Developmental milestones Flashcards
Some examples of developmental delay
Cerebral palsy and Down’s syndrome
When do we check a child’s development?
antenatal, newborn check, 6 week GP check, 3+4 months with imms, 9 months, 12 months, 2 years, 3.5 years, 5 years
What are the four areas of development we measure?
- Gross motor - bigger movements
- Fine motor - smaller movements
- Hearing and speech
- Social
What is an isolated delay?
Affects just the one area of development
What is a global delay?
Affects more than one area of development
Timeline of hearing and speech progression
- All babies have hearing screen
- Newborns: startle to loud noises
- 3-4 months: babbling
- 7 months: mama dada
- 10 months: meaning
- 12 months: 2-3 words
- 2 years: 2+ word phrases → expressive language comes after receptive language
- 3 years: 3+ word sentences
- 4 years: grammatically correct
Red flag for hearing and speech development
Not startling to noise, delayed babble - consider environment (are they being stimulated by parents)
Timeline of social development
- 6 weeks: smiles
- 6-8 months: finger feeds, stranger fear
- 12 months: drinking from cup, peek a boo, waves bye
- 18 months: spoon feeds, symbolic play
- 2 years: dry by day, pulls off some clothes
- 3 years: parallel play
- 4 years: takes turns and shares
- 5 years: chooses own friends, understands rules of play
Red flag for social development
No speech by 2 - suggests autism
Timeline for gross motor development
- Newborn: flexed, head lag
- 6-8 weeks: raises head when prone
- 3 months: pushing up onto elbows
- 6-8 months: sits without support, rolls
- 9 months: crawls, stands with support
- Children with cerebral palsy will struggle to crawl
- 10 months: cruising
- 12 months: stands independently, walks unsteadily
- 18 months: walks independently
- 2 years: kicks ball
- 2.5 years: runs and jumps
- 3 years: rides tricycle
- 4 years: catch ball, up and down stairs
- 5 years: hop
Timeline for fine motor development
- Newborn: fixes and follows
- 4 moths: reaches for toys
- 6 months: palmar grasp, transfers objects hand to hand
- 9 months: immature pincer grip
- 10 months: accurate, mature pincer grip
- Look at symmetry - at this age children shouldn’t have a preference on side (not right or left handed) so if they are favouring one side, indicates hemiplegia
- 16-18 months: marks with crayon
- 18 months: tower of 3
- 2 years: tower of 6, draws lines
- 3 years: builds bridge, draws circle, dresses and undresses simple clothes
- 3.5 years: draws cross
- 4 years: draws square, buttons, brushes teeth
- 5 years: triangle
Red flags for motor development
- Walking: >18 months
- Holding an object placed in hand: >5 months
- Sits unsupported: >9 months
- Reach for object: >6 months
- Run: >2.5 years
Cerebral palsy
- Non-progressive damage
- Sx: abnormal posture and tone, feeding difficulties, slowing of head growth
- Spastic hemiplegia/quadriplegia/diplegia
- Dyskinetic: problems with movement
- Ataxic/hypotonic: no coordination
Pathophysiology of cerebral palsy
- Damage to basal ganglia = dystonia and uncoordinated movement
- Damage can be seen on MRI - normally motor impairments
- Peri-ventricular leukomalacia: accumulation of damage around ventricles
Autism spectrum disorder
- Presents age 2-4
- Impaired social interaction and speech/language development
- Ritualistic and repetitive behaviour
- 1/4 have seizures too
