Child Development 6 weeks 2 years Child Development Centre Well - - PowerPoint PPT Presentation

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Child Development 6 weeks 2 years Child Development Centre Well - - PowerPoint PPT Presentation

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Child Development 6 weeks 2 years Child Development Centre Well Child Waikato Hospital Symposium 222 Pembroke Street Private Bag 3200 2019 Hamilton 3240 07 839 8726 www.waikatodhb.govt.nz/cdc What is child development? A

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Child Development 6 weeks – 2 years Well Child Symposium 2019

Child Development Centre Waikato Hospital 222 Pembroke Street Private Bag 3200 Hamilton 3240 07 839 8726 www.waikatodhb.govt.nz/cdc

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What is child development?

  • A predictable pattern of skills developed one after

the other, in a top to bottom sequence.

  • Reflects the growth and development of the brain

and central nervous system.

  • Brain development starts in 4th week of gestation

and continues into the third decade of life.

  • A milestone is the achievement of a key

performance skill.

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What is normal development?

  • Commonly divided into 4 domains:
  • Gross motor
  • Fine motor (and vision)
  • Language (and hearing)
  • Social, emotional and behavioural
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What is normal development?

  • The normal age at which milestones are achieved

can vary widely.

  • The median age is when 50% of children have acquired

the skill.

– Most parent information discusses the median age of developmental milestones » 50% of kids walk at 12 months

  • The limit age is when 98% of children have acquired the

skill.

– Most guidelines recommend referral at the limit age of developmental milestones. » 97.5% of kids walk at 18 months.

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What is normal development?

– As milestones become more complex, multiple domains may be involved

  • Feeding self – fine motor, gross motor, social

– There are a few normal variations of development

  • Bottom-shuffling to walking without crawling

– Often familial

  • Initial language delay in bilingual children
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Normal Development

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Normal Development

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Normal Development

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Normal Development

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Normal Development

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Normal Development

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Normal Development

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Abnormal development

  • Development can be affected by genetic and

environmental factors.

  • Positive social experiences in early childhood

support brain development.

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Abnormal development

– Developmental delay

  • Milestones achieved slower than the standard

population

– eg. Intellectual disability

– Disordered development

  • Abnormal pattern of milestone acquisition

– eg. Autism

– Developmental regression

  • Loss of developmental milestones/skills

– eg. Rett syndrome

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Abnormal development

How common are developmental problems?

  • Global developmental delay affects 1-3% of children

– up to 33,000 NZ children

  • Autism 1%

– >11,000 NZ children

  • Mild learning disability 1-2%

– up to 22,000 NZ children

  • Severe learning disability 0.3-0.5%

– up to 3,300 NZ children

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What do I do if I’m worried?

  • Parents Evaluation of Developmental Status

(PEDS) – Screening tool used to identify developmental and behavioural problems in 0-8 year olds.

  • Screening tools do not diagnose developmental
  • problems. They screen populations to determine who

requires further investigation.

– 10 questions that draw out parent concerns.

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PEDS

  • The language is
  • important. Please don’t

change the wording on the form unless using a translator.

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PEDS Form

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PEDS form

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Step 6-Pathways on PEDS Interpretation forms

Pathway A – two or more predictive concerns High risk of developmental delay. Refer on. Pathway B

  • one predictive

concern Repeat at next appointment. Pathway C – non-predictive concerns Low risk of developmental delay. Offer information and discuss strategies. Pathway D – parental communication difficulty Use an interpreter if appropriate. Pathway E – no concerns

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Supporting Child Development

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Supporting Child Development

– Use your senses

  • Touch, listen and look at objects (e.g.

sand, leaves and toys)

– Move about

  • Help your child move, push and pull
  • bjects

– Out and about

  • Go to libraries
  • Read books
  • Visit parks

– climb, throw and kick balls

  • Ride a bike

– Explore

  • Use a variety of things for your child to

explore and play with

– bubbles, pots and pans, play doh.

  • Cupboards are full of exciting things

– Talk and problem solve

  • Puzzles

– Use imagination

  • play out simple ideas and gradually

introduce different scenarios or roles

  • play with dolls/teddies/figurines
  • creatively use boxes or containers as

play objects (e.g. as a car)

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What to do next?

  • Why refer?

– Early identification and intervention improve the

  • utcomes for children with developmental

disability.

  • Preschool interventions are highly cost-effective.

– Provides parents and caregivers with reliable information. – Early detection of a genetic diagnosis may impact

  • n family planning.
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  • When to refer

– Any concerns about loss of skills (regression) – Unusual pattern of skill acquisition (disordered development) – Concerns flagged on screening tool (PEDS) and corroborated by observations and kindergarten information.

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Child Development Centre

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Child Development Centre

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  • Dr Sneha Sadani
  • Waikato DHB
  • NZ Ministry of Health
  • Queensland Health

Child and Youth Community Health Service

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Questions?