This surveillance aid will facilitate the identification of motor weakness that presents between birth and five years of age. This aid is designed for children who were born on or after 38 weeks of gestation. If a child is born prior to 38 weeks of gestation, please use adjusted age for developmental milestones.
The assessment of milestones recommended in this aid is consistent with the Bright Futures Guidelines. The exception is rise to stand from floor, which is not included as a Bright Futures milestone but is a quick, easy, and important way to identify motor weakness.
During surveillance, recall the Clinical Pearl: Red flags for urgent referral include tongue fasciculation, loss of motor milestones, or CK greater than 3x normal.
If transaminases (AST and ALT) are elevated, check CK. Since AST/ALT can come from muscle or the liver, while CK comes only from muscle, this test will help localize the child's problem and may prevent unnecessary liver tests. MORE CLINICAL PEARLS
This website is partially supported by the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.