From the Guidelines
At the 11-month child check, the physical exam should assess key developmental milestones, including gross motor skills such as sitting without support, pulling to stand, and crawling, as well as fine motor skills like reaching for cubes and transferring them, and picking up small objects with a 3-finger grasp, as outlined in the most recent guidelines 1. The healthcare provider will evaluate these skills to determine if the child is meeting expected milestones.
- Gross motor skills assessment includes checking if the baby can:
- Sit without support
- Pull to stand
- Come to sit from lying
- Crawl
- Fine motor skills assessment includes:
- Reaching for cubes and transferring them
- Picking up small objects with a 3-finger grasp
- Raking small objects with 4 fingers The physical exam will also include standard measurements of height, weight, and head circumference plotted on growth charts, as well as a complete physical examination of all body systems, including vision and hearing screenings, as recommended in the guidelines 1. These evaluations help identify any developmental delays early, allowing for timely intervention if needed, and are essential for monitoring the child's overall development and health. Normal variation exists in development timing, but significant delays warrant further investigation, and the healthcare provider should be vigilant in identifying any potential issues and addressing them promptly.
From the Research
Physical Exam Milestones for an 11-Month-Old Child
The expected physical exam milestones for an 11-month-old child during a well-child check include:
- A head-to-toe examination to review growth and detect any abnormalities 2
- Assessment of developmental milestones, including motor and sensory function, and primitive reflexes 3
- Screening for postpartum depression in mothers of infants up to six months of age is not applicable at this age, but developmental surveillance should continue 2
- Review of immunizations and updating as appropriate 2
- Guidance on health and development issues relevant to the child's age and the parents' needs 4
Developmental Surveillance
Developmental surveillance involves:
- Eliciting parental concerns 4
- Performing skilled observations of the child 4
- Providing guidance on health and development issues relevant to the child's age and the parents' needs 4
- Formal developmental screening is recommended at 9,18, and 30 months, with autism-specific screening at 18 and 24 months 2
Physical Examination
A full physical examination should be performed, including: