Prof. V Wong

Growth

• Increase in size
• Its progressions are mainly structural and can be measured with some degree of reliability in terms of ht, wt, bone-age etc

Development

• Increase in complexity
• It involves both structure and function
• Its numerous simultaneous progressions are closely related but manifest many variations
• Normal growth and development of body, mind and personality progress in parallel at similar rates and pattern toward predictable outcomes
• The limits with which children of a population vary are taken as guidelines from norms of that aspect of growth or development
• Assessment means weighing up of the situation's strength and weaknesses
• It is a process whereby the child's problems and his assets are identified
• In medical terms: involving the detailed expert and often multidisciplinary investigations of manifestations of suspected developmental delay or abnormalities
• It is a diagnostic and problem-solving exercise
• In educational terms, this a continuing process of describing a child's current level of performance together with strengths and weaknesses, in order to establish an appropriate course of teaching and to produce likely educational needs in immediate future

1. Gross motor activity
2. Fine motor and vision
3. Hearing and vision
4. Social behaviour and play

Development normally advances synchronously between these areas

General observation of child behaviour

• 19 mo: curious in books, can turn pages, fingers to build bricks, take cubes out of box, empty box of bricks onto table, put cubes into box and cover box, learn relationship of box and things hidden, match shapes, affectionate toward mother, seeks attention from mother

Fine motor

• Picks up small objects
• Use thumb and index finger - one hand at a time
• 18 mo: use of common objects, eg. Cup and spoon, aware of what they are being used for
• Drinking from cup, feeding from spoon
• Name of common obj - eg. Car, cup, ball, doll
• Cannot hold pen very well, inferior pincer, scribbles

Visual following

Gross motor

• Unable to walk down stairs
• Climbing down backwards
• Down stairs by age 2 yo
• Before age 2 yo, backwards, on bum
• Can squat and play with toys
• Gets up without difficulty

Symbolic play (comprehensive language aspect)

• Obj used daily
• Appreciate function of obj by showing how to use them
• Imitation skills of child which child observes from adult daily

18 mo

• Car with wheels - push fwd and backward

Child with CEREBRAL PALSY

• Posture: bad head control
• Hands in extended position
• Difficulty controlling UL and LL
• Difficulty swallowing as a result of CP
• Preferential looking: examiner looks through hole in board to see what pattern baby is looking at
• Examination of eye: pupil size, pupillary reaction, ophthalmology to look at retina
• Uncomfortable: head movt, UL movt, body into extended movt
• Corneal examination: corneal opacity?

Distraction test for hearing

• Nurse distracts child
• Does child turn head toward sound source?

Distraction test

• Quiet room with ambient noise level below 40 dB
• Child mature enough to sit erect, perform head turn in horizontal plane
• Suitable for age 6-18m (older: lose interest)
• Parents must be instructed not to react in any way when sounds are presented
• Second tester at back is to remain outside child's vision
• A definite head turn in direction of sound will constitute a pass
• Pitfalls which may invalidate the test