Professional Documents
Culture Documents
Dev
Dev
birth to 5 years
INTRODUCTION
• method
– scientific knowledge
– tools of systematic enquiry and observation
• practical stepwise approach
• outlines key areas of associated psychological
processes,
• Developmental impairments ~heterogeneous
group condition
– start early in life
– delay and/or an abnormal pattern of progression
in
– one or more domains
• Complexity, severity and its impact
– biological,
– Social
– environmental factors
• common
• Prevalence : 5% to 15%
– :health and behavioural problems
– long term problems of
• social adaptation,
• Learning
• adverse mental health outcomes.
• early identification & intervention
– improve the outcomes.
• part of a multistep process of
– early identification
– Management
• wide variations in practice
• lack of agreement ~ best to conduct this
examination in a clinical paediatric setting
– Subjective clinical impressions based on informal
observations are often used
• miss a significant proportion of children with
problems, which may lead to delay in
identification
• Standardised tests
– differentiate children at different levels of
performance on that particular test
• gold standard
– may be impractical
– time,
– unsuitable for the child’s comprehension or motor
abilities,
– too narrowly focus on measuring development.
What influences development?
ESSENTIAL CONCEPTUAL
KNOWLEDGE
How does a child’s development
progress?
• Progress in • Children’s functional
developmental domains social and cognitive
– cognition, language, social- competence is a product
emotional and perceptual- of this interaction.
motor
• happens in concert with
progress in the
psychological processes
of
– attention, emotional
regulation, social cognition
and motivation in a
mutually dependent
manner
• The process of development and learning is
plastic
– alternative pathways and sensitive periods
• Magnitude of the plasticity varies
– different ages
– biological and social contexts
• Most - attain the substages of development in the
same order;
• But each child develops specific skills at an
individual rate.
A PRACTICAL FRAMEWORK FOR
DEVELOPMENTAL EXAMINATION
1. Systematic enquiry from parents
2. Structured observations of developmental
abilities.
Systematic enquiry
• There are three main aspects to a systematic
enquiry:
1. Eliciting concerns
2. Asking parents about the child’s current
abilities
3. Identifying risk and protective factors
Eliciting concerns
Asking parents about the child’s
current abilities
• functional impairment in communication and
socialising
• Current health status
• self-care abilities
• mental health status
– happy or unhappy,
– tearful or irritable,
– compliant or defiant,
– cooperative or oppositional,
– fearful or anxious/worried
• behaviour, level of activity and impulsiveness.
Identifying risk and protective factors
EXAMINATION/OBSERVATION
• How to observe?
Observations
Step 1
• For comprehension • a cup,
– Object labels (15–18 months): • spoon,
• ‘Look at the –’; ‘where is the –’; ‘give me
the–’ • plate,
– Identifying by use (24–30 months): • 1-inch cubes,
• ‘Which one do we eat with/drink with/sleep • key,
in?’ (avoid pointing by finger or looking at the
objects while asking). • fork,
• pencil,
• For expression: • empty box or
– Objects labels (18–20 months): • car,
• ‘What is this one’ or ‘This is a – (in an
expectant voice)?’ • adding miniature
toys and pictures
Step 2