5. Developmental Milestones - Teaching

Paediatric Developmental Milestones

Age
Gross motor
Fine motor
Language
Social
6 weeks Good head control Fixes and follows face Still in response to sound Smiles
3 Months Neck holding Hands open half the time Startle at loud noises, cooing Recognises mother
6 months Rolls over in both directions (supine to prone and prone to supine) Transfers hand to hand Monosyllabic (mostly babbles)
Knows familiar faces
Likes to play with others, especially parents
9 months Crawling, sit without support, pulls to stand Pincer grasp Bisyllabic ("mama", "bye bye") Stranger fear, holds/bites food 
1 year Walks independantly (a few steps) Stacks 2 blocks, throws objects Two words with meaning Wave, clapping
2 years Running, up and down steps holding on, kicks a ball Stacks 4 blocks, makes or copies straight line simple sentences (with 2 or 4 words) Copies others
3 years Tricycle, walks up and downstairs, one foot on each step Stacks 8 blocks, makes or copies circles Can tell name, age, gender Dresses and undresses self
4 years Hops, jumps, walks Stacks 12 blocks Tell stories, poems Cooperates with other children
5 years Skips (both legs above ground) Can draw a person with atleast 6 body parts, copies a triangle and other geometric shapes Understands complex instructions Wants to please friends
 
Gross Motor Skills
  • 3 months - Neck - Holds neck
  • 6 months - Body - Rolls both directions
  • 9 months - Knees - Crawling
  • 12 months - Feet - Walks
Fine motor skills
  • At 2 years - Draws a line
  • At 3 years - Draws a circle
  • At 4 years - Draws a cross and square
  • At 5 years - Draws a triangle
  • At 6 years - Draws a diamond
Referral for paediatric assessment

Following are certain negative indicators (things a child cannot do) by certain age that you should recognise and refer for paediatric assessment

  • At 5 months of age - Unable to hold objects placed in hand
  • At 6 months of age - Unable to reach for objects
  • At 12 months of age - Unable to sit unsupported
  • At 18 months of age - Unable to walk
  • At 18 months of age - No speech
  • At 15 months onward - If unable to speak monosyllabic words and difficulty understanding speech, arrange hearing test
  • At 2.5 years of age - Unable to run
For further reading

Teaching Plan: Developmental Milestones for Medical Students

Objective: Equip Rose Muller with a thorough understanding of developmental milestones across different domains (physical, cognitive, language, social/emotional) from birth to five years, including strategies to evaluate and communicate these milestones during clinical assessments.

Preparation:

  • Gather educational materials such as charts, videos, and pediatric textbooks that visually represent developmental milestones.
  • Prepare clinical case studies or vignettes that highlight typical and atypical development.

Teaching Session Structure:

  1. Introduction to Developmental Milestones:

    • Explain the importance of understanding developmental milestones in medical practice, especially for pediatricians, family doctors, and specialists in child development.
    • Discuss the role of milestones in screening for developmental disorders and guiding parental education.

  2. Overview of Developmental Domains:

    • Break down the milestones into four main domains:
      • Physical (Gross and Fine Motor Skills): Include milestones like sitting, walking, drawing, and dressing.
      • Cognitive (Problem-Solving, Learning): Cover abilities such as object permanence, cause-and-effect relationships, and explorative behavior.
      • Language (Communication Skills): Discuss milestones related to cooing, babbling, first words, and sentence formation.
      • Social/Emotional (Interaction with Others): Describe social smiling, recognizing parents, cooperative play, and expressing a range of emotions.

  3. Age-Specific Milestones:

    • Use a timeline or chart to detail typical developmental milestones at key ages: newborn, 3 months, 6 months, 9 months, 12 months, 18 months, 2 years, 3 years, 4 years, and 5 years.
    • Emphasize the variability in normal development and the concept of the "developmental range."

  4. Case Studies and Role-Playing:

    • Introduce clinical vignettes that present children at various developmental stages. Ask Rose to identify if the child is meeting appropriate milestones for their age.
    • Include scenarios where children exhibit signs of developmental delays or disorders, discussing potential red flags and the importance of early intervention.

  5. Assessment Techniques:

    • Teach techniques for assessing developmental milestones during clinical examinations, including observation, parent interviews, and standardized tools like the Denver II.
    • Discuss how to communicate findings to parents/caregivers, including sensitive delivery of concerns about developmental delays.

  6. Discussion and Q&A:

    • Allow Rose to ask questions or express concerns about developmental assessment.
    • Discuss how cultural, socioeconomic, and environmental factors can influence development.

  7. Further Resources and Learning:

    • Provide Rose with additional resources such as online courses, textbooks, and articles focused on pediatric development.
    • Recommend joining pediatric rounds, workshops, or seminars that focus on child development.

Closing:

  • Summarize the key points covered and reinforce the importance of continual learning and observation in practice.
  • Encourage Rose to practice these skills in clinical settings under supervision and to utilize resources for ongoing education.

Important Points to Keep in Mind:

  • Use engaging teaching methods including visuals, interactive discussions, and hands-on practice to enhance understanding.
  • Stress the importance of holistic assessment, considering the child’s environment and overall health in addition to specific milestones.
  • Encourage critical thinking and the application of knowledge through case-based learning.

By structuring the session in this way, you ensure that Rose Muller gains a solid foundation in understanding and applying knowledge of developmental milestones, crucial for any medical professional working with children.

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