Developmental examination

Introduction

There are four categories of development:

• Gross Motor
• Fine Motor and Vision
• Speech, Language and Hearing
• Social

Performing the examination

You can do 80% of this without touching the child. The key is to check that the child has reached the appropriate milestones for its age. This can be assessed from just watching the child, and getting them to do stuff. The chart for gauging these advancements is the Denver II screening chart.

File:Denverscreeningchart.png

Gross Motor

• Newborn - Limbs flexed - Symmetrical posture - Head lag on pulling the child up to the sitting position
• 6-8 weeks - Whilst lying on stomach, raises head 45 degrees
• 6-8 months - Sits without support, with a round back at 6 months, and with a straight back at 8 months
• 8-9 months - Crawling
• 10 months - Walks around with support from furniture
• 12 months - Walks unsteadily; broad-base gait
• 15 months - Walks steadily

Fine Motor and Vision

Newborn

• Follows face in midline (but does not turn head)

6 weeks

• "Fix and follow" - follows moving object by turning head

4 months

• Reaches for objects e.g. toys

6 months

• Transfers objects from one to the other
• Palmar grasp - grips object in palm

10 months

• Pincer grip - can grip objects between a single finger and thumb

14 months

• Scribbles with a pencil on a piece of paper

18 months

• 'Tower of 3 cubic building blocks (Unless specified, the building blocks and writing should be done without demonstration. With a demonstration, the child should be able to perform the writing tasks 6 months earlier than specified below)

2 years

• 'Tower of 6 blocks

2½ years

• 'Tower of eight building blocks OR
• Train with four bricks - L-shape with the long side on the floor

3 years

• Bridge - two bricks with a small gap and another brick across the top forming a bridge (after demonstration)
• Able to draw a circle

4 years

• Steps made from building blocks (after demonstration)
• Able to draw a cross

4½ years

• Able to draw a square

5 years

• Able to draw a triangle

Speech, Language and Hearing

Newborn

• Startles at loud noises

3 months

• Vocalises alone, when spoken too, laughs, coos ("aah-aah")