Infants
What are fontanelles and when do they close?
soft spots normally present on the skull of a newborn
anterior fontanel closes ~14 months
posterior fontanel closes by 6-8 weeks of age
Toddler growth?
weight gain is 4-6 lbs per year
birth weight is quadrupled by 2.5 years of age, height increases about 3 inches/year
growth is "steplike" rather than linear
Causes of speech problems
hearing deficits, developmental delays, and physical conditions that impede normal speech production
What is Enuresis and Encopresis?
Enuresis: wetting bed 2x/week for more than 3 months. Has to be at the development age of > 5 years (so if they have a development age of 4 and can’t progress (ex disability), then this isn’t classified as enuresis.
Encopresis: a childhood disorder characterized by repeated defecating in inappropriate places, such as one's clothing. More common in males. May follow psychological stress. May be secondary to impaction/constipation.
Things to do when interviewing an adolescent?
ensure confidentiality and privacy
explain the limits of confidentiality (ex: suicidal)
show concern for the adolescent's perspective
offer a nonthreatening explanation for the questions you ask
maintain objectivity and avoid assumptions and judgments
ask open-ended questions
Growth changes in infants?
gain 5 to 7 ounces of weight gain every week
DOUBLE birth weight by age 6 months, TRIPLE birth weight by age 1 year
growth occurs in "spurts," rather than gradually
What are the common illnesses in this age group and why?
otitis media, tonsillitis, upper respiratory infection (URI)
occur because the internal structure of the ear and throat continue to be short and straight
Preschooler fine motor skills
3 yrs: can copy a circle, imitate a cross, and scribble
5 yrs: pictorial stage such as stick figures
Causes of stress in the school-age child?
school experiences are second only to the family as a social agent
peer relationships are increasingly important!!
stress may result in: regression, violence, acting out, sleep problems, bedwetting, not eating enough, or saying "my tummy hurts"
What are the 2 common eating disorders seen in this age group?
anorexia nervosa (AN) and bulimia
Infant fine motor development?
2-3 months: grasps objects purposefully
6-7 months: transfers object between hands
10-11 months: pincer grasp (thumb & index finger)
11 months: removes objects from container
12 months: builds tower of TWO blocks
Which Erikson and Piaget's stages are this age group on?
Erikson: ages 2-3, Autonomy vs Shame and Doubt (events that happen in this stage, toilet training)
Piaget: ages 2-7, preoperational (young children are able to think about things symbolically. Their language use becomes more mature. They also develop memory and imagination, which allows them to understand the difference between past and future, and engage in make-believe)
Preschooler gross motor skills
3 yrs: ride a tricycle, walks on tiptoes, and broad jumps
4 yrs: skips, hops on one foot, catches a ball
5 yrs: skips on alternate feet, jumps rope, skate, and swim
What are latchkey children?
children who care for themselves after school
they are left to care for themselves without adult supervision... they are often isolated and lonely
Tanner stages?
a widely used system that describes the five stages of pubertal development
numbered from stage I (immature) to stage 5 (mature)
based on breast size and the shape and distribution of pubic hair
Infant gross motor development?
1 month: head lag is present
2 months: partial head lag is present
4 months: head lag is absent
5-6 months: rolls over
8 months: sits erect without support
10 months: pulls self from prone to sitting position
Toddler fine motor development?
12-18 mo: turn pages in a book
15 mo: drop a pellet into a narrow-necked bottle
18 mo-2 yr: builds tower of 4 blocks
What is the main form of play in this age group?
associative play
Children interact, observing each other and sharing material, but their play is not yet mutual and reciprocal
Puberty: what is it and when does it occur?
the period of sexual maturation, during which a person becomes capable of reproducing
begins around 12 years (girls) and 14 years (boys)
Adolescent growth spurt
takes place over a 24-36 month period
usually peak rate at 12 years in girls and 14 years in boys
the final 20-25% of linear growth is achieved
Infant locomotion (walking/crawling)?
7-9 months: crawling (propelling forward with belly on the floor)
9 months: creeping (propelling forward with belly off the floor, on hands and knees)
11 months: cruising (walk with an assist)
11-12 months: pull to stand (if not accomplished by 1 year of age, think HIP DYSPLASIA)
12 months: walks independently
Temper tantrums: how to handle them?
tantrums are linked to anger and distress
should last 15 minutes or less, should not occur more than 5x a day, and shouldn't happen in children older than 5
reinforce with consistency and expectations... starting at 18 months, time-outs work well
provide realistic expectations, and remove the child from public if necessary
offer the child options instead of "all or none"
Preschooler growth
physical growth slows and stabilizes
slender but sturdy, graceful, agile, and posturally erect
weight: gain about 4.5-6.5 lbs per year
height: increases at about 2 to 3 inches per year
Kohlberg: Moral Development
Development of conscience and moral standards
Age 6 to 7: Understand there are rules but unclear as to the reasons they have them. Might judge mishaps or accidents as punishments for misdeeds or “bad” acts
Older school-age: able to judge an act by the intentions that prompted it rather than by the consequences. Rules of conduct are considered more of a mutual agreement and are based on the respect of others
Erikson Adolescent (early and late)
Group identity vs. alienation
Early adolescent: Pressure to belong to a group. Try to “fit in” with peers
Personal identity vs. role diffusion
Late adolescent: Body awareness/Self-awareness. Positive and Negative Roles-may be influenced to be someone he or she is not just to please others