Infant or Severe Developmental Delay

1
PICU Quick Reference Pediatric Neurological
Assessment
Infant or Severe Developmental Delay
Child
Adolescent
2

• Goal Recognize/Report subtle changes in
  baseline neurological status before
  deterioration.
• Most Important Be systematic! Repeat assessment
  same order each time
• Appearance and Observation
• Level of consciousness
• Cranial Nerve Assessment
• Motor Sensory Function
• Vital Signs
• External Monitoring Devices

Exam -

• Infant/Toddler- determine eye opening,
  arousability, level or irritability/consolability,
  symmetry of
• facial expressions and movement of upper and
  lower extremities, listen for increase weakness
• or pitch in cry/vocalizations, assess anterior
  fontanel, check each pupil separately for size ,
  shape,
• equality of reaction to light, check ability to
  track object, note muscle tone for rigid
  extension or
• flexion of extremities, flaccidity and/or unusual
  posturing.
• Child- (In addition )- note c/o headache, assess
  social orientation attention span, orientation
  in
• terms of memory (name of favorite stuffed animal
  etc.) degree of agitation/ restlessness, clarity
• of speech, EOMs, visual acuity, blow fish cheeks,
  tongue deviation, symmetrical shoulder shrug,
• high five, drift assessment, grip strength,
  ability to lift legs against resistance.
• Adolescent- (In addition)-note complaints of
  double vision, dizziness, anxiety, fearfulness

Score patient using Glascow Coma scale