Early And Late Childhood

Beyond infancy, when the primitive reflexes have disappeared, the neurologic examination includes the components evaluated in adults. Again, you should combine the neurologic and developmental assessment and will need to turn this into a game with the child. The goal is to assess optimal development and neurologic performance, and this requires the child to be cooperative.

Perform the DDST as described and shown on pp. 738-739. Children usually enjoy this component, and you can too. Remember that the DDST is better at detecting delays in motor skills than in language or cognitive milestones.

Children with spastic diplegias will often have hypotonia as infants and then excessive tone with spasticity, scissoring, and perhaps clenched fists as toddlers and young children.

The cranial nerves can be assessed quite well using developmentally appropriate strategies as shown in the following table:

Strategies to Assess Cranial Nerves in Young Children

Cranial Nerve

Strategy

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