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Developmental Assessment

Developmental Assessment. Kim Neuling January 2010 (With thanks to Dr Callaghan). Learning objectives. What is development? What is normal/abnormal? How do you assess it? Why do we want to know?. Child development. Process of acquiring new skills

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Developmental Assessment

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  1. Developmental Assessment Kim Neuling January 2010 (With thanks to Dr Callaghan)

  2. Learning objectives • What is development? • What is normal/abnormal? • How do you assess it? • Why do we want to know?

  3. Child development • Process of acquiring new skills • Growth and increase in strength of muscles • Improving muscle control • Change in cognition • Social relationships and personality

  4. Child development domains • Gross motor • Speech, language & hearing • Fine motor & vision • Social, emotional & hearing

  5. Gross motor • Rapid progress in first 18 months • Head control by 6 weeks • Sit by 6 months • Stand by 10 months • Cruising 12months • Walks alone 15 months

  6. Gross motor cont. • 15months – down stairs backwards • 18months – walks well, throws ball • 24months – up and down stairs – 2 feet • per step ,kicks a ball • 36months- rides tricycle • 48 months – hops on preferred foot • 60months – hops on each foot • 72 months – walks backwards on straight line

  7. Fine motor & vision • Newborn-hands closed • 6 weeks- fixes and follows to 90’,hands to mouth • 3months – holds rattle • follows 180’ • 4months – palmar grasp • 6 months- transfers • 10 months pincer grip

  8. Fine motor continued • 12months – pincer grasp and releases o • request,throws things to floor • 18 months – scribbles,may start showing • hand preference • 24 months – 6cube tower,hand • preference, vertical line • 36months – copies circle,cuts with • scissors,threads large beads,9 cube • tower • 48months – copies + • 60months – copies square and triangle,can draw a man • 72months – copies diamond

  9. Speech, language & hearing Newborn startles to sound 3 months coos 6 months babbling 10 months – waves bye bye 12 months – 2-3 words understands simple instructions 15 months – points on request 18 months 10 words

  10. Speech and language cont. • 18 months – 2 word sentences • 24months – short phrases • 36 months – knows name,sex,pronouns • talks incessantly • 48months – knows colours • 60months – knows opposites • 72months – knows comparatives

  11. Social emotional & behavioural • 6 weeks smiles • 10 months plays peek-a-boo • 12 months drinks from a cup • 18 months symbolic play

  12. Developmental milestones

  13. Delayed development • Global delay • Specific impairments – sensory, motor, social, cognitive

  14. Assessment • Observation • History from parent • Simple tools – drawing, building blocks • Standardised tools – Denver • Multi professional assessments (CDC)

  15. Limitations • Technique – ask if not demonstrated • Range of normal very wide/variable • Bottom shuffling & delayed walking • Milestones/stepping stones • Reliability before 6 months less good

  16. Exercise • 4 groups • In each group two people take a turn being a ‘child’. • Work together to try and assess the age of the child assuming they have normal development for their age. • Feedback to the whole group.

  17. How old? • 6-8 weeks • 6 months • 9months • 12 months • 18 months • 2 years • 3 years • 4 years

  18. Why assess? Normal development - reassure Pick up difficulties early Intervention Prevention Cure Support

  19. Interventions • Physiotherapy • OT • Educational support • Behavioural support (Autism, ADHD) • Social and family support • Parenting skills • Medical egthyroxine, hearing aid, steroids

  20. Case 1 • 6y girl • Special school • Down Syndrome

  21. Case 2 • 5y old boy • Weak • Unable to climb stairs • Mild learning disability

  22. Case 3 • 4 y old boy • Doesn’t speak • Poor eye contact • Doesn’t participate in lessons

  23. Born at 27 weeks gestation Grade 4 IVH Increased tone in legs Global developmental delay CP Diplegic CDU assessment Case 4

  24. Child Development Unit • Multi disciplinary team • Assess needs • Inform Educational process • Coordinate care package

  25. Any questions ?

  26. Summary • Child development – we have covered: • What is it? • How do we assess it? • Why do we want to know?

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