From the Guidelines
To document growth and development in a Review of Systems (ROS) for a 30-month-old child, I recommend using a comprehensive yet concise approach that addresses key developmental milestones, as supported by the American Academy of Pediatrics (AAP) recommendations for standardized developmental screening at 9,18, and 30 months of age 1. When documenting growth and development, begin by recording the child's current height, weight, and head circumference, plotting these measurements on standardized growth charts to determine percentiles and track growth patterns over time.
Key Developmental Milestones to Document
- Gross motor skills: ability to run, climb stairs with alternating feet, kick a ball, and jump in place
- Fine motor development: ability to build a tower of blocks, turn pages of a book, use utensils, and beginning to draw simple shapes or lines
- Language development: vocabulary size (typically 50-250 words at this age), ability to form 2-3 word sentences, follow two-step commands, and identify body parts
- Social development: parallel play, beginning imaginative play, showing empathy, and separation behaviors
- Cognitive skills: sorting objects, understanding concepts like "big" and "small," and problem-solving abilities
- Self-care milestones: toilet training status, feeding independence, and dressing skills
Importance of Early Identification and Intervention
Early identification of developmental delays is crucial, as it allows for timely intervention and support, which can significantly impact the child's long-term outcomes and quality of life 1. By using a comprehensive and standardized approach to documenting growth and development, healthcare providers can ensure that children receive the necessary support and interventions to promote healthy development and address any potential delays or concerns.
From the Research
Documenting Growth and Development in ROS for a 30-Month-Old Child
To document growth and development in a 30-month-old child, the following aspects can be considered:
- Developmental Screening: The Denver Prescreening Developmental Questionnaire (PDQ) or its revised version (R-PDQ) can be used to identify children who require a more thorough screening with the Denver Developmental Screening Test (DDST) 2, 3.
- Assessment Tools: The Denver-II is a widely used screening tool that can be used to assess the risk of developmental coordination disorder in preterm children 4.
- Parent-Reported Questionnaires: Parent-reported questionnaires like the PDQ can be used to identify children who require further evaluation, with a predictive value of a referral ranging from 23.3% to 24.7% 3.
- Developmental Milestones: The ROS can include an assessment of the child's developmental milestones, such as gross motor, fine motor, language, and social-emotional development.
Using the Denver Developmental Screening Test (DDST)
The DDST can be used to assess the child's development in various domains, including:
- Personal-Social: Assessment of the child's social and emotional development.
- Fine Motor: Assessment of the child's fine motor skills, such as drawing and puzzles.
- Language: Assessment of the child's language development, including vocabulary and sentence structure.
- Gross Motor: Assessment of the child's gross motor skills, such as walking and running.
Limitations and Considerations
It is essential to note that the provided studies may not directly address the documentation of growth and development in a 30-month-old child. However, they provide valuable information on the use of developmental screening tools and assessment of developmental milestones 2, 3, 4. Studies unrelated to child development, such as those on tuberculosis and granular cell myoblastoma, are not relevant to this topic 5, 6.