Development and developmental assessment

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An assessment of developmental progress is important at every clinical encounter with children. It is important to understand the normal progression of development in the early years and to develop skills in examination to assess development in babies and children of different ages.


Milestones


It is hard to remember all the milestones, so learn the essential ones given in the table.


Milestones that Are Essential to Remember












































Age Milestone
4–6 weeks Fixes to faces with eyes
Smiles responsively
6–7 months Sits up unsupported
9 months Gets to a sitting position
10 months Pincer grasp
Waves bye-bye
12 months Walks unsupported
Two or three words with meaning
18 months Feeds self with spoon
Points to things
Tower of 3–4 cubes
Throws a ball without falling
24 months Sentences of 2–3 words
Running
Kicks a ball

Developmental Warning Signs


There is a wide variation in the age at which milestones are met. Key warning signs of significant developmental problems are listed in the table.


Key Developmental Warning Signs




















































Age Warning sign
At any age Maternal concern
Regression in previously acquired skills
10 weeks No smiling
6 months Persistent primitive reflexes
Persistent squint
Hand preference
Little interest in people, toys, noises
10–12 months No sitting
No double-syllable babble
No pincer grasp
Not chewing
18 months Not walking independently
Less than 6 words
Persistent mouthing and drooling
2½ years No 2–3 word sentences
Not responding to 1-word commands
Not turning single pages
No symbolic play
4 years Unintelligible speech


KEY POINTS



  • Develop your examination skills by assessing the development of any preschool child you encounter.
  • Correct for prematurity, but remember premature babies are at increased risk of developmental delay.
  • Early recognition aids diagnosis of underlying disorders and allows the child to access targeted developmental therapy.
  • See Chapter 38 for causes of delayed development.
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Jul 2, 2016 | Posted by in PEDIATRICS | Comments Off on Development and developmental assessment
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