Children's Hearing and Vision Milestones
Two special parts of the physical examination at all ages should go mentioned because
they’re very important to what we do.
One is the major developments of hearing. What we’re looking for here is birth. Most
babies responds to a loud noise with a startle reflex or marrow exam.
By either 12 weeks, they turn their head to the side the sound comes at. But from 12 to
16-weeks, they actually look towards where the sound is coming from. They locate the
sound by 6-months that’s 16to 24 weeks. By 24-weeks the more they respond to sound no
matter where it’s from and will hunt around the room looking for it.
These were important measurements of sound and ability at physical examinations to
pick up hearing loss in an early age. It has been somewhat surpassed now by the fact that
all newborns in a Hospitals are screened for sound and for hearing.
In screening, it is done mechanically and can be done even by what’s called a Brainstem
Evoke Response. And those who do not respond to the normal neonatal screening, this is
an EEG or Brain Wave Cast to actually why the child is receiving the stimulation of
sound.
The other area as you might believe that’s very important is the development of vision.
Vision in a baby actually is somewhere between 2000 to 2400. They have corneal
reflexes, they have papillary reflex at birth but you’ll notice that they only follow about
90 degrees in the first 4-weeks of life you can not go pass the 90 degree mark or they will
lose tracking completely during that time.
By somewhere around 12 weeks, the patient’s peripheral vision starts to develop better.
By 12 to 20 weeks, the child starts to recognize feeding bottles. By 28 weeks which is
somewhere around the 6th to 7th month term, the child is now able to rescue a dropped
objects as it starts to show a color preference which is actually for Yellow and Red and is
able to discriminate simple geometric forms that would be around 7 months.
Next is by 28 to 44 weeks, they begin to fixate on objects. Depth Perception begins to be
something they require. And by 52 weeks, their vision is actually 20/40 to 20/60 and they
now can follow rapidly movement. After that they develop hand-eye coordination as we
know it.
The Doctor should be well aware of these visual milestones and should be watching them
develop. Also, he has to develop an exam as the child develops later for Amblyopia. And
the first way that’s done is simply by a covered test looking for an eye movement so this
is another important aspect of doing a physical examination on your child and you should
be very aware that hearing and vision at all time should also be examined not just the
heart, lungs, abdomen. This is extremely important.
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