Paeds Hx: Developmental Delay and Milestones

Question 1

Birth history what is important to ask

Answer 1

• any problems before, during or after birth

- were all the scans and blood tests normal (very important if pt comes from abroad and did not have antenatal tests)

Question 2

FHx of developmental delay important questions

Answer 2

• do you know what age did his/her parents/siblings first started walking
• how old is the mother? (important for conditions such as down’s syndrome)
• Ask specifically about DUCHENNE Muscular Dystrophy
• any chance that the parents could be related?

Question 3

Developmental red flags

Answer 3

• loss of skill at any age
  gross:
• can’t sit unsupported by 12 months (median = 9 months)
• not standing by 18 months (median = 12 months)
• persistent toe walking (autism)

Speech and language:

• loss of hearing at any point (do they respond to you?)
• no speech by 18 months
• 2 word phrases by 2 yrs of age

Social:
- not smiling by 2 months

Question 4

Gross motor milestone median ages for:
head control
sits unsupported
walks unsupported

Answer 4

good head control = 6 months
sits unsupported = 9 months
walks unsupported = 18 months

Question 5

vision and fine motor :
fix and follow
effective pincer grip
stack tower of 2-3 cubes/scribbles lines/use spoon

Answer 5

fix and follow = 2 months
pincer = 12 months
tower/scribbles line/uses spoon = 18 months

Question 6

Hearing speech and language:
turn to sounds
imitates sounds
2 word phrases

Answer 6

turns to sounds = 3 months
imitates = 12 months
2 word phrases= 24 months

Question 7

social:
smile
plays peekaboo
symbolic play

Answer 7

smile= 2 months
peekaboo = 12 months
symbolic play= 24 months