Child Health and Rights Quiz

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Questions and Answers

What is the definition of a child according to the United Nations Convention on the Rights of the Child?

Any human being under the age of 21

Any human being under the age of 18 (correct)

Any human being under the age of 15

Any human being under the age of 16

Which of the following is considered a neonate?

A child from birth to 1 month (correct)

A child from 2 to 5 years

A child from 1 month to 1 year

A child from 1 to 2 years

What is one of the primary reasons for focusing on child health?

The majority of child deaths are preventable or treatable (correct)

Children's illnesses are rarely preventable

Children are less likely to develop chronic diseases

Children are generally less dependent on parental care

In 2018, what was the estimated number of children and young adolescents under age 15 that died globally?

6.2 million Signup and view all the answers

What leading cause of death in children under five years is associated with complications from birth?

Preterm birth complications Signup and view all the answers

Which age group has the highest risk of death according to the statistics provided?

Children under 5 years Signup and view all the answers

Which of the following illnesses is NOT a leading cause of death in children under five years as defined by the WHO?

Heart complications Signup and view all the answers

What is a significant contributor to the global burden of disease in children?

Childhood illnesses Signup and view all the answers

By what age should infants typically triple their birth weight?

6-12 months Signup and view all the answers

What does the X-axis represent on the WHO growth charts?

Age of the child Signup and view all the answers

What is the average length at birth for infants?

50 cm Signup and view all the answers

Which of the following indicators is used to identify children who are severely underweight?

Weight for age Signup and view all the answers

How often is length measured in children younger than 2 years?

Every month Signup and view all the answers

What does weight for length/height help to assess?

Situations where age is not identified Signup and view all the answers

What is the significance of the WHO growth charts?

To monitor child’s health using a universal standard Signup and view all the answers

At what age is lung function typically measured for length and height?

Older than 2 years Signup and view all the answers

What are the two major aspects involved in assessing development?

Motor and Psychological Signup and view all the answers

Which factor is NOT mentioned as predisposing delay in development?

High academic pressure Signup and view all the answers

What is the primary goal of the Newborn Screening Program in Jordan?

To screen for congenital and heritable disorders Signup and view all the answers

Which of the following is NOT one of the conditions included in the National Newborn Screening Project of Jordan?

Cystic fibrosis Signup and view all the answers

What method is used for newborn screening of hemoglobinopathies?

Isoelectric focusing Signup and view all the answers

What was the carrier frequency of the HbS gene identified in the study in Northern Jordan Valley?

0.44% Signup and view all the answers

What benefit does early identification of hemoglobinopathies, such as sickle cell disease, provide?

It allows treatment to be initiated in a timely fashion. Signup and view all the answers

Which of these is specifically mentioned as a fine motor skill in development assessment?

Clapping hands Signup and view all the answers

What is the prevalence of beta-thalassemia in the study conducted in North Jordan?

5.93 per cent Signup and view all the answers

How is cystic fibrosis primarily characterized?

Abnormal transport of chloride and sodium across an epithelium Signup and view all the answers

Which screening method is used to detect cystic fibrosis?

Measurement of immunoreactive trypsinogen (IRT) Signup and view all the answers

What potential impact can undiagnosed hearing loss have on a child?

Can affect language, social interactions, and academic performance Signup and view all the answers

What screening tests does the AAP recommend for early childhood?

Anemia, TB, Lead, Urinalysis, Cholesterol Signup and view all the answers

At what age are children screened for iron deficiency anemia?

At 9 months old Signup and view all the answers

Which screening method is recently added for congenital heart defects?

Pulse oximetry Signup and view all the answers

Which of the following is true about anemia screening in Jordan?

Jordan screens only for anemia and undescended testicle Signup and view all the answers

What is the BMI range for a child to be classified as overweight?

Between the 85th and 94th percentiles Signup and view all the answers

What should a health care provider assess to determine a child's BMI percentile?

The child's weight, height, age, and sex Signup and view all the answers

How often does the American Academy of Pediatrics recommend obesity screening for children?

At least once a year starting at age 2 Signup and view all the answers

What percentage of the U.S. population is affected by diseases of the mouth at some point in their lives?

98% Signup and view all the answers

What is one of the benefits of a dental screening program?

It helps to discover dental defects early for corrective measures Signup and view all the answers

At what ages does the American Association of Pediatrics recommend routine vision testing for children?

5, 6, 8, 10, and 12 years of age Signup and view all the answers

What visual acuity threshold indicates a referral for formal optometry evaluation?

20/40 Signup and view all the answers

Which of the following conditions are NOT typically detected through vision screening?

Hearing loss Signup and view all the answers

What percentage of children screened in Jordan were found to have a hearing deficit?

0.05% Signup and view all the answers

What is the recommended method for testing a child's hearing during screening?

With an audiometer Signup and view all the answers

Which of the following health risks is associated with childhood obesity?

Increased risk of joint problems Signup and view all the answers

What age is NOT included in the recommended hearing loss screening schedule?

9 years old Signup and view all the answers

What is the primary reason early correction of visual problems in children is necessary?

To avoid hindering learning ability Signup and view all the answers

Study Notes

Child Health - Early Screening

The UNCRC defines a child as anyone under 18, unless a different age of majority is established by national legislation
A neonate is a child less than 28 days old
An infant is a child less than one year old
An adolescent is a person aged 10 to 18 inclusive

Why Focus on Child Health?

Children are a vulnerable population segment
Children depend on adults for development and survival
Childhood is a critical period of rapid growth and development, making children susceptible to infections due to their immature immune systems
Many child deaths are preventable
Childhood illnesses contribute significantly to the global burden of disease
Evaluating childhood health is a metric for societal progress

Highlight on the Problem

In 2018, an estimated 6.2 million children and adolescents under 15 died from preventable causes
Neonatal period is the time of highest risk for death in children
1 in 26 children died before reaching age 5 in 2018
1 in 11 children died before reaching age 5 in 1990

Deaths by Age (2021)

A breakdown of global deaths by age groups in 2021 was presented in the provided data.

Infant Mortality Rate (2020)

A map showing the global distribution of infant mortality rates in 2020 was presented.

Number of Child Deaths (1960-2020)

A graph illustrating changes in the number of child deaths worldwide from 1960 to 2020, showcasing trends and reductions over time, is presented.

Child Mortality Rate (1960-2020)

A graph showing the global child mortality rates, broken down regionally, from 1960 to 2020.

Causes of Death

Causes of death vary by age; neonatal-period issues might necessitate clinical interventions, whereas public health strategies can more readily address issues beyond the neonatal period
Most interventions linked to prenatal and maternal care interventions decrease neonatal mortality.

Leading Causes of Death (2018)

Preterm birth complications were the leading cause of death among children under five in 2018.
Other significant factors like pneumonia, intrapartum related issues, congenital anomalies, diarrhea, neonatal sepsis and malaria are among the key contributors to child mortality.

Factors Affecting Child Health

Poverty
Poor nutrition
Lack of access to healthcare
Lack of maternal education
Conflict and disaster
Lack of safe water and sanitation
High fertility rate
Poor maternal health services

Morbidity Causes in Children

Vitamin A deficiency is a global leading cause of preventable blindness in children.
Iodine deficiency is a preventable cause of development delay in children
Iron deficiency affects over 50% of children which causes anemia, and reduces school performance.
Helminthic infections cause anemia, poor growth and decreased learning capability.

In Jordan

Child and infant mortality considerably decreased between 1997 and 2012 in Jordan, yet the decrease did not meet global targets.
Neonatal mortality constitutes more than 70% of child mortality under 5 years of age
Many of the deaths under 5 years (one-third) are preventable
Diarrhea, respiratory infections, and other infectious diseases and injuries were other major causes of mortality in this age group as well.

Health Services in Child Health

Monitoring growth and development
Care in illness
Preventive and promotive care

Monitoring Growth and Development

Growth and development are the two primary biological processes of childhood.
Growth is an increase in physical size, encompassing both overall body growth and the growth of individual body parts. This is associated with increasing cell number / size
Development involves acquiring abilities and skills, including motor, social, emotional, and intellectual development.

Stages of Growth and Development (Intrauterine Stage)

The intrauterine stage starts with fertilization and ends with birth
Embryonic Period: It encompasses the period of organogenesis which takes place in the first trimester of pregnancy, any adverse factors in this stage may lead to congenital anomalies or miscarriage
Fetal Period: In this phase, the mother provides nutrients and immunoglobulins to the fetus, and any conditions like stillbirth, early labor, and low birth weight.

Stages of Growth and Development (Extrauterine Stage)

At birth, average body weight falls in the range of 2.5-4.2 kg
Neonatal Period
Infancy Period
Childhood Period
Adolescence Period

Factors Affecting Growth and Development

Genetic factors like ethnicity are fixed, hard to modify, and impact growth from conception to adulthood
Environmental factors like nutrition, infections during infancy and childhood, and inadequate stimulation/care affect growth and development

Growth Monitoring

The main purpose of growth monitoring is to track healthy growth and detect any indications of slowed development to promptly address these concerns.
Checking for growth monitoring will indicate the overall nutritional status of the child
Identifying high-risk children requiring immediate attention, recognizing growth abnormalities linked to underlying conditions can be achieved by growth monitoring.
Prevention of underlying nutritional disorders that lead to mortality and morbidity is another goal of growth monitoring.

Assessment of Growth

Longitudinal assessment: Tracking growth over time by measuring at regular intervals
Cross-sectional assessment: Comparing large numbers of children of the same age at a given point in time to evaluate growth
Basic growth assessments typically measure weight, height, and head circumference.

Assessment of Growth (Charts)

Weight-for-age charts are commonly used metrics to assess growth in children.
Infants or children who weigh less than the expected range can be classified as underweight or severely underweight according to growth charts
Average weight gain for children during their first year is around approximately 750 g per month in the first four months. 500 g/month in the following four months, and 250g/month for the third set of four months.
Infants double their birth weight by 4-5 months, triple by the end of the first year, and quadruple by the end of the second year.
Length or height is measured for infants below the age of 2 years while laying down, for children above the age of 2 years while standing. Average length at birth is around 50 cm and length or height may increase 25cm in the first year, 90cm at 3 years and 100 cm at 4 years of age.

Growth Charts

Growth charts are visual aids developed to record and track child's physical growth and development
WHO growth charts, primarily designed for monitoring children's health and nutritional status over time
WHO growth charts are international norms that outline expected growth patterns in children, tailored for breastfed children up to the age of 2.
X-axis represents the child's age (or age in months/years)
Y-axis shows the measured weight, height, length, or BMI

Indicators Used to Assess Growth

Length/height for age
Weight for age
Weight for length/height
BMI for age

Identifying Growth Problems

Length-for-age: Children with length scores below -2 are considered stunted, below -3 are severely stunted
Weight-for-age: Children below -2 have significant underweight, while -3 indicates severe underweight.
Weight-for-length: Scores exceeding 3 indicate obesity in children, 2 indicates overweight, and 1 indicates possible risk of overweight; -2 indicates wasting, while -3 denotes severe wasting
BMI-for-age: 3+ above the line indicates obesity; 2+ above the line indicates overweight; BMI scores below -2 or lower indicate potential risks or wasting conditions

Development Assessment

Development in children depends on nervous system maturity (myelination)
Development usually follows a consistent sequence but can vary in pace among individuals
Development generally proceeds from head to toe (cephalocaudal).

Development Assessment (Aspects)

Motor development involves skills such as standing & sitting; fine motor abilities such as finger and eye movements
Psychological aspects of development such as attachment to caregivers, vocalization milestones (around 9 months of age), and emotional aspects such as fear development (7–8 months)

Factors Predisposing Delay in Development

Lack of family guidance or support
Lack of environmental stimulation
Emotional deprivation
Health problems (e.g., malnutrition, congenital anomalies, rickets)

Newborn Screening of Jordan

The goal is to identify congenital and heritable disorders through a staged approach.
Newborn screening involves lab analysis of blood samples
Identified abnormalities are reported to case management/clinics
Families receive follow up appointments to confirm the test results

Expanded Newborn Screening Program Conditions in Jordan

Includes 29 conditions (such as 20 inborn errors of metabolism, 3 hemoglobinopathies including sickle cell disease, 2 endocrine disorders, 1 hearing loss disorder, and 3 other metabolic disorders)

Hemoglobinopathies

Worldwide, ~7% of population carries a hemoglobinopathy with clinical significance
Screening via isoelectric focusing detects abnormal patterns indicative of the condition
Early identification enhances the ability to initiate timely treatment for hemoglobinopathy related conditions

Hemoglobinopathies: Study Example (Northern Jordan)

Study on 6-10-year-olds in Northern Jordan Valley identified both alpha- and beta-thalassemia.
HbS gene frequency is low.
HbS/β-thalassemia co-occurrence is observed.
Prevalence of the conditions vary across geographical regions of Northern Jordan (Al-Ghor, Ajloun, Irbid)

Cystic Fibrosis

Genetic disorder affecting mainly lungs, pancreas, liver, and intestine; caused by abnormal chloride/sodium transport across epithelium; leads to thick, viscous secretions
Newborn screening usually involves measuring immunoreactive trypsinogen (IRT) in dried blood spots

Hearing Loss

Undiagnosed hearing loss in children significantly impacts development in language, social interaction, and academic performance
Early identification is critical for accessing resources to assist children's development

Congenital Heart Defects Screening

Pulse oximetry a recently implemented bedside test for identifying critical congenital heart defects.

Screening in Early Childhood

Recommended screenings include Anemia, TB, Lead, Urinalysis, and Cholesterol
In Jordan, Anemia is also one of the screens done.

Anemia

Newborn screening often includes hemoglobin electrophoresis (to identify hereditary conditions)
Age-based anemia screening (particularly iron deficiency anemia) and routine testing in adolescence are common practices

High-Risk Groups for Anemia

Infants fed formula or cow's milk before 12 months without sufficient iron supplementation
Breastfed infants older than 6 months without adequate iron supplementation
Children who consume more than 24 ounces of cow's milk daily
Children with special health care needs

When to Screen Children?

Preterm and low-birth-weight babies require screening before 6 months, and again in 6 months' time if not initially on iron-fortified formula
Children and infants with risk factors should be screened at 9 to 12 months and again 6 months later
All non-pregnant women should be screened every 5 to 10 years

Screening in Middle Childhood and Adolescence

An integrated, sequential set of school-based strategies to support optimal physical, emotional, social, and educational development in children
Tailored to the local community's specific needs, resources, requirements
The screening program should include the environment of the school, health promotion and screening, special needs assessment, and health instruction

Screening in Middle Childhood/Adolescence: Specifics

School entry
Annual screenings
Advantages of the method
Screening can be done by health care workers or teachers

Screening Recommendations: School-aged Children & Adolescents

Learning processing assessment; Speech evaluation, Vision testing; Auditory evaluation; Dental screening; Obesity assessment; Hemoglobinopathy screening; Malnutrition assessment; Strep infection screening; Heart disease assessment; Blood pressure assessment; Depression assessment

Screening for Visual Problems

Routine vision testing is recommended at specific ages (5, 6, 8, 10, 12) by pediatricians.
Visual acuity testing using age-appropriate methods (e.g., Snellen chart) is also important.
Children with visual acuity less than 20/40 are often further evaluated.

Screening for Visual Problems (Conditions)

Myopia
Hyperopia
Squint
Thick cornea
Conjunctivitis
Other eye conditions, requiring early intervention to avoid negative effects on learning abilities

Screening for Hearing Problems

The Bright Futures Steering Committee recommends screening for hearing loss in children at ages five, six, eight, and 10, with additional risk assessments for well-child visits.
The assessment utilizes an audiometer, and children failing the test are referred for further evaluation.
Early detection and treatment of hearing impairments can have a positive impact on children's learning abilities

Screening for Obesity

17% of children & adolescents in the U.S. are obese
Obesity increases the risk for developmental and health issues (e.g., T2 diabetes, high blood pressure, high cholesterol, joint, sleep issues, and psychological problems).
AAP recommends obesity screening for children aged 2 years and older, preferably yearly.
Assessing weight, height, age and sex helps determine BMI percentile
Screening process typically includes BMI percentile information on the standardized growth chart, a description of the results, recommendations

Screening for Obesity (Categories)

Overweight (BMI between 85th and 94th percentile)
Obese (BMI at or above 95th percentile)
Screening results typically include these details: child's BMI-for-age percentile, results explanation, and follow-up action recommendations.

Dental Screening

Oral diseases affect 98% of Americans
Regular dental screenings are recommended.
Screening identifies dental issues early when treatment is most effective and least painful
Screenings can be done using a tongue depressor, gloves, and a flashlight.

Dental Screening: Categories of Conditions

Tooth decay
Gum disease
Dental abnormalities and irregularities
Dental injuries and fractures
Oral tumors
Other oral disorders and infections

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Description

Test your knowledge on child health and the definitions according to the United Nations Convention on the Rights of the Child. This quiz covers important topics such as infant growth, causes of death, and health indicators. Discover vital statistics and insights about children's health globally.