Postnatal and Child Development Flashcards
1
Q
development of the brain in a 4 week old embryo: four main sections in dorsal view
A
future forebrain (prosencephalon) future midbrain (mesencephalon) future hindbrain (rhombencephalon) future spinal cord
2
Q
list the flexures present in the developing brain in a 4 week old embryo in side on view
A
cephalic flexure
pontine flexure
cervical flexure
3
Q
development of the brain in a 5 week old embryo
A
fore/mid/hind brain develops
fore: telencephalon, diencephalon
mid
hind: pons, medulla
4
Q
development of the brain in a 8 week old embryo
A
hemispheres and cerebellum developing
formation of ventricular system: aqueduct, 3rd/4th ventricle
5
Q
list association cortices in the brain
A
motor
sensory
visual
prefrontal
6
Q
features of association cortices
A
fx less predictable
not organised topographically
left-right symmetry weak or absent
7
Q
what association cortex is associated with ADHD?
A
prefrontal
8
Q
what part of the spinal cord is responsible for motor neurons?
A
grey matter in the anterior section of the cord
9
Q
how is the grey matter in the anterior section of the spinal cord divided?
A
proxima
distal
flexors
extensors
10
Q
list pyramidal tracts
A
lateral corticospinal
anterior corticospinal
11
Q
list extra-pyramidal tracts
A
rubrospinal
reticulospinal
vestibulospinal
olivospinal
12
Q
reticulospinal tract is responsible for?
A
coordinating automated movements of locomotion posture e.g. to painful stimuli
13
Q
rubrospinal tract is responsible for?
A
automatic movements of arm in response to posture/balance changes
14
Q
vestibulospinal tract is responsible for?
A
regulates posture to maintain balance, facilitates mainly alpha motor neurons of the postural, antigravity (extensor) muscles
15
Q
anterior corticospinal tract is responsible for?
A
voluntary movements
16
Q
list components of the reflex arc
A
stimulus > sensory receptor > sensory neuron > dorsal column > inteneuron/integrating center > motor neuron > effector
17
Q
what is the Moro reflex?
A
when neck suddenly extended, arms abduct then adduct
18
Q
when does the Moro reflex develop?
A
28-32 weeks gestation
19
Q
when does the Moro reflex disappear?
A
3-6 months
20
Q
the persistence of primitive reflexes can be a sign of?
A
impaired development
21
Q
what is the stepping reflex?
A
baby appears to take steps or dance when held upright with his or her feet touching a solid surface
22
Q
how long does the stepping reflex last?
A
~2months
23
Q
what is the grasp reflex?
A
Stroking the palm of a baby’s hand causes the baby to close his or her fingers in a grasp
24
Q
how long does the grasp reflex last?
A
5-6 months
9-12 in the toes
25
what is the tonic neck reflex?
When a baby's head is turned to one side, the arm on that side stretches out and the opposite arm bends up at the elbow (fencing position)
26
how long does the tonic neck reflex last?
5-7 months
27
what is the rooting reflex?
when the corner of the baby's mouth is stroked / touched, the baby will turn their head and open their mouth to follow and root in the direction of the stroking
28
how long does the rooting reflex last?
4 months
29
what is the suck reflex?
When the roof of the baby's mouth is touched, the baby will start to suck
30
when does the sucking reflex develop?
32-36 weeks gestation
31
what are parachute reflexes?
baby protects themselves with outstretched arms when pushed sideways or forward
32
what is development?
global impression of a child encompassing: growth, ^ understanding, skill acquisition, more sophisticated response and behaviour
33
who helps monitor child development?
parents
doctors
nursery nurses
teachers
34
when are children monitored for development?
opportunistically
| part of a planned programme of reviews
35
list the four domains of child development
gross motor skills
fine motor skills
social skills
speech and language skills
36
gross motor skills include?
```
position
head lag
sitting
walking
running
```
37
fine motor skills include?
```
use of hands
grasp and fine pincer
bricks
crayons
puzzles
```
38
social skills include?
social interaction
stranger reaction
eating skills
dressing
39
speech and language skills include?
vocalisation
words
understanding
imaginative play
40
gross motor development in a new born
limited flexing
symmetrical posture
marked head lag on pulling up
41
gross motor development in a child that is 6-8 weeks
raises head to 45 degrees in prone
42
gross motor development in a child that is 6-8 months
sits w/o support
6 months w/ round back
8 months w/ straight back
43
gross motor development in a child that is 8-9 months
crawling
44
gross motor development in a child that is 10 months
cruises around furniture
45
gross motor development in a child that is 12 months
walks unsteadily
broad gait
hands apart
46
gross motor development in a child that is 15 months
walks steadily
47
describe the variations in how children go from sitting to sitting to crawling to walking
'commando' crawl
crawling on all fours
bottom shuffling
48
vision and fine motor development in a child that is 6 weeks
follows moving object or face by turning the head
49
vision and fine motor development in a child that is 4 months
reaches out for toys
50
vision and fine motor development in a child that is 5-6 months
palmar grasp
51
vision and fine motor development in a child that is 7 months
transfers toys from one hand to another
52
vision and fine motor development in a child that is 10 months
mature pincer grip
53
vision and fine motor development in a child that is 16-18 months
makes marks with a crayon
54
vision and fine motor development in a child that is 14 months - 4 years (building blocks)
tower of 3 > tower of 6 > tower of eight / train w/ 4 bricks > bridge from a model > steps (after demonstration)
55
vision and fine motor development in a child that is 2-5 years (drawing shapes)
line > circle > cross > square > triangle
56
hearing, speech and language development in a child that is a new born
startles to loud noises
57
hearing, speech and language development in a child that is 3-4 months
vocalises alone or when spoken to, coos and laughs
58
hearing, speech and language development in a child that is 7 months
turns to soft sounds out of sight
59
hearing, speech and language development in a child that is 7-10 months
7 months > sounds used indiscriminately
| 10 months > sounds used discriminately to parents
60
hearing, speech and language development in a child that is 12 months
two to three words other than 'dada' 'mama'
61
hearing, speech and language development in a child that is 18 months
6-10 months
| shows two parts of the body
62
hearing, speech and language development in a child that is 20-24 months
uses two or more words to make simple phrases
63
hearing, speech and language development in a child that is 2.5-3 years
talks constantly in 3-4 word sentences
64
social, emotional and behavioural development in a child that is 6 weeks
smiles responsively
65
social, emotional and behavioural development in a child that is 6-8 months
puts food in mouth
66
social, emotional and behavioural development in a child that is 10-12 months
waves bye
plays peek a boo
drinks from a cup with two hands
67
social, emotional and behavioural development in a child that is 18-24 months
holds spoon and gets food safely to mouth
| symbolic play
68
social, emotional and behavioural development in a child that is 2 years
dry by day
| pulls off some clothing
69
social, emotional and behavioural development in a child that is 2.5-3 years
parallel play
interactive play evolving
takes turns
70
list patterns of abnormal development
slow but steady
plateau
regression
71
limit age for head control
4 months
72
limit age for sitting unsupported
9 months
73
limit age for standing independently
12 months
74
limit age for walking independently
18 months
75
median and limit ages for being able to push up on arms/hold head up
median age 1.5 months
| limit age 2 months
76
describe abnormal motor development at 1.5/2 months
```
unable to lift head/push up on arms
stiff extended legs
pushing back w/ head
constantly fisted hand + stiff leg on one side
difficulty moving out of that position
```
77
median and limit ages for being able to sit w/ support, holds head up, rounded back
median age 3 months
| limit age 6 months
78
describe abnormal motor development at 3/6 months
while seated: unable to lift head, floppy trunk, stiff arms, extended legs
when held up: arms flexed and held back, stiff, crossed legs
79
median and limit ages for being able to sit w/o support, arms free to reach and grasp
median age 6 months
| limit age 9 months
80
describe abnormal motor development at 6/9 months
while seated: rounded back, poor use of arms, stiff legs, pointed toes
wont take weight on legs
81
median and limit ages for being able to pull to stand
median age 9 months
| limit age 13 months
82
describe abnormal motor development at 9/13 months
not interested in weight bearing, difficulty pulling to stand, stiff legs, pointed toes
cannot crawl on hands and knees, may use only one side of body to move
83
median and limit ages for being able to stand or walk independently
median age 12 months
| limit age 18 months
84
describe abnormal motor development at 12/18 months
arms stiff and bent, excessive tiptoe gait
| sits w/ weight to one side, predominant use of one hand for play, one leg may be stiff
85
progression of gross motor development
acquisition of tone + head control > primitive reflexes disappear > locomotor patterns > standing, walking, running > hopping, jumping, peddling
86
progression of vision and fine motor development
visual alertness, fixing and following > grasp reflex, hand regard > voluntary grasping, pincer points > handles objects w/ both hands, transfers from hand to hand > writing, cutting, dressing
87
limit age for fixes and follows visually
3 months
88
limit age for reaching for objects
6 months
89
limit age for transfers
9 months
90
limit age for pincer grip
12 months
91
progression of hearing, speech and language development
sound recognition, vocalisation > babbling > single words, understands simple requests > joining words, phrases > simple + complex conversation
92
limit age for polysyllabic babble
7 months
93
limit age for consonant babble
10 months
94
limit age for saying 6 words w/ meaning
18 months
95
limit age for joining words
2 years
96
limit age for 3 words sentences
2.5 years
97
progression of social, emotional behaviour development
smiling, socially responsive > separation anxiety > self help skills (feeding, dressing, toileting) > peer group relationships > symbolic play > social/communication behaviour
98
limit age for smiling
8 weeks
99
limit age for fear of strangers
10 months
100
limit age for feeding self/spoon
18 months
101
limit age for symbolic play
2-2.5 years
102
limit age for interactive play
3-3.5 years
103
what are the three key components to the 'healthy child programme'
screening
general examination and immunisation
health education/promotion
104
progression of screening from <12 weeks gestation to birth
Hbopathy, rhesus, infection > US scan dating and nuchal > US scan detailed > newborn blood spot, hearing and physical
105
progression of screening from birth to 18
physical exam (GP) > vision > preschool background > health review at school transition
106
progression of child health reviews
birth visit > 10-14 day visit > 6-8 wk > 1st year > 2 year > school entry
107
education and health promotion from gestation to 5 years
relationships, breast feeding, vaccination, reading, weaning, social and emotional, injury prevention, learning, physical activity, nutrition
108
factors can affect the developing human at what points in the life cycle?
prenatal
perinatal
postnatal
109
evaluating the child with abnormal development
Hx: parental concern, birth hx, family hx
PMHx: dev hx, current skills
Exam: dev assess + gen/neuro assess, Ix as appropriate
110
approach to developmental assessment
ask > observe > task
| need to assess milestones preceding age > expected milestones for age > next important milestones
111
factors that influence developmental delay
ill health
reduced inherent potential
sensory/motor impairment
lack of physical/psychological stimuli
112
types of developmental delay
global
| specific: language, motor, sensory, cognitive
113
list causes of global delay
chromosomal abnormalities e.g. Down's, Fragile X
metabolic e.g. hypothyroidism, inborn errors
antenatal and perinatal factors e.g. infections, drugs, toxins, anoxia, trauma, folate deficiency
environmental-social issues
chronic illness
114
list causes of motor delay
```
cerebral palsy
global delay e.g. Down's
congenital dislocation hip
social deprivation
muscular dystrophy - Duchenne's
neural tube defects: spina bifida
hydrocephalus
```
115
list causes of language delay
hearing loss
learning disability
autism spectrum disorder
lack of stimulation
impaired comprehension of language (developmental dysphasia)
impaired speech production (stammer, dysarthria)
116
commonly used assessment tools
```
standardised tests
schedule of growing skills (II)
Griffith's developmental scale
Bailey developmental scale
Denver developmental screening tests
```
