DevelopmentDevelopmentDevelopmentDevelopment

Dr Hazel AcombDr Hazel Acomb

Curriculum

• Be able to take an accurate neuro-developmental history

• Be able to perform a reliable assessment of neuro-developmental status at key stages

Aims:• Gain an idea of normal

development with examples

• Awareness of different developmental assessments in use

• Hints for assessing development yourself

Normal Development

Factors effecting Development

• Genetics/ heredity• Opportunity• Health• Physical needs being met• Psychological needs • Sensory impairment

• Can you name the 4 domains of development?

• Look at the milestones cards in your group and put them in order – there will be some overlap.

• If you finish, begin to think about the ages associated with them

• Handout for your reference

• Learning milestones needs to be done– tips

Do not stick to these milestones too rigidly…

• Variation within normal• Range of time for acquisition of

skills

• Opportunity – bungalow, drinks bottles, tricycle…….

Can you name any developmental red flags?

(These might be things that a child SHOULD be doing by a certain age or SHOULD NOT be doing before or after a given age)

• No responsive smile 8w• Not reaching for toys 5m• Not sitting unsupported 9m• Not walking 18m• Not using single words 18m• Hand preference < 12m• Regression

Assessing Development

• May use screening tool• May assess components and

compare to milestones

Questions to ask parent:

• Was he premature?• Have YOU got any concerns about

his development?

Denver• Screening tool• Line down age• Stop testing when

fail 2 in a row in a domain

• Age 0-5

Schedule Growing Skills

• Longer, needs specific kit

• Comprehensive• Age 0-5

Griffiths Mental Development Scale

• Longer, needs specific kit and training course

• Age 0-8• Motor, personal-

social, language, eye and hand coordination, visio-spacial, practical reasoning

Tips

Never say “will you” or “can you” or “shall we” – you risk refusal. Try “Let’s.”

Play with the toys yourself.As you move a new toy in, move the

old one out of sight.Do active tasks last.If shy, try something simple first and

have Mum join inKeep watching!

Practical issues to take into account

• Is child performing at his best?– Unfamiliar environment– Ill child– Pure perversity of a grumpy toddler

• Is equipment available– Stairs, space

• Snapshot only

Examples of normal development…

Group A: Note examples of gross motor and social skills

Group B: Note examples of fine motor and language skills