Insights on Pediatric Development and Health

Sep 3, 2024

Lecture on Pediatric Development and Behavioral Health

Speaker: Dr. Bergen, Pediatrician at UCLA

Introduction

  • Dr. Bergen introduced herself as a general pediatrician.
  • Apologies for the repeated content from previous trainings.
  • Condensed information: 3 hours into 45 minutes.
  • Encouraged an interactive session with questions.
  • Adjustments due to change in schedule: Rebecca Dudowitz to cover additional topics.

Developmental Domains

  • Main Categories: Social, Language, Motor
  • Motor Categories: Gross Motor and Fine Motor
  • Language Categories: Expressive and Receptive

Gross Motor Development

  • Newborn: Turns head side to side, cries, sucks reflexively, rooting reflex.
  • 1 Month: Lifts head.
  • 2 Months: Lifts head and shoulders.
  • 3 Months: Raises torso, head, and elbows.
  • 4 Months: Raises head, neck, shoulders, chest, and wrists; rolls over.
  • 6 Months: Sits unsupported, may tripod.
  • 12 Months: Walks.
  • Beyond 12 Months: Progression includes climbing, walking up and down stairs, and riding a tricycle.

Fine Motor Development

  • Newborn: Hands in fists.
  • 1 Month: Eye movement: Fix on an object.
  • 2 Months: Track objects up and down.
  • 3 Months: Circular eye movement.
  • 4 Months: Hands to midline; put hands in mouth.
  • 6 Months: Raking grasp, transferring objects.
  • 9-12 Months: Immature to mature pincer grasp, pointing starts.

Language Development

  • Newborn: Cries, alerts to sound.
  • 2 Months: Cooing.
  • 4 Months: Ah-gooing (proto-consonant sounds).
  • 6 Months: Babbling.
  • 9 Months: Non-specific "mama" and "dada".
  • 12 Months: Specific "mama" and "dada", plus one word.
  • 24 Months: Two-word combinations, about 50 words, 50% intelligibility.
  • 3 Years: Small sentences, 75% intelligibility.
  • 4 Years: Past tense, 100% intelligibility.

Social Development

  • Newborn: Looks at faces, cries for attention.
  • 6 Weeks: Social smiling.
  • 3 Months: Recognizes and prefers parents.
  • 9-10 Months: Stranger anxiety, joint attention, object permanence.
  • 12-15 Months: Joint attention, social referencing.
  • 18-24 Months: Toddler exploration, temper tantrums begin.

Developmental Screening

  • Prevalence: 15% of kids 3-17 have developmental issues.
  • Screening Tools: M-Chat for autism, other tools for general development.
  • Frequency: Recommended formal screenings at 9, 18, 24, or 30 months.

Developmental Delays

  • Recognizing delays involves understanding standard deviations from the mean.
  • Descriptors: Speech, language, global developmental delays.

Autism

  • DSM-5 Criteria: Social communication impairment, restrictive/repetitive behaviors.
  • Prevalence Rising: Better diagnosis, raised awareness.
  • Treatment: Applied Behavioral Analysis (ABA), other behavioral therapies.

ADHD

  • Symptoms: Hyperactivity, impulsivity, inattention.
  • Diagnosis: Using Vanderbilt assessment, must be present in more than one setting.
  • Prevalence: 11%, more common in males.
  • Management: Combination of medication and behavioral therapy.

Postpartum Depression

  • Symptoms: Persistent depressive symptoms impairing function.
  • Screening: Edinburgh postnatal depression scale.
  • Impact: Affects infant's attachment, language development, and bonding.

Note: These summaries capture key points from the lecture and provide a framework for understanding pediatric developmental milestones, behavioral health issues, and screening methods used in clinical settings. Additional specifics can be found in the provided slides and handouts.