Week 6 - Intro to Paediatric + Child Development Flashcards
*Describe the common musculoskeletal complaints in paediatric primary care and their epidemiology.
De Inocencio (1998) Knee pain 33% Arthralgia 28% Soft Tissue pain 18% Heel pain 8% Lower back Pain 7% Hip pain 6%
Conditions commonly seen in a chiropractic paediatric practice include: (not order of prevalence)
- low back pain,
- thoracic spine pain,
- Scheuermann’s disease,
- neck pain,
- scoliosis, and
- headache.
*Discuss the relevancy of radiologic findings in the paediatric population
- Common imaging techniques have proved to be poor at distinguishing between adolescents with and without LBP.
- Harreby et al showed in the community that 13% of 14 year old school children had radiological abnormalities of the spine (mc = Scheuermann’s changes) but was unable to discriminate between LBP and non-LBP subjects based upon radiological findings.
*Discuss the safety of chiropractic care for children
- Most serious complications reported in the literature have resulted from cervical manipulation.
- Shafrir and Kaufman reported a case of quadriplegia resulting from chiropractic manipulation in a child with spinal cord astrocytoma.
- Another concern is the safety of repeated radiographic examinations in children and adolescents.
- Many pediatricians are concerned that chiropractic care may delay or prevent appropriate medical diagnoses and treatment.
- When children are treated by chiropractors mainly for musculoskeletal disorders no controversy appears to exist.
*Describe Murdoch University Chiropractic’s stance on paediatric care
- students are taught the examination of children; to appropriately manage/co-manage/refer
- students are taught to manage common paediatric orthopaedic conditions and selected neurological disorders; are introduced to the evaluation of the unsettled child but not on chiropractic management of this condition.
- As a school we are in support of providing a safe, evidence based and effective approach to paediatric patients at MUCC and support continued learning by our student clinicians in this field.
*Define childhood development and describe the periods of development
Definition:
Change in the child that occurs over time. Changes follow an orderly pattern that moves toward greater complexity and enhances survival.
Periods of development:
- Prenatal period: from conception to birth
- Infancy and toddlerhood: birth to 2 years
- Early childhood: 2-6 years old
- Middle childhood: 6-12 years old
- Adolescence: 12-19 years old
*Describe the key components of physical development
- At birth the average baby is 50cm long and weigh 3-3.5kg
- By adulthood the child will have grown by 350% and increased its body weight by a factor of 20
- During infancy children are completely dependent on the parent.
- During childhood growth proceeds at a constant rate.
- In adolescence physical changes associated with sexual maturation and the pubertal growth spurt occurs
2-5th month = smiles spontaneously 2-4th month = HEAD CONTROL 3-6th month = turns prone - supine (vice versa) 5-8th month = SITS INDEPENDENTLY 6-9th month = pulls itself up using furniture to stand 9-13th month = SAYS MUMMY AND DADDY 10-16th month = drinks from cup 11-16th month = WALKS INDEPENDENTLY 14-22nd month = climbs stairs 14-30th month = combines 2 different words 20-30th month = puts on clothing 22-30th month = HOPS ON THE SPOT
- Be able to read and interpret standardised growth charts
- growth in length and stature
Birth = Boys ~ 50cm; Girls ~ 50cm
Year 1 = Boys ~ 76cm; Girls ~ 74cm
Year 2 = Length increases about 12 cm
Years 3-5 = Decelerated growth rate to 6cm/year
Mid growth spurt in height
- Between 6.5 and 8.5 years
- More common in girls
Adolescence
20% of adult stature is attained during this 2.5-3 years period
10cm/yr growth for boys
8cm/yr growth for girls
17.3 years
Median age in females when growth in stature ceases
21.2 years
Median age in males when growth in stature ceases
*Differentiate between the onset/duration of puberty and secondary sexual characteristics of females and males
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*Describe the development of gross motor skills in an INFANT
HEAD CONTROL
- Newborn: barely able to lift head
- 6 months: easily lifts head, chest and upper abdomen and can bear weight on arms
SITTING UP
- 2months old: needs assistance
- 6 months old: can sit alone in the tripod position
- 8 months old: can sit without support and engage in play
AMBULATION
- 9 month old: crawl
- 1 year: stand independently from a crawl position
- 13 month old: walk and toddle quickly
- 15 month old: can run
*Describe the development of fine motor skills in an INFANT
Newborn has very little control.
- Objects will be involuntarily grasped and dropped without notice.
- 6 month old: palmar grasp – uses entire hand to pick up an object
- 9 month old: pincer grasp – can grasp small objects using thumb and forefinger
*Describe Speech Milestones
1-2 months: coos
2-6 months: laughs and squeals
8-9 months babbles: mama/dada as sounds
10-12 months: “mama/dada” specific
18-20 months: 20 to 30 words – 50% understood by strangers
22-24 months: two word sentences, >50 words, 75% understood by strangers
30-36 months: almost all speech understood by strangers
*List developmental red flags for INFANTS
Unable to sit alone by age 9 months
Unable to transfer objects from hand to hand by age 1 year
Abnormal pincer grip or grasp by age 15 months
Unable to walk alone by 18 months
Failure to speak recognizable words by 2 years.
Please research the relevance of the body proportions such as:
Trunk length Vs overall height
Upper limb Vs Lower Limb length
Total Height Vs Arm Span
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*List developmental red flags for PRESCHOOL
- Inability to perform self-care tasks, hand washing simple dressing, daytime toileting
- Lack of socialization
- Unable to play with other children
*List developmental red flags for SCHOOL AGE
- School failure
- Lack of friends
- Social isolation
- Aggressive behavior: fights, fire setting, animal abuse
