2025 CCEA GCSE Home Economics: Child Development 3330 Practice Paper with Answers

Oxytocin is the hormone that stimulates the muscular contractions of the uterus during labour, and it also causes the 'let-down' reflex during breastfeeding. Prolactin stimulates milk production, oestrogen and progesterone maintain the pregnancy.

1 mark: C. No partial credit. [1]

Oedema is swelling caused by fluid retention in the body's tissues, commonly noticed in the ankles and feet during pregnancy. Option B describes heartburn, option C describes varicose veins, and option D describes constipation.

1 mark: A. No partial credit. [1]

Ventouse extraction uses a vacuum suction cup, attached to the baby's head, to help guide the baby out during the second stage of labour. Forceps delivery instead uses metal instruments; induction is a method of starting labour artificially; a caesarean section is a surgical delivery.

1 mark: B. No partial credit. [1]

The fontanelle is the soft area on a newborn's skull where the bones have not yet fully joined together, allowing for continued brain growth in the early months of life. Vernix is the waxy coating on newborn skin, meconium is the baby's first stool, and the areola is the darker skin around the nipple.

1 mark: A. No partial credit. [1]

(a) Under the UN Convention on the Rights of the Child, parents are recognised as having responsibilities such as protecting their child from harm and neglect, and providing for their child's health, education and overall development. (b) Having a baby reduces the time and money a couple has available for socialising, as much of their time is now taken up with feeding, changing and caring for the baby, and going out becomes harder to arrange (needing a babysitter or bringing the baby along), so couples often see friends less often, especially in the early months.

(a) 1 mark each for any two valid responsibilities, e.g. protection from harm; provision of education; provision of healthcare; meeting basic needs. (b) 1 mark: valid effect on social life identified (e.g. less free time/money for socialising); 1 mark: correct reason given (e.g. time/money now needed for the baby). [4]

Before deciding to have a baby, a couple might consider whether they are financially stable enough to cover the cost of raising a child; whether their relationship is stable and secure; whether they have suitable housing/space for a child; the impact on their careers and work plans; their age and health; and whether they have support available from family or friends.

1 mark each for any three valid, distinct factors, e.g. financial stability; relationship stability; suitable housing; career/work plans; age/health; family support available. [3]

(i) Progesterone maintains the lining of the uterus so the pregnancy can be sustained, and it relaxes the uterine muscle to help prevent contractions until labour is due to begin. (ii) Oestrogen works together with progesterone to maintain the pregnancy, supports the growth of the uterus, and helps prepare the breasts for milk production later in pregnancy. (iii) Prolactin, released after the baby is born, stimulates the breasts to produce milk.

1 mark each for: (i) maintains the uterine lining/pregnancy, preventing early contractions; (ii) supports pregnancy/uterine growth and prepares breasts for feeding; (iii) stimulates milk production. [3]

(a) Signs that might indicate pregnancy include a missed menstrual period, breast tenderness or enlargement, tiredness, and needing to urinate more frequently. (b) Backache is a common minor problem in pregnancy, caused by the extra weight being carried and hormonal changes loosening the ligaments; it can be relieved by maintaining good posture, wearing flat and supportive shoes, avoiding lifting heavy objects, and doing gentle, pregnancy-safe exercise such as swimming or antenatal yoga.

(a) 1 mark each for any two valid signs of pregnancy, e.g. missed period; breast tenderness; tiredness; frequent urination. (b) 1 mark: a valid minor problem named (other than nausea); 1 mark: a correct, relevant way of relieving it. [4]

(i) The placenta is the organ that develops in the uterus during pregnancy; it allows oxygen and nutrients to pass from the mother's blood into the baby's blood, and allows waste products such as carbon dioxide to pass from the baby's blood back into the mother's, without the two blood supplies actually mixing together. (ii) The umbilical cord connects the developing baby to the placenta; it contains blood vessels that carry oxygen and nutrients from the placenta to the baby, and carry waste products from the baby back to the placenta to be removed.

(i) 1 mark: exchanges oxygen/nutrients from mother to baby; 1 mark: removes waste from baby without blood supplies mixing. (ii) 1 mark: connects baby to placenta, carrying blood vessels transporting oxygen/nutrients/waste. [3]

Tests and checks carried out at antenatal appointments include a urine test (checking for protein or glucose), a blood test (checking blood group, iron levels and immunity to certain infections), a blood pressure test, a weight check, a check of the baby's heartbeat, and screening tests such as ultrasound scans. Taking the blood pressure test as an example: this checks for high blood pressure, which, together with protein in the urine, can be a sign of pre-eclampsia, a potentially serious condition for both mother and baby if it is not detected and managed.

1 mark each for any three valid tests/checks named, e.g. urine test; blood test; blood pressure test; weight check; heartbeat check; screening tests; 1 further mark for a correct explanation of the importance of one named test. Award a maximum of 3 marks overall if only tests are listed with no explanation given. [3]

A midwife provides care and support to the mother throughout pregnancy, during labour and birth, and in the early days after the baby is born, monitoring the health of both mother and baby. A sonographer carries out ultrasound scans during pregnancy, allowing the baby's growth and development to be monitored and any abnormalities to be identified. An obstetrician is a doctor who specialises in pregnancy and childbirth, and becomes involved particularly if complications arise. A paediatrician is a doctor who specialises in the health of babies and children, and may examine the newborn baby after birth.

1 mark each for any two valid health professionals (other than GP) correctly named; 1 further mark for a correct description of the role of at least one of them. [3]

A pregnant woman is advised to avoid unpasteurised soft cheeses, such as brie or camembert, because they can carry listeria bacteria, which can cause listeriosis; pate and liver, because they can also carry listeria and contain very high levels of vitamin A, which can harm the developing baby; and raw or undercooked eggs and meat, because of the risk of salmonella and toxoplasmosis infection.

1 mark each for two correctly named foods to avoid, up to 2; 1 mark each for a correctly matched reason for each food named, up to 2. Award the mark for the reason only if it correctly matches the food named. [4]

(a) Smoking during pregnancy restricts the oxygen and nutrient supply reaching the baby through the placenta, which is associated with the baby having a low birth weight and an increased risk of premature birth. (b) Regular alcohol consumption during pregnancy can cause fetal alcohol spectrum disorder (FASD) in the baby, which can result in lifelong learning and behavioural difficulties as well as characteristic facial abnormalities.

(a) 1 mark: correctly identifies smoking restricts oxygen/nutrient supply via the placenta; 1 mark: correctly links this to a valid consequence (e.g. low birth weight, premature birth). (b) 1 mark: valid further risk from alcohol correctly stated (e.g. FASD, miscarriage, restricted growth). [3]

(a) Rubella (German measles) is a disease that can seriously affect an unborn baby if the mother becomes infected during pregnancy. (b) If a woman contracts rubella during the early weeks of pregnancy, it can cause congenital rubella syndrome in the baby, which can result in serious and permanent birth defects, including deafness, heart defects, and eye problems such as cataracts; the risk and severity of harm is greatest the earlier in pregnancy the infection occurs.

(a) 1 mark: valid disease named (e.g. rubella, listeriosis, toxoplasmosis, chicken pox). (b) 1 mark: correctly identifies that the disease can cause serious/permanent harm to the baby; 1 mark: at least one correctly matched specific effect given (e.g. deafness/heart defects/eye problems for rubella; miscarriage/severe illness for listeriosis; brain/eye damage for toxoplasmosis). [3]

In the first stage of labour, regular contractions gradually thin and open (dilate) the cervix until it reaches a full 10 cm. In the second stage, contractions and the mother's pushing move the baby down and out through the birth canal, resulting in the birth. In the third stage, further contractions deliver the placenta and the remaining membranes (the afterbirth).

1 mark: first stage correctly linked to dilation of the cervix; 1 mark: second stage correctly linked to the birth of the baby; 1 mark: third stage correctly linked to delivery of the placenta/afterbirth. Marks only awarded if stages are given in the correct order. [3]

Bottles and teats can be sterilised using a cold water (chemical) steriliser, in which the equipment is submerged in a solution made from sterilising tablets or fluid; a steam or electric steriliser, which uses steam to kill bacteria; a microwave steriliser, a compact unit designed for use in a microwave oven; or by boiling the equipment in a pan of water for the recommended time. Whichever method is used, all equipment must be washed in hot soapy water first and fully submerged with no trapped air bubbles.

1 mark each for any three valid sterilising methods, e.g. cold water/chemical sterilising; steam/electric steriliser; microwave steriliser; boiling. [3]

(a) A full-term newborn baby has an average birth weight of approximately 3.3 to 3.5 kg. (b) Other physical features recorded include the baby's length, head circumference, the condition of the skin and any birthmarks, and the presence and size of the fontanelle. (c) The Apgar score is used to assess a newborn baby's general physical condition immediately after birth, based on appearance/colour, pulse, grimace (reflex response), activity (muscle tone) and respiration, each scored and totalled, usually checked at one minute and five minutes after birth.

(a) 1 mark: answer in the range 3.2-3.6 kg (approximately 7-8 lb). (b) 1 mark each for any two of: length; head circumference; skin condition/birthmarks; fontanelle. (c) 1 mark: correctly states it assesses the baby's general physical condition/wellbeing at birth. [4]

The sucking and swallowing reflex causes a newborn baby to automatically suck and swallow when something, such as a nipple or teat, is placed in the mouth, enabling the baby to feed from birth. The grasping (palmar) reflex causes the baby to automatically close their fingers tightly around an object, such as an adult's finger, placed in the palm of their hand. The Moro (startle) reflex causes the baby to suddenly throw out their arms and legs and then draw them back in towards the body, in response to a sudden loud noise, bright light, or the sensation of losing support. The stepping reflex causes the baby to make stepping movements with their legs when held upright with their feet touching a firm surface.

1 mark each for any two correctly named reflexes (other than rooting), up to 2, e.g. sucking/swallowing; grasping/palmar; Moro/startle; stepping; 1 further mark each for a correct description of what each named reflex causes the baby to do, up to 2. [4]

A hospital birth gives the mother immediate access to a full range of pain relief options, including an epidural, and to specialist staff, equipment and emergency facilities (such as for an emergency caesarean section) if complications develop during labour, which is particularly reassuring for a higher-risk pregnancy; however, the environment is less familiar and private than home, and hospital routines can feel more clinical. A home birth allows the mother to remain in a familiar, comfortable environment, with more personal control over the birth and no need to travel while in labour; however, there is no immediate access to specialist pain relief such as an epidural, and no immediate access to emergency medical equipment or surgical intervention if complications arise, meaning the mother may need to be transferred to hospital, which takes valuable time. On balance, a home birth may suit a healthy woman with a straightforward, low-risk pregnancy, whereas a hospital birth is generally recommended for a higher-risk pregnancy, where prompt medical intervention could be essential.

Up to 3 marks for valid points on hospital birth (e.g. immediate access to pain relief/epidural; access to emergency equipment/staff for complications; less familiar/private environment) - 1 mark per distinct point, max 3. Up to 3 marks for valid points on home birth (e.g. familiar/comfortable environment; personal control; no immediate access to pain relief/emergency intervention) - 1 mark per distinct point, max 3. Full marks require points on both hospital and home birth; a one-sided answer is capped at 3 marks. [6]

A newborn baby has a range of basic needs that parents must meet. A warm, safe and clean environment is needed, provided through appropriately heated rooms, a safe cot free of hazards, and regular washing/nappy changing. Sleep is essential for the baby's development and should follow safe sleep practices. Food, whether breast or formula milk, must be given regularly, roughly every two to four hours in the early weeks. Fresh air and some time outdoors support healthy development, taken in appropriately for the weather. Love and comfort, through holding, talking to and responding to the baby, helps the baby feel secure and supports emotional development. Appropriate clothing, suited to the room temperature and easy to change, keeps the baby comfortable without overheating or becoming cold.

To help reduce the risk of sudden infant death syndrome (SIDS), parents should always place the baby on their back to sleep, both for daytime naps and at night, as this position has been shown to significantly reduce the risk. The cot should have a firm, flat mattress and be kept clear of pillows, duvets, cot bumpers and soft toys, all of which increase the risk of suffocation or overheating. The baby's head should be kept uncovered, and the room should be kept at a comfortable temperature, not too hot, since overheating is a known risk factor. Parents should avoid smoking around the baby, both during pregnancy and after birth, as exposure to smoke significantly increases the risk of SIDS. Breastfeeding, where possible, has also been shown to reduce the risk. Finally, parents are advised not to share a bed with the baby if they smoke, have consumed alcohol, or are excessively tired, as these factors increase the risk of accidental suffocation.

Level of Response mark scheme. Level 1 (Basic, 1-3 marks): limited knowledge of the baby's needs and/or SIDS prevention, with a few relevant but undeveloped points and little balance between the two parts of the question; basic spelling, punctuation and grammar with noticeable errors. Level 2 (Competent, 4-6 marks): sound knowledge of the baby's main needs and of at least two or three valid SIDS prevention measures, with clear explanation of some points; reasonably well organised with generally clear communication; capped at 6 if only needs OR SIDS prevention is addressed in any depth. Level 3 (Highly Competent, 7-9 marks): comprehensive, well-balanced response covering a good range of the baby's needs (warmth/safety, sleep, food, fresh air, love, clothing) and a good range of correct SIDS prevention measures (back sleeping, clear cot, avoiding overheating, avoiding smoking, breastfeeding); mature, well-structured writing with accurate spelling, punctuation, grammar and appropriate specialist terminology. [9]

Breastfeeding has several advantages for the baby: breast milk contains maternal antibodies that boost the baby's immune system and help protect against infection, it is easily digested and its composition naturally changes to suit the baby's changing needs, and the close physical contact during feeding supports bonding. For the mother, breastfeeding is free and requires no equipment or sterilising, the hormone oxytocin released during feeding helps the uterus contract back towards its pre-pregnancy size, and it may help with post-pregnancy weight loss. However, breastfeeding can be physically demanding, particularly in the early weeks, may cause initial soreness or difficulty as mother and baby learn together, and only the mother can feed the baby, which can make sharing night feeds or returning to work more difficult.

Bottle (formula) feeding also has advantages: any carer can feed the baby, sharing the feeding responsibility and allowing the mother more rest or time away; it is straightforward to see exactly how much milk the baby has taken; and some mothers find it more practical if they are unable to breastfeed or are returning to work soon after birth. However, formula milk and feeding equipment have an ongoing cost, all equipment must be carefully washed and sterilised before each use to avoid infection, feeds must be made up accurately and safely each time, and formula milk does not provide the antibodies found in breast milk, so bottle-fed babies may have a somewhat higher risk of certain infections in early life.

Overall, both methods can meet a baby's nutritional needs safely when carried out correctly, and the right choice depends on the individual circumstances, health and preferences of the mother and family.

Level of Response mark scheme. Level 1 (Basic, 1-3 marks): limited knowledge shown; a few relevant but undeveloped points on breastfeeding and/or bottle feeding, with little balance; basic spelling, punctuation and grammar with noticeable errors. Level 2 (Competent, 4-6 marks): sound knowledge of both feeding methods, with clear explanation of some advantages and disadvantages for mother and/or baby; reasonably well organised and generally clear communication; capped at 6 if only one feeding method is addressed in any depth. Level 3 (Highly Competent, 7-9 marks): comprehensive, well-balanced discussion covering advantages and disadvantages of both breastfeeding and bottle feeding, for both mother and baby; mature, well-structured writing with accurate spelling, punctuation, grammar and appropriate specialist terminology. [9]

Current government guidance recommends that weaning onto solid food should begin at around 6 months of age, once a baby shows signs of readiness such as being able to sit with support and hold their head steady.

1 mark: C. No partial credit. [1]

A rash that does not fade (does not turn white) when a glass is pressed firmly against the skin is a key warning sign of meningitis, alongside symptoms such as a high fever, stiff neck and sensitivity to light, and requires urgent medical attention.

1 mark: A. No partial credit. [1]

A simple figure with a circle for the head and lines directly attached for arms and legs, without a clear body, is known as a 'tadpole' figure, characteristic of the pre-schematic stage of drawing development. Random scribbling and naming of scribble occur earlier, while the schematic stage shows more detailed, proportioned figures.

1 mark: C. No partial credit. [1]

Consistent, loving care from a familiar carer, together with a predictable daily routine, helps a child feel safe and secure, which promotes positive emotional well-being and secure attachment. Inconsistent care, discouraging expression of feelings, and withholding praise can all negatively affect a child's emotional development.

1 mark: B. No partial credit. [1]

A chilled (not frozen, which could injure the gums) teething ring or toy is a safe and effective way to help relieve teething discomfort by numbing and massaging the gums. Rubbing alcohol on a baby's gums is unsafe and should never be done.

1 mark: B. No partial credit. [1]

(i) Iron is needed to form haemoglobin, the substance in red blood cells that carries oxygen around the body; a lack of iron can lead to anaemia. Good sources of iron include red meat, leafy green vegetables and iron-fortified breakfast cereals. (ii) Calcium is needed for the development and maintenance of healthy, strong bones and teeth. Good sources of calcium include milk, cheese and other dairy products, as well as fortified alternatives.

1 mark each for: (i) correct function of iron (forms haemoglobin/prevents anaemia); a valid food source; (ii) correct function of calcium (healthy bones/teeth); a valid food source. [4]

(a) Weaning onto solid food is generally recommended to begin at around 6 months of age. (b) At the first stage of weaning, foods are given as smooth, thin purees that are easy for the baby to swallow; at a later stage, mashed and lumpier textures are introduced, progressing towards chopped finger foods that the baby can pick up and chew for themselves. (c) Signs of readiness for weaning include the baby being able to sit with support and hold their head steady, showing interest in other people's food, and no longer seeming satisfied by milk feeds alone.

(a) 1 mark: around 6 months. (b) 1 mark: first-stage texture correctly described as smooth/pureed; 1 mark: later-stage texture correctly described as mashed/lumpier or chopped finger foods. (c) 1 mark: valid readiness sign given. [4]

A food allergy occurs when a child's immune system reacts abnormally to a specific food, treating a normally harmless protein as a threat; this can cause a range of symptoms, from relatively mild reactions such as a skin rash, itching or swelling, to severe, potentially life-threatening reactions such as difficulty breathing (anaphylaxis), which requires emergency treatment. Common food allergens in young children include nuts, eggs, cow's milk, and shellfish.

1 mark: correctly identifies a food allergy as an abnormal immune reaction to a specific food; 1 mark: correctly describes a range of possible symptoms (mild to severe); 1 mark: valid common allergen named. [3]

(a) The Eatwell Guide is a visual guide, produced by the UK government, showing the recommended proportions of the different food groups that should make up a healthy, balanced diet. (b) Other factors a parent should consider when planning meals include the influence of food advertising, including strategies that specifically target children; being able to read and understand the information given on food labels; any special dietary requirements the child has (e.g. allergies, cultural or religious requirements); the carer's own budget, available time and cooking skills; the child's age and stage of development; and the aesthetics of the food and the child's own food preferences.

(a) 1 mark: correctly describes the Eatwell Guide as showing recommended food group proportions for a balanced diet. (b) 1 mark each for any three valid factors, e.g. food advertising to children; understanding food labels; special dietary requirements; carer's budget/time/skills; child's age/stage; child's food preferences/aesthetics. [4]

At home, safety measures include fitting stair gates to prevent falls, fitting socket covers to prevent electric shock, keeping cleaning products and medicines locked away out of reach to prevent poisoning, using a fireguard around any open fire or heater, and turning pan handles inward on the cooker to prevent scalds. When travelling in a car, safety measures include always using a car seat that is correctly fitted and appropriate for the child's age, weight and size, using the car's child safety door locks so doors cannot be opened from inside, and never leaving a young child unattended in a car.

1 mark each for any two valid home safety measures (e.g. stair gates; socket covers; locking away chemicals/medicines; fireguard; pan handles turned inward), up to 2; 1 mark each for any two valid car safety measures (e.g. correctly fitted car seat; child door locks; never leaving a child unattended), up to 2. [4]

Immunisation is important because it protects the individual child directly from serious, and in some cases potentially fatal, infectious diseases such as measles, whooping cough and meningitis, by allowing their immune system to safely build resistance before they encounter the real disease. It is also important at a population level, because when enough children in the community are immunised, this creates herd immunity, which helps protect babies who are too young to be fully vaccinated yet, and other people who cannot be vaccinated for medical reasons, by reducing the overall spread of the disease.

1 mark: correctly identifies immunisation protects the individual child from serious/potentially fatal disease; 1 mark: correctly identifies the concept of herd immunity at population level; 1 mark: correctly explains herd immunity protects those too young/unable to be vaccinated. [3]

A childminder cares for a small number of children, often in their own home, giving a toddler a familiar, home-like setting with a single, consistent carer and often more flexible hours than a nursery; however, the toddler has a smaller group of children to socialise with and less access to structured, planned early-years activities. A day nursery cares for a larger number of children, organised into age groups with trained staff, a structured programme of activities and consistent set opening hours, giving the toddler more opportunity to socialise and learn through planned activities; however, nurseries are often more expensive and less flexible around a parent's exact working pattern than a childminder.

1 mark: valid advantage/disadvantage of a childminder given; 1 mark: valid advantage/disadvantage of a day nursery given; 1 mark: valid comparison/evaluative point made contrasting the two options. [3]

A parent should seek urgent medical help if their child has a high or persistent fever that does not respond to medication; is having difficulty breathing; develops a rash that does not fade when a glass is pressed against it; becomes unusually drowsy, floppy or difficult to wake; refuses fluids or shows signs of dehydration; is vomiting persistently and cannot keep fluids down; or has a fit (seizure).

1 mark each for any three valid warning signs, e.g. high/persistent fever; difficulty breathing; non-blanching rash; unusual drowsiness/floppiness; refusing fluids/dehydration; persistent vomiting; a fit/seizure. [3]

A centile chart plots a child's measurements, such as height and weight, against expected ranges for children of the same age and sex, allowing a health visitor or doctor to see whether the child is growing steadily along a consistent centile line over time, rather than relying on a single measurement taken in isolation. This benefits parents because it allows early identification of possible growth, feeding or health problems if the child's growth pattern changes unexpectedly, and it can also reassure parents that their child's growth is following a normal, healthy pattern.

1 mark: correctly describes measurements being plotted against expected age-related ranges; 1 mark: correctly explains growth is tracked over time along a consistent pattern; 1 mark: valid benefit to parents stated (early identification of problems, or reassurance). [3]

In the solitary stage, a young child plays alone, exploring toys and their surroundings without seeking interaction with other children. In the parallel stage, the child plays alongside other children, often using similar toys or materials, but without direct interaction between them. In the looking-on stage, the child watches other children playing with interest, but does not yet join in themselves. In the joining-in stage, the child begins to interact directly with other children's play, sharing materials and talking, though not always working towards a shared goal. In the co-operative stage, children play together with a shared purpose, taking on different roles, following agreed rules and cooperating as a group, such as in a group game or shared pretend play.

1 mark each for any three of the named stages (solitary, parallel, looking-on, joining-in, co-operative) correctly explained, given in the correct relative order; award marks only for stages consistent with correct sequencing. [4]

Social skills that should be nurtured in a young child include sharing, taking turns, following rules, co-operating with others, using good manners, and being clean and tidy. These can be nurtured, for example, by parents and carers modelling the behaviour themselves (such as saying 'please' and 'thank you'), by praising and encouraging the child whenever they share, take turns or follow rules well, and by giving the child regular, structured opportunities to practise these skills, such as through group games or activities with other children.

1 mark each for any three valid social skills named, e.g. sharing; turn-taking; following rules; co-operating; manners; being clean/tidy, up to 3; 1 further mark for a valid, correctly linked description of how a skill can be nurtured (e.g. modelling, praise, structured opportunities). Award a maximum of 3 marks if no nurturing method is described. [3]

A baby first develops head control, gradually gaining the strength to hold their head steady over the first few months of life. They then progress to learning to sit, first with support at around 6 months and then unsupported at around 8 months. Time spent in the prone position (on their tummy) helps build the strength and coordination needed for crawling, typically developing from around 6 to 9 months. Finally, the baby progresses to learning to walk, first cruising around furniture at around 9 to 12 months, before walking independently, typically at around 12 to 15 months.

1 mark each for correctly naming, in the correct order, up to four stages (head control; sitting with/without support; prone position/tummy time towards crawling; walking) with an approximately correct age range for each. Accept reasonable variation in the age ranges given. [4]

(a) Prelinguistic communication refers to the ways a baby communicates before they are able to use recognisable words, for example through crying to signal a need, cooing and babbling to explore sounds, and using gestures such as pointing or reaching to communicate what they want. (b) Linguistic communication refers to communication using recognisable words and language, developing from a baby's first recognisable word, typically at around 12 months, through to joining two words together into simple phrases at around 18 to 24 months, and building towards fuller sentences as the child approaches 5 years.

(a) 1 mark: correct definition (communication before recognisable words are used); 1 mark: valid example (crying, cooing, babbling, gesturing). (b) 1 mark: correct definition (communication using recognisable words/language); 1 mark: valid example (first word, two-word phrases). [4]

For a child with a hearing impairment, parents and carers can seek medical intervention, such as hearing aids or grommets where appropriate, to improve the child's ability to hear speech; support from health professionals such as a speech and language therapist and, where relevant, an audiologist can help assess and support the child's communication development; and providing a stimulating, language-rich environment, facing the child when speaking and using clear speech, can help maximise the communication the child is able to access. For a child who is reluctant to speak, perhaps through shyness or anxiety, parents and carers should give the child freedom of expression, avoiding pressuring them to speak on demand, which can increase anxiety; being patient and allowing the child time to respond in their own time helps build confidence; and modelling and exposing the child to plenty of positive verbal and non-verbal communication, through everyday conversation, reading and play, encourages the child to communicate more freely as their confidence grows.

Up to 3 marks for valid strategies addressing a hearing/physical barrier (e.g. medical intervention such as hearing aids; support from a speech and language therapist/health professional; a stimulating language-rich environment) - 1 mark per distinct point, max 3. Up to 3 marks for valid strategies addressing reluctance to speak/other barriers (e.g. allowing freedom of expression without pressure; patience; positive verbal/non-verbal role modelling and exposure) - 1 mark per distinct point, max 3. Full marks require strategies addressing more than one type of barrier; a response addressing only one barrier is capped at 3 marks. [6]

Life events can have a significant effect on a young child's emotional development. The birth of a sibling, for example, can cause a child to feel jealous or insecure, worried that they will receive less attention and love from their parents, and this can sometimes lead to regression, such as a previously toilet-trained child having accidents again, as a way of seeking reassurance. Starting school is another major life event, which can cause anxiety about separation from parents and about coping in an unfamiliar environment with new routines and new relationships to form with peers and teachers. Other life events, such as parental separation, moving house, or the loss of a close relative or pet, can similarly cause a young child confusion, insecurity or grief, sometimes shown through changes in behaviour, sleep or appetite, since young children may not yet have the vocabulary to fully express how they are feeling.

Parents can help manage the impact of these events in several ways. Maintaining familiar routines as much as possible, even during a period of change, helps give the child a sense of stability and security. Giving honest, simple, age-appropriate explanations of what is happening and what to expect helps reduce a child's uncertainty and anxiety. Involving the child in the change where appropriate, for example by letting them help choose a gift for a new sibling or visit their new school beforehand, can give them a greater sense of control and involvement. Giving the child extra one-to-one attention and reassurance during the period of change helps them feel secure and valued, and consistently and patiently reassuring the child that they are loved helps reduce feelings of jealousy or insecurity. Where a child continues to struggle, additional support from a health visitor, school, or other professional may also be sought.

Level of Response mark scheme. Level 1 (Basic, 1-3 marks): limited knowledge shown; a few relevant but undeveloped points on life events and/or how to manage them, with little balance between the two parts of the question; basic spelling, punctuation and grammar with noticeable errors. Level 2 (Competent, 4-6 marks): sound knowledge of at least one life event and its emotional impact, with some valid, explained strategies for managing this impact; reasonably well organised with generally clear communication; capped at 6 if only life events OR management strategies are addressed in any depth. Level 3 (Highly Competent, 7-9 marks): comprehensive, well-balanced response covering more than one life event and its specific emotional impact (e.g. jealousy/insecurity, anxiety, regression) and a good range of correctly explained management strategies (routine, honest explanation, involvement, reassurance); mature, well-structured writing with accurate spelling, punctuation, grammar and appropriate specialist terminology. [9]

A young child needs a balanced diet providing the right proportions of nutrients from each of the main food groups: protein for growth and repair of body tissue, carbohydrates for energy, a moderate amount of fat (important for a young child's brain development and concentrated energy needs), and vitamins and minerals such as calcium and vitamin D for healthy bones, and iron to prevent anaemia, along with fibre for healthy digestion and plenty of water. The Eatwell Guide can support parents and carers in planning meals that provide the correct balance of these nutrients across a child's daily diet, though very young children need proportionally more fat and slightly less fibre than the guide suggests for adults.

An unbalanced diet can have a number of negative consequences for a young child. A diet too high in fat, sugar and processed food, and too low in fruit, vegetables and physical activity, is a major risk factor for childhood obesity, which is linked to both immediate health problems and longer-term risks of conditions such as type 2 diabetes and heart disease in later life. A diet lacking sufficient iron can lead to iron-deficiency anaemia, causing tiredness, poor concentration and reduced resistance to infection. A diet lacking sufficient calcium and vitamin D can affect the healthy development of a child's bones and teeth. An unbalanced or very limited diet, especially if a child becomes a fussy or 'faddy' eater, refusing whole food groups, can also lead to poor overall growth and a lack of essential nutrients needed to support the child's rapid development during these early years.

Overall, providing a genuinely varied, balanced diet during these formative years is essential, both to meet the child's immediate needs for healthy growth and development, and to help establish healthy eating habits that are likely to continue into later childhood and adulthood.

Level of Response mark scheme. Level 1 (Basic, 1-3 marks): limited knowledge of nutritional needs and/or consequences of an unbalanced diet, with a few undeveloped points and little balance between the two parts of the question; basic spelling, punctuation and grammar with noticeable errors. Level 2 (Competent, 4-6 marks): sound knowledge of a young child's nutritional needs, with some correctly explained consequences of an unbalanced diet (e.g. obesity, or a specific deficiency); reasonably well organised with generally clear communication; capped at 6 if only nutritional needs OR consequences are addressed in any depth. Level 3 (Highly Competent, 7-9 marks): comprehensive, well-balanced response covering a good range of nutrients and their importance, together with a good range of correctly explained consequences of an unbalanced diet (e.g. obesity, iron-deficiency anaemia, poor bone development, poor growth/faddy eating); mature, well-structured writing with accurate spelling, punctuation, grammar and appropriate specialist terminology. [9]