All development assessment are done in 4 fields
Gross motor, Fine motor, hearing and social skills. Failure to do so with confidence could mean to fail in exams.
- GROSS MOTOR
- Lie the baby supine and pull him to sitting position
- You can do this by gently holding on his hands or wrist and pulling him towards you into the sitting position.
- Make sure that you support his back once they are in sitting position
Things to watch
- Head holding- whether steady or wobbly
- A new born baby may not be able to hold her head steady and this head control will be achieved by around 6 weeks’ time to 12 weeks
- If he cannot do it , it may indicate hypotonia, cerebral disorder or sedation by drugs
- The intention here is to suddenly extend the neck gently by sudden extension of the neck. Be sure you know how to do it before attempting
- There are several methods of doing this response
- Lie the baby on the bed
- Slide your hands below the head and neck of baby
- Lift the head to about 15 cm from the bed and suddenly allow the baby’s head to drop back into your hands
- The second method is by using vibrations induced by suddenly slapping the bed.
- There should be sudden extension of the arms followed by adduction towards the chest and finally a grimace or cry
- This should be brisk and symmetrical
- If the response is asymmetrical.it could be due to weakness, fracture, dislocation , or hypoxic insult
- Ill babies may have symmetrical response but weak
- This response should disappear by 6 months
- If it persists, it may indicate cerebral disorder particularly if it reappears after disappearing
- Hold the baby in ventral suspension with the baby face down.
- Stand behind the baby and wrap both your hands on either side of the baby back and lift them carefully. Now gently tilt them so that their face is facing downwards
- Watch for the baby to momentarily lift the head upwards wither in line of higher than the body.
FINE MOTOR AND VISION
- Look at the baby’s face from a distance of 2 feet. Also ask the mother if the baby stares at the mother when she passes by
- A normal term baby is able to see presence of people and may appear staring
- If no response, it could mean poor vision. Blindness
- Follows horizontally to 90 degree
- Place the baby on a bed on their back. Turn the face to one side. Now place a red dangling ball in front of the baby’s face at about 25 to 30 centimetre. Now move the ball towards the midline. The baby may move the head all the way beyond 90 degree or may move the eyes alone depending on the gestation age.
- This can be repeated in 5 minutes time.
- If the child fails to do it, it could mean poor vision
HEARING AND SPEECH
- Ring a bell or rattle at a distance of 15 to 20 cm from the baby’s ear by placing it at the same level but back of the baby head so that they cannot see the bell but can hear it.
- If there is no response, then increase the loudness
- A normal child will stop what they are doing, quieten, widen eyes, or turn towards the sound
- IF there is no response,test again in 2 weeks’ time. This baby may need audiology for hearing screening.
- Suddenly clap at ear level about 30 cm . You can also ask if the parents noticed the baby responding to sound.
- The child generally startles with quietening, stopping what they were doing,
- If the child does not pass the test then he should be referred for paediatric audiology referral
- The main intention is to see if the baby is able to smile after the age of 10 weeks.
- Ask the parents if they have seen the baby smile. You can try to interact the baby by smiling and making interacting with them without touching them or by making any sound.
- If the child is able to smile then the child has passed this test
- If the baby doesn’t smile, it could mean developmental delay. This baby should be assessed with other tests for development.
- About 90% of baby smile by about 6-8 weeks.