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1. DEVELOPMENTAL
SURVEILLANCE

2. Components of Developmental
Surveillance
• History
□Parental developmental concerns
□Developmental history- milestone achievement with identification
of abnormal pattern
S Delay
S Dissociation
S Deviancy or deviation
S Regression
□ Medical and family historical risk factor identification
□ Protective factor identification
• Developmental observation
□Gross and fine motor skills
□Speech, Language and social engagement
□Related neurologic function on physical examination

3. Developmental Quotient (DQ)
Child’s developmental or best milestone age (DA)
DQ = ________________________________________ *
100
Child’s chronological age (CA)
A DQ of 100 represents mean or average rate of development
DQ of below 70 – represents development 2 SD below mean-
requires evaluation

4. Average
age(months)
Motor milestones
1 Head off table in prone
2 Chest off table in prone
3 Up to elbows in prone
4 Up to wrist in prone,
rolls prone to supine
5 Rolls supine to prone
Sits with support
6 Sits alone
8 Comes to sit, crawls, pulls to stand
9 Cruises
11 Walks with hand held
12 Walks but falls, stand with support
15 Walks alone, creeps upstairs
18 Runs
2 yr Walks up and downstairs (2feet/step) jumps
3 yr Rides tricycle, alternate feet going upstairs
4 yr Hops on one foot ,alternate feet going
downstairs
5 yr Skips on both foot
GROSS MOTOR MILESTONES

7. 1 Visually fixes
2 Visually follows in horizontal and vertical plane
3 Visually follows in circle, responds to visual treat
4 Hands unfisted ,hands to midline
5 Reaches for object , transfers object from one
hand to another
6 Picks up large object with radial lake
8 Picks up small object with radial lake
9 Picks up small object with immature pincer looks
over edge for fallen toy
10 Uncovers hidden toy
11 Picks up small object with mature pincer
12 Intentional release of objects
16 Scribbles in imitation
18 Scribbles spontaneously
21 Makes tower of 3 cubes
24 Makes horizontal 4 cube train
30 Copies horizontal and vertical stroke in appropriate
orientation , makes 4 cube train with smokestack
36 Copies circle , draws a person with head and one
other body part recognizes one color
FINE
MOTOR
MILESTONES

8. FINE MOTOR MILESTONES – CONTD….
4 yrs Copies cross or square/ copy a bridge
5 yrs Copies triangle/ catch a ball
6-7 yrs Copy a diamond
7 yrs kite
9 yrs Copies a cylinder
11 yrs Can copy cube

11. Age
(mon
)
Receptive milestone Expressive milestone
1 Alert to sound
2 Social smile
3 coos
4 Orients to voice laughs
6 babbles
8 “mama” or “dada”
nonspecifically
10 Understands “no” “mama” or “dada” specifically
12 Follows 1 step commands with
gesture
2-word vocabulary
18 Points to one picture
identifies > 2 body parts
7-10 word vocabulary
21 Points to 2 pictures 20 word vocabulary,
2 word phrases
24 Follows 2-step commands 50 word vocabulary,
2-word sentences (noun/verb)
30 Understands the concept of
“1” Points to
Uses pronoun appropriately
RECEPTIVE AND EXPRESSIVE LANGUAGE
MILESTONES

12. Social smile 1.5
Laugh 4
Peek-a-boo or
pat-a-cake
10
Solitary play 12
Parallel play 24
Interactive play 36
Helps with
dressing
10
Partially dresses/
undresses
24
Dresses
completely
48
buttons 48
Puts shoes on
correct foot
48
Ties shoes 60
Holds bottle 5
Finger feeds 10
Uses spoon 15
Holds cup 15
Spears with a fork 30
Spreads with a knife 48
Urinates independently(girls) 31-33
Urinates independently( boys) 34-37
Dry by day ( girls) 32
Dry by day ( boys) 35
Uses bathroom
independently for bowel
movement (girls)
34
Uses bathroom
independently for bowel
39
SOCIAL AND ADAPTIVE MILESTONES