Peds Milestones & Reflexes

When are pediatric patients screened?

9, 18, 24, and 30 months

What screening test is autism specific? When is it given?

M-CHAT, give at 18 and 24 month vists

When should peds patients regain their weight?

3 weeks

When should peds patient double their weight?

4-6 months

When should peds patient triple their weight?

1 year

Reflex done by holding the child's head and neck above a flat surface with their arms folded at the chest then suddenly letting go of the head/neck and hands

Moro reflex

Normal moro reflex

Abduction and extension of arms

Reflex done by turning the child's head to the side

Asymmetric tonic neck reflex

Normal Asymmetric tonic neck reflex

"Fencer" position

Reflex done by applying pressure to the palm or plantar aspect of the hand or foot

Grasp reflex

Normal grasp reflex

Child should grasp

Reflex done by putting the child's foot on a hard surface

Step reflex

Normal step reflex

Child should take "steps"

Reflex done by placing a child prone after 4-6 months

Child should make "crawling" motion

Crawl reflex

Reflex done by placing the child in ventral suspension position and stimulating one side of the trunk

Galant reflex

Normal Galant reflex

Child's trunk and hips should swing toward the side of the stimulus

What reflex: child has a strong sucking sensation when nipple or finger is placed in mouth

Suck reflex

What reflex: stroking the side of mouth or cheek will cause a child's head to turn and mouth to open in that direction

Rooting reflex

What reflex: stroking the lateral aspect of the infant foot causes the extension of the big toe and fanning out of the little toes

Babinski reflex

What postural reaction: Child keeping head vertical despite a tilt of the body

Head righting

What postural reaction: As a child is pushed laterally by the examiner --> flexes the trunk towards the force to regain center of gravity

Protective equilibrium

What postural reaction: As a child is in free fall in ventral suspension --> extremities extend symmetrically to distribute weight over a broader and more stable base on landing

Parachute

What postural reaction: When held prone, infant will lift head and extend the neck and trunk

Landau response

When should a patient crawl up the stairs?

15 months

When should a patient walk up the stairs holding hands, 2 feet per step?

18 months

When should a patient climb up/downstairs alone, 2 feet per step?

24 months

When should a patient climb up stairs using alternating feet?

3 years

When should a patient tandem walk?

4 years

When should a patient climb up/downstairs using alternating feet?

4 years

When should a patient skip using alternating feet?

5 years

When should a patient be able to perform moro/stepping/grasp reflexes?

Newborn

When should a patient track moving object past midline to 180 degrees?

2-3 months

When should a patient lift their head to 45 degrees when in prone positioning with their arms extended?

2-3 months

When should a patient exhibit no head lag when pulled to sitting?

4 months

When should a patient roll from prone to supine (belly to back) positioning?

4 months

When should a patient roll from supine to prone (back to belly) positioning?

6 months

When should a patient sit with support?

6 months

When should a patient sit with NO support?

9 months

When should a patient pull to stand (may cruise furniture)?

9 months

When should a patient stand without help or walk independently?

12 months

When should a patient grasp objects and bring them to their mouth?

4 months

When should a patient transfer objects from hand to hand?

6 months

When should a patient present a raking grasp?

6 months

When should a patient have a neat/early pincer grasp?

9 months

When should a patient present a mature pincer grasp?

12 months

When should a patient focus on face and track vertically and horizontally?

At birth

When should a patient track across the midline and follow movement?

2 months

When should a patient's eyes and head track 180 degrees?

3 months

When should a patient be able to reach for an object?

4-5 months

When should a patient say coos?

2 months

When should a patient laugh?

4 months

When should a patient babble?

6 months

When should a patient say Mama and Dada non-specifically?

9 months

When should a patient respond to their name?

9 months

When should a patient say Mama and Dada specifically?

12 months

When should a patient say 1 or more words with meaning?

12 months

When should a patient speak in 2-word sentences?

24 months

When should a patient follow 2 step commands?

24 months

When should a patient speak 3-4 sentences?

3 years

When should a patient speak 100% intelligibly to a stranger?

4 years

What would be considered a language delay at 9 months?

No response to name

What would be considered a language delay at 10-12 months?

No babbling

What would be considered a language delay at 18 months?

No words other than mama and dada

Doesn't point to wants

What would be considered a language delay at 24 months?

No 2 word phrases

No 2 syllable words

Doesn't understand simple commands

What would be considered a language delay at 36 months?

Speech not fully intelligible to family

Not using pronouns or verbs

No simple sentences

Echolalia still present

What would be considered a language delay at 4 years?

Speech not fully intelligible to strangers

What would be considered a language delay at 5 years?

Persistent stuttering

Frequent letter substitution

What would be considered a language delay at 6 years?

Speech errors other than "s, ch, sh, z, j, v, th, zh"

What would be considered a language delay at 8 years?

Any speech error

When should a patient handle a spoon well for solids?

18 months

When should a patient eat neatly with a spoon and fork?

3 years