Observation
As emphasized previously, the examination begins as soon as the family and child enter the examination room, before the child is actually touched or asked to perform. Sometimes, it may be the most informative phase of the examination.
Specific behaviors to observe and note include reaction to separation from the parents (in young children); apparent visual and auditory awareness; temperament (calm or hyperactive, compliant, or difficult); spontaneous exploration and interest in toys, games, or books in the room; style, concentration, attention span, or distractibility during play; level and manner of motor activities; attempts to engage the parents and the examiner in conversation, vocabulary, complexity of language, and quality of speech; and interaction with parents or examiner (appropriate, shy, or demanding). Observations of the parents’ response and their way of handling the child’s behavior are also revealing.
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