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| Two types of pediatric screening |
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Definition
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| developmental assessment performed when? |
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| 2 mechanisms of administration of pediatric screening |
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| most widely used test in the pediatric setting |
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Definition
| Denver Developmental Screen II |
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| when is the Denver Developmental Screen used, what domains does it assess? |
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Definition
1-6 months
fine and gross motor skill, language, and social skills. |
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| parent administered screen, assesses gross and fine motor, problem solving, and social skills. |
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Definition
| Ages and Stages Questionnaire |
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gross motor development:
2 months
6 months
12 months |
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Definition
2 = cradled in parent's arms
6 = sitting on the parent's lap or on the exam table requiring minimal trunk support.
12 = cruising or toddling through the room.
Abnormality when 6 month old shows poor head control with pull-to-sit maneuver |
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Term
| involuntary muscle reaction to a stimulus |
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Definition
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Term
| resolves as a child grows, presence later than usual is a sign of brain or nervous system damage. |
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4 months
performed by placing the child's head and neck off of a flat surface with arms folded at chest and releasing head. Pt brings arms back torward chest with hands in a C |
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Definition
| upper motor neuron lesion |
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3 months
occurs when pressure is applied to the palm surface of the child's hand |
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7 months
child adducts legs across midline. |
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8-15 months
occurs when pressure is applied to the plantar aspect of the child's foot |
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Term
| Asymmetric Tonic Neck Reflex (ATNR) |
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Definition
6 months
child is turned to one side, extensor mm tone incrases on that side and in the flexor mm tone on the opposite side "fencer position" |
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persists
Child keeping head vertical despite a tilt of the body |
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persists
as child is pushed laterally by the examiner, he flexes his trunk toward the force to regain center of gravity |
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persists
examiner allows the child to free fall in vertical suspension, child's extremities extend symmetrically to distribute weight over a broader more stable base on landing. |
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| occurs when the child's foot feels a hard surface |
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Term
| Galant Reflex (trunk incurvation) |
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Definition
| occurs when the pt is palced in ventral suspension and one side of the trunk is stimulated. Child's trunk and hips swing toward the side of the stimulus. |
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Definition
| occurs when a child is placed prone after 4-6 months of age |
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Definition
| child has a strong sucking association |
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Definition
| child opens mouth once it is stimulated on the corner of the mouth/cheek |
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2-3 months
extension of the head, then trunk, then legs when held prone |
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| normal for first 12 months. |
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| focuses on face and tracks vertically and horizontally, turns toward light, widens eyes at 8-12 inches |
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| blinks at approaching objects, tracks 60 deg horizontally and 30 deg vertically |
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| tacks across midline, follows movement, raises head to 30 deg from prone position |
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| eyes and head track 180 degrees, looks at hands |
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| notes visual details, pokes at holes in pegboard |
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| stacks blocks, places peg in round hole |
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| holds head up and turns head to side while prone, flexes in ventral suspension, moves in reponse to sound, primitive reflexes present, Doll's eye movement, visually fixes, regards face, tight grasp, follows object to midline. |
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| lifts head to 45 degrees while prone, head and trunk level in ventral suspension, head lags on pull to sitting, holds head midline, lifts chest off table, visually tracks moving objects 180 degrees, smiles on social contact, responds to voice, coos, recognizes parent |
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| lifts head up to 90 degrees, supports self on forearms in prone position, holds head up steadily while in prone, fingers and toes make pre-reach movements, holds hands open at rest, looks at hands, coos, reaches for familiar people, anticipates feeding, anticipates feeding |
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| raises head vertically when prone, sits with truncal support, head tipped forward = no head lag, rolls overs, supports on wrists, and shifts weight, grasps objects = brings to mouth, active at site of food, laughs/orients to voice, displeased when social contact is broken, enjoys looking around |
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| lifts head while supine, rolls front to back and back to front, sits wih pelvic support, rounded back, grasps and transfers objects, rakes at pellet, puts feet in mouth in supine position, turns body to extend reach, raking grasp, transfers objects, makes repetitive vowel sounds, babbles, discriminates social smile, prefers mother, recognizes strangers |
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| sites alone with back straight, pivot when sitting, pulls to stand, creeps or crawls, walks with hands held, fine pincer grasp, alert to sound of name, understands "no", waves "bye bye", uncovers hidden objects, plays peek-a-boo, repeats consonant sounds says "mama, dada" |
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| stands without help, walks with one hand held, cruises, releases on requesnt and gesture, neat pinker grasp, puts 2 cubes in a cup and pellets into bottle, uses 2 words other than mama/dada, throws a ball, imitates actions, comes when called, cooperates with dressing |
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| walks alone, can walk backwards, crawls up stairs, scribbles in imitation, makes tower of 2 cubes, indicates some wishes by pointing, uses 4-6 words, follows one step command with gesture, can use a spoon and cup |
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| walks downstairs assisted, runs stiffly, sits on small chair, feeds self, kisses parents with pucker, says "no", knows 7-20 words, makes tower of 3 cubes, scribbles spontaneously, turns 2-3 pages at a time, masture jargoning, copies parents in tasks, identifies 5 body parts, names pictures, explores drawers and waste baskets |
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| walks stepwise up and downstairs without help, jumps in place with both feet off, uses "i" and "you", 3 word phrases, 50 word vocabulary, understands 2-step commands, listens to stories with pictures, makes tower of 7 cubes, circular scribble, opens doors, handles spoon, turns pages one at a time, removes shoes, pants, etc, parallel play |
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| thows ball overhead, unbuttons, holds pencil in adult fasion, differentiates horizontal and vertical line, uses pronouns appropriately, understands concept of "1", repeats 2-digits forward, tells first and last name when asked |
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| can alternate feet when going upstairs, pedals tricycle, copies circle, undresses completely, dresses partially, unbottons, dries hands if reminded, uses min of 250 words, 3 word phrases, uses plural, past tense, knows all pronouns, understands concept of "2", group play, shares toys, takes turns, plays well with others, knows full name, age, gender |
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| hops, skips, alternates feet when going down steps, copies a square, buttons clothing, dresses self completely, catches a ball, knows colors, says song/poem from memory, asks questions, tells "tall tales", plays cooperatively with a large group of children |
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| skips alternating feet, jumps over low obstacles, copies triangles, ties shoes, spreads with a knife, prints first name, asks what a word means, plays competitive games, abides by the rules, likes to help in household tasks |
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Definition
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Term
| Behavioral Pediatrics involves these 3 diagnoses |
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Definition
| ADHD, ODD, Temper Tantrums |
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| most common neurobehavioral disorder of childhood |
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Definition
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| early intervention services |
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| 3-21 years, evaluation repeated every 3 years |
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| Individual Education Plan (IEP) |
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| individualized plan, quarterly progress report required, updated annually |
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| mainstay of treatment for ADHD |
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Definition
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| inattentive, hyperactive/impulsive, combined |
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| gold standard for dx of ADHD |
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Definition
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| repetitive/consistent patterns of behavior that violates human rights and lacks empathy, remorse, or awareness that what he did is wrong |
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| < 10 years old boys>girls |
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| child cries and harms him/herself to manipulate the parents |
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Definition
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| child holds his breath and suddenly loses consciousness |
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Definition
breath holding spells
cyanotic = MC, related to temper tantrums.
Pallid follows a painful experience. |
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Term
| group of disabilities that have significant difficulties in one or more of the following areas: basic reading skills, reading comprehension, oral expression, written expression, mathematical calculation, mathematical reasoning |
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| high-level language difficult not a visual or visual-motor problem |
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| group of disorders characterized by delays in the development of socialization and communication skills |
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Definition
| Pervasive Developmental Disorder (PDD) |
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Term
| occurs before age 3 with 3 core characteristics: impairment of scoial interactions, impairment in communication, repetitive/restrictive/sterotyped behavior |
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Definition
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1 = abnormal signs from early infancy.
2 = normal development in infancy and in the 2nd yaer of life shows regression of social and communicative skills. |
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| increased head circumfrence associated with |
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| Autism associated with these other disorders (3) |
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Definition
| Fragile X syndrome, Rett Syndrome, Tuberous Sclerosis |
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Term
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Definition
CAST 4-11 years
CHAT 18 to > 24 months
M-CHAT 16-48 months
PDDST II = 18-48 months |
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| impairment of social interactions and restricted repetitive patterns of behavior. MC in boys. Fail to develop peer relationships and display an inability to express pleasure in the happiness of others. |
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Definition
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| Normal development in the first 6 months of life, usually in females. Exhibit symptoms of Autism, receptive and expressive language delay, psychomotor retardation, decreased head growth, breathing abnormalities, seizures, poor coordination of gait/trunk movements. |
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Definition
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Term
| appears in early or middle childhood as oppositional defiant behavior. 2 major subtypes: childhood onset, adolescent onset. |
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Definition
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Term
| when can conduct disorder be diagnosed? |
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Definition
less than 10 yo with 1 criteria.
after 10 yo with 3 criteria. |
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| defiance of rules and argumentative verbal interactions |
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Definition
| Oppositional Defiant Disorder |
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Term
| deliberate aggression, destruction, deceit, and serious rule violations, such as staying out all night or chronic school truency |
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Definition
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Term
| gold standard for dx of snoring vs. obstructive sleep apnea |
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Definition
| polysmonograophy (sleep study) |
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Term
| absence of oronasal airflow in the presence of continued respiratory effort, lasting longer than 2 respiratory cycles. Usually but not always associated with hypoxemia. |
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Definition
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| Cessation of respiratory effort lasting at least 2 repsiratory cycles with O2 desat. |
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Definition
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| decreased breathing associated with a 30% or greater reduction in airflow, usually associated with paradoxical breathing and O2 desat. |
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| signs must be present for how long to dx depression |
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| 2nd leading cause of death among adolescents 15-24 years of age in the US |
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| unexpected, repeated period of intense fear and discomfort along with somatic symptoms such as incrased HR and SOB. Also may have trembling, dizziness, and fear of losing control. |
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| hungry but restricts food intake |
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| vomits usually within 2 hours of overeating due to over-concern of weight gain |
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| eliminates food by vomiting or laxative |
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| manic episodes alternating with depression episodes and normal moods. |
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| 3 meds used to treat bipolar |
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Definition
| lithium, tegretol, depakene |
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| potentially lethal and frequently misunderstood form of child abuse. Often associated with poisoning or suffocation. |
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Definition
| Muchausen Syndrome by proxy |
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