Infant assessment and development – correct answer ■ Proportional changes: weight, height, head,
nervous system, chest
● Weight increases 6-8lbs, up to 20lbs in the 1st year of life
■ Posterior fontanelle closes by 2 months of life
■ Eye alignment
● Some children get cross eyed at times, but usually resolve close to 4 months
■ Red reflex should be symmetrical
■ The abdominal muscles do not close until 3 years of life
■ For boys:
● Both testicles are descended by 6 months
● Note any hydrocele
■ For girls:
● Assess for labial adhesions
■ Musculoskeletal
● Leg fold symmetry
● Hip abduction
○ To make sure there are no hip clicks.
○ Barlow maneuver and Ortolani maneuver will assess for hip click
● Foot shape and flexibility
■ Skin: rashes
● Common – infantile eczema
● Lesions
● Bruising or burns
○ Mongolian spots are normal
■ Feeding difficulties
1 / 3
● Regurgitation and spitting-up
○ Acid reflux is prevalent d/t sphincters are not mature
○ Encourage parents to break up feeding after ~15mL. burp the child and then return to feeding
○ Spitting up can be large amount and it is normal for it to come out of the nose
● Colic
○ Common during newborn period, usually resolves by 6 months of life
Toddler development – correct answer ■ Toddler
● Weight gain 4-6lbs per year
● Height: 3 inches per year
● Visual acuity 20/40
● Brain growth is 75% completed
● Respiratory tract is rapidly developing closer to that of an adult, but still anatomically is much smaller.
● Immune system is weakened, increased risk for any kind of complications
● Measurements: height, weight, head circumference up until 2 years of age
● Physical exam
○ HEENT
■ Anterior fontanel – make sure it is getting smaller and closing
● It usually closes by 18 months – 2 years
■ Screen for strabismus
■ Look for tooth eruption and/or dental decay
● If by 18 months they do not have a first tooth eruption, order x-ray
○ Musculoskeletal
■ Assess for hip dysplasia, gait, out-toeing, bowlegged
○ Neurological
■ Deep tendon reflex
■ Babinski
Preschool development and assessment – correct answer ● Weight gain 5 lbs/year
2 / 3
● Height 2-3 inches/year
● Head circumference, no needed since the anterior fontanelle should have closed 18 months – 2 years
● Screening: vision and hearing
School age children development/ assessment – correct answer ■ Slow but steady growth
● Height: increases 2 in/year
● Weight: 4 ½ – 6 ½ lbs/year
● Skeletal lengthening & fat diminution
● Strength increases yet muscles remain functionally immature
● Start to lose those primary teeth and develop their permanent teeth
● GI system, cardiovascular system becomes that of an adult
● Bladder capacity increases
● Immune system improves
● Bones become hard and they are not as pliable as it was in the early ages
● Prepubescent
● Vital signs: approaching adult values by the end of the school age
○ Blood pressure
○ Vision screening
○ Hearing screening
Adolescence development and assessment – correct answer ■ Extremities grow faster than trunk and
head
■ Facial proportions change
● Nose and chin enlarge first
■ Figure changes
● Pelvis enlarges in females
● Shoulders enlarge in male
■ Subcutaneous fat increases
■ Increased function of sweat glands
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