Friday, October 12, 2012

Early Intervention


Child Developmental Checklist

The following lists are to give a generalized idea of different skill areas (gross motor, fine motor, cognition/problem solving, sensory, self-care, social/emotional/play skills) to look at, and when an early intervention referral and developmental therapy may be appropriate.

Gross Motor
If a child is:

  • Not rolling by 7 months of age
  • Not pushing up on straight arms, lifting his head and shoulders, by 8 months of age
  • Not sitting independently by 10 months of age
  • Not crawling ("commando" crawling , moving across the floor on his belly) by 10 months of age
  • Not creeping (on all fours, what is typically called "crawling") by 12 months of age
  • Not pulling to stand by 12 months of age
  • Not standing alone by 14 months of age
  • Not walking by 18 months of age
  • Not jumping by 30 months of age
  • Not independent on stairs (up and down) by 30 months of age
Red Flag:
  • "walking" their hands up their bodies to achieve a standing position
  • only walking on their toes, not the soles of their feet
  • frequently falling/tripping, for no apparent reason
  • still "toeing in" at two years of age
  • unusual creeping patterns
Fine Motor
If a child is:
  • Frequently in a fisted position with both hands after 6 months of age
  • not bringing both hands to midline (center of body) by 10 months of age
  • not banging objects together by 10 months of age
  • not clapping their hands by 12 months of age
  • not deliberately and immediately releasing objects by 12 months of age
  • not able to tip and hold their bottle by themselves and keep it up, without lying down, by 12 months of age
  • still using a fisted grasp to hold a crayon at 18 months of age
  • not using a mature pincer grasp (tumb and index finger, pad to pad) by 18 months of age
  • not imitating a drawing of a vertical line by 24 months of age
  • not able to snip with scissors by 30 months
Red Flag:
  • using only one hand to complete tasks
  • not being able to move/open one hand/arm
  • drooling during small tasks that require intense concentration
  • displaying uncoordinated or jerky movements when doing activities
  • crayon strokes are either too heavy or too light to see
Cognition/Problem Solving
If a child is:
  • not imitating body action on a doll by 15 months of age (ie, kiss the baby, feed the baby)
  • not able to match two sets of objects by item by 27 months of age ( ie, blocks in one container, and people in another)
  • not able to imitate a model from memory by 27 months of age (ie, show me how you brush your teeth)
  • not able to match two sets of objects by color by 31 months of age
  • having difficulty problem solving during activities in comparison to his/her peers
  • unaware of changes in his/her environment and routine
Sensory
If a child is:
  • very busy, always on the go, and has a very short attention to task
  • often lethargic or low arousal (appears to be tired/slow time respond, all the time, even after a nap)
  • a picky eater
  • not aware of when they get hurt (no crying, startle, or reaction to injury)
  • afraid of swinging/movement activities; does not like to be picked up or be upside down
  • showing difficulty learning new activities (motor planning)
  • having a hard time calming themselves down appropriately
  • appearing to be constantly moving around, even while sitting
  • showing poor or no eye contact
  • frequently jumping and/or purposely falling to the floor/crashing into things
  • seeking opportunities to fall without regard to his/her safety or that of others
  • constantly touching everything they see, including other children
  • hypotonic (floppy body, like a wet noodle)
  • having a difficult time with tansitions between activity or location
  • overly upset with change in routine
  • hates bath time or grooming activities such as; tooth brushing, hair brushing, hair cuts, having nails cut, etc.
  • afraid of/aversive to/avoids being messy, or touching different textures such as grass, sand, carpet, paint, playdoh, etc.
Possible visual problems may exist if the child:
  • does not make aye contact with others or holds objects closer than 3-4 inches from one or both eyes
  • does not reach for an object close by
Possible hearing problems may exist if the child:
  • does not respond to sounds or to voices of familiar people
  • does not attend to bells or other sound-producing objects
  • does not respond appropriately to different levels of sound
  • does not babble
Self-Care
If a child is:
  • having difficulty biting or chewing food during mealtime
  • needing a prolonged period of time to chew and/or swallow
  • coughing/choking during or after eating on a reguler basis
  • demonstrating a change in vocal quality during/after eating (i.e. they sound gurgled or hoarse when speaking/making sounds)
  • having significant difficulty transitioning between different food stages
  • not feeding him/herself finger foods by 14 months of age
  • not attempting to wash own hands or face by 19 months
  • not assisting with dressing tasks (excluding clothes fasteners) by 22 months
  • not able to deliberately undo large buttons, snaps and shoelaces by 34 months
Social/Emotional/Play Skills
If a child is:
  • not smiling by 4 months
  • not making eye contact during activities and interacting with peers and/or adults
  • not performing for social attention by 12 months
  • not imitating actions and movements by the age of 24 months
  • not engaging in pretend play by the age of 24 months
  • not demonstrating appropriate play with an objects (i.e. instead of trying to put objects into a container, the child leaves the objects in the container and keeps flicking them with his fingers)
  • Fixating on objects that spin or turn (i.e. See n Say, toy cars, etc.); also children who are trying to spin things that are not normally spin
  • having significant difficulty attending to tasks
  • getting overly upset with change or transitions from activity to activity

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