Growth and developmental assessment — structured clinical oral

Structured oral viva on growth and developmental assessment: defending serial charting over single plots, the M-CHAT-R/F numbers and the USPSTF-AAP split, early cerebral palsy diagnosis tools, head circumference thresholds, and the short-stature referral conversation.

Prompt

The examiner opens: 'A colleague says every small child and every slow talker gets referred these days — charts and checklists are medicalising normal children.' The viva branches through growth-chart interpretation, failure to thrive, short stature, developmental screening numbers, cerebral palsy early signs, and head circumference red flags.

Stem

You are the GP. A practice colleague argues that growth charts and autism checklists are medicalising normal childhood: "Every small child and every slow talker gets referred these days." ^[1]

References8Show

[1]Ahmad UN, Yiwombe M, Chisepo P et al. Interpretation of World Health Organization growth charts for assessing infant malnutrition: a randomised controlled trial. Journal of paediatrics and child health, 2014.PMID 24134409
[2]de Onis M, Onyango AW, Borghi E et al. Comparison of the WHO Child Growth Standards and the NCHS/WHO international growth reference: implications for child health programmes. Public health nutrition, 2006.PMID 17010261
[3]Goh LH, How CH, Ng KH Failure to thrive in babies and toddlers. Singapore medical journal, 2016.PMID 27353148
[4]Caro R, Savel P, Moss PI Evaluation of Short and Tall Stature in Children. American family physician, 2025.PMID 40531152
[5]Robins DL, Casagrande K, Barton M et al. Validation of the modified checklist for Autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics, 2014.PMID 24366990
[6]Novak I, Morgan C, Adde L et al. Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy: Advances in Diagnosis and Treatment. JAMA pediatrics, 2017.PMID 28715518
[7]Fine A, Schupack KM Childhood Neurologic Conditions: Neuroanatomic Abnormalities. FP essentials, 2022.PMID 36459666
[8]WHO Multicentre Growth Reference Study Group WHO Motor Development Study: windows of achievement for six gross motor development milestones. Acta paediatrica. Supplement, 2006.PMID 16817682

Growth and developmental assessment — structured clinical oral

Stem

You are the GP. A practice colleague argues that growth charts and autism checklists are medicalising normal childhood: "Every small child and every slow talker gets referred these days." ^[1]

References8Show

[1]Ahmad UN, Yiwombe M, Chisepo P et al. Interpretation of World Health Organization growth charts for assessing infant malnutrition: a randomised controlled trial. Journal of paediatrics and child health, 2014.PMID 24134409
[2]de Onis M, Onyango AW, Borghi E et al. Comparison of the WHO Child Growth Standards and the NCHS/WHO international growth reference: implications for child health programmes. Public health nutrition, 2006.PMID 17010261
[3]Goh LH, How CH, Ng KH Failure to thrive in babies and toddlers. Singapore medical journal, 2016.PMID 27353148
[4]Caro R, Savel P, Moss PI Evaluation of Short and Tall Stature in Children. American family physician, 2025.PMID 40531152
[5]Robins DL, Casagrande K, Barton M et al. Validation of the modified checklist for Autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics, 2014.PMID 24366990
[6]Novak I, Morgan C, Adde L et al. Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy: Advances in Diagnosis and Treatment. JAMA pediatrics, 2017.PMID 28715518
[7]Fine A, Schupack KM Childhood Neurologic Conditions: Neuroanatomic Abnormalities. FP essentials, 2022.PMID 36459666
[8]WHO Multicentre Growth Reference Study Group WHO Motor Development Study: windows of achievement for six gross motor development milestones. Acta paediatrica. Supplement, 2006.PMID 16817682