Информациядля педиатровWhat are some of the developmental milestones my child should reach by two years of age?
Your baby enters her second year and becomes a toddler, crawling vigorously, starting to walk, even talking a little. Exploring the boundaries established by your rules and her own physical and developmental limits will occupy much of her time for the next few years.
Here are some other milestones to look for.
* Walks alone
* Pulls toys behind her while walking
* Carries large toy or several toys while walking
* Begins to run
* Stands on tiptoe
* Kicks a ball
* Climbs onto and down from furniture unassisted
* Walks up and down stairs holding on to support
Milestones in hand and finger skills
* Scribbles spontaneously
* Turns over container to pour out contents
* Builds tower of four blocks or more
* Might use one hand more frequently than the other
* Points to object or picture when it’s named for him
* Recognizes names of familiar people, objects, and body parts
* Says several single words (by fifteen to eighteen months)
* Uses simple phrases (by eighteen to twenty-four months)
* Uses two- to four-word sentences
* Follows simple instructions
* Repeats words overheard in conversation
* Finds objects even when hidden under two or three covers
* Begins to sort by shapes and colors
* Begins make-believe play
Social and emotional milestones
* Imitates behavior of others, especially adults and older children
* Increasingly aware of herself as separate from others
* Increasingly enthusiastic about company of other children
* Demonstrates increasing independence
* Begins to show defiant behavior
* Increasing episodes of separation anxiety toward midyear, then they fade
Developmental health watch
Because each child develops at his own particular pace, it’s impossible to tell exactly when yours will perfect a given skill. The developmental milestones listed in this book will give you a general idea of the changes you can expect as your child gets older, but don’t be alarmed if he takes a slightly different course. Alert your pediatrician, however, if he displays any of the following signs of possible developmental delay for this age range.
* Cannot walk by eighteen months
* Fails to develop a mature heel-toe walking pattern after several months of walking, or walks exclusively on his toes
* Does not speak at least fifteen words by eighteen months
* Does not use two-word sentences by age two
* Does not seem to know the function of common household objects (brush, telephone, bell, fork, spoon) by fifteen months
* Does not imitate actions or words by the end of this period
* Does not follow simple instructions by age two
* Cannot push a wheeled toy by age two
Published online: 6/07
Source: Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2004 American Academy of Pediatrics, Updated 5/05)
To order a copy of this book visit the AAP Bookstore.
The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
http://pediatrics.aappublications.org/c ... /120/2/381
Программа Bright FuturesImpact of Implementing Developmental Screening at 12 and 24 Months in a Pediatric Practice
Hollie Hix-Small, PhDa, Kevin Marks, MDb, Jane Squires, PhDa and Robert Nickel, MDc,d
a Early Intervention Program, Special Education Department, College of Education, University of Oregon, Eugene, Oregon
b Pediatrics Department, PeaceHealth Medical Group, Eugene, Oregon
c Developmental Pediatrics Department, Child Development and Rehabilitation Center, Eugene, Oregon
d Developmental Pediatrics Department, Oregon Health Sciences University, Portland, Oregon
OBJECTIVES. The purpose of this study was to investigate the effectiveness and costs of incorporating a parent-completed developmental screening tool, the Ages and Stages Questionnaire, into the 12- and 24-month well-child visits under "real-world" conditions, using a combined in-office and mail-back data collection protocol.
METHODS. A convenience sample of 1428 caregivers and children presenting for their 12- or 24-month well-child visit between April 2005 and March 2006 participated. Children with identified delays or disorders were excluded. Board-certified pediatricians (n = 18 ) and nurse practitioners (n = 2) acted as secondary participants. Pediatricians were blinded to Ages and Stages Questionnaire results when completing the Pediatric Developmental Impression. Patients with delayed Ages and Stages Questionnaire or Pediatric Developmental Impression results were referred for additional evaluation.
RESULTS. Referral rates increased by 224%. Pediatrician referral on the basis of the Pediatric Developmental Impression was predicted significantly by suspected communication delay and gross motor delay. The Ages and Stages Questionnaire and Pediatric Developmental Impression results differed significantly, with overall agreement of 81.8%. Of Ages and Stages Questionnaire–delayed cases, 67.5% were not detected by pediatricians. Of the 78 patients referred on the basis of combined Ages and Stages Questionnaire and Pediatric Developmental Impression results, 53 would not have been referred on the basis of Pediatric Developmental Impression results alone; 37 patients qualified for special services, and 44 were scheduled for additional developmental monitoring. The rate of Ages and Stages Questionnaire return by caregivers/parents was 54%.
CONCLUSIONS. Referral rates increased dramatically, with the greatest increase at 12 months. Although patients with pediatrician referrals were likely to qualify for services (96%), physician referrals accounted for only 42% of total referrals, which highlights the need for pediatric developmental screening. The 54% Ages and Stages Questionnaire return rate, although acceptable under study conditions, calls for alternative implementation strategies.
Пример вопросника "Ages and Stages" (для 4х летнего визита, 99 год, но система ясна)
http://www.medicalhomeinfo.org/training ... nnaire.pdf