dev milestones
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Developmental Milestones-An overview
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Illingworth 1987
Development is continuous from conception to maturity and its sequence is the same in all children,though its rate varies from one child to another
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Developmental MilestonesChildren develop from being totally dependent newborns to independent individuals by the acquisition of skillsRange of normality in the acquisition of skillsDevelopment follows an orderly process in a cephalic to caudal direction
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PrinciplesListen to parents-partnershipMay need to see a child a second timeOpportunistic pick upThe state of the child-take into accountDistinguish between developmental items reported and those observed
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Routine Child SurveillanceNewbornSupine(6-8wks)Sitting(6-9 mths)Mobile toddler(18-24mths)Communicating child(3-4yrs)
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Developmental Milestones4 fields with a sequence of developmentGross Motor - the development of locomotionVision and fine manipulation - the development of eye-hand controlHearing & speech - the devt. of languagePersonal & social - integration of acquired abilities to reflect understanding of env.
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Developmental MilestonesBirthprone: pelvis high, knees under abdo6-8 weekssmiles to maternal overtures fixes & follows prone: pelvis flat, hips extended ventral: briefly holds head up3 monthsholds head up, good eye contact holds rattle in hand turns to sound ear level
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Developmental Milestones4-5 monthsable to reach out for object6 monthstransfers hand to hand Chews, babbles sits with hands forward lifts head spont from supine10 monthsindex finger approach finger thumb appositionwaves bye-bye,
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Developmental Milestones13 monthscasting objects walks without support single words15 monthsfeeds self from cup domestic mimicry 18 monthscasting stops ,tower of 3 Walking well, scribbles
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Developmental Milestones2 yearsjoins 2/3 words, 50 wordsRuns well,climbs, stairscubes tower 6 or 73 yearsmainly dry by day+/- night dresses & undresses fullystairs - alternate feetrides tricycle
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Developmental Warning Signs - at any ageFHx of note eg deafness, cataractsMaternal concernPersistent primitive reflexesPersistent squintDiscordance in developmental abilities in different areasRegression of previously acquired skills
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Causes of Delayed Development(Correct for Prematurity)Idiopathic: constitutional, familial (affecting one field & catching up later)DeprivationIntellectual disabilitySpecific abnormality eg Blind, deaf, cerebral palsy
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Causes of arrested/deteriorating developmentCommonEmotional deprivationIntercurrent illness eg malabsorptionAcute cerebral injury eg encephalitis, traumaSeizures: uncontrolled, prolongedDrugs eg phenytoin excess
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Causes of arrested/deteriorating developmentUncommon/rareHydrocephalusMetabolic eg hypothyroidism, lead poisoningDegenerations- Infections: AIDS, SSPE - Genetic: Wilsons Dx Huntingtons Chorea, Lysosomal storage dx
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Developmental Milestones - Delayed Motor DevelopmentFamilial featureEnvironmental - deprivation, practiceMental subnormalityHypotonia (Downs Syn)Hypertonia (Cerebral Palsy)Neuromuscular problems (DMD)Bottom shufflingVisual impairment
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Developmental Milestones - Summaryordered process of developmentrange of normality in acquisition of skills - bands of normality - delayedrelevance of delay variesearly detection of delayed development desirable for maximum intervention and for parental acceptance
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Video
Developmental examination of a child from birth to 18 months
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