THE IMPORTANCE OF INFANT SCREENING

Produced as a class project at WKU for CFS 294 - Fall, 2009

By Thelma Newsom

THERE ARE MANY REASONS FOR INFANT SCREENINGS!

What is the importance of Infant Screening?

WHAT IS INFANT SCREENING?

Relatively quick preliminary evaluation

Used to determine if a child should be referred for more in-depth assessment

practice of testing every newborn for certain harmful or potentially fatal disorders that aren't otherwise apparent at birth

EFFICIENCY IS THE DRAWBACK OF INFANT SCREENINGS

Full evaluations are costly in terms of time and money

Screening tools are less accurate than follow-up assessment

Overlooks many children who might benefit from special services

REASONS YOU MAY BE CONCERNED ABOUT YOUR

BABY’S GROWTH OR DEVELOPMENT

•No improvement in head control •No attempts to lift the head when laying facedown•Extreme floppiness•Lack of response to sounds or visual cues, such as loud noises or bright lights•Inability to focus on a caregiver’s eyes•Poor weight gain

Every baby is different but your instincts can be right!!

WHY DO WE USE A TRAINED PROFESSIONAL TO SCREEN INFANTS?

Trained observation of strengths and weaknesses of each child!!

A TRAINED PROFESSIONAL……….

Will offer several types of screening for your infant at their well baby routine visits. They can screen for problems with health, vision, hearing, and development.

WHAT TYPES OF SCREENINGS ARE THERE

1.) Developmental Screenings2.) Hearing and Vision Screenings3.) Health Screenings

AT WHAT AGE IS YOUR CHILD SCREENED

•Birth•2 months •4 months •6 months•12 months•15 months•18 months

Age for well baby check-ups

Age for hearing screenings

•18 months •or earlier if child has ear infections

SOME ROUTINE TESTS ARE……

•Phenylketonuria (PKU)

•Galactosemia

•Sickle-cell anemia

•Thyroid defiency or Neonatal Hypothyroidism

•APGAR

•Cystic fibrosis

•Glucose – 6 phosphate dehydrogenase deficiency

•Congenital adrenal hyperplasia

•Human immunodefiency disease (HIV)

Blood is collected from a heel stick and repeated in two weeks for some of these tests

babies are given a clean bill of health, early diagnosis and proper treatment can make the difference between lifelong impairment and healthy development.

WHAT ARE DEVELOPMENTAL SCREENINGS?

DEVELOPMENTAL SCREENING?

Early recognition of any

developmental concerns will help an infant grow up

in the most superlative

growing experience possible.

DEVELOPMENTAL SCREENINGS……… Use of growth

charts and national guidelines to compare how the infant ranks in comparison to other infants their age group

Social/Emotional evaluations

Language evaluations

Fine motor skills Gross motor skills

SOCIAL EMOTIONAL EVALUATIONS….

Show how well a child interacts with others

Can take care of his or her own needs Regulates his or her emotions and behaviors

LANGUAGE EVALUATIONS……..

•How well a child listens to language

•How well a child responds to language

•How well they use vocabulary and grammar

•shows interest in books, prints, music and his or her surroundings

SPEECH MILESTONES FROM BIRTH

By the end of three months:

Smile when you appearStartle upon hearing loud soundsMake “cooing” soundsQuiet or smile when spoken toSeem to recognize your voiceCry differently for different needs

SPEECH MILESTONES FROM BIRTH

By the end of six months:

Make gurgling sounds when playing with you or left aloneBabble repetitive syllables, such as “ba,ba,ba”Use his or her voice to express pleasure and displeasureMove his or her eyes in the direction of soundsRespond to changes in the tone of your voice Notice that some toys make soundsPay attention to music

SPEECH MILESTONES FROM BIRTH

By the end of twelve months:

Try to imitate wordsSay a few words, such as “dada,” “mama” and “uh-oh”Understand simple instructions, such as “Please drink your milk”Understand “No” Turn and look in the direction of sounds

SPEECH MILESTONES FROM BIRTH

By the end of eighteen months:

Point to an object or picture when it’s named Recognize names of familiar people, objects and body partsFollow simple directions accompanied by gesturesSay up to ten words

SPEECH MILESTONES FROM BIRTH

By the end of twenty-four months:

Ask for common foods by nameUse simple phrases, such as “more milk”Begin to use pronouns, such as ‘mine”Ask one to- to two-word questions, such as “go bye-bye?”Follow simple commands without the help of gesturesSay more words every monthSpeak 50 words and understand moreBe difficult to understand

SIGNS OF POTENTIAL DISTRESS OR DEVIATIONS FROM EXPECTED FINDINGS

•Cleft lip or cleft palate•Circumoral pallor•Lip movement asymmetrical•Reflexes absent or incomplete•Protruding tongue

FINE MOTOR/ ADAPTIVE SKILLS

•Child’s ability to use small muscle’s

•Ability to use hand eye coordination movements

•Problem solve

GROSS MOTOR SKILLS……..

Is the child’s ability to use his or her large muscles (rolling over, sitting, jumping)

HOW YOU CAN SUPPORT DEVELOPMENTAL SCREENINGS?

1. Sharing information with your child’s health care professional

2. Asking about any concerns you may have

3. Following recommendations you may have

4. Scheduling additional evaluations

HEARING AND VISION SCREENINGS… Identify hearing

and vision deficits that may interfere with development and learning

Must be detected and treated very early

EYES Expected findings Slate gray or blue eye

colorNo tearsFixation at times - with ability to follow objects to midlineRed reflexBlink reflexDistinct eyebrowsCornea bright and shinyPupils equal and reactive to light

SHOULD I REQUEST ADDITIONAL TESTS?

Why Should I Request Additional Tests?

If you have a family history of an inherited disorder?

Have you previously given birth to a child who's affected by a disorder?

Did an infant in your family die because of a suspected metabolic disorder?

Do you have another reason to believe that your child may be at risk for a certain condition?

HEALTH SCREENINGS……….

Usually take place as a well child check-up

Child care professional weighs and measure your child (length weight and head circumference)

Head to toe exam Asks about illnesses

and healthy habits Ensures child’s

immunizations are up to date

Administer vaccinations

WHAT DO THEY MEAN BY BABY MEASUREMENTS?

Head to toe exam:

•Head •Ears •Eyes •Mouth•Skin•Heart and lungs•Abdomen •Hips and legs•Genitalia

VITAL SIGNS

Temperature - range 36.5 to 37 axillary

Common variations Crying may elevate

temperatureStabilizes in 8 to 10 hours after delivery

Signs of potential distress or deviations from expected findings

Temperature is not reliable indicator of infectionA temperature less than 36.5

VITAL SIGNS

Heart rate - range 120 to 160 beats per minute

Common variations Heart rate range to 100 when

sleeping to 180 when cryingColor pink with acrocyanosisHeart rate may be irregular with crying

Signs of potential distress or deviations from expected findings

Although murmurs may be due to transitional circulation-all murmursshould be followed-up and referred for medical evaluationDeviation from rangeFaint sound

VITAL SIGNS CON’T…… Respiration - range 30

to 60 breaths per minute

Common variations Bilateral bronchial

breath soundsMoist breath sounds may be present shortly after birth

Signs of potential distress or deviations from expected findings

VITAL SIGNS CON’T…… Asymmetrical chest

movementsApnea >15 secondsDiminished breath soundsSeesaw respirationsGruntingNasal flaringRetractionsDeep sighingTachypnea - respirations > 60Persistent irregular breathingExcessive mucusPersistant fine cracklesStridor

GENERAL GROWTH GUIDELINES FOR YOUR BABY:

Birth to 6 months

a baby may grow 1/2 to 1 inch a month and

gain 5 to 7 ounces a week.

Expect your baby to double his or her birth weight by ages 5 to 6 months.

GENERAL GROWTH GUIDELINES FOR YOUR BABY:

a baby may grow 3/8 inch a month

gain 3 to 5 ounces a week.

Expect your baby to double his or her birth height and triple his or her birth weight by age 1.

6 to 12 months

A LIST OF CHILDHOOD VACCINATIONS

AGE Vaccine

Birth-2 months 1-4 months 2 months 4 months 6 months 6-18 months 12-15 months 15-18 months 24 months-18 years

Hepatitis B Hepatitis B DTaP, Hib, IPV, PCV DTaP, Hib, IPV, PCV DTaP, Hib, PCV Hepatitis B, IPV Hib, MMR, PCV DTaP Hepatitis A (in select

areas)

You can help your baby by:

-holding your baby

Offer nutritious foods

-provide physical activities for your child

-schedule resting periods within your daily routine

-plan time to spend together to read, sing, talk, and play to support your child’s brain development

http://www.cdc.gov/growthcharts/

Right click and highlight on one of the links below to access a website that will allow you to plot your own child’s growth

chart

http://vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta?v%3afile=viv_iO9AH2&server=search3.nlm.nih.gov&v:state=root%7Croot-50-10%7C0&

THE IMPORTANCE OF INFANT SCREENINGS!!!!!Produced as a class project at WKU for CFS 294 - Fall, 2009By Thelma Newsom

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Retrieved December 2009, from National Center on Birth defects and Developmental Disabilities: http://www.cdc.gov/ncbddd/child/devtool.htm

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