7 Introduction
6806
Appendix C
Indoor Dangers
Environment
Carbon monoxide (A colorless, odorless toxic gas.)
Possible causes
Wood-burning, coal, gas, kerosene, and propane heating devices emit more carbon
monoxide than electric heating.
Homes with attached garages are at higher risk because vehicles emit carbon monoxide as
waste.
Cooking on a barbeque grill nearby the house increases risk because carbon monoxide is
released in the smoke.
Childproofi
ng measures
Maintain fi replaces and heating system.
Keep home well ventilated. Keep grill farther from the home. Close doors and windows when using the grill.
Install a carbon monoxide detector on each fl oor in the home. Replace or repair as needed.
Learn the warning signs of carbon monoxide poisoning. Seek help at once if these are
noted.
Fire
Possible causes
Problems with household wiring, electrical appliances, chimney fi res, and space heaters are
main causes of fi res. Accidents with matches, lighters, cigarettes, and candles often lead to fi res.
Cooking accidents can cause fi res.
Childproofi
ng measures
Install smoke detectors in every bedroom and near the kitchen. Check monthly and install
new batteries twice yearly.
Have working fi re extinguishers near kitchen and fi replaces.
Keep matches, lighters, cigarettes, and candles out of the reach of children.
Do not
leave lit candles or food cooking on the stovetop unattended.
Plan escape routes from various rooms of the house. Teach fi re safety and escape routes to
even very young children.
Lead paint (Used in buildings built before 1978.)
Possible cause
Lead poisoning comes from breathing lead dust or fumes or eating paint chips. (Lead
causes brain damage.)
Appendix C: Indoor Dangers
identifi es safety concerns and
suggests childproofi ng measures
680
6786
Appendix B
Recommended Childhood Immunizations
Recommended Immunization Schedule for Ages 0 Through 6
—United States • 2009
For those who fall behind or start late, see the catch-up schedule
Vaccine Age
Birth
1
month
2
months
4
months
6
months
12
months
15
months
18
months
19–23
months
2–3
Years
4–6
Years
Hepatitis B
HepB
Rotavirus
RV RV RV
Diphtheria,
Tetanus, Pertussis1
DTaP DTaP DTaP
Haemophilus
infl uenzae
type b
Hib Hib Hib
Pneumococcal
PCV PCV PCV
Inactivated
Poliovirus
IPV IPV
Infl uenza
Measles, Mumps,
Rubella
Varicella2
Hepatitis A
Meningococcal
HepB
HepB
DTaP
DTaP
Hib
PCV
PPSV
IPV
IPV
Infl
uena (Yearly)
MMR
Varicella
MMR
Varicella
HepA (2 doses)
HepA Series
MCV
Range of recommended ages
Certain high-risk groups
1.
Pertussis — whooping cough
2.
Varicella — chicken pox
3.
Human Papillomavirus — virus that can cause cervical cancer and
genital warts (STD); vaccination given to females.
Note: Recommendations are reviewed and updated regularly. Check
updates at the American Academy of Pediatrics
(http://www.aap.orgfor
).
Appendix B: Recommended
Childhood Immunizations provides
U.S. immunization schedules for
children through age 18
678
662
663 Appendix A
Appendix A
in other areas, children do not maintain
a steady pace in reaching milestones.
Development is a journey without a
cruise control.
Q:
Is regression in skills a cause for
concern?
A:
Some brief regressions are due to an
illness or to a change in the child’s
environment, such as a move, a change
Developmental
Milestones Q and A
Q:
Will the developmental milestones
listed and the ages given vary
somewhat from source to source?
A:
Yes. Authors list milestones to fi t the
content of their writing. Ages differ
even for the same milestones because
researchers interpret the milestones
differently. (For example, walking may
be taking a couple of unsure steps or
toddling across a room.) Depending on
the researcher, the age norms may be
based on the age in which 50%, 67%,
or 75% of children reach the milestone;
this makes for reported differences in
the typical age. Thus,
developmental
milestones are only a general idea of the
timing of certain changes.
Q:
Do developmental milestones “fi t”
premature babies?
A:
They do fi
t if you adjust the baby’s age
to his or her due date. For example, if
a baby is born two months early, the
baby will likely achieve milestones two
months later during the fi rst two years.
Q:
When are developmental milestones the
most precise?
A:
These charts are rough guidelines for
the fi
rst year and even less precise in
the following years due to differences
in children’s environments.
Q:
Do developmental milestones remain
the same from generation to generation?
A:
Some milestones have remained
somewhat the same for many years.
However, the environment can
cause changes. For example, putting
babies to sleep on their backs (a SIDS
preventive) has caused babies to roll
over about a month later than when
tummy sleeping was common. Also,
due to more learning materials (games,
books, media) and preschool programs,
many more young children are learning
colors, letters, and numbers before the
kindergarten year than in the past.
Q:
Is the accomplishment of the milestone
or the age the most important to
development?
A:
The accomplishment of the milestone,
regardless of age, is by far the most
important factor. For example, think
about this question: Among your
friends can you tell who walked earlier
and who walked later as a baby?
Q:
Why are ages given?
A:
Ages help parents discuss any possible
delays with their child’s doctor. Doctors
usually watch a child for a few weeks
or months before drawing a conclusion.
If a doctor notes
signifi cant
delays, he or
she may refer the child to a specialist
for further testing.
Q:
If the child is ahead of the norms, does
it mean he or she is gifted?
A:
A gifted child continues to accelerate
over the course of several years. Many
children with more average intelligence
learn some skills early due to an early
exposure to that skill. With the exception
of children who are profoundly gifted,
giftedness is not usually confi
rmed until
age nine or even later.
Q:
Will the child maintain the same pace
of development; that is continue to
be slow, average, or above average in
reaching each milestone?
A:
Because development in one area
reinforces and enhances development
in child care and education programs,
or even a change in family make-
up (a new baby, a divorce, death).
Regression that continues, worsens,
or spreads to several developmental
areas may be a symptom of a serious
developmental problem.
Parents should
always discuss developmental regression
with their child’s doctor.
Developmental Milestones of
Children Through Age 12
Newborn Milestones
Physical
1 Month
Has refl exive movements.
Startles easily (Moro refl ex).
Roots for breast.
Stares at objects, but does not try to grasp.
Attempts to lift head when on tummy.
2 Months
Has more voluntary actions.
Cycles arms and legs.
Holds head up when on stomach at 45-degree above surface.
Uses a refl exive grasp. Holds objects placed in hands for a few seconds.
3 Months
Leans on elbows and holds chest up and head erect for 10 seconds.
Moves arm and leg on each side of the body in unison.
Holds hands open.
May swipe at dangling objects.
Explores face with hands.
4 Months
Rolls from stomach to side.
Holds head steady for a short time.
Turns head in all directions.
Splashes and kicks in bath.
Sits with support of cushions for a short time.
Touches objects close to hand and may bat objects.
Pulls objects placed in hand toward mouth.
Appendix A: Developmental Milestones highlights
the physical, intellectual, and social-emotional
developmental milestones for children through age 12
area
elopment
Appendices