Post-natal child development

Question 1

what are these parts on a dorsal view of the embryo at 4 weeks?

Answer 1

Question 2

what are the flexures at 4 weeks of an embryo?

Answer 2

Question 3

what are the parts of the developing brain at 5 weeks?

Answer 3

Question 4

what are the parts of the developing brain at 8 weeks?

Answer 4

Question 5

how do the parts of the brain develop over time?

Answer 5

Question 6

what are the different functions of the cerebral cortex?

Answer 6

Question 7

what is the difference between primary cortices and association cortices?

Answer 7

association cortices:

• function less predictable

not organised topographically

left-right symmetry weak or absent

Question 8

where is the alpha motor neuron located?

Answer 8

Question 9

what do the pyramidal tracts do and where are they located?

Answer 9

• Organised in 1a and 1b
• Control voluntary movements
• Supply: sacral, lumbar, thoracic and cervical nerves in the lateral corticospinal tract

Question 10

where are extrapyramidal tracts and what do they do?

Answer 10

• Organised in 2b, 2c and 2d
• Responsible for coordination of automatic movements of location and posture (e.g to painful stimuli) (2b)
• Automatic movements of arm in response to posture/balance changes (2a)
• Regulates posture to maintain balance, and facilitates mainly a motoneurons of postural, antigravity (extensor) muscles

Question 11

what are the components of a reflex arc?

Answer 11

Question 12

what are the primitive reflexes?

Answer 12

reflexes seen in babies

1. Moro reflex
   
   1. When babies neck suddenly extended
   2. Arms adduct then abduct
   3. Develops 28-32 weeks gestation and disappears 3-6 months
2. Standing reflex
   
   1. In newborn at 3 months
   2. On trying to make baby stand on his legs:
      
      1. Extension of lower extremities
      2. Hips slightly flexed behind shoulder
      3. Head free to turn
3. 6-9 months get protective reflexes (parachute reflex)
   
   1. Protects with outstretched arms

Question 13

what aspects are looked at in a developmental assessment of a child?

Answer 13

Question 14

what are the gross motor development of a new born?

Answer 14

Question 15

what are the gross motor developments at 6-8 weeks and 6-8 months?

Answer 15

Question 16

what are the gross motor developments at 8-9 months and 10 months?

Answer 16

Question 17

what are the gross motor developments at 12 months and 15 months?

Answer 17

Question 18

what are the normal variations of gross motor development?

Answer 18

Question 19

what is the vision and fine motor development at 6 weeks and 4 months?

Answer 19

Question 20

what are the vision and fine motor developments at 4-6 months and 7 months?

Answer 20

Question 21

what are the vision and fine motor developments at 10 months and 16-18 months

Answer 21

Question 22

what are the vision and fine motor developments at 14 months-4 years and 2- 5 years in building and drawing?

Answer 22

Question 23

what are the hearing, speech and language developments as newborn and 3-4 months?

Answer 23

Question 24

what are the hearing, speech and language developments at 7 months and 7-10 months?

Answer 24

Question 25

what are hearing, speech and language developments at 12 months and 18 months?

Answer 25

Question 26

what are the hearing, speech and language developments at 20-24 months and 2.5-3 years?

Answer 26

Question 27

what are the social, emotional and behavioural developments at 6 weeks and 6-8 weeks?

Answer 27

Question 28

what are the social, emotional, and behavioral developments 10-12 months and 12 months?

Answer 28

Question 29

what are the social, emotional and behavioural developments at 18 and 18-24 months?

Answer 29

Question 30

what are the social, emotional and behavioural developments at 2 years and 2.5-3 years?

Answer 30

Question 31

what are the patterns of abnormal development?

Answer 31

Question 32

what are the limit ages for gross motor control?

Answer 32

head control= 4 months sits unsupported= 9 months stands independently= 12 months walks independently= 18 months

Question 33

what are the abnormal motor developments in cerebral palsy at 1.5 months?

Answer 33

Question 34

what are the abnormal motor developments in cerebral palsy at 3 months?

Answer 34

Question 35

what are the abnormal motor developments in cerebral palsy at 6 months?

Answer 35

Question 36

what are the abnormal motor developments in cerebral palsy at 9 months?

Answer 36

Question 37

what are the abnormal motor developments in cerebral palsy at 12 months?

Answer 37

Question 38

what are the limit ages for vision and fine motor control?

Answer 38

fixes and follows visually- 3 months reaches for objects- 6 months transfers- 9 months pincer grip- 12 months

Question 39

what are the limit ages for hearing, speech and language developement?

Answer 39

polysyllabic babble- 7 months constonant babble- 10 months saying 6 words with meaning- 18 months joints words- 2 years 3 word sentances- 2.5 eyars

Question 40

what are the limit ages for social and emotional behavior?

Answer 40

smiles- 8 weeks fear of stranges- 10 months feeds self/spoon- 18 months symbolic play- 2-2.5 years interactive play- 3-3.5 years

Question 41

who is involved in monitoring child development?

Answer 41

* Parents * All doctors * Nursery nurses * Teachers

Question 42

when in child development monitored/assessed?

Answer 42

* Opportunistically * Planned as part of programme of reviews- “ THE HEALTHY CHILD PROGRAMME “ * 3 key components * Screening, * General examination and immunisation, * Health education /promotion

Question 43

what is the screening, immunisation, child health reviews and health promotion at: pregnancy \<12 weeks pregnancy 12 weeks pregrancy 18-20 weeks birth 2-4 weeks

Answer 43

Question 44

what is the screening, immunisation, child health reviews and health promotion at: 6-8 weeks 2-4 months 8-12 months 13 months 2 years

Answer 44

Question 45

what is the screening, immunisation, child health reviews and health promotion at: 3 years 4-5 years 5-11 years 11-16 years 16-19 years

Answer 45

Question 46

what are the causes of developmental impairments?

Answer 46

* Prenatal (folate, iron, alcohol) * Perinatal (delivery itself-oxygen deprivation. Drugs) * Postnatal (trauma, meningitis)

Question 47

what is looked at in evaluating a child with abnormal development?

Answer 47

* **History** * Parental concern * Birth history * Family history * **PMHX** * Developmental history * Current skills * **Examination** * Developmental assessment, + general and neurological examination * Investigations – as appropriate

Question 48

what needs to be assessed in a child developmental assessment?

Answer 48

* Milestones proceeding age * Expected milestones for age * Next important milestones

Question 49

what are the types of developmental delay?

Answer 49

Question 50

what are the causes of global delay (delay in all 4 domains)?

Answer 50

* Chromosomal abnormalities * e.g. Down’s syndrome, Fragile X * Metabolic * e.g. hypothyroidism, inborn errors of metabolism * Antenatal and perinatal factors * Infections, drugs, toxins, anoxia, trauma, folate def * Environmental-social issues * Chronic illness

Question 51

what are the motor delay causes?

Answer 51

* Cerebral palsy * Global delay eg Down’s syndrome * Congenital dislocation hip * Social deprivation * Muscular dystrophy-Duchenne’s * Neural tube defects: spina bifida * Hydrocephalus

Question 52

what are the language delay causes?

Answer 52

* Hearing loss * Learning disability * Autistic spectrum disorder * Lack of stimulation * Impaired comprehension of language * Developmental dysphasia * Impaired speech production * stammer, dysarthria

Question 53

what tests are commonly used to assess developmental delay?

Answer 53

* Standardised tests * Schedule of Growing Skills (II) * Griffiths developmental scale * Bailey developmental scale * Denver developmental screening tests * OFFER THE RIGHT TOOLS, OBSERVE, LISTEN