Dear All

Thank you for participating in the session today. 

We covered Development station – History and Assessment in a double session today to keep continuity.

In RRR we discussed:

  • Developmental delay – causes: Prenatal, Perinatal, Postnatal…
  • Management of Development delay
  • Wilm’s Tumor

Development station is still  ‘Virtual’ and there is NO CHILD. You will have to verbalize the examination to Examiner.

The Development station – presentation was of a 4 year old whose mother was concerned about his ‘fine motor’ skills. Task was to take a focused history and then do a fine motor assessment.

Dr M was our Role Player, Dr K was in the hotseat. Dr K made a very good attempt at getting relevant history and still had about a minute left. The were a some facts that were missed: Development in domains other than Fine motor – that has to assessed and demonstrated. Co-morbidities, Family history, Who all are involved in child’s care are details important to obtain.

Check for Vision & Hearing tested and if any concerns.

Dr U was in the Hotseat for Assessment, Dr A & Dr T had the  examiner hats. Dr U completed the exam in due time and elicited most points. Summary to examiner needs to be practised.

The Learning points are:

  • General Examination is part of Development examination also.
  • Briefly look for general appearance, any splits, wheel chair, drugs etc.
  • Sit comfortable across child – explain what you will be doing / expect child to do.
  • Collect ‘Tools / Toys’ you will use.
  • ONE TOOL AT A TIME – keep others out of field of vision.
  • Mention Removing the ‘Tool’ after use – else it is present on the table!
  • Start with Offering cube – check for Handedness.
  • Crayon – check type of grasp – palmer or pincer.
  • You will have to describe what you expect the child to do – examiner will confirm or refute.
  • Permission to use scissors
  • Can ‘ask parent’ to help is child is reluctant
  • Make a temple for History and examination so as not to miss important aspects.

Dr Shishir has sent 3Cs & 3Bs to our WhatsApp group – do check – it will guide your examination.

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

Anil Garg