Paediatric

developmental
assessment
Complex integrated care
Assessment with Seth
You are assessing Seth (aged 38 months) after he was referred in
to your community paediatric service by the GP as his parents were concerned
that his left leg is turning in and he is walking on his tiptoes more on one side and
tripping over more than other children at nursery.

What potential differential diagnoses might you need to consider?

Assessment with Seth
Using the Jamboard, post the key things that you will be looking for during the
assessment with Seth in terms of his:
● Gross motor skills
● Fine motor skills
● Communication, social development and independence

Are there any other things you might want to check during the assessment?

Think also about what questions you might want to ask Seth's parent, and what
things it might be useful to have handy during the assessment
Assessment findings
● How did the assessment go overall?
● Did you manage to observe everything that you wanted to see?
● How could you pick up on anything that you weren't able to assess?
● Is there anything you would change about the assessment if you were to do it
again?

● Do you have any concerns about Seth's development?

● What are Seth's next development goals?
Delayed motor development in CP
This is Amelia at 19 months old

She has spastic diplegic cerebral palsy.

Amelia's motor development
How does Amelia's gross motor
development map onto the WHO
windows of achievement?

How does her gross

motor development compare to
Seth's?

How do Amelia's gross

motor development goals compare
to Seth's?
Prognosis
Amelia’s parents want to know your opinion on
her likely prognosis. They are particularly keen
to know when she is likely to walk.

How would you manage this question?

What resources / knowledge might help you to

provide an answer?
Outcome measures - motor development
The Gross Motor Function Classification System
is a gross motor development outcome used in
CP.

GMFCS descriptors illustrate the possible range

of longer term motor outcomes for a child with
cerebral palsy?

The Gross motor function measure can be used

to predict longer term outcome based on
GMFM-66 motor growth curves
Which level best describes Amelia at 19
months?
How might we expect Amelia to be doing
in a year's time?
Amelia aged 2 1/2
How might we expect Amelia to be
mobilising aged 6?
Amelia aged 5
How do the goals of physio change as the
child with CP ages?
● Change in focus from developmental
milestone goals to inclusion and maintenance goals
● Physio role moves from working towards motor
development milestones to providing input to
maintain the functional level achieved and
monitoring things which may lead to deterioration
over the longer term, with focused intervention to
achieve specific goals

Other things that will change as the child

ages include her motivations, the parental role, consent
What interventions might physios use...
● To achieve motor development milestones?
● To maintain functional level achieved and avoid deterioration?
● To achieve specific functional goals
What interventions might physios use?

Novak et al 2020
Multidisciplinary team

Who else might you expect to

work closely with to support
Amelia and her family?

What differences might there be

between a paediatric MDT and an
adult MDT?
Formative task
Write a GP letter to summarise your findings from Seth's assessment.

Think about:
● Addressing the reason for referral
● Format and layout
● Tone
● Amount of information to include

Submit it to the submission inbox on Canvas