Community Flashcards
Milestones - Gross Motor
6 weeks
Head side to side
Milestones - Gross Motor
3 months
No head lag
Milestones - Gross Motor
*6 months
Roll both ways
Sit unsupported
Milestones - Gross Motor
9 months
Attempts crawl
Milestones - Gross Motor
*12 months
Crawling
Cruising
Milestones - Gross Motor
*18 months
Walks
Starting to run
Milestones - Gross Motor
*2 years
Throw/kick ball
Walk up stairs
Milestones - Gross Motor
3 years
Tricycle
Milestones - Gross Motor
4 years
Balance one foot
Milestones - Gross Motor
5 years
Hop one foot
Milestones - Fine Motor
Neonate
Primitive (until 6 months)
Milestones - Fine Motor
*3 months
Grasp
Milestones - Fine Motor
6 months
Transfer
Milestones - Fine Motor
*9 months
Pincer
Parachute reflex
Milestones - Fine Motor
*12 months
Points
Milestones - Fine Motor
18 months
2 block tower
Milestones - Fine Motor
*2 years
Straight line
>4 block tower
Milestones - Fine Motor
3 years
8 block tower
Milestones - Fine Motor
4 years
Circle
Tripod grasp
Milestones - Fine Motor
*5 years
Square
Person in 3 parts
Milestones - Fine Motor
6 years
Diamond’Triangle
Small sentence
Milestones - Hearing and Speech
Neonate
Startle
Milestones - Hearing and Speech
6 weeks
Familiar sounds
Milestones - Hearing and Speech
3 months
Vocal sounds to respond
Laugh
Milestones - Hearing and Speech
6 months
Localises to voice
Milestones - Hearing and Speech
*9 months
Vocalises
Repetitive babble
Milestones - Hearing and Speech
*12 months
Single words
Single command
Milestones - Hearing and Speech
*18 months
6-20 words
Hands known objects
Milestones - Hearing and Speech
2 years
2 word sentences
Knows body parts
Milestones - Hearing and Speech
*3 years
3 word sentences
Name and gender
2 step command
Milestones - Hearing and Speech
4 years
First and last name
Milestones - Hearing and Speech
*5 years
Age
Milestones - Social and Behaviour
6 weeks
Smile
Milestones - Social and Behaviour
3 months
Enjoys people
Milestones - Social and Behaviour
6 months
Friendly with strangers
Milestones - Social and Behaviour
*9 months
Peek-a-boo
Everything to mouth
Milestones - Social and Behaviour
12 months
Simple objects (cup, brush)
Milestones - Social and Behaviour
*18 months
Pretend play
Drink from cup
Milestones - Social and Behaviour
*2 years
Imaginary/parallel play
Milestones - Social and Behaviour
*3 years
Shares
Milestones - Social and Behaviour
4 years
Joint play
Milestones - Social and Behaviour
5 years
Dresses self
Milestones - Vision
Neonate
Fix and follow 90 deg
Milestones - Vision
*3 months
Fix and follow 180 deg
Knows face
Milestones - Vision
6 months
Full colour vision
Milestones - Vision
*9 months
Looks for fallen toys (object permanence)
Milestones - Vision
12 months
Interest in movements
Milestones - Vision
*15 months
Finds hidden toys
Milestones - Vision
18 months
Points to distant object
Milestones - Vision
*5 years
Knows colours
Development Screening Tools
Ages and Stages Questionnaire (ASQ)
For 0-4yo
Good sensitivity and specificity
Development Screening Tools
Denver II
0-6yo
Good for language delay
Development Screening Tools
Parents Evaluation of Developmental Status (PEDS)
0-8yo
Fast, easy to use
Relies on parents being good observers
Development Screening Tools
Goodenough Harris/DAP (Draw a person test)
> 3yo
1 point for each detail = 3 months
1 year = 4 points
IQ Screening Tools
Griffith Scale
0-2yo
IQ Screening Tools
Bailey scale
1-3yo
Neurodevelopment/intelligence
IQ Screening Tools
McCarthy scale
2-8yo
IQ Screening Tools
Peabody picture test
> 2.5yo
IQ Screening Tools
Wehsler Preschool and Primary Scale of Intelligence (WPPSI)
3-7yo
IQ Screening Tools
Wehsler Intelligence Scale for Children (WISC)
6-16yo
Intelligence
Tympanometry
Type A - normal (spike at 0)
Type B - fluid in middle ear, perforation, debris in external ear (flat curve)
Type C - Eustachian tube dysfunction (spike at minus numbers)
Hearing testing
- What to use at which age?
Any age: OAE (otoacoustic Emmisions. Measures evoked sound waves by hair cells
0-3 months: ABR (auditory brainstem response)
- Screening to detect moderate to severe hearing loss
>6 months: behavioural observed (reflexes to sounds)
6m-2y: visual reinforced (response to sounds and visual reinforcement)
2y-5y: conditioned play (engage in activity overtime they hear the noise)
>4y: Kendell Toy Test (two similar sounding toys in front of child e.g. house and mouse, asked to take one)
>4-5y: Pure tone audiometry - tones at various frequencies and decibels. Test air and bone conduction
Hearing loss
Mild 20-40dB
Mod 40-60dB
Severe 60-90dB
Profound >90dB
Air < Bone = Conductive hearing loss
- Gap between the air and bone conduction (air worse)
- Usually due to outer or middle ear
Air + bone low = Sensorineural hearing loss
- Air and bone scores similar but both are reduced
- Usually due to inner ear, auditory nerve, cortex
Mixed hearing loss:
- Gap between air and bone AND both depressed
Cerebral Palsy
Delayed motor milestones (toe walking, scissoring)
Asymmetrical gross motor function (early favouring, fisting one hand)
Persistent primitive reflexes
Co-morbidities: epilepsy, cognitive, psychiatric, visual, speech. Spastic - UMN (reflexes.tone), clasp knife, contractures. Dyskinetic - involuntary movements (athetosis - slow writing, chorea - rapid jerky, dystonia - contractions). Ataxic - cerebellar signs, nystagmus. Motor function by 2 years is best indicator
Level 1: walks without restriction
Level 2: walks without devices (limited outdoor activities)
Level 3: walks with mobility device
Level 4: self mobility with device
Level 5: self mobility severely impaired even with supporting technology
Hearing loss genetic causes
- Congenital deafness: Connexin 26 gene/GJB2, Connexin 30 gene/GJB6. Normal at birth SNHL 1-6y. Disrupts K+ in ear
- Waardenberg: white forelock
- Pendred: goitre + SNHL - iodine defect
- Usher: visual failure + SNHL
- Alport: nephritis + lens defect + SNHL, M>F
- Jervell and Lange Nielson: long QT
- Downs: C + SNHL
- Goldenhaar: C and/or SNHL
