should infants be fully toilet trained by (dry by night)?

Answer 33

3-4 years

Question 34

By what age should birth weight have doubed?

Answer 34

4-5 months

Question 35

At what age should birth weight have tripled?

Answer 35

A year

Question 36

When do neonates regain weight lost after birth?

Answer 36

10-14 days

Question 37

Up to what age is it legally required that children use a booster seat in the car?

Answer 37

7

Question 38

What is echolalia?

Answer 38

Repetition of speech ## Footnote *May be a feature of ASD*

Question 39

What is infantile colic?

Answer 39

Excessively unsettledness or crying (\>3 hours/day \> 3 days a week) *The child is otherwise well and thriving with no identifiable medical problem*

Question 40

What is the difference between a cognitive impairment and a learning difficulty?

Answer 40

Cognitive impairment - generalised, often with an IQ \< 70 Learning difficulty - specific to one area and a normal IQ *Terms are sometimes used interchangably*

Question 41

What IQ range represents a mild cognitive impairment?

Answer 41

50-70

Question 42

What is dyslexia?

Answer 42

Specific learning difficulty with reading Usually associated writing difficulty (dysgraphia), especially spelling

Question 43

What is dyscalculia?

Answer 43

Impaired arithmetic skills

Question 44

Specific laguage impairment is highly comorbid with which condition, which is often diagnosed later in childhood?

Answer 44

Dyslexia

Question 45

What are your differentials for developmental regresssion?

Answer 45

Autism spectrum disorder Neurodegenerative disorders e.g. Rett's syndrome Inborn errors of metabolism Structural brain disease Infectious diseases Psychiatric disease Seizure disorders e.g., Lennoz-Gastaut Trauma/injurt Sensory deficits Psychosocial

Question 46

What is the definition of overweight and obese in children?

Answer 46

Overweight: \> 85th centile Obese: \> 95th centile

Question 47

What is the definition of an underweight child?

Answer 47

\< 5th centile

Question 48

What is the definition of nocturnal enuresis?

Answer 48

Urinary incontinence during sleep in children 5 and over

Question 49

At what age are children able to sit unsupported?

Answer 49

6 months - curved back 9 months - straight back

Question 50

When do a child's first teeth usually appear?

Answer 50

6-12 months Incisors (front 4)

Question 51

What are the two types of breath holding spells?

Answer 51

1. Blue (cyanotic breath holding) 2. Pale spells (pallid breath holding) * Pallid: due to slow HR, may mimic a seizure*

Question 52

What are some of the milestones you would expect a 12 month old to have achieved?

Answer 52

Stand and walk holding on Pull to standing Pick up objects using pincer grip, grasp pencil 2 clear words Shake head "no" Babble frequently when alone Point at wanted objects Wave "bye"

Question 53

What are some of the milestones you would expect an 18 month old to have achieved?

Answer 53

Stand and walk alone well Bend or crouch to pick up an object Push a pram/cart Walk backwards Kick ball Stack 2-3 blocks into a tower Scribble with a pencil 4-8 clear words Follow single instruction Shows sense of self; says "no" or "mine" Drink from a cup Points to body parts, clothing and objects Helps with dressing Completes simple puzzles e.g., one or two shapes in holes Plays correctly with toys e.g., making an airplane fly

Question 54

What are some of the milestones you would expect a 2 year old to have achieved?

Answer 54

Run Throw a ball Walk up and down steps, holding on Jump Scribble in circles with a crayon/pencil 20-50 clear words 2-3 word sentences Names pictures and objects when asked Follows two-step commands Shows interest in books and stories Uses a spoon Early imaginative play

Question 55

What are some of the milestones you would expect a 6 month old to have achieved?

Answer 55

Lift head and chest of ground when lying down Roll over side to side Sit up with support Stand with support Reach for objects Transfer objects from hand to hand Laugh Search for sound by turning head Drink from cup with adult holding it

Question 56

What are some of the milestones you would expect a 3 month old to have achieved?

Answer 56

Lift head when lying on tummy Head control when sitting Kick Follow objects with eyes Tries to make sounds Laugh Responds to sound Smiles Active, visual interest in the world and people

Question 57

At what age can children wave?

Answer 57

9 months

Question 58

At what age do children start using a pincer grip?

Answer 58

9 months

Question 59

At what age can children start breathing through their mouth?

Answer 59

6 months

Question 60

At what age do you refer a child who cannot sit without support?

Answer 60

12 months

Question 61

At what age do you refer a child who cannot walk unaided?

Answer 61

18 months