Paediatrics

Question 1

What is childhood development defined by?

Answer 1

The acquisition of psychomotor skills

Question 2

What 4 domains is development assessed in?

Answer 2

Motor skills, Speech and Language, social and emotional and cognitive

Question 3

What is developmental delay?

Answer 3

Delay in meeting milestones in comparison to peer group under the age of 5

Question 4

What is the definition of a significant delay ?

Answer 4

A delay of >2 standard deviations below the mean

Question 5

What is the definition of a severe delay?

Answer 5

Functional age < 66% of chronological age.

Question 6

What is global developmental delay?

Answer 6

Functional age < 66% of chronological age in more than 2 or more developmental domains

Question 7

What is a learning disability?

Answer 7

Developmental delay beyond the age of 5.

Question 8

What are the risk factors of transient developmental delay?

Answer 8

Illness and social factors

Question 9

What can minimise the impact of development delay on a child’s future learning and social development?

Answer 9

Early recognition and intervention

Question 10

What are the causes of developmental delay?

Answer 10

Exogenous, genetic non- metabolic, genetic metabolic disorders

Question 11

Give examples of exogenous causes of developmental delay

Answer 11

Teratogenic e.g. elicit drugs
Perinatal and prenatal e.g. asphyxia
Postnatal neurological insult e.g. hypoglycaemia
Psychosocial - starvation

Question 12

Give examples of genetic, non- metabolic causes of developmental delay

Answer 12

Chromosomal syndromes e.g. Down syndrome
Autosomal dominant disorders e.g. tuberous sclerosis
X-linked e.g. fragile X syndrome

Question 13

Give examples of genetic metabolic causes of developmental delay

Answer 13

Inborn errors of metabolism e.g. homocystinuria

Question 14

What should a developmental delay history centre on?

Answer 14

Postnatal history, maternal illness, personal child health record, prenatal, perinatal history, a social and family history.

Question 15

What should a clinical examination of developmental delay entail?

Answer 15

A detailed examination to assess whether a child has achieved age appropriate milestones.

Question 16

By 2 months what milestones should a child have reached?

Answer 16

Fixes and follows ( S+L)
Smiles in response ( SEC)

If not present by 3 months - this is a RED FLAG

Question 17

By 3 months what milestones should a child have reached?

Answer 17

Loss of head lag (GM)
Lifts head in prone and ventral suspension (GM)
Turns to sound (S+L)

Question 18

By 6 months what milestones should a child have reached?

Answer 18

Uses palmar grip (FM)
Transfers from hand to hand (FM)
Reaches for toys (FM)
Vocalises (S+L)
Social response (SEC)
Shows interest in toys (SEC)

Presence of moro reflexes and head lag at 5 - 6 months = abnormal development

Question 19

By 9 months what milestones should a child have reached?

Answer 19

Crawls (GM)
Sits unsupported (GM)
Uses pincer grip (FM)
Babbles (S+L)
Waves goodbye (SEC)
Plays games such as pat- a -cake (SEC)
Develops stranger anxiety (SEC)

If not present by 10 months = RED FLAG

Question 20

By 12 months what milestones should a child have reached?

Answer 20

Weight bears on pull to stand (GM)
May be cruising or walking (GM)
Releases objects with good control (FM)
Says 2 or more clear words (S+L)
Communicating with gestures such as pointing (SEC)
Indicating their wants - shaking head for no (SEC)
Uses toys for their purpose (SEC)
Develops object permanence (SEC)

If pincer grip not present by 12 months = RED FLAG

Question 21

By 18 months what milestones should a child have reached?

Answer 21

Walks independently (GM)
Stacks 2 or 3 building blocks (FM)
Knows up to 10 words (S+L)
Engages in symbolic play (feeding dolls) (SEC)

If not walking and not able to say 15 words by 18 months = RED flag - require urgent referral to audiology

If hand preference is shown before 1 year old = RED FLAG

Question 22

By 2 years old what milestones should a child have reached?

Answer 22

Runs and jumps (GM)
Kicks and throws a ball (GM)
Knows 50 - 100 words (S+L)
Joins 2 words together (S+L)
Engages in pretend play (SEC)

Question 23

By 3 years old what milestones should a child have achieved?

Answer 23

Climbs stairs with alternate feet (GM)
Descends with both feet on one step (GM)
Walks in a straight line (GM)
Builds towers of up to 10 blocks (FM)
Copies a circle (FM)
Forms short sentences (S+L)
Can be understood by strangers (S+L)
Using personal pronouns to refer to themselves (SEC)
Interested in playing with other children (SEC)
Asking questions (SEC)

Question 24

By 4 years old what milestones should a child have achieved?

Answer 24

Uses tripod grasp to hold pencil (FM)
Engages in role play (SEC)
Distinguishes friends (SEC)

Question 25

By 5 years old what milestones should a child have achieved?

Answer 25

Stands on one leg (GM)