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Excerpts from Bright Futures Guidelines: Surveillance of Development Milestones and Physical Exam PDF Print E-mail
Written by Administrator   
Tuesday, 28 June 2011 17:52

Recommendations Relevant to Gross Motor Surveillance

(accessed 2011 from http://brightfutures.aap.org/)

1 month:

• Surveillance of Development: “is able to lift his head when on tummy”
• Physical Exam: “Assess neurologic tone”

2 months:

• Surveillance of Development: “is able to hold up head and begins to push up in prone position, has consistent head control in supported sitting position, shows symmetrical movements of head, arms, and legs, shows diminishing newborn reflexes”
• Physical Exam: “Assess torticollis, neurologic tone, strength and symmetry of movements.”

4 months:

• Surveillance of Development: “pushes chest to elbows, has good head control, demonstrates symmetrical movements of arms/legs, begins to roll and reach for objects”
• Physical Exam: “Assess/Observe developmental hip dysplasia; neurologic tone, strength, and movement symmetry.”

6 months:

• Surveillance of Development: “rolls over and sits, stands and bounces; moves to crawling from prone; rocks back and forth; is learning to rotate in sitting; will move from sitting to crawling”
• Physical Exam: “Assess/Observe developmental hip dysplasia, neurologic tone, movement strength and symmetry.”

9 months:

• Surveillance of Development: “expands motor skills”
• Physical Exam: “Assess/Observe developmental hip dysplasia; neurologic tone, movement strength and symmetry. Elicit parachute reflex.”

12 months:

• Surveillance of Development: “stands alone”
• Physical Exam: “Observe gait.”

15 months

• Surveillance of Development: “walks well, stoops, recovers, can step backwards”

18 months

• Surveillance of Development: “walks up steps/runs”
• Physical Exam: “Observe gait, hand control, arm/spine movement.”

24 months:

• Surveillance of Development: “throws ball overhand; goes up and down stairs one step at a time, jumps up”
• Physical Exam: “Observe running.”

2.5 year visit

• Surveillance of Development: “jumps up and down in place, throws ball overhand”
• Physical Exam: “Observe coordination.”

3 year visit

• Surveillance of Development: “throws ball overhand, walks up stairs alternating feet”

4 year visit

• Surveillance of Development: “hops on one foot, balances on one foot for 2 seconds”
• Physical Exam: “Observe fine/gross motor skills.”

5 and 6 year visits

• Surveillance of Development: “Balances on one foot, hops, and skips”
• Physical Exam: “fine/gross motor skills, gait”

Last Updated on Monday, 20 August 2012 19:19
 

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Increased CK (especially if CK>3x nl) indicates the need for prompt referral and diagnosis.
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