2-NORMAL & ABNORMAL DEVELOPMENT-F-SC-Med07.pdf

8/17/2019 2-NORMAL & ABNORMAL DEVELOPMENT-F-SC-Med07.pdf

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Normal Development

•The basic science of Pediatric is Growth & Development

•It is a continuous process from conception to maturity.

•

It depend on maturation &myelenation of nervoussystem.

•The sequence of development is the same but the rate

varies.

•Direction of development Cephalocodal.


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Fields of development


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Median and limit ages

• Median age: When half the populationacquire a skill; serves as a guide to normal

pattern of development.

• Limit age: When a skill should have been

acquired; further assessment is indicated if

not achieved.


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MENTAL &PSYCHOSOCIAL DEVEOP.

•

SOCIAL SMILE ----------- 40 dayes• LAUGHING--------- 2 months

• MOTHER RECOGNITION------- 4 months

• FATHER RECOGNITION--------- 9 months

• SPEECH At 1 year -----------2words +mama & dada

• DRAWING

------ at 3 y.

-------at 4 y.

------- at 5 y.


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Primitive reflex & equilibrium

responseReflex appearance Disappearance

Moro Birth 4 months

ATNR 2 weeks 6 monthsToe grasp Birth 8-15 months

Hand grasp Birth 3 months

X adductor Birth 7 months

Head writing 4-6 months Persist voluntary

Protective eq. 4-6 months Persist voluntary

Parachute 8-9 months Persist voluntary


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ATNR


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MORO


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Head support


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LOCOMOTOR DEVELOPMENT

Headsupport

sitting

stand walkrun

Go

Up

stair

s

Go

do

w

n


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D.M.S

Age G.M F.M.V Cog.Lan. Social

6 week Raise head Follow witheyes

startle Fix onface

3 mo Hold headup

Hand open Smil 2m .Coos

Recognisepar.(2)

4-5mo Rolls Sit sup Grasp Orient tovoise

Observ

surrouding

6 mo Sits Transfer Babbels Recognise st

9-12 mo Crawel,C,pto s (9) Wa

Pincer graspThrow

release

Dada/mama1-8word

Play Pate acake come

when called

18 mo Run Feed self Point to B.P Play around

24 mo Walksup&down

Removeclothing 5.B

Tow stepcommand

Parallel play


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> 6 months of age


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3- 4 months


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6 months


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7 months


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10 months


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3-4 months


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11 months


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DELAYED LOCOMOTOR

DEVELOP.

Head

support

sitting

standingwalking


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CAUSES OF DELAYED MOTORDEV.

• Normal motor deve. Abn. Dev. In

CNS

Systemic

environ.

musculo

skeletal

MRCP

RICK.MALNUT.

CHRONICSYSTEMDISORD.


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Developmental Delay

• Global D D: Delay in aquistion of all skill fields.

• Specific D D: When one Field of D. or skill area

is more delayed than other or devlop in

disorderd way.


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Causes OF D D & Learning Dif.

Prenatal

Genatic

Teratogenic

Metabolic

Cong infection

Neurocutaneous S.

Chromosomal disorderCerbral dysgensis

Alcohol & drug abuse

Hypothyrodism,Phenylketonuria

Rubella C MV

T S,N.F

PerinatalPrem

B.Asphyxia

Metabolic

I.V.H/Periven. Leukomalasia

H.I.E

Hypoglycemia

Postnatal

Infection Anoxia,Trauma

Met

Meingitis,EncephlitisSeizurres,Head injury

I.E.M

Other 25%


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Developmental Delay

• Developmental warning signs:

• 1.Family history, deafness, cataract.

•

2.Maternal concern.• 3.Dribbling.

• 4.Persisting O.A.T.R.

• 5.Persistent squint.• 6.Discordance in dev.abilities.Regression.


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Causes of D.D

• 1.Prematurity.

• 2.Idiopathic,Constitutional,familial.

•

3.Deprivation.• 4.Mental retardation.

• 5.Specific abnormalities.

• 6.Autistic spectrum.


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DEGREES OF MR

• Mild (IQ 70 -51) Educable

• Mod.(IQ 50-36) trainable

• Severe (IQ 35-20) minimal self care

•

Profound (IQ


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Diagnosis of MR

• History

• C/P (odd features )

• Eye ex. (cataract)

• Heart ex.(cong. Cyan. D.)• Head ex.(micr. & macro-cephally)

• Hepato-splenomeg.

• Lab screening tests (t3&4)-urine(red.sub.) urine(cyanide-fecl)

• Radiology


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Spastic child

neurological disorder


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6 Week old

•Gross motor: Head control(0-3 mo).

• Moro response

• Ventral suspension.

• Prone position

• Fine motor and vision : Stares

• Follow horizontally


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6 Weeks (con)

• Hearing & speech: Rattleor bell

• Startle response

• Social behavior: Smile socially

• Turn to regard

• Warning signs at 6 week:

• No visual fixation, Failure to respond to

• sound, Asymmetrical N.R, Ex Head lag, Nosm


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6-8 Months

• Gross motor: Wton leg

• Parashut response.

• Sits; pullto sit.

• crawl

• Fine motor & vision: Grasp

•Transfer.

• Follows fallen toys


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6-8 Months (cont)

• Hearing & speech: Vocalize.

• Babbling; laughs; Respond to own name

• Social behavior: Mouthing

• Hand foot regard; Play speek-apo-

• Warning Signs:

• Hand preference, fisting,

• Squint, Persistence of N.R


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12 Months

• G.M: Stand.

• Walk.

• Fine motor & vision: Point with index finger.

• Through; Pincer grasp;Hold2 object.

• Hearing& speech: Turn to sound; Mum & dad.

•

Social behaviors & play: Drink; Wave good-by


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18 Months

• Gross Motor: Climb stair.• Fine motor & vision: Scribbles

• Turn pages.

•

Hearing & Speech:Utter3 or more wordssentence.

• Point to body parts.

• Social: Holdspoon; Explore environment.

• Takes off choose; toiletneed


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2 years

• G.M: Climb & descends stairs; Jump; Kicks a

• Ball.

•

Fine motor & vision: Pick sup hundreds;Vertical line.

• Hearing& Speech: Uses pleural; Give name.

•

Social: Play alone; Eats with spoon & fork.• Puts on clothes. Dry through day


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Done by :

Daniah gareebA2-2

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2-NORMAL & ABNORMAL DEVELOPMENT-F-SC-Med07.pdf