Developmental examination should be further evaluated in child of 12 wks if he -
Ans. is 'd' Does not hold head at 90deg (Ref. O.P. Ghcii, 6/e, p 44 (5/e, p 32-33); API Medicine, 6/e, p 1134, Nelson 17/e, p 39). A child learns to lift and control his head in horizontal plane and above the horizontal plane by 4-12 wks. Therefore if a child of 12 wks age is not able to lift his head above 90deg he needs further evaluation. A child babbles at - 5-6 months* A child vocalizes by - 6-7 months* A child transfer objects from one hand to other by - 6-7 months* Therefore the absence of these features does not need any further evaluation in a child. The important developmental milestones is listed in the following table. Go through it again and again. You are sure to have at least one question on this topic. Note : I have given this list from API medicine 6/e and have also cross-checked from CPDT, 15/e. If you find some differences with some other books, blame it on API. But still, you can rely on it. Age Milestone One month Motor In prone position holds chin up* head sagging. Visual Watches person, follows moving object*. 2-3 months Motor Momentary support of head; turns to the side. Visual Follows moving object through 180 degrees. Social Smiles on social contact*, listens to voice and coos. 4-5 months Motor Better head control, tries to reach for object, regards toy in hand and puts in mouth, turns from supine to prone position.* Social Laughs aloud, excites at sight of food, may show displeasure, says "aah, ngah". 6-7 months Motor Rolls over side briefly leaning forward on hands, bounces actively if supported standing. Adaptive Grasps large objects, transfers from one hand to the other*. Social Prefers mother, babbles*, enjoys mirror. Language Polysyllabic vowel sounds 'm-m-m'*. 9-10 months Motor Sits Sites up alone without support*, pulls to standing position. Adaptive Creeps or crawls*, grasps objective with thumb and forefinger, crude release of toy, pokes with forefinger, uncovers hidden toy. Social Responds to sound of name*, waves bye- bye, holds own bottle. Language Mama, dada 12 months Motor Stands momentarily alone, walks holding to furniture*, walks with one hand held. Adaptive Gives toy on request, Social Cooperates in dressing. Language Two words besides mama, dada. 15 months Motor Walks alone*, crawls up stairs, builds tower of 2 cubes, makes a line with crayon. Social Points or vocalises wants. Language Follows simple commands, 4 to 6 words, jargons. 18 months Motor Runs stiffly with one hand held, walks upstairs, climbs into chair and sits, explores drawers and baskets. Adaptive Tower of 3 cubes, vertical stroke, imitates scribbling. Social Feeds self, seeks help when in trouble, complains when wet or soiled. Language 10 words, names pictures. 24 months Motor Runs well, walks up and downstairs, one step at a time.* Adaptive Opens doors, tower of 6 cubes, imitates horizontal stroke, circular scribbling. Social Handles spoon well, helps to undress, listens to stories. Language Puts 3 words together (Subject, verb, object). 30 months Motor Adaptive Social Language Jumps, walks backwards. Tower of 8 cubes, makes vertical and horizontal stroke, imitates a circle. Helps put things away. Refers to self as "I", knows full name. 3 years Motor Adaptive Social Language Climbs upstairs alternating feet rides tricycle.* Copies a circle and cross,* tower of 9 to 10 cubes. Helps in dressing and putting on shoes, plays simple games. Knows sex and age.* counts 3 objects, uses plurals. - API, 6/e
Does not vocalize.
Does not babble.
Does not change bright red ring from one hand to other even if given in hand.
Does not hold head at 90deg.
Assessment of Growth