Development and Assessment tools Flashcards
What does a well child examination include?
Ø Growth measurements
Ø History
Ø Physical Exam
Ø Developmental Assessment
Ø Anticipatory Guidance
Ø Immunizations
Ø Answer questions
Five Critical Areas of normal development surveillance
- Physical Growth
- Gross Motor Control
- Fine Motor Control
- Language
- Personal-Social
Normal Development at 1 month
Physical Growth (since birth)
ØReturn to birth weight by 2 weeks
Ø~1-2 in. ↑ length
Gross Motor Control
ØLift head while prone
Throaty sounds
ØVowels: \ah\, \uh\, \ee\
ØPersonal-Social
Normal Development: 2 months
Physical Growth (since birth)
Ø~4 lb.
Ø~2-3 in.
Gross Motor Control
ØBegins to push up when prone
Ø Fine Motor Control
ØSymmetrical limb movement
Language
ØSmiles socially, different
cry/need, non-crying sounds
ØVowel sounds (“eh”), coos,
squeals start (2 ½ months)
Personal-Social
ØRecognizes parent
Normal Development: 4 months
Gross Motor Control
Ø Rolls from front to back, reaches
Ø Holds head steady (upright)
Ø Fine Motor Control
Ø Ulnar grasp
Gross Motor Control at 6 months
Ø Sits/tripod
Ø Reaches with one hand
Ø Roll from back to front
Normal development: 9 months
Gross Motor Control
ØCrawls, pulls to feet with support
ØMay stand alone, cruise
Fine Motor Control
ØPincer grasp, holds bottle,
throws object
Normal Development: 12 months
Gross Motor Control
ØWalks, bangs toys together,
Øpulls to stand, stands alone
Fine Motor Control
Normal development 12-24 months
Physical Growth: refer to growth charts
Ø Gross Motor:
Ø 15 months: Crawls upstairs
Ø walks backwards independently
Ø 18 months: Runs, throws objects from standing
without falling, walks up steps with help
Ø 24 months: Walks up & down steps
without help, kicks a ball, jumps
Language in the second year
15 months: 3-6 words, simple command without gesture, Consonants: t, d, w, n, h
Ø 18 months: Mature jargoning (some intelligible words), 6-10 word vocabulary, understands 5 body parts, follows two-step commands
Ø 24 months: Uses pronouns (I, you, me)
inappropriately, 50-word vocabulary,
uses two word sentences, can verbalize toilet need
Gross and fine motor changes at 3 years old
Ø Gross Motor: Can alternate feet
when going up steps,
pedals tricycle, stand on 1 foot
Ø Fine Motor: Copies a circle,
undresses completely, dresses
partially, washes & dries hands if
reminded, unbuttons,
draws a person (2 body parts)
How much language does a 3 year old have?
250 words, 2-3-word sentences, uses plurals, knows first and last name, knows pronouns,
understandable, understands prepositions (on, in, under, by
Normal personal-social development at year 3
Personal-Social: Group play, shares
toys, takes turns, plays with others,
self-care skills, imaginative play,
toilet trained, knows own sex
Normal gross and fine motor control at 4 years
Ø Gross Motor: Hops, skips, alternates feet going down steps, brushes own teeth
Ø Fine Motor: Copies a square,
buttons clothing, dresses self completely, catches ball, draws a person (3 body parts)
Language at 4 years old
Knows hundreds of
words, knows 4 colo , says a
song or poem from memory,
asks questions, knows full name,
age, gender
Personal-social development at 4 years old
Tells “tall tales,” fantasy play, plays cooperatively with a group of children
Normal growth and motor skills at 5 years
Ø Physical Growth: See charts, healthy eating
Ø Gross Motor: Skips alternating feet,
jumps over. Low obstacles, can tie a knot
Ø Fine Motor: Copies triangle, ties shoes,
spreads with knife, draws a person
(6 body parts), prints some letters &
numbers
Language at 5 years old
Language: May know more
than 1000 words, prints
first name, asks what a
word means, good
articulation, counts to 10,
listens/attends
Personal-social at 5 years old
Personal-Social: Plays competitive games, abides by rules, likes helping in
household tasks
Normal growth and motor control at 6 years old
Ø Physical Growth: see chart,
healthy eating
Ø Gross Motor Control: see 5 years
Ø Fine Motor Control: Draws a person
(6+ body parts), copies shapes
Language development at 6 years old
Knows thousands of
words, 6-7 word sentences, may
read 1 syllable words
Normal personal-social development at 6 years old
- Acceleration of the separationindividuation theme initiated even in infancy
- Go from being able to deal with one variable cognitively to dealing with more than one
- Magical thinking diminishes
- Reality of cause-effect relationships better understood
Normal growth and motor control at 7-8 Years Old
Ø Physical Growth: see chart, healthy eating
Ø Gross Motor Control: Active for at least an hour/day
Ø Fine Motor Control: May draw a person with 16 details, ties shoes
Language by this age may show adult proficiency
7-8
Personal-social development at 7-8 years old
Personal-Social
* Participates in school &
after school activities
* Children with learning
disabilities begin to struggle
* Has friends
* Does chores when asked
* Get along well with family
11-14 Years Old growth and motor control
Ø Physical Growth: see chart, healthy
eating
Ø Onset of puberty & secondary
sexual characteristics
Ø Gross Motor Control: Active for at
least an hour/day
Ø Fine Motor Control: Continued
refinement
15-17 Years Old normal development
Ø Physical Growth: see chart, healthy
eating
* Further development of
secondary sexual characteristics
Ø Gross Motor Control: Active for at
least an hour/day
Ø Fine Motor Control: Continued
refinement
Ø Language: Articulate
* May begin driving
* seat belt & cell phone
precautions
Children in early intervention programs are
more likely to:
A. Live independently
B. Graduate from high school
C. Productively contribute to society
D. Save society $30,000-$100,000 per child
E. All of the above
F. None of the above
Motor delays tend to manifest in the ____ year of life
1st
Language delays tend to manifest in the ____
toddler & preschool years of life
Learning disabilities manifest during the ____
school years
Motor delays may signify:
- Neuromuscular
- Genetic/metabolic
- Infectious
- Other abnormalities
Language delay must involve a thorough_____
hearing assessment
Developmental surveillance
A flexible, longitudinal, continuous, & cumulative process
whereby knowledgeable health care professionals identify
children who may have developmental problems
Developmental screening
Ø “The administration of a brief standardized tool aiding the
identification of children at risk of a developmental disorder”
Ø Not diagnostic!
Developmental Evaluation
Ø “Aimed at identifying the specific developmental disorder
or disorders affecting the child ”
Early intervention services are a
range of targeted services to
help young children who have:
- Developmental delays
- Kids can outgrow or
catch up - Developmental disabilities
- Kids don’t outgrow or
catch up
Early Intervention Specialist:
Ø Sub-specialty in Special Education
Ø Works with children from birth to
kindergarten
Ø Homes and/or preschool setting
Ø Provides “interventions” at the early
signs of developmental difficulty
Ø Evaluate, create tx plans, establish
goals, monitor progress, coordinate
care of of many specialists
* PT, OT, Speech Language Pathology, Psychology, Nursing, Nutrition, Social work, Audiology
Accuracy of clinical judgment in detecting developmental disabilities:
Detects < 30% of developmental disabilities!
Ages & Stages Questionnaire
Ø Relies on information from parents
Ø Screens for developmental problems
Ø Takes 10-15 minutes for parent to complete
Ø Can be used in patients 4 months to 5 years
Ø Separate 3-4 page form for each well-child visit (age-specific)
Ø Available in English, Spanish, Korean & French
Ø Standardized scoring procedures
Ø Can be photocopied
How often should developmental surveillance be done?
Every well-child visit
How often and when should developmental screening be done?
- 9, 18, & 30 months or
- When concern is expressed
When should autism screening be done?
18 & 24-30 months
