Toddler and Preschool Health

Question 1

Toddler definition

Answer 1

1-3 years

Question 2

Preschool definition

Answer 2

4-5 years

Question 3

Anthropometric measurements for toddlers

Answer 3

length, height, weight, head circumference up to 2 years

Question 4

Anthropometric measurements for preschooler

Answer 4

height, weight, blood pressure starting at 3 years old, then each year

Question 5

What laboratory tests are recommended for toddlers?

Answer 5

hematocrit (at 2 years or once between ages 1-5 unless otherwise indicated)
lead screening by 2 years-based on appropriateness from risk factors

Question 6

What laboratory tests are indicated for preschoolers?

Answer 6

PPD for TB between 4-6 years if at risk

Cholesterol screening from 2-9 years–if family history

Question 7

What is the toddler schedule for well child visits?

Answer 7

12, 15, 18, 24, 30, 36 months

Question 8

When does the anterior fontanel close?

Answer 8

18 months

Question 9

Chest and head are _____ until age 1.

Answer 9

equal in size

Question 10

Which is larger, chest or head, by end of this preschool period?

Answer 10

chest grows 5 cm >head by end of this period

Question 11

Discuss potential signs of cardiac issues in this age group.

Answer 11

Increased RR at rest or during sleep
Eyelid or orbital edema
squatting during play 
sleeping in knee-to-chest position
exercise intolerance

Question 12

Where is the point of maximal impulse (PMI)?

Answer 12

near the 4th intercostal space midclavicular line

Question 13

Name gross motor skills for a 2 year old

Answer 13

up and down steps
kicks ball without falling
runs with wide gait

Question 14

Name fine motor skills for a 2 year old

Answer 14

tower of 8 cubes

turns a doorknob

Question 15

Describe language development of a 2 year old

Answer 15

up to a 50 word vocab
can follow 2-step commands
talks constantly
**2 words together by 2

Question 16

Name gross motor skills of a 3 year old

Answer 16

hops at 3.5 years

rides a tricycle

Question 17

Name fine motor skills of a 3 year old

Answer 17

copies a circle

builds a tower

Question 18

Discuss language development of a 3 year old

Answer 18

up to a 900 word vocabulary

**3 words together by 3

Question 19

Name gross motor skills of a 4 year old

Answer 19

up and down stairs with alternating feet

rides bicycle with training wheels

Question 20

Name fine motor skills of a 4 year old

Answer 20

draws a person with 4 to 6 parts

tower of 10 blocks

Question 21

Discuss language development for a 4 year old

Answer 21

can understand phrases and simple analogies

**4 words together by 4

Question 22

Name gross motor skills of a 5 year old

Answer 22

skips
jumps rope
plays ball

Question 23

Name fine motor skills of a 5 year old

Answer 23

copies a square
copies multiple shapes
prints letters
ties shoes

Question 24

Discuss language development of a 5 year old

Answer 24

vocal greater than 2000 words
uses sentences regularly
knows at least 4 colors
**Five words together by 5

Question 25

Discuss play in toddlers and preschoolers

Answer 25

onlooker and parallel play (Play by friends) in toddlers associative, cooperative, dramatic, physical play (play with friends) in preschoolers

Question 26

What is the Bayley scales?

Answer 26

gold standard for the diagnosis of developmental delays in infants/toddlers to 42 months of age separate mental, motor, and behavioral rating scales

Question 27

When should utensils be introduced?

Answer 27

introduce spoon between 15-17 months of age

Question 28

When do nightmares begin?

Answer 28

Around age 3

Question 29

When do night terrors begin?

Answer 29

Typically between 2-6 years--most outgrow as they get older. When they wake up, do not know they were crying

Question 30

When does physiologic and psychological readiness for toilet training begin?

Answer 30

Typically between 1.5 and 2.5 years Average daytime control is typically achieved by 2 Average nighttime control lags behind by 1 year compared to daytime contorl

Question 31

Name developmental warning signs of a 1 year old.

Answer 31

not imitating sounds not pulling to standing not indicating desires by point/gesture

Question 32

Name developmental warning signs of a 18 month old.

Answer 32

no eye contact | does not feed self with spoon

Question 33

Name developmental warning signs of a 2 year old.

Answer 33

is not walking up stairs is not using 2-3 word phrases is not noticing cars, animals is initiating self-stimulating behaviors (rocking, flapping)

Question 34

Name developmental warning signs of a 3 year old.

Answer 34

``` Is not aware of external environment cannot ride a tricycle does not follow simple direction continues baby talk does not imitate adult activities ```

Question 35

Name developmental warning signs of a 4 year old.

Answer 35

``` does not listen to a story does not speak in sentences engages in head banging or rocking is not toilet trained does not draw a human figure ```

Question 36

Name developmental warning signs of a 5 year old.

Answer 36

Magical thinking is still dominant | no impulse control

Question 37

Discuss stuttering.

Answer 37

Occurs in 10% of children More common in males Maybe familial Lasts for several weeks to 6 months but 50% of cases resolve spontaneously without intervention

Question 38

When should you refer for stuttering?

Answer 38

Lasts >6 months Child >6 years old Child avoids speaking

Question 39

What is autism?

Answer 39

Pervasive development disorder Marked abnormal or impaired development in social interaction usually noted within first year of life *language delay

Question 40

What is asperger's syndrome?

Answer 40

Pervasive development disorder Severe and sustained impairment of social interaction *No language delay, OCD tendencies **Not in DSM-V

Question 41

What is Rett's disorder?

Answer 41

Pervasive development disorder Neurogenerative developmental regression following a period of normal functioning through the first 5 months of age *Has only been diagnosed in females

Question 42

What is the etiology of Rett's?

Answer 42

unknown

Question 43

What is the clinical presentation of Rett's?

Answer 43

``` lack of gain in developmental milestones CNS irritability and withdrawal symptoms Loss of skills previously mastered (speech and hand) Stereotypic hand movements Delayed head growth seizures scoliosis hypertonicity ```

Question 44

What is childhood disintegrative disorder?

Answer 44

Pervasive developmental disorder | marked regression in a multiple areas of functioning following a period of at least 2 years of normal development

Question 45

Onset of developmental delay must occur by what age to diagnose a Pervasive development disorder?

Answer 45

by age 3

Question 46

DSM-IV-TR requires _ total behaviors from what 3 categories to diagnose a pervasive development disorder?

Answer 46

6 total behaviors from these 3 categories motor language communication/social

Question 47

Who are pervasive development disorders most common in and what is the prevalence?

Answer 47

most common in males (excepts Rett's), but if occurs in females, more severe 2-5:10,000

Question 48

What should visual acuity be by 5 years old?

Answer 48

20/30