Developmental Station

The developmental station is the most predictable of the whole exam, and should really be the easiest to pass comfortably. The child will be between 0-5 years of age. Unless you are presented with a child under the age of one, there is rarely enough time to do a full examination, and so the examiner will usually ask you to perform one or two parts thoroughly. This is most commonly fine motor and speech/language.

Summary of Developmental Schedule

The following schedule (download as a PDF) will hopefully be helpful – the entire station on a single page. The amount of information is manageable to learn, and should take roughly the right amount of time in the exam. Please let us know if you have any suggestions or additions to make to the schedule.

Developmental Thumbnail

How to perform a developmental assessment

Introduction

Introduce yourself to the child and mother. Sit down with the child and make them feel at ease. Ask the mother if she has any concerns about hearing. Remember to take a step back and think if the child may have any syndromic diagnosis (the child may also be completely healthy).

Fine Motor Examination

Clear the table of toys and think where you are going to start. Generally try to run through a focused schedule of drawing, bricks, cutting and beads.

Drawing: get some paper and pens on the table, and encourage the child to draw. Follow the schedule in the attachment below. Do one thing at a time, and encourage the child to copy you. Once you reach the point at which the child is unable to progress further, mention to the examiner “John has managed to copy a circle, which is a 3 year old skill”.

Bricks: clear away the paper, and put a few bricks on the table. Show the idea of making a tower, and give the bricks to the child one by one. Encourage them to build a tower, and continue for as long as they can. If they manage well (or appear 3+ years old), try building a bridge, then steps and then larger steps. Once you have reached their maximum ability, turn to the examiner and comment “John has managed to make a tower of 4 bricks, which is an 18 month skill”.

Cutting: clear away the bricks, and hand the child some paper and scissors. Run through the schedule and again comment to the examiner about their level of ability.

Beads: clear away the paper/scissors, and get some Griffiths beads and string. Encourage them to make a string of beads.

Summarise: finally turn to the examiner and summarise your findings in a short presentation, and make a conclusion about their overall level of development. Mention if you think there is an underlying diagnosis (i.e. Down’s, Noonan’s etc).

Speech / Language

To assess speech and language, you need to think about both receptive and expressive communication. However, for the exam, the child may be reluctant to say much at first, and may not participate fully until they have become more comfortable with you.

Therefore, it makes sense to start with receptive language ability, and pick up the expressive language as you go along, and comment on this later.

The idea is to find the child’s maximum ability. In general, start at the 18 month level. Clear the table and lay out a number of common toys. Ask the child to “show me the car”, “show me the dog” etc. As you finish this part, mention to the examiner: “John has shown understanding of nouns, which is an 18 month skill”.

Continue with the different steps of development, as shown in the PDF. Each time, mention to the examiner that “John has shown understanding of negatives – this is a 3 year skill”.

Once you have reached a point where the child is unable to perform the task that you requested, you can stop. There is no point in continuing further. Hopefully as the child has started to become more comfortable with you, he/she may have started to vocalise or say some words, demonstrating their expressive ability.

Sum up your findings to the examiner, explaining that John was able to show understanding of prepositions (which is a 2.5 year old skill), but didn’t manage to understand negatives or adjectives yet (a 3 year old skill). He also spoke with sentences stringing 4 words together (a 2.5 year old skill). You would therefore suggest his language ability is currently at the 2.5 year old level. If you have noticed anything else on general inspection that might affect the child’s development, mention it here. You could also mention about plotting height and weight on a growth chart.

Performed fluently, this schema is very quick. There are lots of different developmental assessment guides (e.g. Schedule of Growing Skills, Griffiths, Bayley etc), by a range of authors. They have slightly different ranges for each skill, which can be confusing when revising. The key is to sound confident, so the examiner knows you have picked a schema and are using this in your exam.

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