Developmental Milestones and Child Health Surveillance

Question 1

what gross motor milestones should be present when a child is:
newborn?
6-8 weeks?
6-8 months?
10 months?
12 months?
2-2.5 years?

Answer 1

Symmetrical and flexed posture, marked head lag on pulling up
Raises head to 45 degrees when lying prone
Sitting
Standing
Starting to try to walk
Walks steadily,runs and jumps

Question 2

what hearing, speech and language milestones should be present when a child is aged:
newborn?
3-4 months?
7 months?
12 months?
18 months?
2 years?

Answer 2

startles to loud noises
vocalise alone or when spoken to
turns to soft sound out of sight, polysyllabic babble
2/3 words other than ‘dada’ and ‘mama’, understand their name
6-10 words, can point to body parts when asked
join 2 or more words to make simple phrases

Question 3

what social, emotional and behavioural milestones should be present when a child is aged:
6-8 weeks?
6-8 months?
10-12 months?
18 months?
18-24 months?
2 years?

Answer 3

smiles responsively
puts food in mouth
waves bye, plays peek-a-boo, drinks from a cup with 2 hands
holds a spoon and gets food safely to the mouth
symbolic play
toilet training

Question 4

what vision and fine motor milestones should be present when a child is aged:
6-8 weeks?
4-6 months?
7 months?
10 months?
16-18 months?

Answer 4

following moving object or face by turning their head
palmar grasp
transfer toys from one hand to another
mature pincer grip
makes marks with crayons

Question 5

what is the limit age (that requires referral) for not reaching the developmental milestone sitting?

Answer 5

9 months

Question 6

what is the limit age (that requires referral) for not reaching the developmental milestone walking?

Answer 6

18 months

Question 7

what is the limit age (that requires referral) for not reaching the developmental milestone transferring toys from one hand to another?

Answer 7

9 months

Question 8

what is the limit age (that requires referral) for not reaching the developmental milestone mature pincer grip?

Answer 8

12 months

Question 9

What milestones should be reached in brick building between the ages of 1 and 3 ?

Answer 9

Tower of three – 18 months
Tower of six – 2 years
Tower of eight – 2.5 years
Bridge (from a model) – 3 years

Question 10

What pencil skills should be present between 2 and 5 years?

Answer 10

Line – 2 years
Circle – 3 years
Cross – 3.5 years
Square – 4 years
Triangle – 5 years

Question 11

what is the limit age (that requires referral) for not reaching the developmental milestone smiling responsively?

Answer 11

8 weeks

Question 12

what is the limit age (that requires referral) for not reaching the developmental milestone symbolic play?

Answer 12

2 - 2.5 years

Question 13

What antenatal health surveillance should take place?

Answer 13

Ensure intrauterine growth
Check for maternal infections e.g. HIV
Ultrasound scan for fetal abnormalities
Blood tests for Neural Tube Defects

Question 14

What newborn health surveillance should take place?

Answer 14

Clinical examination of newborn
Newborn Hearing Screening Programme e.g. oto-acoustic emissions test
Give mother Personal Child Health Record

Question 15

What child health surveillance should take place in the first month?

Answer 15

Heel-prick test day 5-9 - hypothyroidism, PKU, metabolic diseases, cystic fibrosis, medium-chain acyl Co-A dehydrogenase deficiency (MCADD)

Midwife visit up to 4 weeks

Question 16

What hearing tests are available for newborns ?

Answer 16

Otoacoustic emission test - A computer-generated click is played through a small earpiece. The presence of a soft echo indicates a healthy cochlea

Auditory Brainstem Response test- May be done if otoacoustic emission test is abnormal

Question 17

What hearing tests are available for infants age 6-9 months?

Answer 17

Distraction test- Performed by a health visitor

Question 18

What hearing tests are available for > 3 years?

Answer 18

Pure tone audiometry - Done at school entry in most areas of the UK

Question 19

Children in which centiles for height require review?

Answer 19

children below 2nd centile for height should be reviewed by their GP
children below 0.4th centile for height should be reviewed by a paediatrician

Question 20

How often should weight be monitored in young children?

Answer 20

infants aged 0-1 years should have at least 5 recordings of weight
children aged 1-2 years should have at least 3 recordings of weight
children older than 2 years should have annual recording of weight