Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
During routine check-ups for children aged 0 to 5 years, key developmental milestones to assess include:
- Physical growth and measurements: length/height, weight, and head circumference should be measured and plotted on growth charts to monitor growth patterns NICE NG72,NICE NG194.
- Motor development: assessment of gross motor milestones such as sitting, crawling, walking, and fine motor skills; watch for delayed motor milestones or abnormal movements which may indicate cerebral palsy or other motor problems NICE NG72.
- Vision and hearing: checks for visual and hearing impairments should be performed in line with national screening recommendations NICE NG72,NICE NG194.
- Speech, language, and communication: evaluate the child's ability to communicate and understand language, identifying any delays or difficulties NICE NG72.
- Social and emotional development: assess social smiling, visual fixing and following in infants, and later social, attentional, emotional, and behavioural development using tools such as the Strengths and Difficulties Questionnaire (SDQ) NICE NG72,NICE NG194.
- Cognitive development: monitor for global developmental delay, learning disabilities, and intellectual disabilities using parent questionnaires like the Parent Report of Children's Abilities – Revised (PARCA-R) and standardised tests such as the Wechsler Preschool and Primary Scales of Intelligence (WPPSI) at around 4 years NICE NG72.
- Feeding and sleep: check for feeding difficulties and sleep problems including sleep apnoea NICE NG72.
- Neurological signs: assess tone, reflexes, posture, and behaviour to identify abnormalities such as hypotonia or spasticity NICE NG72,NICE NG194.
- Screening for autism spectrum disorder: be alert to early signs and refer as appropriate following NICE autism guidelines NICE NG72.
- Physical examination: includes inspection of head, face, eyes, ears, neck, limbs, heart, lungs, abdomen, genitalia, spine, skin, hips, and cry quality NICE NG194.
These assessments should be tailored to the child's corrected age if born preterm and include discussions with parents about any concerns. Enhanced surveillance is recommended for children born preterm or at risk of developmental problems NICE NG72,NICE NG194.