Pediatric Development

Front 1

neonates

Back 1

-alert and are able to interact
-are near sighted and are able to see 8-12 inches
-have a preference for human faces
-preference
-distinguish moms voice from other females within several hrs of life
-distinguish moms smelln

Front 2

newborn infant- growth

Back 2

-avg newborn 3.4 kg (7.5 lbs)
-avg length 20 in
-newborn head larger, chest rounder, abd more prominent
-"rooting" for nipple, suck ,gag, swallow

Front 3

APGAR score

Back 3

-slide 6
-done 1 min after birth and 5 min

Front 4

Ballard scoring system

Back 4

-to eval gestational age
1. Neuromuscular maturity:
-posture, square window, scarf sign, heel to ear, arm recoil, popliteal angle
2. Physical maturity:
-lanugo, plantar creases, breast, eye, ear, genitals

Front 5

primitive reflexes

Back 5

-slide 9

Front 6

physical development- first yr

Back 6

-full term infants regain birthweight by 10 days
-double birthweight by 5 months
-triple birthweight by 1 yr
-daily wt gain 20-30 grams in first 3-4 months
-daily weight gain 15-20 grams for rest of first yr

Front 7

developmental milestones 1-2 months

Back 7

-Social: Smiles spontaneously, responsively
-Fine Motor: Follows past midline
-Language: Vocalizes
-Gross Motor: Head up to 45 degrees.

Front 8

developmental milestones 3-5 months

Back 8

Social: Regards own hand
Fine Motor: Reaches, brings object to mouth.
Language: Squeals, raspberry sound
Gross Motor: Bears weight on legs, sits with support

Front 9

emotional development 2-6 months

Back 9

-Trust develops as infants learn their needs are being met
-Become attached to trusted adult.
-Infants who are picked up and held when in distress cry less at 1 year and show less aggressive behavior at 2 years.
-At 2 months, social smile and increased eye contact makes parents feel they are being “loved back.”
-At 4 months, infant and trusted adult will match expressions 30% of the time. (eye widening, smiling, lip puckering)

Front 10

emotional development 2-6 months cont

Back 10

-Excitement builds, infant turns away, returns to interaction.
-If parent turns away, infant leans forward, reaches or tries to engage parent.
-Cries if not successful.

Front 11

cognitive development 2-6 months

Back 11

-at 4 months, infants beging to explore their own bodies (staring at hand, touching ears, cheeks, genitals)

Front 12

developmental milestones 6-8 months

Back 12

-Social: Wave bye-bye, indicates wants, separation anxiety from mom.
-Fine Motor: Thumb, finger grasp, bangs 2 cubes, passes object from hand to hand.
-Language: Dada, Mama, jabbers.
-Gross Motor: Stands holding on, pulls to stand, sits without support.

Front 13

developmental milestones 9-11 months

Back 13

-Social: drinks from cup, imitates activities, plays ball with examiner.
-Fine Motor: Puts block in cup, thumb and index finger to pick up pellet.
-Language: One word, follows simple commands (Come here. Give it to me)
-Gross Motor: Cruises, stands alone.

Front 14

cognitive milestones 6-12 months

Back 14

-everything in mouth!
-objects are picked up, inspected, switched hand to hand, banged, dropped, mouthed
-finding out what things are for
-at 9 months, infants realize that things exist when not seen. Look for things no longerin sight

Front 15

emotional development 6-12 months

Back 15

-Infants look from parent to stranger (known vs. unknown). May cling or cry. Separations cause anxiety.
-Autonomy is developing. May want to hold spoon, feed self.
-Tantrums when desire for autonomy conflicts with parental control.

Front 16

communication 6-12 months

Back 16

-At 7 months, infants good at non verbal communication.
-At 9 months, find that emotions can be shared between 2 people. (happily shows toy to parent)
-At 8-10 months, babble multiple syllables
-Sound referring to specific object or person.

Front 17

Denver developmental screening test

Back 17

-developmental screening for newborns through 6 yrs old
Personal/Social (smiling, spoon, fork, dress)
Fine Motor (reach, cube towers, copy shapes)
Language ( turn to voice, mama/dada, opposites)
Gross Motor (roll over, walk up steps, hop)

Front 18

developmental milestones- 1 yr

Back 18

-social: drink from cup, plays simple ball game
-fine motor: neat pincer grasp, scribbles
-language: mama, dada with meaning, 1-2 other words
-gross motor: walks independently, stoops and recovers

Front 19

physical development 12-18 months

Back 19

-growth rate slows in 2nd yr of life
-appetite declines
-"baby fat" burned due to increased activity/mobility
-most walk near 1st birthday
-wide based gait at first with knees bent, arms flexed
-after practice, greater balance

Front 20

cognitive development 12-18 months

Back 20

-toddlers reach for and grasp things
-stack blocks
-objects used for intended puposes
-make believe play

Front 21

emotional development 12-18 months

Back 21

-“Intoxicated” with power to distance themselves from parent.
-Explore but return to parents for reassurance

Front 22

linguistic development 12-18 months

Back 22

-Receptive language before expressive. Respond to “no” “bye-bye” and “give me”.
-First words around 12 months.
-By 15 months, point to body parts, 4-6 words correctly, including nouns.

Front 23

developmental milestones 18 months

Back 23

Social: Feeds self, seeks help when in trouble, kisses parents with pucker.
Motor: runs stiffly, sits on small chair
Language: Says 10-15 words, identifies body parts, names pictures.

Front 24

physical development 18-24 months

Back 24

-Motor development increases, better balance, agility.
-Start running, climbing.
-Height and weight increase at steady rate.
-Head growth slows slightly. (.25 cm/month)

Front 25

cognitive development 18-24 months

Back 25

-Cause and effect are better understood
-Flexibility in problem solving (ie: stick to reach toy)
-Object permanence is established (toddlers know where an object will be even if they did not see it moved.)

Front 26

emotional development 18-24 months

Back 26

-Prior independence become “clinginess”
-Child “attaches” to parent.
-Bedtime separations difficult.
-Blanket, toy to symbolize absent parent. Continues until symbolic presence of parent is internalized.
-Realize mirror is image of themselves.
-Give broken toy to parent to fix.
-Internalize standards of behavior. “No, no” when tempted to touch forbidden object.

Front 27

linguistic development 18-24 months

Back 27

-in this period, most dramatic developments are in language
-labeling of objects
-realization that words can stand for things
-vocab of 10-15 words at 18 months and 200 words at 24 months
-understand 2 step commands
-words become more impt in behavior control

Front 28

developmental milestones 24 months

Back 28

-social:Handles spoon well, helps to undress; Listens to stories with pictures.
-Motor: Runs well, up and down stairs one at a time, climbs on furniture, jumps, kicks ball.
-Language: Speech half understandable, puts 3 words together (subject, verb, object)

Front 29

preschool years 2-5 yrs of age

Back 29

-attachment and separation issues are reshaped
-social sphere widens
-alternate between exploration and dependence
-learn to adapt to rules and relationships in preschool setting

Front 30

physical development 2-5 yo

Back 30

-Growth of body and brain slows.
-Decreased nutritional requirements and appetite.
-Body becomes and leaner and abdomen flattens.
-Physical energy peaks.
-Less sleep is needed (11-13 hours) including 1 nap.

Front 31

gross and fine motor milestones 2-5 yo

Back 31

-Walk with mature gait, run well by end of 3rd year.
-Variation in ability to throw, catch, ride bicycle
-Handedness established by 3rd year.
-Bowel and bladder control during this period (avg. 30 mos.) Daytime bladder control precedes bowel control. Girls before boys.
-Bedwetting normal in girls to 4 yrs and boys to 5 yrs.

Front 32

language 2-5 years

Back 32

-develops rapidly
-vocab increases to >2000 words
-# of words in sentance = childs age
-By 4 years, child can count to 4 and use past tense. By 5 years, future tense used.
-Language indicates cognitive and emotional development. Developmental delays may become apparent due to speech delays at 2 years.

Front 33

cognition 2-5 yrs

Back 33

-characterized by
-Magical thinking-confusion of coincidence with causality ( carrying umbrellas causes rain, anger at person can make them sick)
-Animism- attributing inanimate objects with characteristics of living things
-Egocentrism- inability to see another’s point of view

Front 34

play 2-5 years

Back 34

-Play is increasingly complex. Acting out common themes (putting baby to bed at 2-3 years) to complex scenarios (trip to zoo at 3-4 years) to imaginary scenarios (trip to the moon at 4-5 years.)
-Play is rule governed.
-Aggressor role instead of victim (spanking doll)
-Taking on super powers

Front 35

emotional development 2-5 yrs

Back 35

-Challenges include: accepting limits while maintaining autonomy, controlling aggressive impulses, interacting with adults and peers.
-Children learn how much power they have by testing limits with adults.

Front 36

Temper tantrums 205 yrs

Back 36

-occur when internal controls are lost. If tantrums are intermittently reinforced, behavior becomes entrenched. Peak at 2-4 years.
-If >15 min. or >3X day, may be result of medical, social or emotional problems.

Front 37

developmental milestones 30 months

Back 37

-Social: Names friend, refers to self as “I”. Helps put things away.
-Fine Motor: Holds crayon in fist, vertical line, copies crude circle.
-Language: Knows two actions, carries on simple conversation.
-Gross Motor: Balances on each foot 1 second, walks backwards.

Front 38

developmental milestones 3 yrs

Back 38

-Social: Plays board games, brushes teeth without help.
-Fine Motor: Copies circle, tower of 8-10 cubes.
-Language: Speech all understandable, gives first and last name.
-Gross Motor: Balances 2 seconds, rides tricycle using pedals, dresses self.

Front 39

developmental milestones 3-4 yrs

Back 39

Social: Prepares cereal, takes off shoes and jacket.
Fine Motor: draws a person with 3 parts, begins to button and unbutton.
Language: Knows actions, prepositions, adjectives knows own sex, names 4 colors.
Gross Motor: Hops, balances on each foot 3 seconds.

Front 40

developmental milestones 4-5 yrs

Back 40

Social: Plays outside at least 30 minutes, self care at toilet.
Fine Motor: Copies + in imitation, copies square, draws person with 6 parts.
Language: Opposites, knows days of the week, “What do you do if you are sleepy, hungry?”
Gross Motor: Balances 6 seconds, heel to toe walk.

Front 41

middle childhood 6-12 yrs

Back 41

-Children separate from parents and seek acceptance from other adults (teachers) and peers.
-Self esteem important.
-judged on ability to "produce"
-pressure to conform

Front 42

developmental milestones 6-7 yrs

Back 42

-knows if morning or afternoon
-defines words by use
-copies a triangle
-draws person with 12 parts
-reads short sentences
-adds and subtracts 1 digit numbers

Front 43

physical development 6-12 yrs

Back 43

-Growth occurs in 8 week long irregularly timed spurts each year.
-Loss of deciduous (baby) teeth at about 6 years with eruption of 1st molars. Adult teeth 4 / year.
-Lymphoid tissue grows (tonsils and adenoids)
-Muscle strength, stamina and coordination increase.
-Sexual organs remain immature.

Front 44

cognitive and lang development 6-12 yrs

Back 44

-Conservation rules based on observable phenomena (clay ball made into snake)
-Can understand others’ point of view.
-By 3rd or 4th grade, children enjoy strategy games and word play.
-Have interests, hobbies.

Front 45

social and emotional development 6-12 yrs

Back 45

-Occurs in home, school, neighborhood. Home most influential. Parent-child relationship provides security for growth.
-Chores at home allow child to contribute to family.
-School increases separation from family and increases importance of teachers and peers.
-conformity is rewarded
-HEADS: Home Education and employment Activities Drugs Sexuality Suicide to assess functioning in all areas

Front 46

adolescence

Back 46

-wt almost doubles and height increases by 15-20%
-Girls reach peak height velocity between 11 ½ and 12 years.
-Boys reach peak height velocity between 13 ½ and 14 years.

Front 47

tanner stages

Back 47

1: prepuberty
2: Male genital development begins with testicular enlargement, scrotal skin reddens. In females, breast buds appear.
3: Penis lengthens in male. In females, enlargement of breast and areolar tissue.
4: In males, penis enlarges and scrotal skin becomes pigmented. In females, areola and nipple form separate mound from breast.
5: In males, genitals reach adult maturity. In females, areola assumes same contour as breast.