Developmental Assessment & Growth Abnormalities Flashcards
- A skilled individual monitors development over time as part of providing routine care
- Helps recognize children at risk for a developmental disorder
Developmental Surveillance
elements of developmental assessment
- Listening to parent concerns
- Obtaining a developmental history
- Making careful observations during office visits
- Periodically screening all infants and children for delays using validated screening tools
- Referring children who fail screening tests for further evaluation and intervention
- Recognizing conditions and circumstances that place children at increased risk of delays
- Should occur at all well child visits
Refers to the circumstance in which a child has not demonstrated a developmental skill (such as walking) by an age at which the vast majority of normally developing children have accomplished this task.
Prompt recognition is key
Developmental delay
what is M-CHAT for?
- Modified checklist for Autism in toddlers
- Screen toddlers 18-30 months to assess risk for Autism Spectrum Disorders
- Two stage tool to assess risk for ASD in children
- 1st stage is a 20-item yes/no parent report questionnaire
- < 5 min to administer and 2 min to score
There is a second test but probes for additional information and examples of at-risk behaviors for any items failed on the first stage
What is the Denver Developmental Screening Tool II:
- compares a given child’s performance with the performance of other children the same age
- Subjectively allows clinician to observe and assess child’s overall behavior
the 4 areas to screen functioning in Denver Developmental Screening Tool II:
- Personal-social: such as smiling and getting along with others
- Gross motor: such as walking or running
- Language: such as combining words and understanding language
- Fine motor adaptive: such as grasping, drawing, eye hand coordination
Will have child do specific things (such as walk up steps, wave bye bye, or bang 2 blocks together) for respective categories
interpretations for Dever Developmental Screen
- Normal: no delays and a maximum of one caution
- Suspect: two or more cautions and/or one or more delays; rescreen in one to two weeks
Drawbacks of Denver
- Validity is low
- Small sample size of normal (based on a little over 2000 kids)
- Does not require an advanced degree
- Studies show only 50% with developmental needs are identified
- Length of time it takes to complete/score
- High sensitivity , but low specificity
Age and Stages Questionnaire assess for what 6 things
- Communication
- Gross Motor
- FIne Motor
- Problem Solving
- Personal
- Social
cut off for ages and stages questionnaire
2 Standard Deviations below mean
- If below cutoff in one or more areas, diagnostic referral indicated
- If close to cutoff, provide follow up activities to practice specific skills, then re-screen in 4-6 months, earlier if needed
developmental milestones during 1-2 mo
- Holds head erect and lifts head
- Turns from side to back
- Regards faces and follows objects through visual field
- Drops toys
- Becomes alert in response to voices
- Recognizes parents
- Engages in vocalizations
- Smiles spontaneously
- Melodic vowel sounds called “COOING”
- Reciprocal vocal play between parent and child
developmental milestones uring 3-5 mo
- Ulnar grasps, then later thumb opposition
- Reaches for and brings objects to mouth
- “Raspberry” sound
- Sits with support
- Laughs
- Looks toward voice
- Turns from front to back (around 4 months)
- An infant can follow an object through the field of vision, but the object ceases to exist once infant can’t see it
- “puppy prop” weight supported on forearms with head up
dev milestones during 6-8 mo
- Babbling
- Sits alone for short period
- First scoops up a pellet then grasps it using thumb opposition
- Imitates “bye bye”
- Passes object from hand to hand in midline
- Rolls from back to stomach
- Inhibited by the word no
- start to feed self with puffs or cheerios
- “Commando” crawl around 7 months
dev milestones during 9-11 mo
- Crawls
- pull self up into standing position and cruise
- stand alone for short period
- Imitates “pat-a-cake” or “peek-a-boo”
- Recognizes name
- Uses thumb and index finger to pick up small items, such as pellets (neat pincer grasp)
- Follows 1 step commands, ex: “Come here” or “Give that to me”
- Babbling continues with repetition of sounds, “da da da da”
- Can feed self with puffs or cheerios
- Word comprehension begins and increases over the next few months
- Object permanence begins (realization that objects exist even when not seen)
dev milestone during 1 year
- walk independently
- Mama and dada specific
- Perfects neat pincer grasp
- Gives toys on request
- Can build a tower of two cubes
- Points to desired objects
- Can say 1-2 other words
- Babbling reaches peak
dev milestones during 18 mo
- Builds tower of 3-4 cubes
- Throws a ball
- Seats self in chair
- Dumps things out from cups or bottles
- Can walk up and down stairs with help
- Can say around 4-20 words
- Understands 2 step command, ex: “go get that toy and bring to me”
- Carries stuffed animal or doll around
- Can feed self with spoon/fork
- Recognizes 3 body parts
dev milestones during 2 years
- Giant leap in receptive vocabulary and language development at 2 and up
- Around a 50 word vocabulary
- Can say short phrases, +2 words - Kicks ball on request
- Builds tower of 6-7 cubes
- Points to named objects or pictures (points at remote)
- Turns pages of a book individually
- Plays with mimicry
- imitative behaviors and parallel play
dev milestones during 30 months
- Walks backwards
- Hops on one foot
- Uses prepositions
- Copies crude circle
- Points to objects described by use (point to what changes the channel)
- Refers to self as I (may not occur until age 3)
- Holds crayon in fist
- carry on a conversation
dev milestones during 3 years
- Holds crayon with fingers
- Builds tower of 9-10 cubes
- Copies circle
- Gives first and last name
- Rides tricycle using pedals
- Can dress with supervision
Rule of 3s: 3 numbers, 3 letters, 3 colors, 3 shapes, 3 wheels
dev milestones during 3-4 years
- Climbs stairs with alternating feet
- Button and unbutton
- “what do you like to do for fun?” answers
- Knows own sex
- Gives full name
- Feeds self at mealtime
- Takes off shoes and jacket
dev milestones during 4-5 years
- Runs and turns without losing balance
- Stands on one leg for around 10 seconds
- Draws a person (head, arms, legs, 2 eyes, no torso)
- Should be able to copy a square
- Knows days of week
- “What do you do if you’re cold, hungry?” knows answers
- Self-care at toilet (may need help wiping)
- Dresses self (still needs help tying shoes)
dev milestones during 5-6 years
- Can catch a ball
- Skips smoothly
- Tells age
- Knows right and left hand
- Can describe favorite tv show with detail
- simple chores at home
- Good motor ability but little awareness of dangers
dev milestones during 6-7 years
- Knows morning or afternoon
- Reads several one syllable printed words (my, dog, see, boy)
dev milestones during 7-8 years
- Ties shoes
- Knows what day of week it is currently
- Adds and subtracts one-digit numbers