Developmental assessment: history, examination and standardised tools — formative SAQs

SAQ 1 (10 marks)

A 20-month-old is referred because the caregiver is worried about speech and social interaction. [1]

1. Outline your structured developmental history and free-observation plan. (4) [1] [2]
2. Which examination and first-line sensory checks do you prioritise? (3) [1] [4]
3. How would you use standardised tools without over-claiming diagnosis? (3) [1] [3]

Model answer

Open concern, take pregnancy/NICU/milestone/regression history, and observe free play for joint attention, gesture, language and motor skills before tools. [1] [2] Examine growth, dysmorphology and neurology; arrange hearing (and vision as indicated). [1] [4] Use a general developmental screen and M-CHAT-R/F with follow-up when indicated; screens identify risk and do not alone diagnose; refer early with clear handover. [1] [3] [9]

SAQ 2 (10 marks)

Compare screening tools with formal diagnostic developmental instruments and name validity threats. [1] [5]

1. What do screening tools do and not do? (4) [1] [3] [6]
2. When are Bayley-type or similar instruments appropriate? (3) [4] [5]
3. List two validity threats in clinic. (3) [1] [5] [8]

Model answer

Screens (ASQ-type, PEDS-type, M-CHAT-R/F) identify risk; they are not diagnoses. [1] [3] [6] Formal instruments require trained assessors and support diagnostic evaluation of global delay/ID pathways. [4] [5] Validity threats include wrong age form, uncorrected prematurity age early on, distress/illness, language discordance without interpreter, and missing hearing. [1] [5] [8]