Dear All

Thank you for participating in the session today.

In RRR we discussed:

• GMFSC – assessment
• Neuro – Surgical interventions in ‘Cerebral Palsy’
• Gross Developmental delay: Workup

Dr A gave an update on DCH exam she had ‘written’ a few days ago. DCH is less difficult than Membership exam however all exams are difficult and taxing. Domains tested are similar in both exams: Communication, History, Clinical systemic examination, Development. Practice with our group for MRCPCH was very helpful.

We discussed Development assessment in our session. 4 year old with concerns regarding fine motor activities. Task to assess age by fine motor assessment. Dr S took the Hotseat with Dr A & Dr AG with examiner roles. Dr S completed the task well covering most of the skills. 

There are a few Learning points:

• Vision & Hearing – ask in History. Do not need to test yourself.
• Correct with aids – spectacles or hearing aids – if needed
• General observation is must – here also
• Start with Dexterity – offer crayon / cube to both hands
• Non Dominant hand vs ‘CP affected’ hands ‘behave’ differently
• push the ‘child’ to task they cannot perform – upper age limit
• Appreciate and encourage their action / response
• In exam without children and with Examiner it may feel Odd – but do it
• Write points in 3 mins while waiting – unlikely to get time during assessment

Dr Anamika gave the following mnemonic for assessment tools:

3 Bs, 2 Cs & 1 S:

Book : Board: Beads – Cubes – Crayons – Scissors

to be used not necessarily in the same order.

In History for station – useful tips:

• Time when concerns were first noted: age birth vs specific age
• Focus appropriately. Screening questions to cover other aspects.
• NICU admission – usually prolonged – hence do NOT get into treatments and investigations
• ASK: What were you told at time of discharge.

Please visit www.mrcpchonline.org to add your comments or points I may have missed.

Anil Garg