1
Q
- Able to fix briefly on faces or objects
- Follows face to midline
A
1-2 weeks
cognitive d.
2
Q
- Responds to affection, changes in environment
- Indicates pleasure and displeasure
A
4 months
cog. d
3
Q
-Continues to use visual exploration to learn about environment but is also beginning to use oral exploration for learning
A
6 months
cog. d
4
Q
-Indicates boredom (crying/fussiness) when no changes in activity occur
A
2 months
cog. d
5
Q
- Begins to demonstrate differentiated types of crying (hunger, discomfort, fatigue)
- Coos
- Has clearer behaviors to indicate needs for food, sleep, play, comforting
A
2 months
communicative
6
Q
- Cries in differentiated manner to express hunger, fatigue, pain
- Babbles more expressively and spontaneously
A
4 months
communicative
7
Q
Turns and calms to parent’s voice
Communicates needs through behaviors
Undifferentiated cry
A
1-2 weeks
communicative
8
Q
- Uses string of vowels together (babbling “ah,” “eh,” “oh”) and enjoys vocal turn taking
- Beginning to recognize own name
- Will begin to use consonant sounds (“m,” “b”) then combine together (“ah,” “ba”) as jargon
A
6 months
communicative
9
Q
when will baby start cooing?
A
2 months
10
Q
when will babe begin to recognize own name
A
6 months
11
Q
- Attempts to look at parent
- Smiles
- Able to console and comfort self (brings hands to midline and mouth)
A
2 months
social-emotional
12
Q
-Able to sustain periods of wakefulness for feeding
-Will gradually become able to establish longer stretch of sleep (4-5 hours at night)
Has indefinite regard of surroundings
A
1-2 weeks
social-emotional
13
Q
- Socially interactive with parent
- Recognizes familiar faces & is beginning to recognize whether person is stranger
A
6 months
social-emotional
14
Q
- Smiles spontaneously
- Elicits social interactions
- Shows solidified self-consolation skills
A
4 months
social-emotional
15
Q
- Able to suck, swallow, and breathe
- Shows strong primitive reflexes (suck, rooting, palmer grasp, stepping, Moro reflex, tonic neck reflex)
- Able to life head briefly when in prone position
A
1-2 weeks
PD
16
Q
- Able to hold up head and begins to push up in prone position
- Consistent head control in supported sitting position
- Shows symmetrical movements of head, arms, and legs
- Shows diminishing newborn reflexes
A
2 months
PD
17
Q
when can babe show consisent head control in supported sitting position?
A
2 months
18
Q
- increasing mobility, standing, and bouncing; in prone position, will gradually move into crawling position
- Rocks back and forth, often crawling backward before moving forward
- Will learn to rotate in sitting & eventually move from sitting to crawling position
A
6 months
PD
19
Q
when does babe rock back and forth, often crawling backward before moving forward
A
6 months
20
Q
- Develops object permanence
- Learns interactive games, such as “peek-a-boo” and “so big”
- Looks at books & explores environment, physically and visually
A
9 months
cog. d
21
Q
- Developed apprehension with strangers
- Seeks parent for play and comfort, and as a resource
A
9 months
social-emotional
22
Q
when does babe learn games like peek-a-boo
A
9 months
23
Q
-Uses wide variety of repetitive consonants and vowel sounds
Starts to point out objects
A
9 months
communicative
24
Q
- Demonstrates prodeclarative pointing (points to desired object and watches to see whether parent sees it)
- Imitates vocalizations and sounds
- Speaks 1 to 2 words
- Jabbers with inflections of normal speech
A
12 months
communicative
25
when does babe learn object permanence
9 months
26
when does babe start speaking 1-2 words
12 months
27
- Indicates what they want by pulling, pointing, or grunting
- Brings objects over to show you
- Hands you book when they want to hear story
- Says 2-3 words (not Dada/Mama) with meaning
15 months
28
- Has vocabulary of at least 50 words
- Uses 2-word phrases
- Asks parent to read book
24 months
29
- Vocalizes and gestures; speaks 6 words
| - Points to indicate to someone else what they want
18 months
30
when can babe say 2-3 words with meaning
15 months
31
how many words should babe know by age 24 months
50 words
| -use 2 word phases
32
- Plays interactive games (i.e. “peek-a-boo,” “pat-a-cake”)
- Imitates activities
- Hands you book when they want to hear story
- Waves “bye-bye”
- Has strong attachment with parent or significant caregiver
- Shows distress on separation from parent
12 months
33
- Interactive or withdrawn; friendly or aggressive (i.e. hitting, biting)
- Laughs in response to others
- Explores alone but with parent in close proximity
- Spontaneous with affection
- Helps in house
18 months
34
Listens to story
Imitates activities
May help in house
15 months
35
- Imitates adults
- Increases pretend play (i.e. rocking, feeding, or putting baby doll to bed)
- Plays alongside other children (parallel play)
- Refers to self more often as “I” or “me”
- May have established special attachment to transitional object
24 months
36
- Imaginary play, such as with dolls and toys, is increasing
- Play is starting to include other children to increasing degree, such as play tea parties or chase games
- Has fears about unexplained changes in his physical environment and unexpected events (common in children of this age)
2.5 years
37
when does babe start refering to self more ofen as "I" or "me"
24 months
38
- Uses short phrases of 3-4 words
| - Understandable to others 50% of time
2.5 yrs
39
-Follows 2-step commands
-Names one picture, such as cat, horse, bird, dog, or man
-Completes sentences and rhymes in familiar books
-Corrects you if you change word in book they know
In response to, “Where is ___?”, points to object or animal in book
24 months
40
- Points to 1 body part
- Follows simple instructions without gestured cues (“sit down”)
- Shows interest in doll or stuffed animal by hugging it or pretend feeding
- Knows names of favorite books
18 months
41
when can babe follow 2 step command
24 months
42
when should others be able to understand babe 50% of time
2.5 yrs
43
points to one body part
18 months
44
-Completes sentences and rhymes in familiar books
24 months
45
- knows correct action for selected animal or person (i.e. cat meows, horse gallops, bird flies, dog barks, man talks)
- Has friends
- Points to 6 body parts
2.5 yrs
46
Understands and follows simple commands
| Scribbles
15 months
47
Follows simple directions
| Identifies persons upon request (i.e. “Where is ___?”)
12 months
48
can point to 6 body parts
2.5 yrs
49
- Jumps up and down in place
- Throws ball overhand
- Washes and dries hands
- Brushes teeth with help
- Puts on clothes with help
- Copies vertical line
2.5 yrs
50
Bangs 2 cubes held in hands
| Stands alone
12 months
51
Walks well, stoops, and recovers
Able to take steps backwards
Puts block in cup
Drinks from cup
15 months
52
when can babe throw a ball overhead
2.5 yrs
53
drinks from cup
15 months
54
- Walks up steps, runs
- Stacks 2 or 3 blocks
- May imitate crayon stoke and scribbles
- Uses spoon and cup without spilling most of time
18 months
55
copies vertical lines
2.5 yrs
56
kicks a ball
24 months
57
- Stacks 5 or 6 blocks
- Makes or imitates horizontal and circular strokes with crayon
- Turns book pages one at a time
- Imitates food preparation: scrubs, tears, breaks, dips, snaps, beats an egg, “washes” dishes
- Throws ball overhand
- Goes up and down stairs one step at a time
- Kicks a ball
- Jumps up
24 months
58
when can babe use spoon and cup without spilling most of the time
18 months
59
-Rapidly expands motor skills – crawls reciprocally, gets to sitting, begins to pull to stand
9 months
60
when does babe typically start walking well
15 months
61
- Has self-care skills (i.e. self-feeding and self-dressing to extent this is desired and permitted within individual family and cultural norms)
- Imaginative play is becoming more elaborate, with specific themes or story lines demonstrated
- Enjoys interactive play
3 y/o
62
- Gives first and last name
- Sings song or says poem from memory
- Knows what to do if cold, tired, or hungry
- Clearly understandable with most speech efforts
4 y/o
63
Carries on conversation with 2-3 sentences spoken together
Understandable to others 75% of time
Names a friend
3 /o
64
does does babe know their first and last name
4 y/o
65
-Good articulation, tells simple story using full sentences, uses appropriate tenses and pronouns, can count to 10, and names at least 4 colors
5 and 6y/o
66
- Describes features of himself, including gender, age, interests, and strengths
- Responsive or withdrawn; friendly or hostile/aggressive; cooperative or defiant
- Acts appropriately for community’s or family’s cultural values
- Plays with favorite toys (describe play)
- Listens to stories
- Engages in fantasy play
4 y/o
67
```
Hops on one foot
Balances on one foot for 2 seconds
Builds tower of 8 blocks
Copies cross
Pours, cuts, and mashes own food
Brushes own teeth
Dresses self, including buttons
```
4 y/o
68
```
Names 4 colors
Aware of gender (of self and others)
Plays board/card games
Draws person with 3 parts
Tells you what they think is going to happen next in book
```
4 y/o
69
Knows name and use of cup, ball, spoon, and crayon
| Identifies self as girl or boy
3 y/o
70
-Able to tie knot, mature pencil grasp, can draw person with at least 6 body parts, prints some letters and numbers, and is able to copy squares and triangles
5 and 6 y/o
71
when is babe aware of gender
4 y/o
72
- Balances on one foot, hops, and skips
| - Follows simple directions, able to listen and attend, and undresses and dresses with minimal assistance
5 and 6 y/o
73
- Hops on one foot
- Balances on one foot for 2 seconds
- Builds tower of 8 blocks
- Copies cross
- Pours, cuts, and mashes own food
- Brushes own teeth
- Dresses self, including buttons
4 y/o
74
when does babe balance on one foot for 1 second
3 years old
75
when can babe dress self
4 y/o
76
- Builds tower of 6-8 cubes
- Throws ball overhand
- Rides tricycle
- Walks up stairs alternating feet
- Balances on 1 foot for 1 second
- Copies a circle
- Draws a person with 2 body parts (head and one other part)
- Toilet trained during daytime for both bowel andbladder?
3 y/o
77
toilet trained during daytime
3 y/o
78
rides tricycle
3 y/o
79
what is considered infancy
newborn-1 year
80
what is considered early childhood?
1-4 yrs old
81
what is middle childhoood
5-18 yrs old
82
what age can babe -fixates on human face and follows w/ eyes
2 weeks
83
what age can babe -prone: lifts head, neck and upper chest w/ support on forearms
2 months
84
what age can babe- -prone: holds head upright and raises body on hands
4 months
85
what age is babe - able to comfort self (w/out breast/bottle)
4 months
86
begins to show signs of stranger danger
6 months
87
starts to self-feed
6 months
88
may pull to stand
9 months
89
transfers small objects hand to hand
6 months
90
rolls over
6 months
91
understands some words, e.g. no-no, bye-bye
| -babbles, imitates
9 months
92
Will begin to use consonant sounds (“m,” “b”) and then combine together (“ah,” “ba”) as jargon
6 months
93
Pushes chest up to elbows
4 months
94
Demonstrates symmetrical movements of arms and legs
4 months
95
Uses wide variety of repetitive consonants and vowel sounds
9 months
96
starts to point out objects
9 months
97
Begins to roll and reach for objects
4 months
98
wave "bye-bye"
12 months
99
Indicates what they want by pulling, pointing, or grunting
15 months
100
Walks well, stoops, and recovers
15 months
101
Makes or imitates horizontal and circular strokes with crayon
24 months
102
stacks 2-3 blocks
18 months
103
stacks 5-6 blocks
24 months
104
can build tower with 6-8 blocks
3 y/o
105
can balance on 1 foot for 2 seconds
4 y/o
106
understandable 75% of the time to others
3 y/o
107
Walks up stairs alternating feet
3 y/o
108
draws a person with 2 body parts
3 y/o
109
Copies cross
4 y/o
110
draw a person with 3 body parts
4 y/o
111
names 4 colors
4 y/o
112
can draw a person with 6 body parts
5 y/o
113
nightmares typically start around
4-5 y/o
114
night terrors typically start around
7 y/o
115
Booster seat until how tall/old?
57 inches or 8 y/o in Colorado
116
when do you assess if they are kindergarden ready?
5 y/o
117
can start introducing solid food if shows interest
4 months
| *introducing too early can lead to DM2, obesity, increase allergy risk
118
how do you introduce new foods to babies?
- Can start w/ any SINGLE new puréed food at a time (fruit, veggie, grain, etc.)
- Could start with veggie become fruit so they like it better
- Could take multiple exposures to a food
- New food every 3-5 days to tell if they are going to have an allergy or intolerance
119
swaddle a baby until how old
4-6 months
120
start rolling over by how old
6 months
121
rear facing car seat until how old
2 y/o or 20 lbs
122
check hip development until how old
2 yrs
123
avg kid sleeps 8 hrs consectively at what age
6 months
124
average age for teething is
7-8 months
125
claw pinch with fingers around how old
6 months
126
how much Vit. D should all kids get?
400IUs
127
when can you offer the flu vaccine?
6 months
| *kids under 9y/o need 2 shots for first flu vaccine
128
Screen hemoglobin at what age
9 months
129
encourage breastfeeding until how old
12 months
130
screen for autism at what age
18 months and 2 years
131
precise pinching at age
12 months
132
appetitie might change around ____ because caloric intake decreases
12 months
133
when could you introduce another language
any age
134
when do you start tracking the kid on a "big-kids" curve?
24 months
135
when can a kid get the intranasal flu vaccine?
24 months
136
teach your kid to swim
5-6 y/o
137
can print some letters and numbers
5-6 y/o
138
able to copy squares and triangles
5-6 y/o
139
what anticipatory guidance would you give to a 1-2 week y/o regarding use of a pacifier
- If breastfeeding, wait to introduce pacifier until 1 m/o to ensure breastfeeding is firmly established
- Avoid using any artificial nipples (i.e. pacifiers, bottles) until 4-6 weeks when breastfeeding is well established
140
1-2 week year old Usual signs of hunger include
putting hand to mouth, sucking, rooting, pre-cry facial grimaces, and fussing (crying is late sign of hunger)
141
what anticipatory guidance for a 1-2 week year old in regards to how often babe should be feeding
- In first few days, baby should be encouraged to breastfeed about 8-12 times in 24 hours to help mature breast milk come in
- Babies go through “feeding frenzy” 3-4 days after birth where they want to eat every 1-2 hours
- At 1 week, baby will eat every 2-3 hours during day and every 3 hours at night with one longer 4-5 hour stretch between feedings; feed at least 8-12 times in 24 hours
142
Signs of fullness when breastfeeding
turning head away from nipple, closing mouth, and relaxed hands
143
anticipatory guidance for 1-2 week y/o in regards to elimination
-Baby should have 6-8 wet diapers in 24 hours after milk comes in; stools as frequently as 1 per feeding or every few days; stools loose if breastfeeding
144
Cord care
“air dry,” keep diaper below cord until it falls out (10-14 days)
- slight bleeding for day or 2 after it falls off
- belly bands and alcohol on cord not recommended
- call if bad smell, redness, or fluid from cord arise
145
what to do with used formula
put unused formula back in refrigerator and don’t mix with new formula
-if heated and left out for 1+ hours, discard it
146
when can you start taking a baby's temperature by ear or mouth
4 y/o
| otherwise use rectal temp
147
what is considered a fever
100.4F/38.0C is considered fever
148
when are skin rashes common
4 and 8 weeks
149
When do you advise tummy time and why is it recommended
1-2 weeks f/u
Babies need “tummy time” to stimulate muscle development & prevent development of flat area on back of head
150
anticipatory guidance 1-2 weeks:
| when do babies go through growth spurts
6 and 8 weeks
*may require more milk at this time
151
2 month anticipatory guidance for babe's position
-Back to sleep and prone to play
152
2 month anticipatory guidance for how often the baby should eat
- Baby still needs to eat every 2-4 hours but can go one longer stretch of 4-5 hours without feeding
- By 3 months, breastfed infants feed every 2-3 hours; if receiving 6-12 feedings in 24 hours, may have one longer stretch of 4-5 hours at night between feedings
- Formula-fed babies feed every 3-4 hours with one longer stretch at night of up to 5 or 6 hours at night between feedings
153
4 month anticipatory guidance:
| signs baby is ready to eat solid food
- fading of tongue thrust reflex (pushing food out of mouth)
| - can raise tongue to move pureed food to back of mouth and opens mouth when spoon approaches
154
anticipatory guidance:
| when does baby's eye sight improve
baby’s vision gradually improves during 1st year of life
| - by 6 months, should be able to follow parent around room with eyes
155
Anticipatory guidance:
Baby’s gross motor skills (ability to control head and body parts and to move around) will rapidly develop during next 3 months
9 months
156
Anticipatory guidance:
| Children ____ years old shouldn’t watch TV, DVDs, or videos, or use computer products
under 2 years old
157
Anticipatory guidance:
| typical for baby’s growth to slow down
6 months
158
```
anticipatory guidance:
brief timeout (1-2 minutes) or until undesirable behavior stops
```
12 months
159
should continue to have at least one nap during day
12 months
160
Get child to dentist by ____ or after first tooth
12 months
161
rear facing carseat for 12 month y/o
- up to 30 pounds and 32 inches for infant only
| - up to 35 pounds and at least 36 inches for convertible seats
162
anticipatory guidance:
| Never make fun of fear; don’t force them to confront people who scare them
15 months
163
anticipatory guidance:
| Toilet training readiness – recognizing signs of readiness, parental expectations
18 months
164
anticipatory guidance:
| Wait to start toilet training until toddler is dry for periods of about _____
2 hrs
165
anticipatory gudiance:
| Encourage child to play with other children but don’t expect them to share play or toys yet
24 months
166
Children use toilet more frequently than adults, often up to _____ times a day
10 times a day
167
Limit TV watching to no more than _____
1-2 hrs a day
168
anticipatory guidance:
| Preschool considerations – readiness for early childhood programs, playgroups, or playdates
2.5 yrs old
169
anticipatory guidance:
| Encouraging literacy activities – singing, talking, describing, observing, reading
3 y/o
170
anticipatory guidance:
School readiness – structured learning experiences, opportunities to socialize with other children, fears, friends, fluency
4 y/o
171
anticipatory guidance:
Engage child by pointing out letters, particularly ones that begins their name if they show interest in words and play with sounds by making rhymes of real and nonsense words
4 y/o
172
anticipatory guidance:
| Anticipate child’s normal curiosity about their body and differences between sexes*
4 y/o
| *use correct terms for genitals
173
anticipatory guidance:
Explain to child that certain parts of body (those normally covered by bathing suit) are private and shouldn’t be touched by others without their permission
4 y/o
174
PE:
Genitals: testes
fully descended
1 year
175
when do you first calculate BMI
2 y/o
176
participates in parellel play
2 y/o
177
when you start measuring height standing?
2 y/o
178
when do you attempt opthalmoscopic exam
3 y/o
179
start checking BP at what age
4 y/o
180
PE:
| Developmental structured develop mental screening (universal)
2.5 y/o
181
PE:
Visual acuity: objective measure using HOTV tumbling E test; snellen letters and numbers orpicture tests (Allen figure or LEA symbols)
3 y/o
182
assign chores
5 y/o
183
physical Exam: Neurologic: evaluate tone, strength, and symmetry of movements; elicit parachute reflex
9 months
184
physical exam: Parachute reflex (arms go forward as if to catch a fall forward) to check for hemiparesis
9 months
185
screening: Screening: TB (S): positive risk screening questions; TB skin test
6 months
186
physical exam: Torticollis (head tilt) metatarsus adductus (food deformity)
2 months
187
Physical Exam: Eyes: assess ocular mobility for lateral and horizontal gaze
6 months
188
Screening: Vision (S): parental concern, abnormal fundoscope exam, or abnormal cover/uncover test; refer to ophthalmology
9 months
189
Physical exam:Head: palpate fontanel
2 months
190
1-2 weeks:
| how many stools per day
3 or 4 stools perday
191
Some children may go through period of nigh waking; briefly visit with reassurance
15 months
Pediatric Growth and Development
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