These tests are usually done when the child goes for the immunisations at nine months. They are done at a clinic, satellite or mobile clinic. The “Road-to-Health” card is examined to identify any high risk factors such as the antenatal history or birth history.
Note: In premature babies, for purposes of developmental assessment, the correct gestational age is calculated by subtracting the number of months born early from the actual age. For example, a child born at 32 weeks gestation is considered to be only seven months old and not nine months old.
||The weight is plotted on the growth chart.
||The head circumference is plotted on the growth chart. The weight should be on similar centiles.
||The body shape, face, ears, hands and feet are checked for dysmorphic features. Dysmorphism means an abnormality of the physical structure of a single or multiple parts of the body. Characteristic patterns of malformations may be recognised as syndromes, for example Down Syndrome or Foetal Alcohol syndrome.
Gross and fine motor examination:
||The child should sit unaided for at least one minute and be able to use the hands for playing and eating. In order to sit unaided a child needs good trunk and neck control.
||The child’s limbs are observed for any asymmetry of movements. Decreased movement on one side may indicate hemiplegia.
||Any signs of an abnormal posture, floppiness or spasticity are checked.
||A child of nine months usually takes objects to the mouth if within its reach. He/she should be able to hold a bottle and drink from a cup.
Language, hearing and vision:
||An absence of speech sounds indicates a developmental problem, for example deafness, emotional problems or a mental handicap.
||The child should turn when called.
||The child is observed whilst it makes eye contact or follows an object in front of him/her. The examiner will also check for signs of a squint.
|Prefers familiar people
||Infants interact differently with caregivers and strangers within their first few months, but begin to show a consistent preference for their primary caregivers at about eight – nine months of age. At this stage, the infant tends to look warily at unfamiliar people or strangers and resists being handed over to them by a caregiver.
||The examiner looks whether the caregiver responds appropriately to the child’s behaviour. For example, does she respond calmly and caringly when the infant signals his/her needs?