Developmental Assessment

Zac 2013 Developmental Assessment Developmental Assessment Gross motor skills refer to the use of the large muscles
es of the body; Fine motor skills refer to the use of small muscles of the hands; Cognition means the use of higher mental processes including thinking, memory, and learning; Language refers to the comprehension and production of meaningful symbolic communication; Social and emotional functioning refers to emotional reactions to events and interactions with others Standardized screening methods, on parental reports. o Ages and Stages Questionnaires (ASQ), second edition, o Parents Evaluation of Developmental Status (PEDS), elicit behaviour from the child o Denver Developmental Screening Test o Battelle Developmental Inventory (BDI-2) The Denver Developmental Screening Test II is commonly used by general pediatricians (Figs. 8 -1 and 8-2). The Denver II assesses the development of children from birth to 6 years of age in four domains: Personal-social Fine motor-adaptive Language Gross motor Causes of delayed in Development Gross Motor Development Global developmental delay 1. Genetic syndromes and chromosomal abnormalities 2. Brain morphologic abnormalities 3. Endocrine deficiencies hypothyroidism, prolonged hypoglycaemia 4. Neurodegenerative diseases 5. Congenital infections 6. Idiopathic mental retardation
Motor Dysfunction 1. CNS damage kernicterus, birth injury, neonatal stroke, trauma, prolonged seizures, metabolic insult, infection 2. Spinal cord dysfunction Werdnig-Hoffmann disease, myelomenigocele, polio 3. Peripheral nerve dysfunction brachial plexus injury, heritable neuropathies 4. Motor end-plate dysfunction myasthenia gravis 5. Muscular disorders muscular dystrophies 6. Benign congenital hypotonia
Motor intact but otherwise restricted 1. Congenital malformations bony or soft tissue defects 2. Diminished energy supply chronic illness, severe malnutrition 3. Environmental deprivation casted, nonweight bearing 4. Familial and genetic endowment slower myelination 5. Sensory deficits blindness 6. Temperamental effect low activity level, slow to try new tasks 7. Trauma child abuse
Gross Motor Development Observe Age 2 months 6 months 12 months Early Reflex Patterns Primitive Reflexes and Protective Equilibrium Responses Reflex Appears Disappear Hand grasp Birth 3 months Moro Birth 4 months response development of cortical functioning
Method Cradled in arms Sitting with minimal support on surface Cruising or toddling
elicited can occur spontaneously after a loud noise abrupt extension of the infants neck Allowing the infant's head gently to move back suddenly (from a few inches off the mattress). placing the infant supine turning the head to the side.
Result symmetrical abduction and extension of the arms with extension of the trunk followed by adduction and flexion. frequently is accompanied by crying
Interpretation evaluate the integrity of the central nervous system and to detect peripheral problems, such as congenital musculoskeletal abnormalities neural plexus injuries.
Crossed adductor Asymmetrical tonic neck reflex (ATNR)
Birth 2 weeks to 4 weeks Not often seen immediately after birth, when the newborn has high flexor tone throughout the body, Birth
7 months 6 months
ipsilateral extension of the arm and the leg into a "fencing" position. The contralateral side flexes as well. A new-borns limb motions are strongly influenced by head position first steps in the coordination of vision and reaching 1
Toe grasp
8 15 months
Disclaimer: NOT INTENDED FOR PROFIT. FOR PERSONAL USE ONLY. Plagiarism not intended. I do not own any of the materials. I only compile various resources. Credits goes to the textbook authors, lecturers and friends. Peer reviews and corrections are encouraged. These notes are used as a brief insight only and DO NOT REPLACE a good textbook. USE AT YOU OWN RISK . ISAAC 2013
Head righting
4-6 months
Persists voluntarily
Protective equilibrium Parachute
4-6 months 8-9 months
Persists voluntarily Persists voluntarily
Elicited in a sitting infant by abruptly but gently pushing the infants centre of gravity past the midline in one of the horizontal planes. the body is abruptly moved head first in a downward direction
Zac 2013 Developmental Assessment infants ability to keep increased trunk flexor the head vertical despite tone toward the force a tilt of the body. an outreached hand and limb away from the force,
outstretching of both arms and legs
demonstrates the integrity of the sensations and motor responses of the central nervous system
Antigravity Muscular Control Control Development Head neck flexors allow head control control develops in an organized fashion, from head to toe, or in a cephalocaudal progression, paralleling neuronal myelination Trunk Control and Sitting Progressive control of the shoulders and upper trunk in the first few months of life, plus a decrease in flexor tone, Evolution of trunk control down the thoracic spine can also be observed with the infant in a sitting position
Neonate minimal control of the neck flexors, holding their heads upright only briefly when supported in a sitting position In prone position,, remains in a tightly flexed position and can simply turn the face from side to side along the bed sheets.
Infant the head lags behind the arms and shoulders
Hold the chest off the bed with the weight supported on the forearms
5 to 6 months Anticipates the direction of movement of the pullto-sit manoeuvre and flexes the neck before the shoulders begin to lift lumbar lordotic curve can be seen when the child is standing
Development of locomotion Age Method 3 to 4 months Prone-to-supine rolling 5 to 6 months Supine-to-prone rolling 5 to 6 months Early commando crawling 6 to 9 Months Creeping 9 to 10 months 9 to 17 months 13 months 22 Months (1 yr 10 mth) 36 Months (1.5 months) 4 Year old 5 Years old Cruising / Supported standing Walking three steps alone Walks Throw a ball balance on one foot Hop Cathing Ball
Development sufficient control of shoulder and upper trunk musculature to prop up on the arms requires control of the lumbar spine and hip region pulling with upper arms and passive dragging of the legs voluntary control moves to the hips and legs, the child is capable of getting up on the hands and knees, assuming a quadruped position Increased control to the feet and disappearance of the plantar grasp
Moro response Moro Reflex First phase of the Moro response. Symmetrical abduction and extension of the extremities follow a loud noise or an abrupt change in the infants head position. Second phase of the Moro response. Symmetrical adduction and flexion of the extremities, accompanied by crying.
Asymmetrical tonic neck refl ex (ATNR). Flexion of the arm and leg on the occipital side and extension on the chin side create the fencer position.
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Zac 2013 Developmental Assessment Head control Development of head control on the pull-tosit manoeuvre. A, At 1 month of age the head lags after the shoulders. B, At 5 to 6 months the child anticipates the movement and raises the head before the shoulders. Development of posture in prone A, The newborn lies tightly flexed with the pelvis high and the knees under the abdomen. B, At 2 months of age, the infant extends the hips and pulls the shoulders slightly. C, At 3 to 4 months, the infant keeps the pelvis fl at and lifts the head and shoulders. Protective equilibrium response As the child is pushed laterally by the examiner, he fl exes his trunk toward the force to regain his center of gravity while one arm extends to protect against falling (lateral propping).
Development of sitting posture
A, At 1 to 2 months of age the head is held up intermittently, but trunk control is lacking. B, At 2 to 3 months of age the infant raises the head and shoulders well but lacks control of the thoracolumbar area. C, At 3 to 4 months, support in the lumbar area is required to sit. D, At 5 to 6 months the infant holds the head erect and the spine straight.
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Zac 2013 Developmental Assessment Parachute response. As the examiner allows the child to free fall in ventral suspension, the childs extremities extend symmetrically to distribute his weight over a broader and more stable base on landing.
Development of locomotion.
A, Crawling implies that the belly is still on the floor. B, Creeping refers to mobility with the child on the hand and knees (quadruped). C, Cruising refers to standing with two-handed support on stationary objects before moving with steps. D, Early free walking.
Fine Motor Development Voluntary Grasp gains control of fi ne motor skills in an orderly progression, from the midline to the periphery or from proximal to distal Fine Movement Involuntary Grasp both hands together for midline hand play Swiping Raking palmar grasp Appears birth 2nd to 3rd Month Interpretation A newborn grasps reliably and reflexively at any object placed in the palm cannot release the grasp unless stroke from the ulnar side Hands are no longer tightly fisted, and the infant may begin sucking on a thumb or individual digit Able to hold an object in either hand if it is placed there Independent hand radial palmar or wholehand grasp inferior-pincer or radialdigital grasp Pincer Grasp Fine Pincer Grasp Position in Space 5 to 7 months Neither the hand nor the thumb functions independently at this point and, consequently, the child uses the hand like a rake. ability to bend the fingers against the palm squeeze objects, and obtain them independently for closer inspection hands independently to transfer objects across the midline. movement of the thumb allows it to adduct as the fingers squeeze against the palm in a radial palmar or whole-hand grasp the thumb moves from adduction to opposition. The site of pressure of the thumb against the fingers moves away from the palm toward the fingertips differentiated use of the fingers allows the child to explore the details of an object allowing opposition of the tip of the thumb and the index finger self-feeding and exploration of small objects. position the hand in space to achieve vertical or horizontal orientation before grasping or releasing an object. 9 Months Inferior-pincer grasp Between ventral surfaces of thumb and index finger, proximal and distal thumb joints extended, beginning opposition 10 Months Pincer grasp Between distal pads of thumb and index finger, proximal thumb joint extended, distal thumb joint slightly flexed, thumb opposed to index finger 12 Months Fine pincer grasp Between fingertips or fingernails, distal thumb joint flexed, proximal thumb joint slightly flexed
4 to 5 months
9 months 10 Months 9 to 12 months 1 Year
6 Months Rake Thumb adducted, proximal and distal thumb joints flexed, fingers extended
7 Months Inferior-scissors grasp Raking object into palm with flexed fingers and proximal and distal thumb joints flexed
8 Months Scissors grasp Between thumb and side of curled index finger, distal thumb joint slightly flexed, proximal thumb joint extended
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Zac 2013 Developmental Assessment
Development of Complex Fine Motor Skills Early in the second year of life the young child uses the grasp to master tools and to manipulate objects in new ways. Dropping and throwing, stacking, and putting objects in and out of receptacles become favourite pastimes. Mastery of the cup and spoon supplement or replace finger feeding as a more efficient and less messy means of eating Drawing analyzing the age level of a drawing is to count the number of features in the drawing The child receives one point for each of the following features: two eyes, two ears, a nose, a mouth, hair, two arms, two legs, two hands, two feet, a neck, and a trunk Each point converts to the value of 1/4 year added to a base age of 3 Age Movement 18 Months Use both hands equally well. If there is handedness with neglect of other limb neurodevelopmental
Hearing and Speech Cognitive Development of Sensorimotor Intelligence The nature of an infants thinking is assessed through concrete interaction with the environment. Develops an understanding of the concept of object permanence, the ability to recognize that an object exists even when it cannot be seen, heard, or felt. o Infants continued though brief gaze at the site where a familiar toy or face has disappeared o repeat actions that they have discovered will produce interesting results o Between 4 and 8 months of age, infants become interested in changes in the position and appearance of toys can track an object visually through a vertical fall Search for a partially hidden toy. consists of exploring toys to gain information about their physical characteristics. Activities such as mouthing, shaking, and banging o 9 to 12 months locate objects that have been completely hidden peekaboo becomes a favourite pastime at this point. infant can crawl away from the mother and recall where to return to find her. o I yo MEANING PURPOSE touch a comb to the hair in a meaningful nonpretend action, o 18 Months (1 1/2 ) deduce the location of an object even if they have not seen it hidden from view. maintain mental images of desired objects develop plans for obtaining them Develops an understanding of cause-and effect relationships.
Development of Symbolic Capabilities Imitation Genuine pretending begins using objects for their actual purpose but accompanied by exaggerated sounds or gestures 5
Zac 2013 Developmental Assessment Development of Logical Thinking Preschool - mental representation and symbolic thinking o all objects are alive like themselves Mr Car, the moon follows them on an evening walk. o number and quantity vary with appearance School Adolescent - extend logical principles to increasingly diverse problems.
FINDINGS SOMETIMES PRESENT ON HISTORY OR EXAMINATION Decreased vision or hearing Staring spells, motor automatism Lethargy, ataxia Myxoedema, delayed return on DTRs, thick skin and tongue, sparse hair, constipation, increased sleep, coarse voice, short stature, goitre Irritability, cold sweats, tremor, loss of consciousness Unexplained bruises in varying stages, failure to thrive Short stature, weight below third percentile Poor purposeful attending in multiple settings Vomiting, irritability and seizures, failure to thrive Hepatomegaly, jaundice, hypotonia, susceptibility to infection, cataracts Fair hair, blue eyes, mousy odor to urine Ongoing evidence of active or progressive disease Language Development Receptive skills the ability to comprehend communication expressive skillsthe ability to produce communication.
POSSIBLE DISORDER Specific sensory deficits Seizure disorders Overmedication with anticonvulsants Hypothyroidism Hypoglycemia Child abuse and neglect Malnutrition or systemic illness ADHD Some inborn errors of metabolism Galactosemia Phenylketonuria Chronic infection, infl ammatory disease, malignancies
Receptive 1. At birth, the newborn is particularly attuned to the human voice and may turn toward a parent who is gently whispering. 2. Children remain interested in sounds as they grow older and turn voluntarily toward the source of a sound by 3 to 4 months of age 3. children will understand one-step commands such as throw the ball by approximately 1 year of age 4. The labelling of commonplace items in pictures is slightly more complex and begins after 1 year of age. 5. The ability to choose between two pictures when asked sho w me the . . . should be consistent between 18 and 24 months of age. 6. By 21/2 years of age, receptive language skills have advanced beyond the understanding of simple labels. The child is able to identify objects by their use.
Expressive 1. By 2 to 3 months of age, children begin to coo or make musical sounds spontaneously. 2. 6 months of age, children place consonant sounds with vowel sounds, creating what is known as babble. Mama, Dada 3. By 6 months of age, children reliably respond to their name 4. By 9 to 12 months of age, a. children integrate babble with intonational patterns consistent with the parents speech. This is called jargon. b. Follow verbal routines, such as waving bye-bye or showing how big they are. 5. 1 year old first meaningful words 6. 18 months 20 -50 words 7. 18 to 24 months - word usage increases rapidly, standard forms replace baby talk, and word combinations begin 8. Telegraphic speech (two word sentences) 9. 2 - Ask what? 10. Age 3 complex language of pronouns and prepositions ask questions Why? Age 0 1 month 1 -4 months 4-9 months Receptive Startles or widens eyes to sound Quiets to voice, blinks eyes to sound Turns head toward sound; responds with raised arms when parent says up and reaches for child; responds appropriately to friendly or angry voices Listens selectively to familiar words; begins to respond to no; responds to verbal routine such as wave bye -bye or clap; turns to own name Points to three body parts (eyes, nose, mouth); understands up to 50 words; recognizes common objects by name (dog, cat, bottle, ball, book); follows one-step commands accompanied by gestures (give me the doll, hug your bear, open your mouth) Points to pictures when asked show me; understands soon, in, on, and under; begins to distinguish you from me; can formulate negative judgments (a pear is not a cookie) Follows two-step commands; can identify objects by use Expressive Shows variation in crying (hunger, pain) Makes musical sounds; coos; participates in reciprocal exchange Babbles; repeats self-initiated sounds
9 12 months
Uses symbolic gestures and jargon; repeats parent initiated sounds Uses words to express needs; learns 20 to 50 words by 18 months; uses words inconsistently and mixed with jargon, echolalia, or both
12 18 months
18 months - 2 years
Uses telegraphic two-word sentences (go bye-bye, up daddy, want cookie)
30 months 2 year
3 year
Knows several colours;
Uses jargon and echolalia infrequently; makes average sentence of 21/2 words; adjectives and adverbs appear; begins to ask questions, asks adults to repeat actions (do it again) Uses pronouns and plurals; 6
knows what we do when we are hungry, thirsty, or sleepy; is aware of past and future; tunderstands today and not today Can answer such questions as do you have a doggie? which is the boy?, and what toys do you have?; understands little, funny, and secret Understands same versus different; follows three-step commands; completes opposite analogies (a brother is a primary colors;, boy, a sister is a . . .); understands why we have houses, stoves, and umbrellas Understands what we do with eyes and ears; understands differences in texture (hard, soft, smooth understands if, when, and why; identifies words in terms of use; begins to understand left and right
3 year
4 years
Zac 2013 Developmental Assessment can tell stories that begin to be understood; uses negative (I cant, I wont); verbalizes toilet needs; can tell full name, age, and gender; forms sentences of 3 to 4 words Can relate experiences in sequential order; can say a nursery rhyme; can ask permission Tells a story; uses past tense; counts to 3; names enjoys rhyming nonsense words enjoys exaggerations; asks many questions a day Indicates I dont know; indicates funny, and surprise; can define in terms of use; asks definition of specific words; makes serious inquiries (how does this work? and what does it mean?); uses mature sentence structure and form
5 years
Social Development Early Capabilities: Social Responsivity Neonates begin this process by fi xing visually on faces in preference to other sights, a skill that is evident during the fi rst few days of life Responsive smile develops soon thereafter The social smile is another innate behavior, although it may not appear until 4 to 6 weeks of life Development of Attachment During the fi rst 6 months of life, infants are rather indiscriminate in their social behavior, smiling and later laughing with anyone willing to play. Infants develop a sense that their parents exist when out of sight sooner than they learn inanimate objects are permanent. By 6 to 8 months of age, children protest when their parents leave the room. As infants begin to recognize faces of familiar caregivers, they may squirm and cling in the company of unfamiliar people, exhibiting stranger awareness. o The severity of the reaction varies with the infants temperament and with previous experiences. o Extreme reactions, known as stranger anxiety, may occur in children who have not had routine care from alternative caregivers. o Pediatricians are advised to refrain from holding the 9- to 12- month-old child at the well-child visit. o A child who remains playful and calm while securely in the parents arms may quickly fret or cry even if gently removed from that security. By 1 year of age, most children have experienced periods of separation from a parent, whether it be for minutes or hours. o Infants who have developed a secure attachment to their parents show signs of recognition and pleasure when they are reunited with them. o While progressing in gross motor development, the child initiates separation bywalking away independently and exploring at greater distances from parents. o Typically, infants return regularly for some verbal encouragement, eye contact, or hugging and then venture farther. o In contrast, infants who have not developed secure attachments may show indifference, ambivalence, or disorganization at reunion with their parents. o Their exploration of the environment during the toddler years is limited. o These children are at risk for troubled social relationships as they become older. Development of Social Play Infants and young toddlers tend to line up and engage in similar activities simultaneously. This pattern is called parallel play. Sharing for a young toddler involves showing or handing a prized toy to another child, only to take it back within seconds. By 2 years of age, with the development of symbolic capabilities in cognitive development, children begin to pretend. o They will seek to engage their parents in activities that satisfy their growing curiosity. o They enjoy reading with caregivers and having their labeling questions answered. Near 3 years of age, children begin to include one another in their pretending games. o At first both children may select the same role (e.g., two mothers), whereas later, the roles become more realistic and interactive. o The young preschooler is especially interested in imitating the parent of the same gender but shows no preference for same- or opposite-gender playmate o taking turns is also a challenge for the pre-schooler who possesses a limited concept of time o Impulse control is just developing in the preschool years. o Active goals for this age group include learning to gain the cooperation of ones peers, learning to communicate ideas to new friends, and learning to handle conflicts By 4 to 5 years of age, o peer interactions grow increasingly cooperative and complicated; o pretend play involves themes requiring greater feats of imagination and experience, such as trips or parties. o Older preschoolers enjoy helping with household tasks and frequently are more interested in participating in gender-specifi c activities than they were at an earlier age. T o his interest may relate to cognitive and social development. o As children understand that they are in the same category as their same gender parent, they become interested in the implications of category membership. o Strict adherence to the rules of category membership reflects the concrete and inflexible thinking of the pre-schooler o No rules variable, broken Children become capable of playing by rules when they reach school age. With superior logical capabilities, they realize that rules are invariant and must be followed regardless of the personal implications. As they progress through the elementary school years, board games and sports become preferred activities for groups of peers.
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Zac 2013 Developmental Assessment Development of Sense of Self at 6 to 9 months of age, when infants display interest in their own mirror images. 7- to 8- month-olds o prefer to grab the cups and spoons rather than accept passive roles in eating. o resist pressure to do something that they would prefer not to do (e.g., fussing to stand when placed in a sitting position). 1 Year old o Expand sense of self o Explore environment with ease o can feed themselves with a cup and spoon o clear ideas about what they want 2 to 3 year old o donning and doffi ng clothing combine with the chil ds desire to imitate adults and to gain parental approval o allows toilet training to begin o practice emerging self-care skills, such as zipping or buttoning a coat
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Zac 2013 Developmental Assessment Developmental Milestones

Range 03 months Actual At birth 2 weeks 1 month Eating Dressing General/Social/ Play Gross Motor Fine Motor Vision Follows a dangling ring at 25cm 45 Hearing Language Cry
Startles responds to sound 1. 2. 3. 4. 1. 2. Head to one side arm and leg on the face side out stretched, pull to sit has Head lag Ventral suspension head in line with body and hips semi extended. Prone head sideways, arms and legs flexed, buttocks ahigh Standing automatic walking When prone; lifts chin intermittently Rooting Reflex Touch the corner of the Mouth with finger and observe child turn to direction of stimulation Fixate face and follows Quietens, cries or blinks to sound
6 weeks
Social Smile
1. 2. 3.
Follows a dangling ring at 25cm 90 Eyes unfocused Blinks to light
(QUIET LOCATION) place child in seated on parents lap and hold bell to the side and ring gently. Response include cry, startle, quiet and blink
Vocalizes own sounds
FACE regard 1. Observes mothers face as she talks 2. Observes examiner
3.
Grasp Reflex introduce a finger into palm from the ulna side and observe for flexion and gripping of finger
4.
Moro reflex- support head on palm of hand an inch above surface and release hand rapidly. Observe sudden abduction and extension of arms (refer if persist after 3 months)
12 weeks 3 months
Excited when feeds approach
1. 2.
Recognize Mother Thumb sucking
1.
Head Erect When Prone, Child lifts head and chest up so that face is 45-90 degrees to surface Little to no Head lag
Holds object for few seconds when placed in hands Brings hands to midlines Plays with fingers and clasps hands
Follows a dangling ring at 25 cm 180 Watches adult within visual field
3. 4. 5.
Interest in surrounding Enjoys caring routines Responds vocally with played with
(QUIET LOCATION) Turns head at level of sound place the child seated on parents lap and hold bell 8 inches behind ear and ring bell gentle. Note the child turning direction Quietens to rattle at ear level
Coos and Squeals high pitched happy squealing
Vocal play
2. 3.
Back rounded Hold child by armpit in sitting position, observe curvature of back Legs flexed supports child in standing position with feet gently touching surface, observe weight bearing
4. 5. 46 months 16 weeks 4 months 1.
Kicking legs alternating Ventral suspension head well above live of body and shoulders extended Sustained head control place child in supine position and hold both childs elbow and pull to sitting position, no head lag
Reaches for objects without getting it
Fixate on a toy brick
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Disclaimer: NOT INTENDED FOR PROFIT. FOR PERSONAL USE ONLY. Plagiarism not intended. I do not own any of the materials. I only compile various resources. Credits goes to the textbook authors, lecturers and friends. Peer reviews and corrections are encouraged. These notes are used as a brief insight only and DO NOT REPLACE a good textbook . USE AT YOU OWN RISK . ISAAC 2013

Range Actual 5 months Eating Dressing General/Social/ Play Laughs and squeals Gross Motor 1. Rolls over supine to prone 2. Reaches out for objects child seated, so that elbows at same level as table. And hands on table. Place toy on table within reach, observe child to reach to toy Fine Motor 1. Voluntary grasp 2. Reaches for objects and gets it Vision Hearing Distraction hearing test Language
6 months
Likes and dislikes food
Anger watch if child shows his anger if something he is holding is taken away
3. 4.
Transfers objects from one hand to another Rolls over prone to supine
3.
Whole hand palmar grasp place child on parents lap and offer a cub, if child graps and retains (refer if not able) (Raking) or ulnar grasp
Adjusts position to see Follows adult across room
Response to name Turns head at below level of sound Localized sound place child on lap of parent, approach child from behind. Calls child name softly several times, observes turn
Reduplicated sounds (Da, Ba, Ma)
5. 6. 7.
Lifts legs and grasps feet, raises head from pillow. When held, pulls self to sit Sits with support with both hands under armpits TRIPOD SIT
4.
Mouthing
5. 6. 7.
Bidextrous approach Transfers from 1 hand to another Drops cube when given another
79 months
7 months
1. 2.
Stranger anxiety Prefers mother
8. Downward parachute reflex Sits briefly with support
Holds one brick when offered next
Makes noise for attention
3. 4.
Responds to name Enjoys mirror
8 months 9 months
Chews biscuit Tries to grasp spoon when fed
5. 6. 7. 8. 9.
Object permanence finds toy Responds to NO Wave bye bye Plays peek-a-boo Plays pat-a-cake
Crawl 1. Sitting without support for more than 10 mins, can lean forward and turn body sideways to reach a toy Pulls to standing with support Creeps 1. Grasps with finger and thumb, scissor fashion Looks at distant point when sitting Follows fallen objects place child on parents lap and attract attention with red yarn, drop it so that if falls out of his line of vision and observe if child continues to look at where the red yarn disappeared
Formal distraction test Responds to name Variable babble Mama dada Imitates one word
2. 3.
2. 3.
4.
5.
Throws toys to the ground Matching tplace cube in each hand of hild and encourage child to hit cubes together BUT do not show or touch his hands Index finger approach child use index finger to reach Finger thumb apposition
10

Range 10 12 months Actual 10 months 11 months Eating Dressing General/Social/ Play 1. Responds to words 2. Waves bye-bye 3. Will not give object to examiner 4. Looks for fallen objects 5. Will give object to examiner Gross Motor Fine Motor Vision Hearing Language
1.
Cruising place the child and holding on to chair, watch child walk sideways holding on to chair
12 months (1 yo)
Finger feeds
Dressing
2. 3. 4. 5. 6.
Object recognition Release object on request Simple ball game Friendly Shows affection to familiar adult
2. 2. 3.
Stands alone Rise to sitting from supine Walks with support walks with one hand held
1.
Good pincer grasp 2 fingers
Follows fast moving objects roll ball on the floor and watch his eyes Recognize familiar people from 20 feet or more
Turns to name Associate voice with person Understands simple instructions
2 3 words with meaning Follows one step command Shows understanding to familiar objects
Holds own bottle Drinks from feeder cup Holds spoon but cant feed
2. 3. 4.
13 18 months
15 months 1yo+3
Picks up cup and drinks from it Use cup and spoon
Helps with dressing Knows when wet or soiled
Indicates desire by pointing Explores toys, soundmakers with interest Carries toys by hair or ear Rejection CURIOUS DANGER!! PROTECT
Broad based gait walks alone, arms u[ and feet wide
5. 1. 2.
Cast repeatedly Thumb Finger approach give raisin with thumb and index finger Puts in objects offer cubes and place cubes in small pail Throws objects To and fro scribble Tower of 2 cubes
Sees small objects Looks with interest at coloured pictures and pats page
Jargon speech 2-6 words Communicates wishes, obeys commands Pointing and vocalizing
Kneels Stands from sitting without support Pushes wheeled toy 18-24 months 18 months 1yo+6 Feeds independently Use Spoon safely Chews well Holds cup with two hands without much spilling Takes off socks and shoes 1. 2. 3. 4. 5. 6. 7. 8. Points to named body parts Domestic mimicry Dry by day Obeys 2 simple orders Explores dustbins Symbolic play alone Dislikes being left alone Imitates simple activities = Feeds doll 1. 2. 3. 4. 5. Steady, purposeful walk with arms down, starting and stopping safely, Walks backwards Walks carrying toy Climbs into adult chair, walks upstairs with hand held, two feet to one steep Runs, squats, Creeps downstairs
3. 1. 2. 3. 4. 5.
Inserts pellet into bottle Circular scribble Tower of 3 cubes Turns several pages of book Hands preference Primitive tripod grasp when holding crayons 6 20 words Use more than 6 words Echoes prominent or last words in short sentences Demands object by simple words Enjoys nursery rhymes, attempts to sing
Points to one object in picture card
24 months 2yo
Feeds with fork and spoon without spilling
Puts on shoes
1. 2. 3. 4. 5. 6. 7. 8.
Independent feed himself Toilet training Attention seeking Temper tantrums Obeys 4 simple orders Role play Wants immediate satisfaction of needs Intense curiosity, can open doors, no danger awareness
1. 2. 3. 4.
Walks well, runs, climb stairs, avoid obstacles Walks backward with toy Walks up and down stairs holding on ( 2 feet to a step holding railing) Kicks ball
1. 2. 3. 4. 5.
Copies vertical line Hold pencil with tripod grip Tower of 6 cubes Turns single pages of book Points to picture
Recognize fine detail in book
Understands simple words Understands simple instructions mari siniand duduk
2 to 3 word sentences with meaningnak susu nak air Uses pivotal grammar Uses questions Talks to self when play Asking names of objects and people
Drinks from cup well Ask for food and drink
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Range Actual 30 months 2yo+6 Eating Dressing General/Social/ Play 1. Dry by night Gross Motor Jumps Rises from knees without hands Fine Motor Vision Hearing Language Refers self using pronoun I
25 36 months
36 months 3yo
Eats with fork and spoon and knife
Helps in dressing Brush teeth
2. 3. 4. 5. 6. 7.
Helps to put things away Starts to play with other children Knows age and gender Likes hearing and telling stories Washes hands Brushes teeth
1. 2. 3. 4. 5. 6.
Climb - Walks up stairs 1 foot and down 2 feet per step Stands on one leg Jumps Walks on tip-toes Throws ball Pedals tricycle
1.
Copies circle
1. 2.
Recognize at least 1 colour Lots of nursery rhymes
2. 3. 4.
8. 9. 10.
Parallel play - play with other children Vivid make believe play Regular toilet needs
Tower of 9 cubes Builds train and bridge if shown Draws a man with face and 2 other body parts 3. 4. 3 words sentences dik nak Makan Answer simple questions Good account Understands thirsty, hungry, sleepy Understands n, under, n Enjoys long story Ask why Recognizes 2 or 3 colours
37 48 months
48 months 4yo
Able to undress
1. 2. 3. 4. 5. 6.
Tells a story Goes to toilet alone Dramatic make believe play Takes turns Group play Sharing
1. 2.
Walks up stairs and down 1 foot per step Hops
1.
Copies cross
Counts 10 or more
1. 2.
3. 2. 3. 4. Builds steps of bricks Draws a man with limbs and fingers Matches primary shapes into simple form board 4. 5. 6.
49 60 months
60 months 5yo
Uses knife and work
Able to put on clothes and do up large buttons
1. 2. 3.
Understands rules Chooses own friends Comforts playmate in distress
1. 2. 3. 4.
Stands on tip toes Skips Catches ball Runs on toes
1.
Copies square
1. 2. 3.
2. 3.
4. Draws a man with recognizable face with 3 parts Use scissors Copies triangle 5.
Repeats digits 1,2,3,4,5 Names at least 4 colours Use grammatical speech Asks whenand howquestions Enjoys joke
6 yo
1. 2. 3. 4.
Cannot bear to lose games Will cheat to win Blames others Can go to toilet and clean himself
1. 2.
Turns somersaults and doing stunts Can bounce and catch a ball
4. 1.
1. 2.
3. 2. 3. 4. Draws a man with 6 parts Ties shoe laces
Writes letters and numbers Distinguish morning and afternoon Understands left and right
12
13

Developmental Assessment

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Developmental Assessment

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Zac 2013 Developmental Assessment Developmental Assessment Gross motor skills refer to the use of the large muscles

Crossed adductor Asymmetrical tonic neck reflex (ATNR)

Protective equilibrium Parachute

4-6 months 8-9 months

Persists voluntarily Persists voluntarily

outstretching of both arms and legs

Infant the head lags behind the arms and shoulders

Development of sitting posture

9 months 10 Months 9 to 12 months 1 Year

Zac 2013 Developmental Assessment

Uses telegraphic two-word sentences (go bye-bye, up daddy, want cookie)

Knows several colours;

Zac 2013 Developmental Assessment Developmental Milestones

Follows a dangling ring at 25cm 90 Eyes unfocused Blinks to light

Vocalizes own sounds

FACE regard 1. Observes mothers face as she talks 2. Observes examiner

Excited when feeds approach

Recognize Mother Thumb sucking

Follows a dangling ring at 25 cm 180 Watches adult within visual field

Coos and Squeals high pitched happy squealing

4. 5. 46 months 16 weeks 4 months 1.

Reaches for objects without getting it

Fixate on a toy brick

Zac 2013 Developmental Assessment

Likes and dislikes food

Adjusts position to see Follows adult across room

Reduplicated sounds (Da, Ba, Ma)

Stranger anxiety Prefers mother

8. Downward parachute reflex Sits briefly with support

Holds one brick when offered next

Makes noise for attention

Responds to name Enjoys mirror

Chews biscuit Tries to grasp spoon when fed

Zac 2013 Developmental Assessment

Good pincer grasp 2 fingers

Turns to name Associate voice with person Understands simple instructions

Picks up cup and drinks from it Use cup and spoon

Helps with dressing Knows when wet or soiled

Broad based gait walks alone, arms u[ and feet wide

Points to one object in picture card

Feeds with fork and spoon without spilling

Recognize fine detail in book

Understands simple words Understands simple instructions mari siniand duduk

Drinks from cup well Ask for food and drink

Zac 2013 Developmental Assessment

Eats with fork and spoon and knife

Helps in dressing Brush teeth

Recognize at least 1 colour Lots of nursery rhymes

Walks up stairs and down 1 foot per step Hops

Uses knife and work

Able to put on clothes and do up large buttons

Understands rules Chooses own friends Comforts playmate in distress

Stands on tip toes Skips Catches ball Runs on toes

3. 2. 3. 4. Draws a man with 6 parts Ties shoe laces

Zac 2013 Developmental Assessment

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