Developmental history

Question 1

What important consideration should be made when looking at developmental milestones?

Answer 1

although there is variability in the age when particular milestones are achieved, development always takes place in the same order.

Question 2

when does a child 1st smile?

Answer 2

6 weeks

abnormal if this not achieved by 10 wks

Question 3

when does a child 1st sit unsupported?

Answer 3

6 months

Question 4

when does a child start to develop pincer grasp?

Answer 4

10-12 months

Question 5

what can a child achieve at 1 year?

Answer 5

walk unsupported
speak 2 or 3 words
tower or 2 cubes

tower or 3 or 4 cubes at 18 months, and 2 to 3 word sentences at 24 months

Question 6

what must be excluded in all children with speech delay?

Answer 6

deafness

Question 7

what developmental features are looked for, and what age are they expected to be achieved, with regards to baby positioning as a measure of gross motor development?

Answer 7

birth: generally flexed posture
6 weeks: pelvis flatter
4 months: baby can lift head and shoulders with weight on forearms
5 months: roll over
6 months: extend arms supporting chest off couch

Question 8

when does a baby achieve good head control?

Answer 8

4 months

head control starts to develop at 6 wks

Question 9

what are the developmental stages of sitting as a measure of gross motor skill?

Answer 9

6 weeks: curved back, needs support from adults
6-7 months: sits with self-propping
9 months: gets into sitting position alone

Question 10

when can child walk upstairs?

Answer 10

usually by 18 months, can walk up stairs holding bannister and is very steady on feet
should be investigated if can’t walk independently at 18 months

Question 11

when can baby stand with support?

Answer 11

6 months
by 10 months can pull to standing and stand holding on
12 months standing and walks with 1 hand held.
15 mnths-baby walks independently and stoops to pick up objects

Question 12

features assessed for in fine motor development?

Answer 12

grasping and reaching
manipulation
building bricks
penicil skills

Question 13

stages of grasping and reaching?

Answer 13

baby grasps very soon after birth
can hold rattle and shake purposefully by 4 mnths
5 mnths-can reach for object
6 mnths-transfer object from hand to hand
7 mnths-finger feeds

Question 14

stages of manipulation?

Answer 14

5 mnths-whole hand grasp
9 mnths-immaturepincer grasp
10 mnths-points at bead
12 mnths-mature pincer grasp

Question 15

stages of building bricks?

Answer 15

12 mnths-give bricks to examiner
15 mnths-builds tower or 2 cubes
18 mnths-tower of 3 to 4 cubes
3 years-tower of 9 cubes

Question 16

stages of pencil skills?

Answer 16

18 mnths-scribbles
3 yrs-draw a circle
4 yrs-draw a cross
4 1/2 yrs-draw a square
5 yrs-draw a triangle

Question 17

stages in speech and language development?

Answer 17

3 mnths: vocalises
8 mnths: double babble e.g. mama
12 mnths: 2 or 3 words with meaning e.g. mummy
18 mnths: 10 words
24 mnths: linking 2 words
3 yrs: full sentences, talks incessantly

Question 18

when do we worry about primitive reflexes still being present?

Answer 18

if persistent at 6 mnths

but most should disappear well before this, and some persist-parachute reflex

Question 19

stages of social development?

Answer 19

6 wks: smile responsively
16 wks: laughing out loud
7 mnths (to 10): stranger anxiety
9 mnths: peak a boo, waves bye bye
15 mnths: drinks from a cup
18 mnths: spoon feeding self
2 and a half yrs: toilet trained by day, but very variable age
3 yrs: dresses self (except buttons)

Question 20

examples of primitive reflexes?

Answer 20

stepping-appears at birth, disappears by 1 mnth, baby steps up when dorsum of foot touches surface
moro-appears at birth and disappears by 3 mnths, dropping baby’s head back quickly causes symmetrical abduction then adduction with arm extension
palmar grasp-appears at birth, disappears by 3 mnths, touching palm with object causes baby to grip it
plantar reflex-appears at birth, disappears at 8 mnths, pressing on ball of foot causes toes to curl
asymmetric tonic neck reflex (ATNR)-appears at birth, disappears by 6 mnths-turing baby’s head causes arm to extend on side baby facing and flexes on opp. side
parachute reflex-develops from 9 mnths and persists, elicit by pitching baby forward suddenly.

Question 21

when should a child be able to draw a circle?

Answer 21

3 years