Child Development Exam 2

What is epigenetics?

-       The study of stable changes in gene expression that are mediated by the environment

How did the Dutch Hunger winter effect the children who were born to mothers who were pregnant with them during this period. How did the time of the pregnancy affect the outcome?

-       a winter in WWII where Dutch families were severely malnourished because of a blockade. Used as example of epigenetic change because metabolic restriction in early pregnancy permanently altered the child’s metabolism

-       Women who were well fed at the beginning of the pregnancy and malnourished by the end had babies who were small and stayed small the rest of their lives

-       Women who conceived while malnourished but were well fed by the third trimester had infants born at normal weights but had high rates of obesity, diabetes, and heart disease later in life

Explain Meaney et al.’s studies on maternal behavior in rat pups. What effect does poor mothering have? What can we learn from the cross-fostering component of this study?

-       Meaney studied care being provided to baby rats in early development and how gene expression changed in rats with inadequate maternal care.

-       Inattentive moms have stressed offspring that don’t explore their surroundings because their genes change to be highly methylated

-       In cross-fostering studies, we can take babies born by one mother and give them to another mother to raise in order to separate genes from environment

Oberlander observed epigenetic changes in the fetal cord blood that were linked to maternal depression and anxiety in the third trimester. What were these changes? How did this relate to stress-induced cortisol levels in 3-month-olds?

-       Maternal depression and anxiety in the third trimester were linked to stressed infants. When the mother becomes depressed and anxious, the DNA methylation within the NR3C1 gene promoter in fetal cord blood increases, which increases stress induced cortisol levels in 3-month-olds

Prenatal stress poses risks for the child outcomes. What are some of the concerning outcomes?

-       Epigenetic changes in the fetus, epigenetic. Changes in structures of the mother’s body that support fetal development (placenta), and epigenetic changes in the mother that may affect infant caregiving

What did researchers find when they studied monozygotic twins as part of a longitudinal study at the Spanish Cancer Center?

-       Pattern of DNA methylation was highly similar in identical infant pairs. However, identical twins have different life experiences outside the womb, so the pattern of DNA methylation (how genes are expressed) would differ more for older twins than younger twins

Prenatal Development

What is gestational age?  In terms of gestational age – what is a normal full-term infant? A very preterm infant?

-       Gestiational age is the number of weeks since the woman’s last menstrual period. Normal term pregnancy is 37-42 weeks, while preterm infants are  born:

o   Moderate to late preterm (32-37 weeks)

o   Very preterm (28-32 weeks)

o   Extremely preterm (less than 28 weeks)

When we chart fetal development in this class, we use ages that are based on conceptual age. How is this different from gestational age?

-       "Conceptual age" refers to the time elapsed since the moment of conception, while "gestational age" refers to the time elapsed from the first day of the last menstrual period

Be familiar with the following: amniotic fluid, period of the embryo, period of the fetus, placenta, umbilical cord, cephalocaudal, proximodistal

-       Amniotic fluid: protects fetus from infection, cushions it’s movement, regulates fetal body temperature, protects from sudden blows, helps digestive and respiratory system develop. Initial source is amniotic cells and 2^nd trimester is made of fetal urine mostly

-       Umbilical cord: has three blood vessels. One carries food and oxygen from placenta to fetus. Two arteries carry waste from the fetus back to the placenta. Filled with Wharton’s jelly that cushions and protects vessels

-       Embryonic period: period that extends from the time the organism becomes attached to the uterus until the end of the 8th week of pregnancy. All the major organs have taken primitive shape by the end of this period

-       Fetal period: begins 9 weeks after conception, with the first signs of the hardening of the bones and continues until birth

-       Cephalocaudal development: areas near head develop before areas further down

-       Proximodistal development: development centered outward; structures near torso develop more rapidly than those in the periphery

When does the placenta become a source of nutrients? How does the placenta work?

-       At 8-12 weeks, the placenta takes over as a nutrient source for the fetus instead of the uterus lining.

-       The placenta connects to the umbilical cord through the chorionic villi, where are “fingers” of tissue containing networks of blood vessels that connect to the fetus’ circulatory system. When the mother’s blood comes in contact with the villi, nutrients are exchanged for waste through the villi walls. It also acts as a filter, preventing some viruses and bacteria from reaching the fetus

What are the parts of the umbilical cord?

-       One vein carries food and oxygen from the placenta to the fetus

-       Two arteries that carry waste from the fetus back to the placenta

o   Umbilical cord is filled with Wharton's jelly that cushions and protects blood vessels 

What are some of the protective functions of the amniotic fluid?

-       Protects fetus from infection

-       Cushions fetus’s movements and helps it move

-       Regulates fetal body temperature

-       Protects from maternal falls or sudden blows

-       Helps the fetus’s digestive and respiratory system develop

When does cleft lip and cleft palate emerge in development? When are they usually repaired? What challenges does an unrepaired cleft palate pose?

-       Palate develops at 5-9 weeks and cleft palates are repaired after birth (3-6 months). Cleft palate children cannot breast feed and may have trouble with language development if unrepaired

Is the fetus active? When does the mother feel the movements?

-       The fetus beings making spontaneous movement 5-6 weeks after conception and gradually move more. However, the mother does not feel it until the end of the second trimester

What are some of the things the fetus does in the womb? Do these actions aid development? Explain fetal swallowing and breathing and the role they serve.

-       Fetal activity is important for the normal formation of organs and muscles. Fetal swallowing of amniotic fluid begins at 11 weeks, and helps develop the gastrointestinal tract

-       Fetal breathing of amniotic fluid begins at 10 weeks erratically, helping to stimulate lung growth

Does the fetus respond to light? Voices? What have 4-d scans revealed about sensitivity to touch?

-       Fetus does respond to light, as heart rate and movement increase if a bright light is held against a mother’s abdomen (26-weeks)

-       4-d scans have revealed that fetuses touch their upper part and sides of their heads at the beginning, and as they got older, touched more sensitive parts of their faces like their moth, suggesting tactile sensations affecting touching patterns

Nutrition

Explain the Guatemala food supplementation. Both supplements resulted in an increase in calories – how did this affect the likelihood of delivery a low-birth weight baby? What additional benefits were seen in the group that consumed Atole (the high protein supplement?

-       Medical clinics were set up in four villages in Guatemala. The mothers in two villages were fed sugary Fresco drink and two were fed protein-rich Atole. The villages fed the Atole resulted in growth gains. Babies were taller, weighed more, and when tested at 11 years old, the scored significantly higher on cognitive tests.

Is anemia common? How did providing iron-folic acid supplements to anemic women in Nepal improve child outcomes?

-       37% of pregnant women are anemic. In a region in Nepal, anemia was especially prevalent, and mothers received daily iron-folic acid supplements from early pregnancy to 12 weeks postpartum. When children were tested at 7-9 years of age children in iron-folic groups scored higher on tests of working memory, inhibitory control, and fine motor skills.

Staple foods have been fortified with iron, Vitamin A, folic acid. What is the advantage of doing so?

-       Fortifying foods improves nutritional status of a population

What is spina bifida? Explain how food fortification has affected the incidence of this disorder?

-       Spina bifida involves the disruption of the complete closure of the neural tube and spin. The higher the malformation on the back, the great the amount of nerve damage and loss of muscle function/sensation. A cause could be from folic acid deficits, which supplements can reduce the risk of

Thalidomide posed extreme risks, but only at a certain time in the pregnancy. When did it pose risks and what were some of the adverse outcomes?

-       Thalidomide was a sleeping aid prescribed to reduce morning sickness. If it was taken 20-36 days after fertilization, the chance of birth defects increased 50%. Adverse outcomes included malformations of arms and legs

Why is Dr. Kelsey an important figure?

-       Dr. Kelsey was the reason thalidomide was not approved for use in the US. She rejected the application because the drug’s safety was not sufficient

What is congenital rubella syndrome? When in the pregnancy is the baby at risk? What led to the drop in cases?

-       Congenital rubella syndrome is when a baby is born with symptoms like hearing loss, congenital heart disease, and vision loss due to cataracts. It occurs when a woman contracts rubella in the first three months of pregnancy, giving the baby a 50-90% chance of having a child with the syndrome . Drop in cases due to a vaccine in 1969 and public health campaign

What risks does the measles pose for a pregnancy?

-       Measles in pregnant individuals is associated with severe affects like incrased hospitalization and pneumonia. It can cause miscarriage, stillbirth, low birth weight, and increased risk of preterm delivery.

Preterm Births

How might a parent feel after the birth of a preterm baby? How can hospitals help?

-       Parents may feel responsible, overwhelmed, and inadequate. Hospitals can help by providing psychosocial support through open communication, emotional support, family-centered developmental care, etc.

What is toxic stress?

-       Toxic stress is a severe, frequent, or prolonged stress response to adverse events in the absence of a supportive caregiver. It has the ability to disrupt brain circuitry, organ systems, metabolism, and normal physiology of the child’s biological systems

What makes the NICU a stressful environment for the infant? What can be done to reduce the stress?

-       The NICU is stressful because there’s a lot of demands, lights, loud sounds that are not supportive for development and far from the conditions of the fetus.

-       To reduce stress, clinical care could be tailored to the child’s needs, revolve around their sleep/wake cycles, use gentle voice to help prepare baby for contact, and use evidence-based techniques to manage pain

How can pain be managed in the NICU?

-       Sweet liquids, medication, breastfeeding, swaddling, pacifier, skin-to-skin contact, facilitated tucking, sensorial saturation (massage, touch, voice, smell)

Explain what is meant by family centered care in the NICU

-       Approach that recognizes family as part of the NICU care team

What is kangaroo care? Describe the studies that have shown it has positive effects.

-       Kangaroo care is a method of holding a baby that involves skin-to-skin contact. Baby only wears diaper and the baby’s bare skin is placed against the parent’s bare chest

-       Benefits for parents include improved feeling of closeness to baby, increased confidence to care for baby, increases mother’s milk supply 

-       Benefits for babies include stabilizing heart and respiration rates, helping optimize oxygen saturation rates in blood, regulating temperature, conserving calories, helping with pain tolerance, and protecting brain development 

What are the current recommendations regarding kangaroo care?

-       Preterm babies should receive kangaroo care for at least an hour a day

What did Field and colleagues find when they massaged preterm infants?

-       Weight gain was greater for the massage therapy group compared to the standard care control group with 10-15 min a day sessions 2-3 times a day for 5-10 days.

Research has shown that full-term infants benefit when parents read books to them. Why does book reading seem to be beneficial?

·       Linguistic benefits 

o   Language used in books is far richer than the language of everyday speech – exposure to grammatically rich constructions 

·       Interactive aspect 

o   Tend to elicit more interactive communication between infant and caregiver including more frequent verbal responses, eye-contact, touch and feel 

·       Parental aspect 

o   Reduces parental stress and gives parents a sense of control 

Summarize the studies that have looked at parental book reading in the NICU.

-       NICU infants fall behind in language skills over the first two years. NICU reading group lost less ground when compared to a control group without reading intervention

What are the three stages of the birth process? In what position would we expect the head? What is a breech presentation? A Cesarian delivery?

·       First stage of labor 

o   Averages 12 hours for first birth, 6 hours for subsequent births 

o   Contractions result in dilation of cervix 

o   Fetus moves down neck of uterus 

o   May result in bloody discharge, nausea, severe pain, trembling legs 

·       Second stage of delivery 

o   Delivery lasts half hour to one hour 

o   Pushing occurs during this stage 

o   Crowning occurs (babies head starts to show) 

o   Baby exists birth canal 

·       Third stage of expulsion of placenta and umbilical cord 

·       Failure to progress (takes longer than usual) 

o   Walking, napping, or having a warm bath helps 

o   Oxytocin may be administered 

o   Forceps or vacuum may be used 

·       Breech presentation 

o   Fetus is turn around so feet and buttocks are positioned first 

o   Dangerous to fetus 

o   Attempt to turn baby (massage and muscle relaxants) 

o   If unsuccessful, opt to do a Cesarean delivery 

·       Cesarean delivery 

o   Rates vary widely among countries 

o   Not related to world region or economic development 

o   Does not impact future vaginal birth 

-        

What is an Apgar score? How is it determined? When is it given?

·       5 criteria 

o   Appearance (skin color – pinkish? Bluish?) 

o   Pulse (heart rate) 

o   Grimace response (cries, coughs, pulls away) 

o   Activity (spontaneous movement? Floppy) 

o   Respiration 

·       Rated at 1 and 5 minutes after birth 

o   Given score of 0-2 on each item 

o   Good health: 8 and above 

o   1 minute score: how baby dealt with birth 

o   5 minute score: adjustment to life outside womb 

Know the following reflexes: placing and stepping, sucking, rooting, palmer grasp reflex. When do they disappear?

-       Placing and stepping (hold baby under arms, seeing if they make stepping motions)

o   Disappears in 2 months

-       Sucking (object or substance in mouth)

-       Rooting (turns toward touch on cheek or mouth)

o   Disappears in 4 month

-       Palmar grasp reflex (holds object placed in hand)

o   Disappears in 5-6 months

What is the Brazelton Neonatal Behavioral Assessment Scale designed to do? Give an example of an item from the scale. When is this scale typically administered?

-       Goal is to get a portrait of the infants strengths, adaptive responses, and vulnerabilities.

-       Some examples of items on the scale include engagement with objects, cuddling, defensive movements. The scale is administered from birth to 2 months

Temperament is rooted in biology. Are differences in temperament seen in infants?

-              There are three temperament categories in infants.

Thomas and Chess distinguished three board temperament categories. What are they? What are the characteristics that go along with each?

·       Easy babies (40% of infants) 

o   Adjusts easily to new situations 

o   Quickly establishes routines 

o   Are generally cheerful and easy to calm 

·       Difficult babies (10% of infants) 

o   Irregular in biological functions 

o   Are irritable 

o   Likely to react intensely and negatively to new situations or try to withdraw from them 

·       Slow-to-warm up babies (15% of infants) 

o   Low in activity level and their responses are typically mild 

o   Tend to withdraw from new situations but in a calm way 

o   Require more time than easy babies to adapt 

Rothbart has found infants differ in reactivity. What is reactivity?

-              Reactivity: measured by infant’s initial responses (physiological and behavioral) to sensory stimuli of different qualities and intensities

Extraversion/Surgency, Negativity Affectivity, and Effortful Control are the three broad dimensions of temperament. Be sure you are familiar with the dimensions that fit under each.

-              Extraversion/Surgency: positive emotionality, activity level, impulsivity, risk-taking

-              Negative Affectivity: fear, anger, sadness, discomfort

-              Effortful Control: attention shifting and focusing, perceptual sensitivity, inhibitory and activation control 

When does crying peak?

-              Crying peaks at 2 months

How often do infants need to be fed?

-              Whenever baby is hungry. Maybe every 1.5-2 hours. Formula fed babies may go longer between feedings

About how much time do infants spend in quiet alertness? NREM sleep? REM sleep? Does REM sleep serve any function?

·       Walking activities and crying (1-4 hours) 

·       Quiet alertness (alert inactivity 2-3 hours) 

·       Drowsiness (varies) 

·       Regular non-REM sleep (newborn 8-9 hours) 

o   Full rest, little body activity, breathing slow and regular, eyes closed-no eye movement 

·       Irregular (REM) sleep (newborn 8-9 hours) 

o   Gentle limb movements, occasional stirring, breathing is irregular, facial movements and smiles; some eye movements 

Do sleeping patterns vary across cultures? How so?

·       Western countries 

o   By 4 months, sleep 6 straight hours per night  

o   By 8 months, sleep 8 hours at night  

·       Traditional cultures  

o   First year of life they rarely sleep more than 3 hours straight – Babies in close proximity to mom, spend more time napping  

What sleep position seems to be safest?

-              On the back

Can newborns recognize their mother’s face? Explain.

-              Not really. In study where mother’s heads were covered by scarves, the baby did not recognize the mother

What did Quinn find when he looked at face preferences in infants that had fathers as their primary caregiver? When they had mothers as their primary caregiver?

-              They would prefer to look at the faces of the gender of their primary care giver, so babies can distinguish between male and female faces.

What did Anzures et al. find when they gave Caucasian families a child-oriented videotape featuring two engaging Asian women?

-              Infants who viewed the Asian women DVD were able to recognize new Asian faces in the novelty preference tasks. So engaging in experiences with people of different races improves recognition of other race faces

Explain DeCasper and Spence’s study in which mothers read a story to their baby in the last 6 weeks of the pregnancy.

·       Pregnant moms recited lines patterned after a specific Dr. Seuss book for the last 6 weeks of pregnancy 

o   Tested when just 2.5 days old 

o   Long burst of sucking on the pacifier turned on one story 

o   Short burst of sucking on the pacifier turned on the other story 

·       Finding: infants worked harder to hear the familiar story (the one their mother read when she was pregnant). The stories they heard at the test phase were read by another woman 

What can we conclude when the baby shows a preference for one stimulus over the other?

-              A preference indicates an ability to discriminate. Both a preference for the familiar or a preference for the novel item show that the baby can discriminate

What is a novelty preference? Do we always see it?

-              Increased interest and attention toward new and unfamiliar stimuli

What is the moderate discrepancy hypothesis?

-              Moderate discrepancies from highly familiar stimuli tend to receive the highest degree of attention and affect

What is habituation? Dishabituation? What can we conclude when the infant dishabituates to a new stimulus?

-              Habituation – the diminished effectiveness of a stimulus in eliciting a response, following repeating exposure to the stimulus.

-              Dishabituation – the reappearance or enhancement of a habituated response due to the presentation of a new stimulus.

o   Dishabituation can be interpreted as a signal that the new stimulus can be discriminated from earlier habitual stimulus

Although there are wide variations in the age at which infants achieve developmental milestones, it is still helpful to be aware of the average age. What is the average age for sitting independently? For crawling? For walking?

-              Average age for sitting independently: 6 months

-              Average age for crawling: 9 months

-              Average age for walking: 12-18 months

Does being able to sit affect how infants interact with objects? Is there any reason to think it has beneficial effects on language development?

-              Sitting allows infants to better explore objects and encourages face to face interactions with caregivers and frees the hands for communicative gestures

What does it mean to say we perceive the world in terms of affordances?

-              Affordance is the fit between one’s physical capabilities and the features of the environment that allow a particular action to be performed

Adolph tested 12-month-olds who had just started to walk, 12-month-olds who were experienced crawlers (and had not yet started to walk), and an older group of infants – 18-month-olds who were experienced walkers. What did they find? What conclusion do they draw from their findings?

-              The New walkers (12 m olds) made risky decisions

o   They decided to go down drop offs that were too steep

-              Experienced crawlers (12 m olds) made good decisions about which drop offs were too steep to crawl over

-              Experienced walkers (18 m olds) made good decisions

§  So, experience helps infants to tune into the information that is relevant for moving in the environment in a particular way

Short Answer Question

Describe Gibson and Walk’s visual cliff? If we tested new crawlers on the visual cliff, what would we expect to see? What would we see if we tested infants who had been crawling for a few weeks?

Gibson and Walk’s visual cliff is a raised table divided into a patterned surface that transitions to glass only, with the pattern on the floor. This gives the illusion of a drop. New crawlers were venture right on the plain glass, while infants that have been crawling for a few weeks will refuse to cross the plain glass on the first trial. This shows that as infants gain experience crawling, it can lead to a fear of heights