Development and milestones Flashcards
For preterm babies what age do you use when assessing development?
Corrected age
This is the chronological age minus the number of weeks they were preterm
Red flags at 6 weeks
Not fixing/following
Not smiling
A fixed squint at what age is a red flag?
3 months
Red flags at 4 months
Head lag
Cannot bring hands together
Red flags at 6 months
Cannot roll over F-B
An inability to sit unsupported is a red flag at what age?
9 months
12 month red flags
Not crawling
Not babbling
18 month red flags
Not walking or speaking
Cannot understand commands
Red flags at 36 months
Unintelligible speech
Regression or loss of skills is a red flag when?
ANY age
Early hand preference
Red flag before ~12 months
Non-age specific red flags
Regression Hearing loss Low or increased muscle tone Persistent toe walking Persistent primitive reflexes- moro Maternal concern Discordant development
The 4 domains of development
Gross Motor
Fine Motor
Hearing, Speech and language
Social, emotional and behavioural
Primitive reflexes
Tonic neck Grasp Step Crawl Moro Sucking
Moro reflex
Pretend to drop baby
Arms come out
Lasts until ~4/12
Global developmental delay
Delay in 2 or more areas
Causes of global developmental delay
Idiopathic mostly ASD Hypothyroidism HIE PVL IVH Head trauma Neglect
Palmar grasp
6/12
Pincer grasp
Neat pincer
9/12
Neat at 12/12
Hand preference
18/12
Casting
12/12
Build tower 2-4 blocks
18/12
Hold head at 90 degrees in ventral suspension
3/12
Rolls F-B
6/12
Supported sitting and pulls to sit without head lag
6/12
Unsupported sitting
9/12
Cruising and briefly stand alone
12/12
Cruising can occur from 10/12
Walking well
18/12
2 years if bum shuffler
Pushes wheeled toy
15/12
Climbs on furniture
2 years
Runs
16/12- 2 years
Babbling
6/12
Turns to sound
3/12
Still in response to sound
6/52
Two syllable words
9/12
Knows name
12/12
Joins 2-3 words
2 years
Questioning and echolalia
2.5 years
Short sentences
3 years
Understands simple commands
15/12
Fluent speech and defines words
5 years
Smiling
6 weeks
Refer at 10 weeks if not doing it
Laughing and putting objects in mouth
6/12
Stranger anxiety and separation anxiety
9/12
Stranger anxiety becomes established at 12/12
Object permanence
12/12
Drinks from beaker with lid
12/12
Wave goodbye
9/12
Indicates wants without crying
15/12
Regular sleep pattern
18 months-2 years
Plays near but not with others
Won’t share
2 years
Role play and can feed themselves skilfully
2.5 years
Toilet training
3 years
Plays well with other children and shares
70% dry by night
Unsupervised dressing
4 years
Chooses own friends
Comforts in distress
5 years
3 key referral points to remember for smiling, sitting and walking
Not smiling at 10 weeks
Not sitting unsupported at 1 year
Not walking by 18 months
