DEVELOPMENTAL ASSESSMENT

STEP 1: General observation

Observe the child’s posture and movement, assess whether he can sit unsupported for > 10 minutes
(9 months) or he has any stranger anxiety (> 7 months).

*If the child can sit without support means he is around 9 months, proceed to STEP 2 to STEP 8.

Prepare:
1) Toys
2) Raisin
3) Cubes
4) Picture book
5) Crayon
6) Paper
7) Spoon
8) Cup
9) Cubes
10) Rattle

Give one item at a time according to the sequence above as the assessment goes on

*If the child is a small baby and cannot sit even with support, proceed to the steps to assess a baby 6
months old or below.

STEP 2 : Fine motor & vision

1. Give toys
Reaching for toy (6 months)
Transferring the toy (6 months)
Mouthing (6 months)
Manipulating with interest (9 months)
Dropping (9 months)
Casting (12 months)
2. Take away the toys
Object permanence (9 months)
Points to what he wants (12 months)
Looks for toys out of sight (12 months)

3. Give raisin
Pokes with index finger (9 months)
Immature pincer grasp (9 months)
Mature pincer grasp (12 months)

4. Give cubes
Banging (12 months)

*If the child can perform up to 12 months, proceed to the following

5. Give cubes and demonstrate the towering

Towers 2 cubes (15 months)
Towers 3 cubes (18 months)
Towers 6/7 cubes (2 years)

6. Give picture book

Shows interet in pictures (12 months) – social behaviour
Looks with interest and pats page (15 months)
Enjoys and turning few pages at a time (18 months)
Recognizes fine detail and turns one page at a time (2 years)

7. Give crayon and paper

Palmar grasp, to and fro scribbles (15 months)
Primitive tripod grasp, to and fro scribbles and dots (18 months)
Tripod grip, circular scribbles and vertical line (2 years)
Hand preference emerging (18 months)
Hand preference obvious (2 years)
STEP 3 : Social behavior
1. Hide toys partially
Can find it (9 months)

2. Play peek-a-boo
Plays peek-a-boo (9 months)

3. Clap hands
Can imitate hand clapping (9 months)

4. Give spoon
Tries to grasp when fed (9 months)
Holds but unable to feed (12 months)
Holds and brings it to mouth (15 months)

5. Give cup, spoon, cubes. Demonstrate rattle spoon in cup and put cubes in-out of cup
Child able to do that (12 months)

*If the child can perform up to 12 months, proceed to the assessment of social behavior by interviewing
the mother (STEP 6)

STEP 4 : Hearing and speech

1. Perform distraction hearing test
Horizontal (6 months)
45° (9 months)
Vertical (12 months)

*If the child has normal hearing function and development, proceed to the speech assessment by
interviewing the mother (STEP 7)
STEP 5 : Gross motor
1. Observe from far, then give toys to make the child move

6 months Pulls self to sit when hands held

Sit with support

*If only can do until here, proceed to the steps to assess a baby 6 months old or below.

9 months Sits unsupported for > 10 minutes

Can lean forward and turn body sideways to reach for toy without
falling
Pulls to stand for a few moment, falls back with a bump
Held standing, steps with alternate feet

12 months Rise to sitting from supine

Pulls to stand, goes down holding on to support
Walks with hand held
Cruising around furniture

15 months Stands from sitting without support

Stand steadily, walk
Kneels unaided

*If the child can stand from sitting on his own, bring him down to the floor to see him walking

Walks with wide feet and arms up (15 months)

Often falls or bumps into furniture (15 months)
Walks well with arms down, starting and stopping safely (18 months)
Runs carefully but cannot avoid obstacles (18 months)
Squat to pick objects and stand up using hands (18 months)
Runs and avoiding obstacles (2 years)
1.

*For further gross motor assessment, interview mother on how the child moving around at home
(STEP 8)

STEP 6 : Interview the mother regarding the social behavior

1. Holds, bites and chew biscuits (9 months)
2. Holds own bottle (12 months)
 3. Drinks from a cup (12 months)

4. Helps with dressing (15 months)

5. Indicates when wet or soiled (15 months)
6. Explores toys, household objects and soundmakers (15 months)
7. Restless and curious about surrounding people (15 months)

8. Holds cup with 2 hands and drinks without much spilling (18 months)
9. Takes off shoes and socks (18 months)
10. Puts on shoes (2 years)
11. Knows where objects belong to (18 month)
12. Imitates simple daily activities (18 months)

13. Able to open door handle and run out (2 years)

14. Rebellious behavior and tantrum (2 years)
15. No idea of sharing (2 years)

STEP 7 : Interview the mother regarding the speech

1. Babbles (6 months)

2. Shouts for attention (9 months)

3. Babbles loudly and tunefully (9 months)
4. Imitates adult coughing, smacking lips, ‘brrr’ (9 months)
5. Understands ‘no’ and ‘bye-bye’ (9 months)

6. Knows and respond to own name (12 months)

7. Shows understanding of names of familiar objects and people (12 months)
8. Understands simple instruction; ‘give it to mummy’, ‘clap hands’, ‘say bye-bye’ (12 months)
9. Jargons loudly using vowels and consonants (12 months)

10. Use how many words?

>2 words: 15 months
>6 words: 18 months
 >50 words, speak 2 word phrases: 2 years

11. Communicates by pointing and vocalizing (15 months)

12. Jabbers loudly (15 months)

13. Echoes prominent or last word in short sentences (18 months)

14. Points to body parts on himself and sometimes on the doll (18 months)

15. Asking names of objects and people (2 years)

16. Shows and repeats words for body parts when asked (2 years)
17. Refers to self by name (2 years)
18. Talks to self in play ( 2 years)

STEP 8 : Interview the mother regarding the gross motor

1. Movement

9 months Moves on the floor by rolling, squirming

Attempts to crawl

12 months Moves by crawling, bottom shuffling, creeping or bear walking

15 months Walks alone, feet wide and arms up; often falls or bumps into furniture
Crawls upstairs and come down backwards

18 months Walks well with arms down; starting and stopping safely
Runs carefully but cannot avoid obstacles
Climbs forward into adult chair
Walks upstairs with hand held, 2 feet to a step; comes down on his bottom

2 years Runs and avoids obstacles

Walks backwards with toy
Walks upstairs and downstairs 2 feet to a step holding railing
1.
2. Handling

18 months Pushes and pulls large toys or boxes around

Carries objects when walking
Squats to pick objects and stands up using hands
 2 years Pulls toy by string forwards and backwards
Throws small ball overhand without falling
Pushes tricycle with feet
2.

Developmental Assessment (6 months old or below)

STEP 1 : General observation

Observe the child’s movement and posture. The child only can sit with support (6 months) and friendly
to strangers (< 7 months.)

1. Head
On one side (1 month)
In midline (3 months)
Raises head from pillow (6 months)

2. Hands
On face side outstretch (1 month)
[SB] Hands closed with thumb turned in (1 month)
[FM] Brings hand to midline, plays with fingers, clasps hand (3 months)

3. Legs
On face side outstretched (1 month)
Kicking alternately (3 months)
Lifts legs and grasps feet (6 months)

4. Body
Rolls both ways (6 months)

STEP 2 : Vision
1. Give red ball
Follows red ball 90° (6 inch away) from face, from side to midline (1 month)
 Follows dangling red ball 180° horizontally and vertically. Converges eyes when ball moves
towards face (3 months)
Follows adult across the room (6 months)

STEP 3 : Fine motor

1. Give rattle
Brings hands to midline, plays with fingers, clasps hands (3 months)
Holds rattle for a few seconds but does not regard it (3 months)
Reaches out for toy 6-12 inch away, transfers (6 months)
[SB] Reaches out for objects, manipulates, mouths and transfers (6 months)

STEP 4 : Social behavior

1. Check for grasp reflex
Grasps finger (1 month)

2. Interview the mother

Stops crying when talked to (1 month)
Excited or smiles when feeds approach (3 months)
Enjoys caring routine (3 months)
Responds vocally when played with (3 months)
Puts hands on bottle and pats it when feeding (6 months)

STEP 5 : Gross motor

1. Pull the child to sit up

1 month Pulled to sit: head lag

When body vertical, head held momentarily before falling forwards

3 months Pulled to sit: little or no head lag

Held sitting: head held erect for few seconds, back straight except lumbar
curve

6 months Pulled self to sit when hands held

 Sits with support
1.

2. Stand the child up

1 month Automatic walking

3 months Sags at knee
6 months Held standing: weight bears on feet
2.
3. Put the child onto prone position

1 month Head sideways

Arms and legs flexed
Buttocks high

3 months Lifts head and upper chest using forearm to support

Buttocks flat

6 months Lifts head and chest supporting on extended arms and flat palms
3.

4. Do ventral suspension

1 month Head in line with body

Hips semi-extended

3 months Head well above line of body

Hips and shoulders extended
4.

STEP 6: Interview mother regarding hearing and speech

1 month Startled by sudden noise

3 months Sudden loud noise distressing

Coos (ooh, eeh)
Turns towards sound
Quietens to rattle 6-1 inches at ear level

6 months Turns to mother’s voice across the room

Babbles (goo-goo, dada)
Laughs and squeals in play