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203 Cards in this Set
- Front
- Back
What is the definition of race?
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a family, tribe, people or nation belonging to the same stock; a class or kind of people unified by shared interests, habits or characteristics
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Define ethnicity
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Of or relating to large groups of people classed according to common racial, national, tribal, religious, linguistic or cultural origin or background
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What is the definition of culture?
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a set of implicit or explicit guidelines transmitted to individuals from a particular society, group or subgroup, which tells them "hot to view the world, how to experience it emotionally, and how to behave in it in relation to other people to supernatural gods, and to the natural environment.
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What are the "groups" that help make up culture?
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The groups we are born into: gender, race, national origin, sexual orientation, class or religion.
Social groups: age, disability and social and economic status |
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What are the characteristics of culture?
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-Not static
-changes and adjusts over time - Experience impacts your culture |
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True or false: EVERY patient encounter is a cross-cultural encounter?
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True
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What is a set of attitudes, skills, behaviors and policies that enable organizations and staff to work effectively in cross-cultural situations?
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Cultural competency
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What are the characteristics of culturally competent health communication?
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1. Avoids stereotyping patients
2. Increases your understanding about patients' expectations 3. Helps you to develop the best strategies to elicit patient cooperation |
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Describe 3 things that culturally competent provides consistently and systematically do?
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1. Understand and respect their patients' values, beliefs and expectations
2. understand the cause and control of specific diseases and the effectiveness of treatments in different population groups 3. Adapt the way they deliver care to each patient's needs and expectations |
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What are 2 examples in history where an overt racial/ethnic disparity was conducted in health care?
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1. History of segregation of hospitals/wards
2. Research abuses: Tuskagee |
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___% of white girls and ____% of black girls <15 years old that presented to the ED with abdominal pain were asked about their sexual activity.
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44 and 100
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African American children are __ times more likely to be hospitalized for asthma than white children
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3
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With cultural differences and limited english proficiency, providers are less likely to...?
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1. identify with and understand their patient's situation and feelings
2. Establish a connection and trust with providers 3. Receive sufficient information 4. Be encouraged to participate in medical decision-making |
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What are personal biases?
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Unfounded assumptions that lead to prejudiced thoughts usually exist below the level of our awareness. They are often untested and unexamined, yet they shape how we act.
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What factor is the most robust determinant relating to access to health care and poorer health outcomes including higher lead levels, lower immunization rates, higher asthma hospitalizations, developmental delay and failure to thrive
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Socioeconomic status
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what are examples of health beliefs impacted by religion?
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Circumcision, contraception, immunization, Jehovah's witnesses refusal of blood products
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How can we become more culturally competent?
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1. Develop self awareness
2. recognize and respect core cultural factors that impact patient 3. appreciate cultural differences in health beliefs and methods of healing 4. recognize impact of social context on patient care 5. Develop skills in cross cultural communication |
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It is ___ to rely on generalizations because there is a potential to _____.
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harmful; stereotype
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What is familismo?
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idea that collective loyalty to extended family that outranks the needs of the individual. extended family makes important medical decisions
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Which groups have different time orientation and is perceived as cyclical?
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American Indian/Alaska natives
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Describe the concept of Hozhooji (Navajo).
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Communication style: important to think and speak in a positive way (thought shape reality and control events)
-Do not discuss possibility of bad outcome instead reference hypothetical third party |
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Should you instantly insist on eye contact with Asian or native american patients? Why or why not?
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No: Asian cultures avoid eye contact to show respect
Native american cultures think that eye contact will result in lost souls |
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What is simpatia?
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"kindess" in spanish, value placed on politeness, pleasantness in the face of stress, avoidance of hostile confrontation
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Describe personalismo.
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Warm, personal relationship, socially appropriate physical contact, conversing about patient;s life before the visit
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What is the word for appropriate deferential behavior on basis of positions of authority, age, gender, social position and economic status?
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Respeto
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What is acculturation?
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cultural modification of an individual, group by adapting to, or borrowing traits from another culture; a merging of cultures as a result of prolonged contact.
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Which groups often place children in a kinship as oppose to foster care?
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African american
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What are some social factors impacting health care?
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1. Tension
2. environmental change 3. LIfe control 4. Social status, poverty education |
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A birth weight less than ____ grams has been associated with risk for developmental delay.
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1501
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What gestational age has been deemed a risk factor for developmental delay?
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Less than 33 weeks
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Give some examples of central nervous system insults or abnormalities that increase the risk for developmental delay.
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1. neonatal seizures
2. intracranial hemorrhage 3. need for ventilator support for more than 48 hours 4. birth trauma |
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An APGAR score of 3 or less at 5 mins could be caused by ____ leading to developmental delays.
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asphyxia
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What deficiency, if occurring in the first year, has been thought to cause low IQ score?
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IRON
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Are breastfed babies supplemented with iron?
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Not usually, but their levels are usually checked
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What does the presence of inborn metabolic disorder increase the risk for?
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developmental delay
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How many days spent in the NICU would increase the risk for developmental delay?
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10 or more
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Hyper or hypobilirubinemia increases the risk for developmental delay?
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Hyper
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Why should a newborns muscle tone be assessed?
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Hyper or hypotonicity can indicated an increased risk for developmental delay
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Frued's oral stage describes children from ages ___ to ____.
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Birth to 18months
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THe major primary body zone of the oral stage is the ____.
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Mouth
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THe conflict of weaning is characteristic of which freudian category?
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Oral
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Describe the interpersonal characteristic during the oral stage.
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Focus on self with little differentiation from others.
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A child that is 18 months to 3 years old can be placed into which stage of Freud?
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Anal
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the primary conflict of the anal stage is ____.
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Toileting
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The interpersonal focus of rebellion vs compliance with parents wishes describes which stage of Freud?
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Anal
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What age group fits Freud's Phallic category?
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Age 3-6
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What is the major conflict of the Phallic stage?
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Oedipal Complex
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Describe the oedipal complex.
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Attraction to opposite sex parent with identification with same sex parents as major interpersonal focus
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6-11 year olds are placed into which of Freud's stages?
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Latency
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6-11 year olds are placed into which of Freud's stages?
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Latency
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Which stage has no major conflict and the child identifies mostly with same sex peers and powerful heroes?
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Latency stage
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Describe the Freudian stage for adolescents.
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Genital Stage
-Separation from family is major conflict -sexual maturity and expression are major activities -successful extrafamilial relationships |
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Which theorist is known for his description of emotional development?
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Erikson
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Generally describe Erikson's ideas.
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Developmental challenges as points in which the individual must choose the more desirable emotional stance.
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How is trust developed according to erikson and what is the outcome?
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Develops when needs are met by a consistent person
-sense of hope and optimism is outcome |
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A toilet training toddler would be in which of Erikson's stages
A. Trust v Mistrust B. Initiate v Guilt C. Industry v Inferiority D. Autonomy v Shame |
D. Autonomy v Shame
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How would Erikson describe a newborn?
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Trust vs Mistrust
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____ and ____ appear when a toddler is forced to be dependent when the child can actually master control.
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Shame and doubt
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In what stage of erikson does a child gain control over the environment?
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Autonomy vs Shame: Toddler
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Initiative vs Guilt stage is characteristic of which age group?
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Preschooler: 3-5 years old
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according to erikson, when is a child's conscience developed?
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During the initiative v guilt stage age 3-5 when the child starts to listen to inner voice
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For preschoolers, when does guilt arise?
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when the child does something in conflict with goals of others
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Why does a preschooler use their senses and power?
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To control the body and want
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At which stage of Erikson does the child start to complete activities?
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School age- Industry v inferiority
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What is the positive outcome of erikson's industry v inferiority stage?
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Sense of competence
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What causes inferiority according to Erikson?
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When the school age child experiences a situation when more is expected than he or she can achieve
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When does a child reach Erikson's Identify v role confusion stage?
A.3-5 years B. School Age C. Adolescent D. Birth-18 months |
C. Adolescent
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WHich of erikson's stages is the child preoccupied with physical appearance?
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Identity v. Role confusion
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What is the positive outcome of the identity v role confusion stage?
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Sense of fidelity to values and other people
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A child who is unable to solve conflicts between concept of self and society is how old and in which of erikson's stages?
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Adolescent and in Identity v Role Confusion stage
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WHich theorist is a critic of Erikson?
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Noam
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What does the theorist Noam argue?
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-Believes early adolescence is more concerned with GROUP COHESION and less concerned with identity
-Younger adolescents are more susceptible to peer pressure -Development is NOT LINEAR |
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Which theorist is the known for theories about temperament of children?
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Stella Chase
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According to Stella Chase, 40% of children are thought to fit into the ____ category.
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Easy
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Only ___% of children are described as difficult by Chase.
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10
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True or False: temperament is learned?
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False: it is innate
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What should parents of an "easy" child do?
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Spend separate time with the child since he can be forgotten
-Teach child how to develop own rules |
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Why are easy children often taken advantage of?
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They may do what others want even though it may not be in their own best interest.
-child is trusting |
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Describe an Easy child?
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-Regularity
-Positive approach -High adaptability -Mildy to moderately intense mood. |
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To care for a difficult child, parents need to be...(5 things)
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1. Firm and consistent
2. Patient 3. Gradual repeated reinforcement of positive and negative for expected 4. Give minimum number of rules for any one time 5. Provide a venue to extra emotions and energy |
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Describe a difficult child.
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-irregularity of biological function
-negative withdrawal in response to new stimuli, non adaptability -slow adaptability -intense mood |
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15% of children who are characterized as having negative mood of mild intensity and have a hard time adapting to new situations are thought to be called...
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Slow to warm
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If a parent is encouraged to maintain calm as anger accelerates, avoid competition with child, encourage repetition and maintain consistent rules, they are caring for a ______ child.
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Slow to warm up
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Describe "goodness of fit."
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-central is understanding how child's temperament on the family
-Impact of temperament on child's adaptive functioning |
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Who is the theorist responsible for Moral Theory?
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Kohlberg
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A child from birth to 2 years old is placed in Piaget's _____ stage.
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Sensorimotor; no thinking structures
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The preoperational stage was founded by which theorist and characteristic of the ___ to ___ year old age group.
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Piaget; 2 to 7
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What occurs in the preoperational stage?
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develop language skills cognitive structures-prelogical
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A 7year old through adolescence is placed in piaget's _____ stage.
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Concrete operational
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Describe what occurs in the concrete operational stage of development.
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-Begins to question life
-Solves problems but haphazardly -Mass, number, linear time - deductive reasoning |
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Piaget is known for his theory of _____ development
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cognitive
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In the formal operational stage, an adolescent is capable of...
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sophisticated logical though. Can think both abstract and hypothetically and solve problems using the logic of combinations
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According to Koldberg, an "amoral" child is ___ to ___ year old?
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Birth to 1.5 (18 months)
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How would Kohlberg categorize an 18 month old? How long will this child be in the stage?
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In the preconventional stage; until 9 years of age
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What occurs in Kohlberg's preconventional stage?
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-Behavioral decision made on fear of punishment
-Good and bad defined in terms of physical consequence |
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Which of Kohlberg's stages do MOST people remain?
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Conventional Thinking stage
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If a child's moral thinking is guided by his or her interpersonal relationships and place in society, Kohlberg would stage them as being in _____.
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Conventional thinking
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A child in Kohlberg conventional thinking stage will make behavior decisions on what the child ____, and is based on ____ and ____ for authority.
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Desires; laws; respect
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Name the 2 subcategories of Kohlberg's Post conventional stage.
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1. Social Contract Legalistic
2. Universal Ethical Principle |
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Which age group is known to fit into the social contract legalistic category?
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Adolescent
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If a young adult makes decisions based on higher principle, they are exhibiting Kohlberg's___ ____ ____.
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Universal Ethical Principle
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Describe the tonic neck reflex.
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-increased tone
-leg extension of side of head direction -flexion on contralateral arm and leg |
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What is the stepping and walking reflex?
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Range from minimal weight bearing to several brisk steps with plantar stimulation
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When does the Moro reflex emerge and disappear?
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Emerge: complete at 37 weeks
Disappear: 3-6 months |
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Which newborn reflex emerges at 28 weeks and disappears at 2 months?
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Palmer grasp
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What is a unique trick to increase the suck of an infant under 2 months old?
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Elicit the palmar grasp
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When does the tonic neck relfex emerge and disappear?
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Emerge: 35 weeks
Peak: 4-6 weeks of life disappear: 7-8 months |
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The pacing and stepping reflex emerges at ____ weeks and disappears at ___
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37; 2-4 months
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The ankle clonus reflex can have anywhere from ___ to ___ beats?
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5-10
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Which of the newborn reflexes never disappears?
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pupillary response; none before 32 weeks
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When does the babinski reflex disappear?
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When the child starts walking
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Beginning in 33-35 weeks gestation and ending at about 1 month, the ____ reflex can be seen.
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Ankle Clonus
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An infant grows between __ and ___ inches in the first year?
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9-11
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How much does the head of an infant grow in the first 3 months?
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2cm/month
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Between 4-6 months of age, a baby's head will grow how much?
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1cm/month
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If an infant's head has grown 0.5cm since last month's visit, that child can be ___ to ____ months old.
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6-12
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The posterior fontanelle usually closes at ___ months.
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2
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When does the anterior fontanelle usually close?
A. 3-6 month B. 18months- 2 years C. 2-3 years D. 8 months |
B
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How much weight does a child gain on a daily basis during the first 6 months of life?
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1 ounce; 1-2 lbs a month
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A 6-12 month old usually gains about ____ per day.
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0.5 ounces
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By the end of the 2nd year, a baby's birthweight will have ____.
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quadrupled
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If a child has been gaining 5 lbs per year, they are probably in which age group?
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2-9years old
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In the 2nd year of life, a child will grow about ___ inches.
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5
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If a child has grown between 3-4 inches in the past year, how old are they?
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around 4. Grew in the 3rd year of life
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How many teeth does a 2.5 year old have?
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20
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How many inches on average does a child grown after the 3rd year of life?
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2-3 per year
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What are the general accomplishments of a 0-3month old?
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1. 4 weeks lifts and turns head
2. raise head momentarily to ventral 3. reflex grasp 4. coos 5. follows eyes to midline |
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What specific things occur at the 5 week mark of life?
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1. Regards Face
2. Lifts head while prone 3. Equal movements of extremities 4. Mother responds to infant cues |
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At 2 months old a baby should be able to...?
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1. follow to midline
2. sustain head in ventral 3. active grasp 4. vowel sounds 5. smile spontaneously |
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At what month should an infant be able to raise head above ventral plane and legs extended up to 90 degree angle?
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3 months
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An infant can follow past the midline at ___ months.
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3
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If at 3 months old there is no evidence of a ___ ____, the HCP should evaluate the child's environment.
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social smile
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A 3 month old does what when it hears sound?
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stops movement, appears to listen, turns toward sound
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LIst the developmental red flags at 3 months old.
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1. persistent fisting
2. Failure to alert to visual/auditory stimuli |
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What are the developmental red flags for a 4-6 month old?
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1. poor head control
2. failure to reach for object by 5 months 3. no social smiles |
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What is a cortical thumb a sign of?
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hypertonicity
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when should head lag be gone?
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4 months
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which direction to infants roll first and at what month>?
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belly to back at 5 months
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describe the laugh of a 4 month old.
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Loud; may go from laughing to crying
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What milestones occur at 5months?
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1. can hold head erect
2. belly to back 3. can be pulled to a standing position and can support weight |
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LIst the milestones for 6 months of age.
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1. NO head lag
2. reach for an object 3. TURNS TO VOICE 4. transfer from hand to had after learning grasp 5. flex knees temp then extends 6. may sit alone but rolls 7. bears some weight 8. clear preference for caregiver 9. may accept strangers; cuddles 10. interested in legs and feet |
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When should a child start making repetitive vowel sounds?
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6.5 months
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If a child pursue a pellet with raking, but cannot pick it up; responds to facial expressions and pivots in prone position to go after an object he or she is most likely ___ months of age.
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7
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a major accomplishment of an 8 month old is ___
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unsupported sitting
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What is the speech of an 8 month old like?
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repetitive consonants "mama" baba
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at what age does a child usually respond to their name?
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8 months
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When does separation anxiety begin to manifest?
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8 months
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LIst the 10 accomplishments of the 9 month old.
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1. sits without support, stands holding on
2. Imitates speech sounds 3. creep or crawl 4. may take steps with both hands held 5. poke with index finger 6. pincer motion 7. wave bye-bye 8. release an object by request 9. object permanence 10. become less dependent on presence of mother |
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at what age does object permanence manifest?
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9 months
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What are the red flags of 6-12 month olds?
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1. primitive reflexes still present after 6 months
2. no babbling by 6 months 3. no reciprocal vocalization by 9 months 4. inability to localize sound by 10 months |
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When can a child follow a 2 step command?
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2 years old
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How long can an 11 month old typically stand?
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2 seconds
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If a baby has just learned to respond to "no," has a pincer grasp without ulnar and can play with a large ball, how old is this child?
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12 months
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When can a child say one word besides "dada" and "mama"?
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15 months
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When should a child extend an object and release it into offered hand?
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12 months
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If a child stoops down to recover a toy on the floor what is the minimum age of the child?
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15 months
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To put a pellet into a small bottle a child should be how old?>
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15 months
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At 15 months, a child should be abet to put __ (#) cube(s) on top of another with demonstration.
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1
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A child who walks alone at its target age could be how old?>
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15 months
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List 4 major accomplishments of 18 months olds?
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1. Says 3 words besides mama and dada
2. walks backward 3. imitates household chores (sweeping) 4. Scribbles |
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What should occur in a 20 month old child in terms of mobility?
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Go down the stairs one at a time with 1 hand held
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If a child can move up stairs one at a time, but not downs stairs, how old is this child?
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18months
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List the developmental red flags for children 15 months to 24 months.
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1. No consonant production by 15 months
2. No words other than mama/dad by 18 months 3. Hand dominance before 18 months 4. Not walking by 18 months 5. Inability to walk up and down stairs by 24 months 6. No two words sentences by 24 months |
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How old is a child that can kik a ball forward, remove articles of clothing and combine 2 words?
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2 years
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How many teeth does a 2 year old usually have?
|
grow 8 teeth to total 14-16
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What type of play is consistent with infancy?
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solitary play
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Parallel play is descriptive of which age group?
|
toddlers older than 2
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What type of play can be seen in preschoolers?
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-cooperative play
-dramatic presented play -Rough and tumble play |
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How old must a child be to draw a proper circle?
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3 years
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If a child can draw a cross but not a square, how old are they?
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4 years old
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A 5 year old child should have mastered drawing a ____?
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square
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Drawing a triangle is a milestone of which age?
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6
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a child with mild lordosis and a portuberant abdomen is usually about ___ years old?
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2
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What fine motor skill is a milestone for a 4.5 year old?
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drawing a person with 6 parts
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What activity does a 2.5 year old do with his or her thumb?
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wiggles them
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How old is a child who can build a tower of 8 cubes?
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2.5-3
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Describe gender identity between children 2-6 years of age
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-2 year old knows male or female
-3-4 year old show sex typed preference - 5-6 year old notion of how male or female should dress |
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What are the key principles of growth and development?
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-it is orderly and sequential
-each child sets their own pace -behaviors become increasing integrated -there are critical periods -environmental, social, genetic and nutrition all play a role |
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How do children grow?
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First cephalocaudal; then proximaldistal
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True or False: a lisp is a language delay?
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False: it is an articulation delay
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Which delays are the most common in development?
|
language
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True or False: Speech and language are not synonymous?
|
True
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Language acquisition is influenced by ___ factors and the child's ___ ___?
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biological; rearing environment
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What is the purpose of a baby's earliest communication?
|
To attract attention from parents and others in environment
|
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Define receptive vocabulary.
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Refers to words an individual understands and which greatly increases in second year
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If an infant utters its first word around 10 to 15 months, that infant is thought to have ___ vocabulary?
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Spoken
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Parents should understand ___% of what their child is saying by age 2.
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50
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By age 2.5, what % of speech is understandable?
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75%
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By 3.5 years a child should have increased complexity of his or her sentences to ___ to ___ words.
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4-5
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What terms should a 5 year old understand?
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If; because; and when
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When should a child no longer drop the beginning consonant?
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2 years
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By ___ years, a child should not drop the END consonant.
|
3.5
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When can a child pronounce (th) sound?
|
3 years
|
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what 2 letters are often mixed until 5 years of age?
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R and L
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What are the 3 characteristics of stuttering?
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repetition
pauses eye blinking |
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When should a child be referred for stuttering?
|
- > 6
-embarrassed -interferes with communication -parents very concerned -lasts > 6 months |
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If a child comes in with a speech delay, what should the clinician check first?
|
HEARING
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What is the speech production of a 1 year old?
|
- 1-3 words, relies on pointing to convey needs
- understands simple commands |
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Describe the speech production of a 2 year old?
|
-Vocabulary of 300 words
-talks frequently -comprehends most daily conversation |
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At what age would a child have routine use of sentences; spoken vocabulary of 900 words; adds adjective and adverbs to sentences; and 75% of speech.
|
Age 3
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Developmental language disorders effect ___to ___% of all preschoolers.
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5-8
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Give examples of the abnormal movement patterns of infants that would be considered a red flag?
|
1. increased tone
-early rolling (1month) -pulling directly to stand @ 4 months -W-sitting -persistent toe walking 2. Hand dominance prior to 18 months -hemiparesis |
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List the motor development milestones that would be considered red flags if not reached?
|
1. no rolling to prone to supine by 7 months
2. no rolling supine to prone by 9 months 3. no unsupported sitting by 10 months 4. no independent steps by 28 months |