17. Development .pptx

DEVELOPMENTAL MILESTONES V. MANONMANI MEDIAN AGE • The age when half of a standard population achieve that developmental milestone • Serves as a guide to when stages of development are likely to be reached The age by which the developmental milestones should have been achieved. LIMIT AGES Lim...

DEVELOPMENTAL MILESTONES V. MANONMANI MEDIAN AGE • The age when half of a standard population achieve that developmental milestone • Serves as a guide to when stages of development are likely to be reached The age by which the developmental milestones should have been achieved. LIMIT AGES Limit ages are usually two standard deviation from the mean. Useful as to whether a child’s development is normal (ie more useful than the median age) Failure to meet limit age gives guidance for action regarding more detailed assessment , investigation or intervention VARIATION IN DEVELOPMENT The acquisition of development abilities follows a similar pattern between children but may vary in rate and still be normal Example :• motor development is the progression of an infant from immobility to walking, but not all children do it in the same way. ASSESSING CHILD DEVELOPMENT • Consider 4 fields of developmental skills • Gross motor (GM Development is cephalocaudal in progression) • Vision & fine motor • Hearing, speech and language • Social , emotional & behavioral FIELD OF DEVELOPMENT WITH LIMIT AGES DEVELOPMENT SCREENING AND ASSESSMENT • Developmental Screening : Checks a whole population of children at set ages by trained professionals • Developmental Assessment : Detailed analysis of particular areas of development and it follows concern after screening that a child’s developmental progress may be disordered in some way. • A range of tests have been developed to assess development in a formal reproducible manner • Screening test : The Denver Developmental Screening Test Exampl e Perform Assessment on a 3-year-old child. Steps a. Take a ruler and draw vertical line at age 3 yrs. b. Perform tests in and around that area. CASE VIGNETTE • Amy a 15-month-old girl has delayed speech and still cannot say Mama or Papa. • Normal development in the other domains – gross and fine motor, social and behaviour • Parents and 3 older siblings had normal speech development Q. Which of the following is most likely in Amy? A Autism B Hearing loss C Mental Retardation D Familial delay • Consists of 125 tasks, or items. • Includes four areas: • 1. Personal –Social: • Getting along with people and caring for personal needs DENVER II OVERVIEW • 2. Fine Motor-Adaptive: • Eye hand coordination, manipulation of small objects, and problem solving • 3. Language: • Hearing, understanding, and using language • 4. Gross Motor: • sitting, walking, jumping - overall large muscle movement Provide an organized clinical impression of a child’s Overall development to alert the user to potential developmental difficulties VALUE OF THE DENVER II Used to determine how a child compares to other children It is not a predictor of later development RED YARN POM-POM (4” IN DIAMETER) RAISINS OR “O” SHAPED CEREAL RATTLE WITH NARROW HANDLE 10 1” SQUARE COLORED WOODEN BLOCKS DENVER II Test Materials: SMALL, CLEAR GLASS BOTTLE WITH A 5/8 INCH SMALL BELL TENNIS BALL RED PENCIL SMALL PLASTIC DOLL WITH FEEDING BOTTLE PLASTIC CUP WITH HANDLE BLANK PAPER NOTE: Children need to be supervised appropriately with test materials to prevent choking or DENVER II •Test Form  Some items have a small footnote number on the left end of the bar. This number refers to the numbered instructions on back of test form  R = Report (Information may be given from parent or caregiver) •Test administration Items requiring less active participation should be administered first Tasks that the child can perform easily should be administered first  Items in Fine Motor-Adaptive next (do not require child to speak)  Language items next  Gross Motor items as these require more confidence which is gained as test progresses.  Praise child’s efforts even if they fail on an item  Items that use the same materials may be administered consecutively. Keeps the flow going. Whenever possible, the examiner should observe what the child can do. Number of Items to be tested Depends on age and ability of child Step 1: in each sector, administer at least three items nearest to and totally to the left of the age line and every item that is intersected by the age line  Step 2: if the child is unable to perform any item in step 1 (fails, refuses, has had no opportunity) administer additional items to left in the appropriate sector until child passes three consecutive items Continue to administer items to the right of any passes in each sector until three failures are recorded The child may be given up to three trials to perform each item, when appropriate, before scoring a failure Ask the caregiver or parent if the results are typical of child’s performance. Consider if the child is ill, hungry, upset, etc. Rescheduling may be necessary if child is not being cooperative DENVER II Age Calculations Example: Year Date of Test Month 2011 10 17 30 +17= 47 -8 - 20 9 Date of Birth Age of Child - 2008 3 1 Day 27 Adjusting for prematurity: • Born more than 2 weeks before expected delivery date • Are less than 2 years of age Age of Child Age of Child 6 weeks premature Adjusted Age of Child Year Month 2 Day 19 - 1(30days) 1 - 14 5