Page 8 - Neurological examination of children

Development

Neurological examination of children
Table 2. Adapted from: Denver development screening test (75% percentile) and
Illingworth: The development of the infant and young child.

AGE GROSS MOTOR FINE MOTOR SOCIAL LANGUAGE The approach to neurological examination takes into consideration the child’s age, the level
of development and the specific neurological concern.
5 weeks Lifts the head to 45 Fine hand movements Smiles Makes sounds
degrees, turns the Opens hands responsibly Start with a basic neurological screen
head
Are the social interactions normal? Is language and speech appropriate? Does vision,
3 months Supports weight on Opens hands Smiles Laughs hearing and gait appear to be normal? Watch the child play, draw or write.
forearms spontaneously responsibly
Only slight head lag Hands primarily open More detailed neurological screen
Neonates: Observe the spontaneous and stimulated patterns of movement, the ability to
5 months Rolls from abdomen Reaches for things Smiles at own Babbles fixate and follow with the eyes and the sucking reflex.
to the back reflection in mirror
Ticklish Infants aged 1-8 months: The »180-degree examination« is useful. Careful obervation du-
6 months Sits briefly with Transfers objects Imitates sounds ring this simple, stepwise procedure will provide valuable information.
rounded back Palmar grasp
9 months Gets into sitting position. Pincer grip Waves bye-bye Reacts to:
Pulls to stand Plays peek-a-boo Where is daddy? FIGURE 1

12 months Walks with support of Lets go of toys on Reacts on command 1-2 meaningful Graphics by 4. VERTICAL
Hanne Agerholm
hand, “botton shuffling” command Shy. words SUSPENSION
· Tone and power
or “bum scooting”, Understands · Scissoring (CP)
stands without support 10-12 words · Advanced weight-
3. SITTING bearing
18 months Runs. Climbs stairs with Makes marks with a crayon Takes off clothes At least 6 words · Ability to sit
assistance Eats with spoon Shows two body parts · Head and body
Walks backwards control
24 months Throws and kicks a ball Builds tower of 6 blocks Washes and 2-3 word sentences
Climbs down stairs Draws vertical line dries hands Shows 6 body parts
2. TRACTION 5. HORIZONTAL
· Head control SUSPENSION
36 months Jumps with a broad Builds a bridge of 3 Puts on t-shirt Understandable talk · Position
stance blocks (from a model) Plays with others Asks questions · Tone and power
Stands on one leg for Imitates circle Helps lay the table
one second
48 months Jumps successfully Draws a cross Puts on clothes Recognises 4
Stand on one leg for Brushes teeth colours
3-4 seconds Plays role games 1. SUPINE 6. PRONE
Takes turn · Movements · Position and
movements
· Tone and power
· Symmetry
Department of paediatrics, Viborg Regional Hospital
Heiberg Alle 4, DK-8200 Viborg 2. edition, Dec. 2017 The Regional Hospital, Viborg
Centre of Health Sciences Education (CESU), Aarhus University, Department of Paediatrics
DK-8200 Aarhus N, Denmark