DEVELOPMENTAL ASSESSMENT

Possible Order of Examination

Be opportunistic
Talk as you go along

Introduction
• Growth parameters
o Size for age – FTT, gigantism, ex premmie
o Measurements/charts – macro/microcephaly
• State
o Alert & active
o Sleeping, drowsy
o Irritable
o Obvious neuro problems – floppy infant posturing (froglike
posture, paucity of movement, hemiplegia, invol movements
• Obvious dysmorphic features if present
• Any interventions (NG tube, nasal oxygen, IV drip, on a wheelchair
etc)

Followed by
Generally don’t remove the child from mum’s lap if he or she is there
• Test vision, hearing, language, personal-social interaction & FM
control there (Test vision before hearing)
• Do GM assessment last – when you have to remove from mum’s lap
←
• Throughout - observe and assess personal social interaction &
language - comment on any vocalising, language, interaction with
caregiver & you

←
← Summary
←
← Age
← Is development normal or delayed?
← If delayed, is it globally delayed or is there dissociation between the
fields of development? Give approx developmental age for different
developmental domains
←
← Terms:
← Global vs isolated delay
← Age-appropriate
← Chronological age vs corrected age vs developmental age
TERMS USED IN DA
VISION
Comment on any squint, nystagmus or obvious abnormality

Fixate
Follow 180° or more
Hand regard – watches movement of own hands before face & engages in
finger play

FINE MOTOR DEVELOPMENT

Reaching out for objects, hold rattle – move rattle
Palmar grasp
Transfer objects to mouth
transfer from one hand to the other
Index finger approach to objects
Pincer grasp

Tower of cubes
Look out for hand dominance

HEARING
Startle
Responds to noise (stops crying, pupils dilate, turns etc)
Responds to own name

LANGUAGE
Coos responsively to parent’s talk from about 5-6 weeks
Vocalises in response and also when alone
Quietens to sound of sound of rattle or small bell ringing
From about 9 months, babbles loudly & tunefully in long repetitive strings of
syllables, from about 12 months – babbles in conversational cadences
Imitate adult vocalizations
Words

SOCIAL BEHAVIOUR & PLAY

Response to strangers, stranger anxiety
Response to caregiver (initiating play, as well as comfort)

Eye contact
Communicative intent
Joint attention, sharing of interests, enjoyment
Waves bye, claps hands
Pretend play
Picture books

ADLs (activities of daily living)

Holding own milk bottle
Finger food
Drinking from cup
Spoon feeding
Dressing – helps by lifting arms for sleeves, putting foot out for shoe etc
GROSS MOTOR DEVELOPMENT
180° manoeuvre

Tone Pull to sit

Head lag Pull to stand
Head control Stand unsupported
Ventral suspension Cruising
Prone Pushes large wheeled toy on level
Scissoring Walk independently
Slip sign Broad based gait
Sitting up unsupported, straight back Tiptoe gait
Pivoting Sitting/squatting to standing – Gower’s sign
Creeping
Crawling, 4 point crawl
Stairs – 2 feet to a step, or alternating feet