BASIC PEDIATRICS 2A PRELMS [S.Y.

2020-2021]
AGE GROWTH DEVELOPMENT PREVENTIVE PEDIATRICS
0 ✓ AVERAGE BIRTHWEIGHT OF FILIPINOS: 3,000 g ✓ Marked physiologic transitions NEWBORN SCREENING (R.A 9288)
0-30 DAYS (Birth to 1st month)
NEONATE

✓ AVERAGE LENGTH: 50 cm ✓ Observe how the child react to a wide range of sensory Article 3 Section 5 states that: “Any health practitioner who
✓ HEAD CIRCUMFERENCE: 32-37cm stimuli: Hearing, Vision, Feeling delivers, or assists in the delivery, of a newborn in the Philippines
✓ LYMPHATIC TISSUES: small but well developed at birth Interactional abilities: shall, prior to delivery, inform the parents or legal guardian of the
✓ CNS: brain continue to dramatically grow after birth ✓ Type of attachment with parents, especially with mothers newborn of the availability, nature and benefits of newborn
✓ it is important to monitor for maternal depression → this screening”
may affect the quality of interaction and the attachment of ✓ Ideally done immediately after twenty-four (24) hours
the child later from birth but not later than three (3) days
Behavioral states: Active alert, drowsy, crying ✓ Preterm (<37 weeks), LBW (<200g), and sick neonates may
have a sample taken before 24 hours if blood
transfusion will be done; otherwise immediately after 24
hours from birth and a repeat screening should be
collected at the 28th day of life.

RECOMMENDED AVERAGE HOURS OF SLEEP: 10-19

hours/day
1M ✓ Neural plasticity and myelination peaks VISUAL ACUTY ASSESMENT:
INFANCY
1-12 MONTHS

✓ Acquires new abilities in all developmental domains: infants ✓ Fixes & Follows Test: for infants and pre-verbal children
begin to respond and habituate to the familiar while ✓ External Inspection of the Eye, Pupil, and Adnexa
✓ becoming more attentive to novel stimuli o eyelid deformities, ptosis, hemangioma
✓ Actively seek stimuli: They become more interested in the o check for the pupils
world, more sociable, and ✓ Ocular Motility Assessment
✓ more mobile→ they are easily distracted while feeding o Corneal light reflex - Versions and Ductions
✓ Explore the body: They explore their bodies by staring at o Cross-over test
their hands, blowing bubbles, and touching their faces ✓ Red Orange Reflex
✓ Slowly, the demand for autonomy emerges
RECOMMENDED AVERAGE HOURS OF SLEEP: 12-13 hours/
day
2M ✓ SOCIAL AND EMOTIONAL SKILLS: Smiles responsively
✓ RED FLAG: Not alert at mother at 2 months
3M ✓ GROSS MOTOR: Good head control
✓ FINE MOTOR: Hands open
✓ RED FLAG: Poor head control by 3 months
✓ RECEPTIVE LANGUAGE: Alerts to voice (0-3 mos.)
✓ EXPRESSIVE LANGUAGE: Cries, Coos (0-3 mos.)
✓ ADAPTIVE SKILLS: Opens mouth expectantly
✓ RED FLAG: No social smile by 3 months
4M ✓ FINE MOTOR: Reaches for objects
✓ RED FLAG: Hand still fisted by 4 mos.
✓ RECEPTIVE LANGUAGE: Turns to voice, name
✓ COGNITIVE SKILLS: Stares at own hand
5M ✓ GROSS MOTOR: Rolls over
✓ FINE MOTOR: Transfers objects
GROWTH MEASUREMENTS: WEIGHT
✓ < 6 months old: Weight in grams = Age in months x 600 +
Birth Weight
✓ 6-12 months old: Weight in grams = Age in months x 500
+ Birth Weight

BASIC PEDIATRICS 2A PRELIMS [GROWTH, DEVELOPMENT, AND PREVENTIVE PEDIATRICS TABLE] 1 A.C.B.S [S.Y. 2020-2021]
 6M ✓ TEETH: Eruption usually occurs at 6 months of age- ✓ GROSS MOTOR: Sits with support BREASTFEEDING:
mandibular central incisors ✓ FINE MOTOR: Holds bottle ✓ Mothers must be encouraged to exclusively breastfeed up
✓ EXPRESSIVE LANGUAGE: Blows raspberries, to six (6) months and continued up to two (2) years and
monosyllabic babbling (4-6 mos.) beyond
✓ RED FLAG: Does not turn to sound by 6 months ✓ Safe, adequate, timely and properly fed complementary
✓ ADAPTIVE SKILLS: Holds bottle, Finger feeds feeding using fresh, natural, and indigenous complementary
✓ SOCIAL AND EMOTIONAL SKILLS: Stranger anxiety food shall begin at six (6) months of age.
✓ RED FLAG: Not laughing in playful situations by 6 months
✓ RED FLAG: Not searching for dropped objects at 6 months COMPLETE BLOOD COUNT FOR IRON DEFICIENCY
ANEMIA:
✓ cognitive and psychomotor abnormalities in children.
✓ complete CBC at least once between the ff. time intervals
for those at risk:
o 6-24 months
o 2-6 years and 10-19 years

IRON SUPPLEMENTATION:

VITAMIN A SUPPLEMENTATION:

7M ✓ RED FLAG: Unable to hold objects by 7 months

✓ RECEPTIVE LANGUAGE: Turns head to sound
8M ✓ GROSS MOTOR: Sits without support
✓ COGNITIVE SKILLS: Bangs 2 cubes
9M ✓ GROSS MOTOR: Pull to stand
✓ FINE MOTOR: Pincer grasp
✓ EXPRESSIVE LANGUAGE: indiscriminate “dada”, “mama”
Polysyllabic babbling (7-9 mos.)
✓ SOCIAL AND EMOTIONAL SKILLS: Plays interactive
games (peek-a-boo), Waves bye-bye
10 M ✓ RED FLAG: Does not sit independently by 10 months
✓ RECEPTIVE LANGUAGE: understands the word NO,
follows 1-step gestural commands

BASIC PEDIATRICS 2A PRELIMS [GROWTH, DEVELOPMENT, AND PREVENTIVE PEDIATRICS TABLE] 2 A.C.B.S [S.Y. 2020-2021]
 12 M ✓ LENGTH OR HEIGHT: 75 cm Period of rapid growth and development FIRST DENTAL VISIT: at the time of eruption of the first tooth
1-2 YEARS OLD
TODDLER
✓ Particularly in the socio-emotional, cognitive, and motor and no later than 12 months of age.
areas
✓ Because they are more mobile à it allows for separation and RECOMMENDED AVERAGE HOURS OF SLEEP: 11-13
✓ increasing independence hours/day
✓ They are thrilled with their newfound ability because they
are able TEMPER TANTRUMS AND BREATH-HOLDING SPELLS:
✓ to explore and control the distance between them and their 1st year of life IS age-typical expressions of frustration or anger
parents TIME-OUT: removal of positive reinforcement for an
✓ However, toddlers tend to move closer to their parents and unacceptable behavior (1 minute/year of age)
often return to them because they have a need for a
reassuring touch DEWORMING:
Manipulation of objects in novel ways Administration and the Management of Adverse Events
✓ Make-believes centers on symbolic play, like pretending to Following Deworming (AEFD) and Serious Adverse Events
drink from an empty cup and imitation of parents or older (SAE)- RECOMMENDS DEWORMING FOR ALL CHILDREN
siblings AGED 1 TO 12 YEARS
Temper tantrums emerge ALBENDAOLE
✓ Toddlers are unable to delay gratification, suppress anger, ✓ 12-23 months:
or normally communicate well what they are feeling o 200 mg, single dose every 6 months
Object permanence is established ✓ 24 months and above:
✓ GROSS MOTOR: Walks unassisted o 400 mg, single dose every 6 months
✓ FINE MOTOR: Scribbles MEBENDAZOLE
✓ RECEPTIVE LANGUAGE: Follows 1-step verbal ✓ 12 months and above:
commands o 500 mg, single dose every 6 months
✓ EXPRESSIVE LANGUAGE: Shakes head “NO”, first real *ether drug shall be taken on full stomach
word other than “mama” or “dada” (10-12 mos.)
✓ RED FLAG: Does not babble or use gestures by 12 months
✓ ADAPTIVE SKILLS: Drinks from a cup well
✓ SOCIAL AND EMOTIONAL SKILLS: Hands a toy or book to
parent when she wants to play or hear a story
✓ RED FLAG: Hard to console, stiffens when approached by
1 year
✓ COGNITIVE SKILLS: Egocentric-symbolic play
✓ RED FLAG: No object permanence at 12 months
16 M ✓ RED FLAG: No single utterances by 16 months
18 M ✓ RECEPTIVE LANGUAGE: Identifies 1 or more body parts
1.5 Y (1.6 years old)
✓ EXPRESSIVE LANGUAGE: Mature jargoning, up to 10
words (1.6 years old)
✓ ADAPTIVE SKILLS: Feeds self with a spoon
✓ RED FLAG: No interest in cause and effect games at 18
months
GROWTH MEASUREMENTS: WEIGHT ✓ GADGETS AND MEDIA INFLUENCE ON BEHAVIOR:
✓ < 2 years old or cannot stand: use tared weighting scale ✓ Children < 18 months: NO TV
or infant scale ✓ Children > 2 years: 1 hour/day
✓ > 2 years old: weigh alone
2Y ✓ CNS: Myelination of cerebrum completed by 2 years old ✓ GROSS MOTOR: Runs well TOILET TRAINING: Developmentally ready by 2-4 years old
✓ RECEPTIVE LANGUAGE: Follows 2-step verbal
commands
✓ EXPRESSIVE LANGUAGE: 2-word phrases, up to 50
words

BASIC PEDIATRICS 2A PRELIMS [GROWTH, DEVELOPMENT, AND PREVENTIVE PEDIATRICS TABLE] 3 A.C.B.S [S.Y. 2020-2021]
 ✓ RED FLAG: No 2-word phrases by 2 years
✓ ADAPTIVE SKILLS: Cooperates in dressing
✓ SOCIAL AND EMOTIONAL SKILLS: Parallel play
✓ COGNITIVE SKILLS: Sorts by shapes and colors
✓ RED FLAG: Does not categorize similarities at 2 years
GROWTH MEASUREMENTS: LENGTH OR HEIGHT Expressive language skills rapidly develop during the preschool VISUAL ACUITY ASSESMENT:
3-5 YEARS
PRESCHOOL AGE

✓ < 3 years old: use recumbent length years coinciding with the time when children are exposed to an ✓ Subjective/Formal Visual Acuity Testing
✓ 3 years old and above: those that were able to stand using expanding social sphere o LEA Pictures chart: for preschoolers or children
standing height Language à linked to both cognitive and emotional development; who are not familiar with letters
it plays a critical part in behavior regulation and allows the child to o Sloan letters, HOTV chart: for literate children
express feelings ✓ External Inspection of the Eye, Pupil, and Adnexa
Adapt to new rules and relationships o eyelid deformities, ptosis, hemangioma
Play à increases in complexity and imagination, from simple o check for the pupils
imitations to more extended scenarios ✓ Ocular Motility Assessment
✓ Involves learning, physical activity, socialization with peers, o Corneal light reflex - Versions and Ductions
and practicing adult roles o Cross-over test
✓ Allows for conflict and anxiety resolutions ✓ Red Orange Reflex
✓ A creative outlet
Children also learn what behaviors are accepted by testing RECOMMENDED AVERAGE HOURS OF SLEEP: 9-10
limits hours/day
✓ Testing limits increases when it gains attention especially
when limits are inconsistent
Handedness is established
Temper tantrums may still be seen at this time
3Y ✓ GROSS MOTOR: Pedals a tricycle BLOOD PRESSURE MONITORING:
✓ FINE MOTOR: Copy circle ✓ Routine blood pressure measurement for children starting 3
✓ RED FLAG: Cannot stand on one leg by 3 years old years of age.
✓ EXPRESSIVE LANGUAGE: 3-word sentences, answers ✓ Elevated BP in children:
“what” and “where” o 1-13 y/o: >90th percentile to <95th percentile
✓ RED FLAG: No 3-word sentences by 3 years (whichever is lower)
✓ ADAPTIVE SKILLS: Dry by day o >13 y/o: BP 120/<80 to 129/<80 mmHg
✓ SOCIAL AND EMOTIONAL SKILLS: Imaginative play,
enjoys interactive play
✓ RED FLAG: Does not play with other children at 3 years, in
constant motion, resists discipline
✓ COGNITIVE SKILLS: Correctly names some colors, recalls
part of a story (3-4 years old)
✓ RED FLAG: Does not know full name at 3 years
4Y ✓ GROSS MOTOR: Hops
✓ FINE MOTOR: Copy square
✓ RECEPTIVE LANGUAGE: Follows 3-step verbal
commands
✓ EXPRESSIVE LANGUAGE: Tells stories, 100% clear
speech
✓ SOCIAL AND EMOTIONAL SKILLS: Has favorite toys and
stories, spends more time in fantasy play
✓ RED FLAG: Cannot count sequentially at 4 years
5Y ✓ GROSS MOTOR: Skips R.A. no. 9482 “Anti-Rabies Act of 2007”
✓ FINE MOTOR: Copy triangle ✓ Free routine immunization or Pre-Exposure Prophylaxis
✓ SOCIAL AND EMOTIONAL SKILLS: Tests rules, plays (PEP) for school children aged five (5) to fourteen (14)
games with simple rules (tag, hide and seek) years.

BASIC PEDIATRICS 2A PRELIMS [GROWTH, DEVELOPMENT, AND PREVENTIVE PEDIATRICS TABLE] 4 A.C.B.S [S.Y. 2020-2021]
 ✓ RED FLAG: Does not know letters at 5 years
Increasing separation from parents and seek acceptance from RECOMMENDED AVERAGE HOURS OF SLEEP: 9-11
SCHOOL AGE
6-10 YEARS
other adults, such as their teachers, and from their peers hours/day
They begin to feel under pressure to conform to their peers’
style
✓ Self-esteem becomes a major issue
✓ The home and the family remain the most influential
More independent
✓ Cognitive abilities are also into play as children look into
factors such as external and internal rewards
✓ They begin to enjoy strategy games and work play
Perceptions of body image
Take on household chores
6Y ✓ LYMPHATIC TISSUES: adult dimension by 6 years ✓ FINE MOTOR: Copy diamond
✓ TEETH: Eruption of permanent teeth begins at around 6 ✓ COGNITIVE SKILLS: Reads a book
years old ✓ RED FLAG: Does not know own birthday or address at 6
years
7Y ✓ ADAPTIVE SKILLS: Takes on responsibilities and chores
(7-8 years old)
9Y ✓
10 Y ✓ LYMPHATIC TISSUES: peaks about 10-12 years old after
which it decreases in size
14 Y ✓ Skeletal growth for females RECOMMENDED AVERAGE HOURS OF SLEEP: 9-9.25
ADOLESCENCE

hours/day
17 Y ✓ Skeletal growth for males
18 Y ✓ TEETH: complete at around 18 years old TABACCO USE AND CIGARETTE SMOKING:
✓ 80 % of people who smoke had their cigarette before 18
years of age
✓ most preventable cause of mortality and morbidity
✓ parental disapproval may prevent adolescents from
becoming established smokers.

BASIC PEDIATRICS 2A PRELIMS [GROWTH, DEVELOPMENT, AND PREVENTIVE PEDIATRICS TABLE] 5 A.C.B.S [S.Y. 2020-2021]