Paediatric Development

Question 1

What is the normal development milestones of a 12 months old?

Answer 1

• Standing unsupported
• Pincer grip
• “Mama/Dada/No”
• Fear strangers

Question 2

What is the normal development milestones of a 18 months old?

Answer 2

• Stack 2 blocks
• Walk without help
• Anxious separated from parent
• Knows 6-12 words
• Scribbles

Question 3

What is the normal development milestones of a 2 years old?

Answer 3

• Link 2 words into sentences
• Understand 2-step commands

Question 4

What is the normal development milestones of a 3 years old?

Answer 4

• Use a tricycle
• 3-word sentences
• Constantly talk

Question 5

What are the primitive reflexes?

Answer 5

• Moro = startle reflex
  
  • Sudden drop → arms outstretched
• Stepping
• Rooting = turns head and sucks towards stimulus
• Palmar & plantar grasp = if palm is touched the baby will grasp
• Atonic neck = head turns if arm is extended
• Babinski = toes up and spread
  
  • Opposite to adults

Question 6

When do the primitive reflexes disappear?

Answer 6

• 2 months = Stepping
• 4 months = Rooting, Moro
• 4-5 months = Grasping
• 6-9 months = Babinski

Question 7

In what order does gross motor skills develop?

Answer 7

Head to Toe

Question 8

When do 50% of children develop head control and what is the upper limit of development?

Answer 8

• 50% = 1 month
• Upper limit = 4 months

Question 9

When do 50% of children sit unsupported and what is the upper limit of development?

Answer 9

• 50% = 8 months
• Upper limit = 10 months

Question 10

When do 50% of children stand with support and what is the upper limit of development?

Answer 10

• 50% = 10 months
• Upper limit = 12 months

Question 11

When do 50% of children walk independently what is the upper limit of development?

Answer 11

• 50% = 12 months
• Upper limit = 18 months

Question 12

When do 50% of children fix and follow and what is the upper limit of development?

Answer 12

• 50% = 6 weeks
• Upper limit = 3 months

Question 13

When do 50% of reach and follow and what is the upper limit of development?

Answer 13

• 50% = 4 months
• Upper limit = 6 months

Question 14

When do 50% of children transfer and follow and what is the upper limit of development?

Answer 14

• 50% = 7 months
• Upper limit = 9 months

Question 15

When do 50% of children polysyllabic babble and follow and what is the upper limit of development?

Answer 15

Bababababa or Lalalalala

• 50% = 5 months
• Upper limit = 7 months

Question 16

What is the upper age limit of development for consonant babble?

Answer 16

• 10 months

Question 17

What is the upper age limit of development for saying 6 words with meaning?

Answer 17

• 18 months

Question 18

What is the upper age limit of development for joining words?

Answer 18

• 2 years

Question 19

What is the upper age limit of development for 3 word sentences?

Answer 19

• 2.5 years

Question 20

When do 50% of children smile and follow and what is the upper limit of development?

Answer 20

• 50% = 6 weeks
• Upper limit = 8 weeks

Question 21

When do 50% of children fear strangers and follow and what is the upper limit of development?

Answer 21

• 50% = 7 months
• Upper limit = 10 months

Question 22

What is the upper age limit of development for 3 word sentences?

Answer 22

• 18 months

Question 23

When do 50% of children fear strangers and follow and what is the upper limit of development?

Answer 23

• 50% = 7 months
• Upper limit = 10 months

Question 24

When do 50% of children show interactive play and follow and what is the upper limit of development?

Answer 24

• 50% = 2.5-3 years
• Upper limit = 3-3.5 years

Question 25

What are the MRCPCH Developmental Milestones for a 6 week old?

Answer 25

* Gross motor * Good head control - *raise head to 45° when on tummy* * Stabilise head when raised to sitting * Fine motor / Vision * Tracks object/faces * Speech / Language * Stills * Startles at loud noises * Social * Social smile - *visual problem if not*

Question 26

What are the MRCPCH Developmental Milestones for a 6 month old?

Answer 26

* Gross motor * Sit without support with rounded back * Rolls from tummy to back - *vice versa slightly later* * Fine motor / Vision * Palmar grasp * Transfer hand to hand * Speech / Language * Turns head to loud noises * Understands “bye bye” / “no” * Babbles - monosyllabic * Social * Puts objects to mouth - *stops at 1 year* * Shakes rattle * Reaches for bottle / breast

Question 27

What are the MRCPCH Developmental Milestones for a 12 month old?

Answer 27

* Gross motor * Walks alone - 9-18 months * Fine motor / Vision * Can stack 2 blocks * Neat pincer grip * Casting blocks * Speech / Language * Shows understanding of nouns * 3 words * Points to own body parts * Social * Waves “bye bye” * Hand clapping * Plays alone if familiar person nearby * Drinks from beaker with lid

Question 28

What is the threshold for worry if a child can't walk along and what are the potential diagnosis?

Answer 28

18 months * Duchenne's MD * Hip problems * Cerebral palsy

Question 29

What are the MRCPCH Developmental Milestones for a 18 month old?

Answer 29

* Gross motor * Runs - 16 months * Fine motor / Vision * Draws to and fro * Stacks 4 blocks * Speech / Language * Shows understanding of nouns * 1 to 6 different words * Points to body parts on a doll * Social * Imitates every day activities

Question 30

What are the MRCPCH Developmental Milestones for a 2 year old?

Answer 30

* Gross motor * Runs on tiptoes * Walks upstairs - both feet on each step * Throws ball at shoulder level * Fine motor / Vision * Draws a vertical straight line * Stacks 8 blocks * Puzzle * \>2yrs = shape matching * \<2yrs = randond effort * Turns several pages of book at a time * Speech / Language * Shows understanding of verbs * 50+ word vocabulary * 2 words joined together

Question 31

What are the MRCPCH Developmental Milestones for a 2 and a half year old?

Answer 31

* Gross motor * Kicks ball * Jumping * Fine motor / Vision * Draws a horizontal straight line * Speech / Language * Shows understanding of prepositions in and on * 3 to 4 words joined together * Social * Eats skilfully with spoon

Question 32

What are the MRCPCH Developmental Milestones for a 3 year old?

Answer 32

* Gross motor * Hops on one foot for 3 steps * Walks upstairs - one foot per step * Walk downstairs - two feet per step * Fine motor / Vision * Draws a circle * Creates a bridge with blocks * Can perform single cuts with scissors * Uses Griffiths beads * Speech / Language * Shows understanding of adjectives * Understands negatives * Social * Begins to share toys with friends * Plays alone without parents * Eats with fork and spoon * Bowel control

Question 33

What are the MRCPCH Developmental Milestones for a 3 and half year old?

Answer 33

* Fine motor / Vision * Can cut papers into pieces using scissors * Speech / Language * Shows understanding of comparatives

Question 34

What are the MRCPCH Developmental Milestones for a 4 year old?

Answer 34

* Gross motor * Walks upstairs and downstairs in adult manner * Fine motor / Vision * Draws a cross, square (4.5) and triangle or person (5) * Creates steps with blocks * Can stack 12 blocks * Can cut paper in half with scissors * Uses small beads * Speech / Language * Shows understanding of complex instructions * Uses complex narrative/sequences to describe events * Social * Concerns/sympathy for others when hurt * Has best friend * Has bladder control * Engages in imaginative play * Observes play rules * Eats skilfully with little help * Dressing undressing without help

Question 35

What are the normal HR, RR and systolic BP in children?

Answer 35

Question 36

What are the protective reflexes?

Answer 36

* Neck righting = keep head perpendicular * 4 months → preparing for sitting and falling * Parachute = arms in front to protect head from fall * 9 months → preparing for walking and potentially falling