GROWTH AND DEVELOPMENT

1. A three-month-old full-term infant has gained 15 ounces (420 gm) since birth. Her height velocity is normal. Her parents want to know if this is adequate. What would you tell them?
2. A fifteen-month-old boy says no recognizable words. His parents are concerned and wonder if he needs speech therapy. How would you respond to their concern?
3. An infant rolled over at four months and sat with assistance at six months, but at one year he is unable to stand or sit alone. His parents are quite concerned and ask if this is normal. Explain your answer.
4. The parents of a nine-month-old infant are concerned because she is not sitting. She has increased tone and scissoring of her lower extremities. She can grasp a rattle, but does not reach for objects. She coos and has a social smile. What would you tell her parents?
5. A six-month-old has a head circumference in the 50th percentile, height in the fifth percentile, and weight in the fifth percentile (baby was at 50th percentile for all measurements at three months). How would you evaluate this child?
6. The parents of a fourteen-month-old boy born at 30 weeks gestational age are concerned he is not walking. He sat alone at nine months and says two to three words in addition to Mama and Dada. How would you Council these parents?
7. The mother of a ten-year-old girl wants to know when she might start her periods. What would you tell her?
8. A twelve-year-old boy complains that he is the shortest person in his class. He is 54 inches tall. He wants to know if he should take a "growing medicine". What additional information do you need from the history and physical examination before Counciling him regarding his growth potential?
9. The parents of an eight-year-old girl want to know how tall she will be. She has consistently been at the 25% for age for both height and weight for the past four years. What would you tell her? What additional family information may modify your response?
10. A six-month old infant is seen for a well child examination. His height and weight have remained at the 25% but his OFC has gone from the 25% to greater than the 95% over the past four months. What would you be most concerned about? How would you evaluate this child?