Neurodevelopmental Assessment Early Intervention

Prepared by KIMS and CDC, Trivandrum for Perinatal risk stratification of preterm neonates and developmental outcomes - multi - centre study

GROWTH MONITORING

Very Low Birth Weight Chart

Fetal - infant growth chart for preterm infants( weight , head circumference, and length). Reproduced with permission from Fenton TR; licensee BioMed Central Ltd. This is an Open Access article: Verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL. http://www.biomedcentral.com/14712431/3/13.)

4 MONTHS (corrected age)

Hb DDST: Gross motor Fine motor Language Personal social AT angles: Adductor Heel to ear Popliteal Dorsiflexion Scarf sign Differential tone Muscle tone Neck Trunk DTR

Date: _________________________

8 MONTHS (corrected age)

DDST: Gross motor Fine motor Language Personal social

Date: _________________________

Hyper/Hypotonia

Asymmetry AT angles: Adductor Heel to ear Popliteal Dorsiflexion Scarf sign Hyper/ Hypotonia Asymmetry

Increased / decreased / normal Increased / decreased / normal Muscle tone

Differential tone

Neck Decreased <1+ / Normal 1- 3 + /Increased 4 + / Clonus 5 beats or more Trunk

Increased / decreased / normal Increased / decreased / normal

CDC grading Head Control Persisting primitive reflexes Moro > 4 mo corrected age

DTR CDC grading:

decreased <1+ / normal 1- 3 +/ increased 4 + / clonus 5 beats or more

Sitting

Function assessment

Lack of bimanual integration > 9 months corrected age

12 MONTHS (corrected age)

Hb Iron supplementation may be stopped Refraction DASII

Date: _________________________

18 MONTHS (corrected age)

Language assessment: REELS DASII

Date: _________________________

Mental development quotient Motor development quotient Clusters Interpretation: Score >85 is Normal <75 is Abnormal AT angles: Adductor Heel to ear Popliteal Dorsiflexion Scarf sign Differential tone Muscle tone Neck Trunk DTR CDC grading: Standing Increased / decreased / normal Increased / decreased / normal Normal Cerebral palsy Hearing problem Language delay Cognitive problems Visual problem Chronic medical problem Hyper/ Hypotonia Asymmetry

Mental development quotient Motor development quotient Clusters Interpretation: Score >85 is Normal <75 is Abnormal

Any abnormal movements

Choreoathetoid / Tremors / Ataxia Oral motor function Excessive drooling, poor coordination of suck and swallow, inability to chew in children with molars

Diagnosis at 18 months

Decreased <1+ / normal 1- 3 +/ increased 4 + / clonus 5 beats or more

FOLLOW UP ASSESSMENT

Summary Statement of FU Visits

Prepare cereal Brush teeth no help

May Pass by report Footnote no.

(See back of form)

Percent of children passing 25 50 75 90 R TEST ITEM 1

Wash and dry hands Brush teeth with help Put on clothing

Play board/card games Dress no help Put on T-shirt Name friends

86%
Copy Draw person 6 parts Copy demon stated Pick longer line

Feed doll Remove garment Use spoon/fork Help in house Drink from cup Imitate activities Play ball with examiner Wave bye-bye Indicate wants Play pat-a-cake Feed self Work for toy Regard own hand Smile
spontaneously

Copy + Draw person 3 parts Copy Thumb wiggle Tower of 8 cubes Imitate vertical line Tower of 6 cubes Tower of 4 cubes Define 7 words Opposite-2 Count 5 blocks Know 3 adjectives Define 5 words Name 4 colours Understand 4 prepositions Speech all understandable Know 4 actions Use of 3 objects Count 1 block Use of 2 objects Name 1 colour Know 2 adjectives Know 2 actions Name 4 pictures Speech half understandable Point 4 pictures Body parts 6 Name 1 picture Combine words Point 2 pictures
Balance each foot 2 second Balance each foot 1 second

88%

Tower of 2 cubes Dump raisin demonstrated Scribbles Put block in cup

Bang 2 cubes held in hands Smile responsively Regard face Take 2 cubes Pass cube Rake raisin Look for yarn Reaches Regard raisin Follow 180 Hands together Grasp rattle Thumbfinger grasp

Balance each foot 6 seconds Heel-to toe walk Balance each foot 5 seconds Balance each foot 4 seconds Balance each foot 3 seconds Hops

Follow past midline Follow to midline 6 word 3 word 2 word 1 word Dada/mama specific

Broad jump Throw ball overhead Jump up Kick ball forwards

Jabbers Runs Walk backwards Walk well Stoop and recover Stand alone Stand-2 seconds Get 2 sitting Pull to stand Stand holding on Sit-no support Pull to sitno head lag Roll over Chest uparm support Bear weight on legs Sit- Head steady Head up 90 Head up 45 Lift head Equal movements

(Check boxes for 1st,2nd or 3rd test)

Imitate speech sound Single syllables Turn to voice Turn to rattling sound Squeals Laughs Ooolah Vocalizes Response to bell

Typical Yes No Compliance (See Note 31) Always Complies Usually Complies Rarely Complies Interest in Surroundings Alert Somewhat Disinterested Seriously Disinterested Fearluiness None Mild Extreme Attention Span Appropriate Somewhat Distract able Very Distract able

1969, 1990 W.K Frankenburg and J.B Dodds 1978 W.K. Frankenburg

Combine syllables Dada/Mama non-specific

Walk up steps

GROWTH RECORD - BOYS