Psychiatry
Developmental Assessment
Third Shifting
Dr. Vivian Yu
Why is there a need for early identification of \ u 2 0 2 2 Every well child must be an opportunity for developmental disorders? health care professional to evaluate the overall development of the child \ u 2 0 2 2 critical to the well-being of the child o delay may be due to a medical condition \ u 2 0 2 2 Further developmental evaluation is requir o delay may indicate an increased risk of whenever the child fails to meet any of the behaviour/ psychiatric disorders or other following milestones o developmental disorders Language delay o early detection may prevent further \ u e 0 0 1 Turn to sound by 6 months deterioration and improve future \ u e 0 0 1 Babbling and gesturing outcomes of those identified waving bye-bye by 12 months) \ u 2 0 2 2 responsibility of every primary care physician \ u e 0 0 1 Single words by 16 months spontaneous just \ u e 0 0 1 2-word (not Common Presentation of Developmental echolalic) phrases by 24 months Delay \ u e 0 0 1 loss of any language or soc \ u 2 0 2 2 Newborn any age (American Academy of o Dysmorphism Neurology and Child Neurology o Major organ system dysfunction Society 2000) (feeding/ breathing) o Motor delay \ u e 0 0 1 Poor head control by 3 months \ u 2 0 2 2 Early Infancy (2-4 mo) o Failure to interact with the \ u e 0 0 1 Hands still fisted by 4 months environment \ u e 0 0 1 Unable to hold objects by 7 mo o Vision and hearing impairment \ u e 0 0 1 Does not sit independently \ u 2 0 2 2 6-18 months months o gross motor delay o Psychosocial delay \ u 2 0 2 2 Toddler \ u e 0 0 1 No social smile by 3 months Language delay o \ u e 0 0 1 Not laughing in playful situa months \ u 2 0 2 2 Preschool o Language difficulties or delays \ u e 0 0 1 Hard to console, stiffen o Behaviour difficulties approached by 1 year o Delays in fine motor skills \ u e 0 0 1 In constant motion, resists \ u 2 0 2 2 School Age \ u e 0 0 1 Does not play with other o 3 years Academic underachievement o Cognitive delay o Behaviour difficulties History \
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History of illness/ Past medical history 2 Maternal history 2 Family history Relatives with same illness Consanguinity of parents Functioning and intellectual capacity of parents 2 Emotional tone at home 2
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2 months: not alert to moth 6 months: not searching
12 months: no object permane 3 years: does not know full nam 4 \u00bd years: cannot count s 5 years: does not know let
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Developmental HistorySCHOOL AGE Developmental History CHILDREN \ u 2 0 2 2 The Philippine Society for Developmental and \ u 2 0 2 2 Reading skills Behavioral Pediatrics states that developmental o slow in learning connection between letters surveillance is a flexible, continuous and and sounds cumulative process o confuses basic words Kibbutz \ue000
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PSYCHIATRY ASSESSMENT DEVELOPMENT EVELOPMENTAALLA SSESSMENT
makes consistent reading errors letter reversal (b-d) (p-q) letter inversion ( m-w) transpositions (felt-left) word reversal (was-saw) number reversal (14-41) repeats, omits, or adds words does not like reading at all avoids reading aloud uses fingers to follow a line of print when reading slow to remember facts slow to learn new skills, relies heavily on memorization poor coordination, unaware of physical surroundings and prone to accidents awkward and clumsy, has trouble with fine motor skills
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anthropometric measurements \u201cSyndromic\u201d appearance dull facial expression: unreliable neuro exam: sensory impairments psychometric testing
Screening Test Denver Developmental Screening Test- II (Denver II) o For children ages 0-6 years o 4 domains: gross motor, fine motor, language and social o Materials: bell, set of 10 blocks, glass bottle, rattle, tennis ball, pencil, yarn, raisins, zippered bag, cup, doll, baby bottle o Scoring: P= Pass N= No Opportunity F= Fail R= Refused o Interpretation: \ \
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Re-evaluation needed in 3 months if 1 delay AND/OR 2 or more cautions
Untestable- there is significant refusals or no opportunity test items
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Refer to specialist if Failed test Classified as untestable consecutive screening
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2 0 2 2 Assessment tool that gives quantitative DQ visual-motor/ problem-solving and language abilities u 2 0 2 2 CAT (Clinical Adaptive Test) o Problem-solving items for ages from birth to 36 months u 2 0 2 2 CLAMS (Clinical Linguistic and Auditory Milestone Scale) o Language milestone from birth to 36 months u
Other test for Visual-motor and Problemsolving Skills \ u 2 0 2 2 Goodenough-Harris Draw-a-Person test \ u 2 0 2 2 Gessell figures \ u 2 0 2 2 Gessell block skills
Screening for Language Skills \ u 2 0 2 2 ELMS (Early Language Milestone Scale) o For 0-3 years o 5-10 minutes to complete o high sensitivity Evaluation of \ u 2 0 2 2 (Parent\u2019s PEDS Developmental Status) questionnaire o For ages 0-8 years o Structured set of 10 questions about parental concerns in various areas of u e 0 0 1 Advance- if child passes item the falls development completely to the right of age line \ u 2 0 2 2 ASQ (Ages and Stages Questionnaires) u e 0 0 1 Normal- if child passes, fails, or refuses o for ages 4-48 months items where age line falls between the o series of 11 questionnaires to be 25th and 75th percentiles completed at home by parents u e 0 0 1 Caution- if child fails or refuses o item multi-domain screen with good where the age line falls between the sensitivity and specificity 75th and 90th percentile u e 0 0 1 Delayed- if child fails orFor refuses Autismitem which falls completely to the left of age \ u 2 0 2 2 CHAT ( CHeckilist for Autism in Toddlers) line o from 18 months and older, and M-
CHAT (Pervasive Developmental \ u 2 0 2 2 PDDST 0 2 2 Gross Motor, Language, Fine Motor, Social Disorders Screening Test) I and II Either advance, normal, caution, delayed \ u 2 0 2 2 STAT (Screening Tool for Autism in Two0 2 2 Pass- if there is no delay OR only 1 cautionyear olds) 0 2 2 Fail- if there are 2 or more delays noted
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PSYCHIATRY ASSESSMENT DEVELOPMENT EVELOPMENTAALLA SSESSMENT
(Social Communication SCQ Questionnaire) o Formerly known as Autism Screening Questionnaire (ASQ) For ADHD • Teacher’s ___________ •
Diagnosis: Labs • Newborn screening • EEG • CT scan • Hearing test Referrals • Pediatrician o Developmental o Genetics • Psychiatrist • Occupational Therapist • Speech Therapist • Special Education Program
Kibbutz
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