From Birth to Five Years

Practical Developmental Examination

Ajay Sharma, Helen Cockerill

• Publisher: Routledge
• Year: 2021
• ISBN:
  9781000459685
• Edition: 2
• Topic: Médecine
• Subtopic: Pédiatrie

This fully updated new edition of From Birth to Five Years: Practical Developmental Examination is a step-by-step 'how to' guide to the developmental examination of pre-school children. Based on up-to-date research into current child development philosophies and practices, this text supports the wider group of professionals who are required to assess children's developmental progress as part of their day-to-day working practices.

It begins with a practical framework for developmental examination, then progresses through each of the key developmental domains, offering guidance on enquiry and observation, and on how to chart typical and atypical patterns, with red flags for recognising significant delay or disordered development. Advice is also given on how to make sense of the findings and how best to communicate this information to parents. To consolidate and expand on the practical and theoretical information across this book and its companion, Mary Sheridan's From Birth to Five Years, an updated companion website is available at www.routledge.com/cw/sharma, which includes the following additional learning material:

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• An interactive timeline of the key developmental domains;

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• Introductions to theory with links to further reading;

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• Research summaries;

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• Video clips demonstrating practical assessment skills;

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• Downloadable resources including pictures to support examination of verbal and non-verbal development, and tips to facilitate and promote development.

Developed alongside the original Mary Sheridan's From Birth to Five Years: Children's Developmental Progress, this unique guide expands on its normative developmental stages by offering practical guidance for health, education and social care professionals, or anyone concerned with monitoring children's developmental progress.

1 A practical framework for developmental examination

DOI: 10.4324/9781003057185-1

A developmental examination is a part of the process of early identification and management of children’s health and developmental difficulties, which includes a public health programme of raising community awareness, proactive surveillance of health and development and multidisciplinary response to any concerns arising.

Supporting children’s development – public health to specialist services

The purpose

The purpose of assessing development is to address any concerns raised by parents and primary care practitioners and improve children’s developmental outcomes. The assessment explores children’s strengths and weaknesses in the context of risk and protective factors and provides the way forward for supporting the child and the family. This purpose is broader in its scope than measuring or describing children’s development and is achieved through establishing a partnership with parents.

Methods and tools

Tests for evaluating children’s development can be categorised as:

1. A. Standardised development tests: These tests, for example, Griffith’s or Bayley’s scales, compare children’s performance to the expected norms for their level of abilities or function. They are considered the gold standard by some but may be impractical in terms of time, unsuitable for the child’s comprehension or motor abilities, and often too narrowly focused on measuring development (Greenspan and Meisels 1996).
2. B. Eclectic structured methods: These methods combine the knowledge of child development with a system of eliciting information about the child through enquiry, making structured observations using appropriate tools and making sense of the findings in the context of the risk and protective factors for the child. One such method is described in this book. It may, on its own, lack the sensitivity and specificity of standardised assessments but combined with the right knowledge, training and experience, it has a useful place in clinical practice. It enhances practitioners’ awareness about how development progresses and helps them identify the child’s strengths and vulnerabilities, and provide the necessary guidance and support.

Another approach, sometimes used, is to form subjective impressions about a child’s developmental age on superficial observations and scant knowledge of developmental norms. Tempting though it may be, particularly in a busy clinical setting, making such assumptions has no place in evaluating development; it risks falsely reassuring parents and delaying identifying an impairment or raising undue anxiety (Glascoe and Dworkin 1993).

The framework

The developmental examination framework described here combines the tools of systematic enquiry (asking) and observation with the knowledge of developmental progression and its disorders and provides a basis for identifying developmentally vulnerable children.

An outline of the approach to evaluate development

Asking

Gathering information from parents and carers is undoubtedly the most important aspect of evaluating development (Dooley et al. 2003). It has three components:

Listening and eliciting concerns

An assessment generally starts with an open-ended question, such as ‘Please, tell me about your concerns’. However, parents, for various reasons, may not always bring up all their concerns (Box 1.1) (Glascoe and Marks 2011). Well-elicited and carefully interpreted parental concerns can guide practitioners in deciding the focus of further detailed enquiry. Using a structured set of questions can help explore concerns (Table 1.1).

Table 1.1 Questions for eliciting concerns

Do you have any concerns about how your child talks and makes speech sounds? Do you have any concerns about how your child understands what you say? Do you have any concerns about how your child uses his or her hands to do things? Do you have any concerns about how your child walks or runs? Do you have any concerns about how your child behaves? Do you have any concerns about how your child gets along with others? Do you have any concerns about how your child does things for him or herself? Do you have any concerns about your child’s learning? Do you have any concerns about your child’s hearing or vision? Do you have any other concerns?

Source: Glascoe (1999)

BOX 1.1 Barriers to parents raising concerns or accessi...