Paeds Cases · growth-development-and-behaviour
Floppy infant OSCE — localisation, safety and family counselling
OSCE on floppy infant assessment: bedside localisation, red-flag recognition, urgent pathway and closed-loop counselling.
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Study tools
Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is a 10-minute assessment of a 3-month-old with progressive floppiness. Station B is 8 minutes counselling parents after you identify a peripheral progressive pattern.
Station objectives
- Distinguish tone, strength and laxity at the bedside. [1]
- Localise central versus peripheral patterns using power, reflexes and posture. [1] [2]
- Recognise progressive SMA-pattern red flags and protect airway/feeding. [5] [9]
- Counsel concurrent urgent genetics/neuromuscular referral without false reassurance. [9]
- Use teach-back and a closed-loop safety-net plan. [5]
References6ShowHide
- [1]Peredo DE, Hannibal MC The floppy infant: evaluation of hypotonia. Pediatrics in review, 2009.PMID 19726697
- [2]Bodensteiner JB The evaluation of the hypotonic infant. Seminars in pediatric neurology, 2008.PMID 18342256
- [5]Laverty CG Hypotonia in the Newborn Infant. Pediatric clinics of North America, 2025.PMID 40619196
- [9]Finkel RS, Mercuri E, Darras BT Nusinersen versus Sham Control in Infantile-Onset Spinal Muscular Atrophy. The New England journal of medicine, 2017.PMID 29091570
- [16]Sarintra N, Ekdahl R, Sanders SC More Than Just a Floppy Baby: Maintaining High Clinical Suspicion of Infant Botulism. Cureus, 2026.PMID 41728439
- [17]Suzui R, Wada I, Matsubara M Undiagnosed Maternal Myotonic Dystrophy Type 1 Revealed by Congenital Myotonic Dystrophy in the Neonate. Cureus, 2026.PMID 42037975