Ophelia Luong OCYL2camacuk Potentially the most fun that youll ever have in an OSCE A Brief Recap Four Domains Gross motor Vision and fine motor Hearing speech and language Social emotional and ID: 584288
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Slide1
Developmental Assessment
Ophelia
Luong
OCYL2@cam.ac.ukSlide2
Potentially the most fun that you’ll ever have in an OSCE
…Slide3
A Brief Recap Slide4
Four Domains
Gross motor
Vision and fine motor
Hearing, speech and languageSocial, emotional and
behavioural Slide5
Developmental Delay
Can be global delay
In all four domains
EG Down’s or Fragile X
Can be delayed in one or two domain EGGross motor – Duchenne’s muscular dystrophy
Social – Autism Spectrum DisorderSlide6
Developmental Milestones
Median age
Limit age
2 SDs from mean
Age by which milestone should have been achieved
Prompt for further actionBut remember, variations in patterns of developmentBottom-shufflers
Bilingual households
And correct for prematurity up to 2ySlide7Slide8
Gross Motor
Limbs flexed, head lag
-
Newborn
Raises head
–
6w
Sits unsupported
– 6m (curved); 8m (straight)
Crawls
– 8-9m
Cruises
– 10m
Walks
– 12m (unsteady); 15m (steady)
Runs
– 18m
Kicks ball and jumps, can do stairs one at a time
– 2y
Tricycle, can do upstairs like adult
– 3y
Stands on one foot
– 4y
Skips
– 5y
4m
– Head control
9
m
– Sitting unsupported
12m
- Standing
18m
– WalkingSlide9
Vision and Fine Motor
Fixes and follows in midline
– newborn
Fixes and follows horizontally – 6w
Reaches for things and palmar grasp – 4-6m Transfers
– 7mPincer grasp – 10mBangs
bricks
together –
12m
3m
– Fixing and following
12m
– Pincer grip
9
m
– TransferSlide10
Fine Motor
18m –
Tower of 3-4
Scribbles
2y –
Tower of 6
Line
3
y –
Bridge (after demo)
Circle
3.5y –
Cross
4
y –
Steps (after demo)
Square
5
y –
Triangle
Can copy 6m earlierSlide11
Hearing, Speech and Language
Startles to loud noises
– newborn
Vocalises
and coos – 6mBabbles – 8m
Parents can understand sounds – 10mKnows name, 2-3 words
excl
mama/dada
– 12m
6-10 words
– 18m
2 word phrases
– 2y
3-4 word sentences w/ personal pronouns
– 3y
Relatively fluent
–
by 5ySlide12
Social, Emotional and Behavioural
Smiles in response
– 6w
Fear of strangers
– 10mWaves bye-bye and plays peek-a-boo – 10-12m
Symbolic play – 18mParallel play
– 3y
Shares toys and group play
– 4-5y
8w
– Smiling
2-2.5y
– Symbolic playSlide13
Social, Emotional and Behavioural
7m -
Puts
food in
mouth
12m -
Finger
feeds and drinks from
cup
18m -
Spoon
,
takes
off socks/shoes, indicates when
soiled
2y -
Spoon
and fork,
helps
with clothing, dry by
day
3y –
Starts to use knife and fork,
dresses w/ supervision
4y -
Dresses
alone
Slide14
Practical TipsSlide15
In an ideal OSCE…
Introduce yourself to child and parent/guardian
Get down to their level – metaphorically and literally
OBSERVE
FeaturesWhat they are doing alreadySee what they can do
Ask the parent questionsAbout hearing and visionAbout things you can’t test
HAVE FUN! Slide16
…But if it goes wrong...
Don’t panic!
Give the child back to their parent
Ask the parents questions insteadSlide17
To prepare beforehand…
Have a picture in mind of what children of a certain age should be doing
People watch!
Films and TV
The concourseSiblings etcSlide18
On the day…
Be aware of space and time
Improvise
Give LOTS of praise
Talk as you go alongMaybe save gross motor for last…Ask the
parents questions(But not “how old is your child?”)Slide19
https://www.youtube.com
/user/
MRCPCHRevision
https://www.youtube.com
/watch?v=4u4B0hs4UKUSlide20
Any questions?
Good luck!