Paediatric Case Taking
DEVELOPMENT CENTRE FOR CHILDREN WITH AUTISM/ADHD/MR/CP
PRE-ASSESSMENT-
Reason
for referral
Other
agencies involved
Mother
concerns
Home
language
Nationality
Date
of birth
HISTORY BY MOTHER-
BIRTH HISTORY:
Delivery- normal/caesarean
Baby had cried immediately after
birth Yes/No
Cry of baby Loud/Moderate/Feeble
Birth weight
Cyanosis Present/Absent
PAST MEDICAL HISTORY:
0-7 days (neonate illness)
8
days – 1 month
1
month – 1 year
1
year onwards
VACCINATION GIVEN:
FAMILY COMPOSITION:
FAMILY HISTORY:
SOCIAL HISTORY:
DEVOLOPMENT HISTORY
DEVELOPMENT MILESTONES
Development milestones in the | |||
Milestones | Patient’s age of | Average age of attainment(months) | Developmental implications |
GROSS MOTOR | |||
Head steady in sitting |
| 2.0 | Allows more visual interaction |
Pull to sit, no head lag |
| 3.0 | Muscle tone |
Hands together in midline |
| 3.0 | Self –discovery |
Asymmetric tonic neck reflex gone |
| 4.0 | Child can inspect hands in midline |
Sits without support |
| 6.0 | Increasing exploration |
Rolls back to stomach |
| 6.5 | Truncal flexion, risk of falls |
Walks alone |
| 12.0 | Exploration, control of proximity |
Runs |
| 16.0 | Supervision more difficult |
FINE MOTOR | |||
Grasps rattle |
| 3.5 | Object use |
Reaches for objects |
| 4.0 | Visuomotor coordination |
Palmar grasp tone |
| 4.0 | Voluntary release |
Transfers object hand to hand |
| 5.5 | Comparison of objects |
Thumb-finger grasp |
| 8.0 | Able to explore small objects |
Turns pages of book |
| 12.0 | Increasing autonomy during book |
Scribbles |
| 13.0 | Visuomotor coordination |
Builds tower of two cubes |
| 15.0 | Uses objects in combination |
Builds tower of six cubes |
| 22.0 | Requires visual, gross, and fine |
COMMUNICATION AND LANGUAGE | |||
Smiles in response to face , voice |
| 1.5 | Child more active social |
Monosyllabic babble |
| 6.0 | Experimentation with sound, |
Inhibits to “No” |
| 7.0 | Response to tone(non verbal) |
Follows one step command with |
| 7.0 | Non verbal communication |
Follows one step command without gesture |
| 10.0 | Verbal receptive language(e.g. |
Speaks first real word |
| 12.0 |
|
Speaks 4-6 words |
| 15.0 | Acquisition of object and personal |
Speaks 10-15 words |
| 18.0 | Acquisition of object and personal |
Speaks two-word sentences(e.g. mommy |
| 19.0 | Beginning grammaticization, |
COGNITIVE SKILLS | |||
Stares momentarily at spot where |
| 2.0 | Lack of object permanence(out of |
Stares at own hand |
| 4.0 | Self-discovery, cause and effect |
Bangs two cubes |
| 8.0 | Active comparison of objects |
Uncovers toy(after seeing it |
| 8.0 | Object permanence |
Egocentric pretend play(e.g. |
| 12.0 | Beginning symbolic thought |
Uses stick to reach toy |
| 17.0 | Able to link actions to solve |
Pretend play with doll(gives doll |
| 17.0 | Symbolic thought |
FEEDING HISTORY:
SELF CARE:
SLEEP:
COMMUNICATION:
PLAY:
PREGNANCY HISTORY
1st Trimester
2nd Trimester
3rd Trimester
MEDICAL ASSESSMENT
Current development status:
Hand skills:
Hearing and Language:
Bowel movement:
Socialization:
Central Nervous System:
HOMOEOPATHIC HISTORY
Appetite:
Craving:
Food/drink
agg/amel:
Thirst:
Urine:
Perspiration:
Sleep:
Physical
sensitivity:
Veg/Non-veg:
Aversion:
Stool:
Physical sensitivity:
SUN | NOISE |
LIGHT/DARKNESS | ODOUR |
TIGHT | MOTION |
SENSES:
TOUCH | SMELL |
TASTE | VISION |
HEARING |
|
MENTAL GENERALS:
IMPRESSION & EVALUATION:
RUBRICS TAKEN:
REMEDY FOLLOW UP CRITERIA: