Developmental Assessment Ophelia Luong OCYL 2cam ac uk

Developmental Assessment Ophelia Luong OCYL 2@cam. ac. uk

Potentially the most fun that you’ll ever have in an OSCE…

A Brief Recap

Four Domains § Gross motor § Vision and fine motor § Hearing, speech and language § Social, emotional and behavioural

Developmental Delay § § Can be global delay § In all four domains § EG Down’s or Fragile X Can be delayed in one or two domain EG § Gross motor – Duchenne’s muscular dystrophy § Social – Autism Spectrum Disorder

Developmental Milestones § Median age § Limit age § § § 2 SDs from mean § Age by which milestone should have been achieved § Prompt for further action But remember, variations in patterns of development § Bottom-shufflers § Bilingual households And correct for prematurity up to 2 y

Raises Cruises head –– 18 m 10 m 6 w Runs Kicks Sits ball unsupported and jumps, can do stairs one at time –flexed, 6 m (curved); 8 m (straight) Limbs head lag -adult Newborn Tricycle, do Stands upstairs on like foot 3 y 4 y Skips 5 y Crawls –a– 8 -9 m Walks –can 12 m (unsteady); 15 m (steady) – 2 y 4 m – –-Sitting 9 m 12 m 18 m Head Standing Walking control unsupported Gross Motor

Vision and Fine Motor Fixes and follows in midline – newborn 3 m – Fixing and § Fixes and follows horizontally – 6 w following § Reaches for things and palmar grasp – 4 -6 m § § Transfers – 7 m § Pincer grasp – 10 m 12 m – Pincer grip § Bangs bricks together – 12 m 9 m – Transfer

3 y 4 y –– 18 m Bridge Steps 2 y– –Tower 3. 5 y (after Tower – of demo) Cross of 3 -4 6 5 y – Triangle Scribbles Square Circle Line Can copy 6 m earlier Fine Motor

Hearing, Speech and Language § Startles to loud noises – newborn § Vocalises and coos – 6 m § Babbles – 8 m § Parents can understand sounds – 10 m § Knows name, 2 -3 words excl mama/dada – 12 m § 6 -10 words – 18 m § 2 word phrases – 2 y § 3 -4 word sentences w/ personal pronouns – 3 y § Relatively fluent – by 5 y

Social, Emotional and Behavioural 8 w – Smiling § Smiles in response – 6 w § Fear of strangers – 10 m § Waves bye-bye and plays peek-a-boo – 10 -12 m § Symbolic play – 18 m § Parallel play – 3 y § Shares toys and group play – 4 -5 y 2 -2. 5 y – Symbolic play

12 m - 3 y Finger – Starts feeds 7 m to -2 y and Puts 4 y use - Spoon drinks - knife food Dresses 18 m from and in - Spoon, mouth alone fork, cup takes off socks/shoes, helps with dresses indicates clothing, w/ when dry supervision by soiled day Social, Emotional and Behavioural

Practical Tips

In an ideal OSCE… § Introduce yourself to child and parent/guardian § Get down to their level – metaphorically and literally § OBSERVE § Features § What they are doing already § See what they can do § Ask the parent questions § § About hearing and vision § About things you can’t test HAVE FUN!

…But if it goes wrong. . . § Don’t panic! § Give the child back to their parent § Ask the parents questions instead

To prepare beforehand… § Have a picture in mind of what children of a certain age should be doing § People watch! § Films and TV § The concourse § Siblings etc

On the day… § Be aware of space and time § Improvise § Give LOTS of praise § Talk as you go along § Maybe save gross motor for last… § Ask the parents questions § (But not “how old is your child? ”)

§ https: //www. youtube. com/watch ? v=4 u 4 B 0 hs 4 UKU https: //www. youtube. com/user/MRCPCHRevision

Any questions? Good luck!