[Child development examinations in well-child clinics for infants and young children]

The health centres for infants and toddlers have recently been supplied with new forms for examination and registration of psychomotor development. These forms, which were especially designed for use in this setting are largely based on the work of Gesell. His sub-division in 5 fields of development is followed and items are chosen from his work. The forms are completed by adding a number of neurological items directed at the detection of pathology (Touwen) and some items concerning speech and language development (Schaerlaekens). The method is based on observations of developmental characteristics at the ages at which 90% of normal children in child health centres display these items. Reference-values are derived from a longitudinal study which was carried out in child health centres and comprised 550 children (Schlesinger-Was). These children provided per item the data for a cumulative percentile curve in which the age of the 90th percentile could be read. It is expected that by directing the assessment at the age of P90 an early detection of developmental disorders will result, while the number of false referrals will stay relatively small. Since the forms were incorporated in the new social-medical record for youth health care which has recently been introduced for nation-wide use, they are available on a large scale. Pediatricians therefore may be increasingly confronted with referrals based on this method of examination.