Lecture Notes: Pediatric Development and Screening

Introduction

• Speaker: Bergen, a general pediatrician at UCLA
• Disclaimer: Not a developmental behavioral pediatrician
• Time management: Condensed information, interactive session
• Adjustments: Fewer screening tool sessions due to unavailability of Paul Chung

Developmental Domains

• Social
• Language (Expressive and Receptive)
  • Expressive: Spoken language and gestures
  • Receptive: Understanding spoken language and cues
• Motor
  • Gross Motor
  • Fine Motor

Gross Motor Development

• Newborn: Head movement side to side, sucking reflex, rooting reflex
• 1 Month: Lifting head
• 2 Months: Shoulders up
• 3 Months: Chest and elbows, head and shoulders lift
• 4 Months: Up on wrists, rolling over (front to back)
• 6 Months: Sitting, tripodding
• 12 Months: Walking
  • Preceded by crawling, pulling to stand, cruising

Fine Motor Development

• Newborn: Fists
• 1 Month: Eye tracking
• 4 Months: Bringing hands to midline, mouthing, reaching
• 6 Months: Raking grasp, transferring objects between hands
• 9 Months: Immature pincer grasp
• 12 Months: Mature pincer grasp, pointing

Language Development

• Newborn: Crying
• 2 Months: Cooing
• 4 Months: Ah-gooing
• 6 Months: Babbling with consonants
• 9 Months: Mama and Dada (non-specific)
• 12 Months: Specific words
• 2 Years: Two-word combinations, 50% intelligibility
• 3 Years: Small sentences, 75% intelligibility
• 4 Years: 100% intelligibility, using past tense

Social Development

• Newborn: Gaze at faces
• 2 Months: Social smile
• 3-4 Months: Laughing
• 9-10 Months: Stranger anxiety, object permanence
• 12-15 Months: Joint attention, social referencing

Developmental Screening

• Prevalence of developmental disabilities: 10-15%
• Screening tools: Surveillance vs. Screening
• Recommended screenings at 9, 18, 24, or 30 months
• Specific autism screening: M-Chat

Autism Spectrum Disorder (ASD)

• Diagnostic changes: DSM-5
  • Social communication impairment
  • Restrictive/repetitive behaviors
• Prevalence: 1 in 68 children, more common in boys
• Diagnostic tools: M-Chat, ADOS
• Treatments: Behavioral therapies like ABA

Attention Deficit Hyperactivity Disorder (ADHD)

• Core symptoms: Hyperactivity, impulsivity, inattention
• Subtypes: Hyperactive, inattentive, combined
• Diagnosis: Vanderbilt tool
• Treatments: Medications, behavioral therapy

Postpartum Depression

• Baby blues vs. Postpartum depression
• Prevalence: Up to 25%
• Screening tools: Edinburgh Postnatal Depression Scale, PHQ-2 and 9
• Resources: Maternal Mental Health Now

Conclusion

• Emphasis on early detection and intervention
• Encouragement to utilize available resources and support systems