HRBP 7205 Introduction to paediatrics 2022 - Tagged

HRBP 7205: An Introduction to Paediatrics

Aims of the Lecture

• Basic Understanding: To provide a foundational understanding of typical developmental milestones in children.

• Role of Paediatric Physiotherapist: To highlight the roles and scope of practice for paediatric physiotherapists and the multidisciplinary team.

• Treatment Understanding: To develop an understanding of various treatments available in the management of paediatrics.

Typical Development During Gestation

• Fetal Development Timeline: A chart illustrating the development of a fetus across 38 weeks of pregnancy, highlighting critical periods for development.

  • Period of the Ovum (Weeks 1-2): Initial development stage.

  • Period of the Embryo (Week 3 - Week 8): Vulnerability to major structural defects (CNS, heart, limbs, teeth, palate).

  • Period of the Fetus (Weeks 9-38): Focus shifts to functional and minor structural defects.

• Health Care Providers' Role: Calculate a woman's due date based on the last menstrual cycle, acknowledging conception timing uncertainty.

Child Development from Birth to 12 Months

• Chronological Progression of Gross Motor Development: Milestones from 0 to 12 months, such as rolling over and sitting up.

Childhood Development (0 - 5 Years)

Early Childhood Development Milestones

• General Overview: The first four years encompass significant physical, emotional, cognitive, social, and moral development.

• Developmental Milestones:

  • 3 Months: Recognizes faces, turns toward sounds, and starts to babble.

  • 6 Months: Responds to emotions, enjoys social games like peek-a-boo, and rolls both ways.

  • 1 Year: Pulls up to stand, tries imitative play, and may say simple words.

  • 2 Years: Sorting shapes/colors, uses simple sentences, and imitates adult actions.

  • 3 Years: Imitates playmates, sorts objects, and understands 'mine/his/hers'.

  • 4 Years: Follows directions, draws circles/squares, and enjoys humor.

  • Disclaimer: Every child develops at their own pace; consult a pediatrician if development concerns arise.

Development of the Brain

• Brain Development Statistics: 90% of a child's brain development occurs before age 5, with only 10% occurring afterward.

Red Flags in Development

Gross Motor Red Flags

• Signs of Concern:

  • Not rolling by 7 months.

  • Not sitting independently by 10 months.

  • Not walking by 18 months.

  • Other unusual motor behaviors (e.g., walking on toes).

Fine Motor Red Flags

• Signs of Concern:

  • Not bringing hands to midline by 10 months.

  • Not using a mature grasp by 18 months.

  • Other atypical fine motor actions (e.g., using only one hand).

Paediatric Physiotherapy

Intervention Types

• Short-term Treatment:

  • Transient conditions that improve over time (in-patient care).

• Long-term Treatment:

  • Permanent or acquired conditions that may deteriorate (out-patient care).

Focus on the Child

• Child-Centric Approach: Recognize that children are not mini adults; interventions must reflect their unique development.

• Family Involvement: Family plays a critical role in successful intervention and is also affected by the treatment process.

Focus on the Therapist

• Play-Based Physiotherapy: Sessions should be enjoyable and appropriately challenging; consider children with learning disabilities.

• Praise and Competitiveness: Use goal setting and positive reinforcement to engage children.

• Imagination and Teamwork: Incorporate creativity to maintain interest and involve multidisciplinary teams.

Physiotherapy Interventions

• Types of Interventions: Focus on mobility, stability, coordination, strength; includes hydrotherapy and play-based therapies.

• Respiratory Interventions: Specific techniques such as ACB and suctioning to support respiratory needs.

Importance of Understanding Typical Development

• Assessment: Critical for evaluating developmental progress and identifying next steps.

• Differentiation: Helps understand infant and child physiological differences from adults.

References

• Adolph, K., Vereijken, Denny. (1998). Learning to crawl. Child Development.

• Bailey, Bruer, Symons & Lichman (2001). Critical Thinking about critical periods.

• Effgen, S. (2005). Meeting the physical therapy needs of children.

• Pountney, T., et al. (2000). The Chailey Approach to Postural Management.

• Shumway-Cook, A. & Woollacott, M. (2001). Motor Control Theory and Applications.