NEURO-DEVELOPMENTAL SCREENING OF CHILDREN
WITHCENTRAL MOTOR DYSFUNCTION AT THE FIRST VISIT
WITHCENTRAL MOTOR DYSFUNCTION AT THE FIRST VISIT
| | Affected ……………. Well | ||
| | 1 | 2 | 3 |
| 1. Historical Information: · First trimester (Eg. Fever) | | | |
| · Second trimester (Eg. Bleeding) | | | |
| · Third trimester (Eg. Diabetics, PIH, Infections) | | | |
| · Birth events - Apgar score | | | |
| - Weight | | | |
| - Gestational age | | | |
| · Neonatal period (Seizure, Infection, Jaundice) | | | |
| · Late Neonatal period (Meningitis, Seizure) | | | |
| · Infancy (Seizure, CNS infection) | | | |
| 2. Clinical Examination: · Nutritional Status | | | |
| - Weight | | | |
| - Mid arm circumference | | | |
| - Skinfold thickness | | | |
3. Developmental Screening - Abilities
| | Affected ……………. Well | ||
| | 1 | 2 | 3 |
| a. Morphology - Ears | | | |
| - Eye brows | | | |
| - Eyes | | | |
| - Mouth | | | |
| - | | | |
| - Hands | | | |
| - Leg | | | |
| - Mandible | | | |
| b. Cranium - Head size | | | |
| - Head Shape | | | |
| - Anterior Fontanal | | | |
| - Head control | | | |
| c. Vision - Visual alignment | | | |
| - Visual engagement | | | |
| d. Hearing Level - Hearing engagement | | | |
| e. Oro-facial Functions - Mouth movements | | | |
| - Swallowing | | | |
| - Chewing | | | |
| f. Hand functions - Bimanual use | | | |
| - Thumb functions | | | |
| - Tripoid grasp | | | |
| - Manipulation of toy | | | |
| - Wrist function | | | |
| g. Posture - Position of ankle | | | |
| - Position of legs | | | |
| - Position of knee | | | |
| - Position of hip | | | |
| - Position of trunk | | | |
| h. Sitting - Head control | | | |
| - Trunk control | | | |
| - Voluntary neck moments | | | |
| - Voluntary hand moments | | | |
| i. Gait - Heel placing | | | |
| - Toe placing | | | |
| - Placing of legs | | | |
| - Arm swinging | | | |
| - Spinal curvature | | | |
| j. Social skills - Stranger awareness | | | |
| - Reciprocal responses | | | |
| - Play engagement | | | |
| k. Communication - Awareness of environment | | | |
| - Taking turn | | | |
| l. Language - Comprehension | | | |
| - Verbal | | | |
| - Non-verbal | | | |
4. Developmental Screening – Needs
| | Minimal ……………… Significant | ||
| | 1 | 2 | 3 |
| a. Behaviour - Repetitive pattern | | | |
| - Social indifference | | | |
| b. Mood - Angry prone | | | |
| - Difficulty to console | | | |
| c. Convulsions - Generalised | | | |
| - Focal | | | |
| d. Obstructive apnoea - Noisy breathing at night | | | |
| - Mouth breathing | | | |
| e. GERD - Vomiting during feed | | | |
| - Vomiting after feed | | | |
| - Frequent Respiratory infection | | | |
| f. Dentition - Malocclusion | | | |
| - Dental caries | | | |
| g. Sleep - Sleep initiation difficulty | | | |
| - Arousals during sleep | | | |
| h. Family adjustment - Denial | | | |
| - Bargaining | | | |
| - Grief | | | |
Prepared by Dr. M.C. Mathew, ASHIRVAD Child Development and Research Centre
