Denver II Developmental Screening Paper - Case Study Example

? Denver II Developmental Screening Paper Pediatric Primary Care by Sasha Khademi Patient Introduction A case of Audrey B., 3 years and month old, female, Caucasian. The girl has no history of major illnesses or surgery, with no current health concerns. Her family has no history of diabetes or heart disease. The girl is in the 75th percentile of height for children of her age. She was born full term through vaginal childbirth and was breastfed for only the first month before she was discontinued and started taking formula feedings. The girl is not taking any medications. and she is currently enrolled in a day-care program where she gets to play with other children of her age. The girl is to undergo a Denver II Developmental Screening test to check if she is growing properly for her age. The ages between toddler and preschool is a sensitive time to assess the child for developmental problems such as mental retardation, which is detected at 2 years old if the child is not able to achieve any language milestones (Hazen, Abrams, Muriel, & Danforth, 2008). Developmental Milestones The Denver II Developmental Screening test was developed as a tool to detect developmental disorders in children early on. It tests the child in various areas with developmental milestones. The developmental milestones from the Denver II Developmental Screening Test include cognitive and language/communication skills, fine and gross motor skills and social/emotional skills. Every year of a child’s life from birth to the age of five has a set of expectations for each category (Shahshahani, Vameghi, Azari, Sajedi, & Kazemnejad, 2010). In the cognitive and language area, a normal child is expected to be able to name and recognize at least one up to six colors. The child should be able to match objects by function. She should be able to stack at least 5 blocks. The child might be easily distracted, but she can understand the difference between pretend and reality, can state her full name and age and can match family by group or function. The child would be talking constantly in complete sentences, can use proper pronouns, plurals, past tense verbs and can ask questions. She is now able to repeat songs or rhymes and can understand the concept of size. The child’s vocabulary would be at 2000 to 4000 words (Children’s Development, 2007; American Academy of Pediatrics, 2011). At this age, language development is closely related to the child’s cognitive ability (Burns, Dunn, Brady, Star, & Blosser, 2012). Since language development at this stage is highly variable, being influenced by the environment and interactions from people around her, a wide range is still considered normal (Hazen, Abrams, Muriel, & Danforth, 2008). In fine motor skills, the child would be able to use a book, can use her fingers for painting and drawing and using crayon. She can string beads, can stack objects nine high, can use play dough and can use scissors with limited mastery. She can draw simple shapes such as a circle and can even draw houses, figures and objects with some relation to each other. The child can now undress by herself, but needs assistance dressing, especially with buttons (Children’s Development, 2007; American Academy of Pediatrics, 2011). In gross motor skills, the child would be able to run around obstacles, can throw overhand, catch and kick a ball, can hop on one foot, can play on the slide, can walk straight without looking at his feet, can climb the stairs and can use the tricycle. The child would be very active at play but still fatigues easily, getting irritated when this happens (Children’s Development, 2007; American Academy of Pediatrics, 2011). In Social skills and emotional development, the child would either be in her parallel or associative play stage, allowing her to play with other children whether interactively or separately without much trouble. She can participate in group activities such as circle time, dramatic play and games involving other children, but may experience difficulty in sharing or problem solving. the child would be able to know her own gender and the difference between boys and girls. She would be able to do some everyday activities such as feeding, putting on clothes, washing hands, using a drinking fountain, pouring water from a pitcher and using the toilet. at this stage, the child is very expressive, showing feelings such as fear, affection, delight and has a sense of humor. Social and adaptive skills are also an indication of increasing cognitive ability since interaction and adherence to rules and social norms are both activities achievable of children with a normal or higher level of cognitive skill. Watching how the child plays is also a great exercise of her cognitive ability since through play, they are granted control over some aspects of their environment in a safe and fun way (Burns, Dunn, Brady, Star, & Blosser, 2012; Children’s Development, 2007; American Academy of Pediatrics, 2011). Results The results of the test taken on October 15, 2012 showed that in the personal-social field, the girl was reported to have been able to brush teeth with help, wash and dry hands, name a friend, put on a shirt without help, play board and cardboard games. The rest of the items under the field such as putting on a dress with no help, brushing teeth with no help and preparing her own cereal were reported to have been untested due to lack of opportunity. These indicate that the girl is normally developed in the personal-social field for her age, negating the need for a retest. In the fine motor-adaptive field, the girl is able to make a tower with up to 8 cubes, can wiggle her thumb, can pick the longer line and can copy a vertical line and a square, showing advanced development in the field, even though the girl refused to copy a circle or a cross, which are still normal for her age. The patient failed to draw a person in 6 parts and copy a square without demonstration, still considered normal for her age. Since there are no deficits, the girl does not need retesting. In language, the girl showed understandable speech and was able to identify up to 4 pictures, 2 actions, 4 colors, 2 adjectives and use 3 objects, indicating normal development. She failed knowing 4 actions, 3 adjective and defining any words. and she refused to understand 4 prepositions, use opposites and count 5 blocks, all of which are expected for her age, indicating no need for a retest. In gross motor skills, the child passed kicking the ball forward, jumping up, throwing the ball overhand, broad jumping and balancing on one foot for up to 2 seconds, refusing to balance for longer than that. she failed at hopping and refused to perform the heel to toe walk. These are all considered normal for a girl of her age. During the test, the girl showed alertness, with no fear, but was easily distracted. All things considered, having passed all the tasks that were considered normal for her age and even exceeding expectations in some areas in fine motor skills, the girl demonstrates how a typically developed 3 year old performs in a Denver II Developmental Screening test. References American Academy of Pediatrics. (2011). Developmental milestones: 3 to 4 years old. Retrieved from http://www.healthychildren.org/English/ages-stages/ toddler/Pages/Developmental-Milestones-3-to-4-Years-Old.aspx Burns, C., Dunn, A., Brady, M., Star, N., & Blosser, C. (2012). Pediatric primary care. Temple, TX: Elsevier Health. Kindle Edition. Children’s development. (2007). Retrieved from http://academic.cengage.com/ resource_uploads/downloads/1428352937_171971.pdf Hazen, E., Abrams, A., Muriel, A., & Danforth, N. (2008). Massachusetts General Hospital comprehensive clinical psychiatry. Temple, TX: Mosby, an Imprint of Elsevier. Shahshahani, S., Vameghi, R., Azari, N., Sajedi, F., & Kazemnejad, A. (2010). Validity and reliability determination of Denver Developmental Screening Test-II in 0-6 year-olds in Tehran. Iran Journal of Pediatrics, 20 (3). 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