TABLE OF CONTENTS
Chapter 1: General Pediatrics
LABORATORY REFERENCE VALUE 6
NORMAL DEVELOPMENT OF CHILD 9
DEVELOPMENTAL MILESTONES 13
Chapter 2: Infective system
HSV INFECTION 17
VZV INFECTION 23
EBV & CMV INFECTION [INFECTIOUS MONONUCLEOSIS (IM)] 31
HHV-6 & 7 INFECTION (ROSEOLA INFANTUM) 37
MUMPS 42
MEASLES 46
RUBELLA 52
HAND-FOOT-MOUTH DISEASE (HFMD) 58
TYPHOID AND PARATYPHOID FEVER 63
RICKETTSIAL DISEASES 68
DENGUE FEVER 73
MALARIA 79
Chapter 3: Respiratory system
FEVER AND RASH 86
COMMON COLD 93
INFLUENZA 100
SINUSITIS (RHINOSINUSITIS) 109
OTITIS MEDIA 115
GAS INFECTION 123
CROUP (LARYNGOTRACHEOBRONCHITIS) 135
ACUTE EPIGLOTTITIS 143
ACUTE BRONCHIOLITIS 148
PNEUMONIA 154
ASTHMA 172
2
,Chapter 4: Cardiovascular system
HEART FAILURE 201
ATRIAL SEPTAL DEFECT (ASD) 230
VENTRICULAR SEPTAL DEFECT (VSD) 238
ATRIO-VENTRICULAR SEPTAL DEFECT (AVSD) 247
PATENT DUCTUS ARTERIOSUS (PDA) 251
COARCTATION OF AORTA 259
TETRALOGY OF FALLOT (TOF) 267
TRANSPOSITION OF GREAT ARTERIES (TGA) 273
CYANOTIC CONGENITAL HEART DISEASES 279
MYOCARDITIS 291
KAWASAKI DISEASE 295
ACUTE RHEUMATIC FEVER/ RHEUMATIC HEART DISEASE 303
Chapter 5: Gastrointestinal system
NEONATAL JAUNDICE
FLUID AND ELECTROLYTES 308
GASTROENTERITIS (GE) 318
MECKEL’S DIVERTICULUM 324
INTUSSUSCEPTION 348
INTESTINAL ATRESIA 352
INTESTINAL MALROTATION 357
HIRSCHSPRUNG DISEASE 363
SHORT GUT SYNDROME 369
GASTROSCHISIS AND OMPHALOCELE 375
WILSON DISEASE 380
Chapter 6: Urological system
URINARY TRACT INFECTION 389
GLOMERULAR DISEASE 402
POST-STREPTOCOCCAL GLOMERULONEPHRITIS (PSGN) 420
NEPHROTIC SYNDROME 426
HEMOLYTIC-UREMIC SYNDROME (HUS) 440
ENURESIS 446
3
,Chapter 7: CNS system
GLOBAL DEVELOPMENT DELAY (GDD) 450
HYPOTONIA AND FLOPPY INFANT 455
CEREBRAL PALSY 457
SEIZURE AND EPILEPSY 469
FEBRILE SEIZURES 487
INFANTILE SPASMS 495
MENINGITIS 500
ENCEPHALITIS 518
BRAIN TUMOURS 521
SPINAL MUSCULAR ATROPHY (SMA) 535
POLIOMYELITIS 540
GUILLAIN-BARRE SYNDROME (GBS) 545
Chapter 8: Hematological System
ANEMIA 550
VITAMIN B12 AND FOLATE DEFICIENCY 564
NEUTROPENIC FEVER 572
THALASSEMIA 576
HEMOPHILIA A & B 591
VON WILLEBRAND DISEASE (VWD) 601
IMMUNE THROMBOCYTOPENIA (ITP) 606
THROMBOTIC THROMBOCYTOPENIC PURPURA (TTP) 615
APLASTIC ANEMIA 620
HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS (HLH) 626
LANGERHANS CELLS HISTIOCYTOSIS (LCH) 632
IMMUNODEFICIENCY IN CHILDREN 635
Chapter 9: Endocrine System
PREMATURITY 642
FAILURE TO THRIVE 656
SHORT STATURE 659
PRECOCIOUS PUBERTY 668
DELAYED PUBERTY 680
HYPOPITUITARISM 685
4
,Chapter 10: Rheumatological System
JUVENILE IDIOPATHIC ARTHRITIS 691
HENOCH-SCHOLEIN PURPURA (HSP) 698
JUVENILE DERMATOMYOSITIS 705
SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) 711
Chapter 11: Pediatrics oncology
ACUTE MYELOID LEUKEMIA (AML) 731
ACUTE LYMPHOBLASTIC LEUKEMIA (ALL) 741
LYMPHOMA 751
MYELODYSPLASTIC SYNDROME 770
NEUROBLASTOMA 776
PHAEOCHROMOCYTOMA 783
RHABDOMYOSARCOMA 787
OSTEOSARCOMA 792
HEPATOBLASTOMA 799
WILM’S TUMOUR 802
Chapter 12: Pediatrics syndromes
TUBEROUS SCLEROSIS COMPLEX (TSC) 806
NEUROFIBROMATOSIS (NF) 811
DOWN SYNDROME (TRISOMY 21) 818
PATAU SYNDROME (TRISOMY 13) 835
EDWARDS SYNDROME (TRISOMY 18) 838
KLINEFELTER SYNDROME 841
TURNER SYNDROME 846
NOONAN SYNDROME 852
RUSSELL-SILVER SYNDROME 855
PRADA WILLI SYNDROME 857
BECKWITH-WIEDEMANN SYNDROME 863
MARFAN SYNDROME 868
DIGEORGE SYNDROME 874
WILLIAMS SYNDROME 878
FRAGILE X SYNDROME 880
5
, Laboratory reference value
Complete blood count (CBC)
Red blood cells (RBC)
Haemoglobin (Hb) ♂ 13.5 – 16.5 g/dL
♀ 12.0 – 16.0 g/dL
MCV 80 - 96 fL
MCH 26 – 33 pg
Hematocrit 0.4 – 0.5 L/L
RBC 4.4 – 5.8 x 1012 /L
RDW 11.8 – 15.8 %
Reticulocytes 0.2 – 2.0 %
White blood cells (WBC)
WBC 3.7 – 9.3 x 109 /L
Neutrophils 1.8 – 6.2 x 109 (40 – 80%) /L
9
Lymphocytes 1.0 – 3.2 x 10 (20 – 40%) /L
Monocytes 0.2 – 0.7 x 109 (< 10%) /L
9
Eosinophils 0.0 – 0.5 x 10 (< 5%) /L
9
Basophils 0.0 – 0.2 x 10 (< 1 - 2%) /L
Platelets
Platelet 150 – 450 x 109 /L
*: Values that are bolded are reviewed according to the newest definition in uptodate
Clotting profile
PT 9.3 – 12.1 s
APTT 25.0 – 31.3 s
INR < 1.0
D-dimer < 0.5 mg/L
Fibrinogen 2–4 g/dL
Electrolyte profile
+
Na 136 – 148 mmol/L
K+ 3.6 – 5.0 mmol/L
Cl- 100 - 109 mmol/L
Ca2+ 2.11 – 2.55 mmol/L
PO43- 0.89 – 1.45 mmol/L
6
, Lipid profile
Total cholesterol Desirable < 5.2 mmol/L
Borderline high 5.2 – 6.1 mmol/L
High ≥ 6.2 mmol/L
LDL Optimal < 2.6 mmol/L
Near optimal 2.6 – 3.3 mmol/L
Borderline high 3.4 – 4.0 mmol/L
High 4.1 – 4.8 mmol/L
Very high ≥ 4.9 mmol/L
Triglycerides Normal < 1.7 mmol/L
Borderline high 1.7 – 2.2 mmol/L
High 2.3 – 5.5 mmol/L
Very high ≥ 5.6 mmol/L
HDL Low < 1.0 mmol/L
High ≥ 1.6 mmol/L
Liver function test (LFT)
AST 15 – 38 U/L
ALT 8 – 58 U/L
ALP 42 – 110 U/L
GGT 11 – 62 U/L
Total bilirubin 4 – 23 μmol/L
Conjugated bilirubin <6 μmol/L
Albumin 39 – 50 g/L
Renal function test (RFT)
Urea 3.1 – 7.7 mmol/L
Creatinine 67 - 109 μmol/L
GFR ≥ 90 (90 – 120) mL/min/1.73m2
Thyroid function test (TFT)
TSH 0.35 – 4.80 mIU/L
fT4 12 – 23 mmol/L
7
, Arterial blood gas
pH 7.35 – 7.45
PO2 10.6 – 14.0 kPa
PCO2 4.7 – 6.0 kPa
HCO3- 22 – 26 mmol/L
Base excess -4 - +2 mmol/L
Others
Total protein 68 – 84 g/L
Globulin 24 – 36 g/L
CK 260 – 530 U/L
LDH 118 – 221 U/L
ESR ♂ Age / 2 mm/hr
♀ (Age + 10) / 2 mm/hr
8
, Illustrate textbook of paediatrics: Normal child development
I. Basic paediatrics knowledge
1. Classification of age
Neonate: < 4 weeks
Infant: < 1 year
Toddler: 1 – 2 years
Young child: 2 – 5 years
Older child: 6 – 9 years
Adolescent: 10 – 19 years (WHO)
2. Respiratory rate in children
Tachypnea in different age groups
• Age < 2 months: > 60 breaths/min
• Age 2 – 12 months: > 50 breaths/min
• Age 1 – 5 years: > 40 breaths/min
• Age ≥ 5 years: > 20 breaths/ min
Age Normal Tachypnea
Neonates < 4 weeks 30 – 50/ min > 60/ min
Infants < 1 year 20 – 30/min > 50/ min
Young child 2 – 5 years 20 – 30/min > 40/ min
Older child 6 – 9 years 15 – 20/min > 30/ min
Age Normal (PEWS)
Infants 1 – 12 months 30 – 50/ min
Toddlers 1 – 3 years old 20 – 40/ min
Pre-school 4 – 6 years old 17 – 33/ min
School age 7 – 12 years old 15 – 30/ min
3. Pulse rate in children
Age Normal
< 1 year 110 – 160/ min
2 – 5 years 95 – 140/min
5 – 12 years 80 – 120/min
> 12 years 60 – 100/min
Age Normal (Uptodate)
0 – 6 months 110 – 180/min
6 months - 1 year 110 – 160/ min
1 – 2 years 90 – 150/min
2 – 5 years 80 – 140/min
5 – 12 years 70 – 120/min
> 12 years 60 – 100/min
4. Blood pressure in children
Age Upper limit of normal of systolic BP
< 1 year 110 mmHg
2 – 5 years 120 mmHg
9
,II. Developmental milestones
1. Background
4 fields of developmental function
• Development milestones refers to acquisition of important developmental skills
• Normal pattern for acquisition of skills are
o Sequentially constant
o Varies in rate between children
Median age and limit age
• Median age
o A guide to the pattern to expect in normal development
o Refers to the age when half the population acquire the skill
• Limit age
o A guide to the necessity for further assessment and examination
o Refers to the age when a skill should have been acquired
o Calculated as “Mean + 2 SDs”
Adjustment for preterm infants
• Assessment of development age according to the expected date of delivery
• Correction is no longer required after about 2 years of age when number of weeks early
the child was born no longer a significant proportion of the child’s life
2. Developmental milestones by median age
Age Gross motor Vision and fine Hearing, speech and Social, emotional
motor language and behavioral
7 months Sits without Transfer objects from Turns to voices Puts food into mouth
support one hand to another Polysyllabic babble Fears strangers
1 year Stands Pincer grip 1st meaning word Drinks with a cup
independently Wave bye-bye
15 – 18 Walks Scribble 6 – 10 words Hold spoon and gets
months independently (18 months) food safely to mouth
(12 – 18 months)
2.5 years Runs and jumps Draws 4-word sentence Dry by day
Parallel play
10
, III. Hearing
1. Hearing checklist
Time Description Example
Shortly after birth Startles and blinks at sudden noise Slamming of door
By 1 month Notices sudden prolonged sound Vacuum cleaner
By 4 months Smiles to sound of parent’s voices even when it is
out of sight
By 7 months Turns immediately to voices
By 9 months Listens attentively to familiar everyday sound
Searches for quiet sounds out of sight
Show pleasure in babbling loudly and tunefully
By 12 months Respond to own name and other familiar words
Respond when you say “no” or “bye-bye”
2. Hearing screening for newborn infants
Evoked otoacoustic emission (EOAE)
• Advantages
o Simple and quick to perform
• Disadvantages
o Affected by ambient voice
o Not a test of hearing but a test of cochlear function
o Misses auditory neuropathy since CN VIII and brain are not tested
11
Chapter 1: General Pediatrics
LABORATORY REFERENCE VALUE 6
NORMAL DEVELOPMENT OF CHILD 9
DEVELOPMENTAL MILESTONES 13
Chapter 2: Infective system
HSV INFECTION 17
VZV INFECTION 23
EBV & CMV INFECTION [INFECTIOUS MONONUCLEOSIS (IM)] 31
HHV-6 & 7 INFECTION (ROSEOLA INFANTUM) 37
MUMPS 42
MEASLES 46
RUBELLA 52
HAND-FOOT-MOUTH DISEASE (HFMD) 58
TYPHOID AND PARATYPHOID FEVER 63
RICKETTSIAL DISEASES 68
DENGUE FEVER 73
MALARIA 79
Chapter 3: Respiratory system
FEVER AND RASH 86
COMMON COLD 93
INFLUENZA 100
SINUSITIS (RHINOSINUSITIS) 109
OTITIS MEDIA 115
GAS INFECTION 123
CROUP (LARYNGOTRACHEOBRONCHITIS) 135
ACUTE EPIGLOTTITIS 143
ACUTE BRONCHIOLITIS 148
PNEUMONIA 154
ASTHMA 172
2
,Chapter 4: Cardiovascular system
HEART FAILURE 201
ATRIAL SEPTAL DEFECT (ASD) 230
VENTRICULAR SEPTAL DEFECT (VSD) 238
ATRIO-VENTRICULAR SEPTAL DEFECT (AVSD) 247
PATENT DUCTUS ARTERIOSUS (PDA) 251
COARCTATION OF AORTA 259
TETRALOGY OF FALLOT (TOF) 267
TRANSPOSITION OF GREAT ARTERIES (TGA) 273
CYANOTIC CONGENITAL HEART DISEASES 279
MYOCARDITIS 291
KAWASAKI DISEASE 295
ACUTE RHEUMATIC FEVER/ RHEUMATIC HEART DISEASE 303
Chapter 5: Gastrointestinal system
NEONATAL JAUNDICE
FLUID AND ELECTROLYTES 308
GASTROENTERITIS (GE) 318
MECKEL’S DIVERTICULUM 324
INTUSSUSCEPTION 348
INTESTINAL ATRESIA 352
INTESTINAL MALROTATION 357
HIRSCHSPRUNG DISEASE 363
SHORT GUT SYNDROME 369
GASTROSCHISIS AND OMPHALOCELE 375
WILSON DISEASE 380
Chapter 6: Urological system
URINARY TRACT INFECTION 389
GLOMERULAR DISEASE 402
POST-STREPTOCOCCAL GLOMERULONEPHRITIS (PSGN) 420
NEPHROTIC SYNDROME 426
HEMOLYTIC-UREMIC SYNDROME (HUS) 440
ENURESIS 446
3
,Chapter 7: CNS system
GLOBAL DEVELOPMENT DELAY (GDD) 450
HYPOTONIA AND FLOPPY INFANT 455
CEREBRAL PALSY 457
SEIZURE AND EPILEPSY 469
FEBRILE SEIZURES 487
INFANTILE SPASMS 495
MENINGITIS 500
ENCEPHALITIS 518
BRAIN TUMOURS 521
SPINAL MUSCULAR ATROPHY (SMA) 535
POLIOMYELITIS 540
GUILLAIN-BARRE SYNDROME (GBS) 545
Chapter 8: Hematological System
ANEMIA 550
VITAMIN B12 AND FOLATE DEFICIENCY 564
NEUTROPENIC FEVER 572
THALASSEMIA 576
HEMOPHILIA A & B 591
VON WILLEBRAND DISEASE (VWD) 601
IMMUNE THROMBOCYTOPENIA (ITP) 606
THROMBOTIC THROMBOCYTOPENIC PURPURA (TTP) 615
APLASTIC ANEMIA 620
HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS (HLH) 626
LANGERHANS CELLS HISTIOCYTOSIS (LCH) 632
IMMUNODEFICIENCY IN CHILDREN 635
Chapter 9: Endocrine System
PREMATURITY 642
FAILURE TO THRIVE 656
SHORT STATURE 659
PRECOCIOUS PUBERTY 668
DELAYED PUBERTY 680
HYPOPITUITARISM 685
4
,Chapter 10: Rheumatological System
JUVENILE IDIOPATHIC ARTHRITIS 691
HENOCH-SCHOLEIN PURPURA (HSP) 698
JUVENILE DERMATOMYOSITIS 705
SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) 711
Chapter 11: Pediatrics oncology
ACUTE MYELOID LEUKEMIA (AML) 731
ACUTE LYMPHOBLASTIC LEUKEMIA (ALL) 741
LYMPHOMA 751
MYELODYSPLASTIC SYNDROME 770
NEUROBLASTOMA 776
PHAEOCHROMOCYTOMA 783
RHABDOMYOSARCOMA 787
OSTEOSARCOMA 792
HEPATOBLASTOMA 799
WILM’S TUMOUR 802
Chapter 12: Pediatrics syndromes
TUBEROUS SCLEROSIS COMPLEX (TSC) 806
NEUROFIBROMATOSIS (NF) 811
DOWN SYNDROME (TRISOMY 21) 818
PATAU SYNDROME (TRISOMY 13) 835
EDWARDS SYNDROME (TRISOMY 18) 838
KLINEFELTER SYNDROME 841
TURNER SYNDROME 846
NOONAN SYNDROME 852
RUSSELL-SILVER SYNDROME 855
PRADA WILLI SYNDROME 857
BECKWITH-WIEDEMANN SYNDROME 863
MARFAN SYNDROME 868
DIGEORGE SYNDROME 874
WILLIAMS SYNDROME 878
FRAGILE X SYNDROME 880
5
, Laboratory reference value
Complete blood count (CBC)
Red blood cells (RBC)
Haemoglobin (Hb) ♂ 13.5 – 16.5 g/dL
♀ 12.0 – 16.0 g/dL
MCV 80 - 96 fL
MCH 26 – 33 pg
Hematocrit 0.4 – 0.5 L/L
RBC 4.4 – 5.8 x 1012 /L
RDW 11.8 – 15.8 %
Reticulocytes 0.2 – 2.0 %
White blood cells (WBC)
WBC 3.7 – 9.3 x 109 /L
Neutrophils 1.8 – 6.2 x 109 (40 – 80%) /L
9
Lymphocytes 1.0 – 3.2 x 10 (20 – 40%) /L
Monocytes 0.2 – 0.7 x 109 (< 10%) /L
9
Eosinophils 0.0 – 0.5 x 10 (< 5%) /L
9
Basophils 0.0 – 0.2 x 10 (< 1 - 2%) /L
Platelets
Platelet 150 – 450 x 109 /L
*: Values that are bolded are reviewed according to the newest definition in uptodate
Clotting profile
PT 9.3 – 12.1 s
APTT 25.0 – 31.3 s
INR < 1.0
D-dimer < 0.5 mg/L
Fibrinogen 2–4 g/dL
Electrolyte profile
+
Na 136 – 148 mmol/L
K+ 3.6 – 5.0 mmol/L
Cl- 100 - 109 mmol/L
Ca2+ 2.11 – 2.55 mmol/L
PO43- 0.89 – 1.45 mmol/L
6
, Lipid profile
Total cholesterol Desirable < 5.2 mmol/L
Borderline high 5.2 – 6.1 mmol/L
High ≥ 6.2 mmol/L
LDL Optimal < 2.6 mmol/L
Near optimal 2.6 – 3.3 mmol/L
Borderline high 3.4 – 4.0 mmol/L
High 4.1 – 4.8 mmol/L
Very high ≥ 4.9 mmol/L
Triglycerides Normal < 1.7 mmol/L
Borderline high 1.7 – 2.2 mmol/L
High 2.3 – 5.5 mmol/L
Very high ≥ 5.6 mmol/L
HDL Low < 1.0 mmol/L
High ≥ 1.6 mmol/L
Liver function test (LFT)
AST 15 – 38 U/L
ALT 8 – 58 U/L
ALP 42 – 110 U/L
GGT 11 – 62 U/L
Total bilirubin 4 – 23 μmol/L
Conjugated bilirubin <6 μmol/L
Albumin 39 – 50 g/L
Renal function test (RFT)
Urea 3.1 – 7.7 mmol/L
Creatinine 67 - 109 μmol/L
GFR ≥ 90 (90 – 120) mL/min/1.73m2
Thyroid function test (TFT)
TSH 0.35 – 4.80 mIU/L
fT4 12 – 23 mmol/L
7
, Arterial blood gas
pH 7.35 – 7.45
PO2 10.6 – 14.0 kPa
PCO2 4.7 – 6.0 kPa
HCO3- 22 – 26 mmol/L
Base excess -4 - +2 mmol/L
Others
Total protein 68 – 84 g/L
Globulin 24 – 36 g/L
CK 260 – 530 U/L
LDH 118 – 221 U/L
ESR ♂ Age / 2 mm/hr
♀ (Age + 10) / 2 mm/hr
8
, Illustrate textbook of paediatrics: Normal child development
I. Basic paediatrics knowledge
1. Classification of age
Neonate: < 4 weeks
Infant: < 1 year
Toddler: 1 – 2 years
Young child: 2 – 5 years
Older child: 6 – 9 years
Adolescent: 10 – 19 years (WHO)
2. Respiratory rate in children
Tachypnea in different age groups
• Age < 2 months: > 60 breaths/min
• Age 2 – 12 months: > 50 breaths/min
• Age 1 – 5 years: > 40 breaths/min
• Age ≥ 5 years: > 20 breaths/ min
Age Normal Tachypnea
Neonates < 4 weeks 30 – 50/ min > 60/ min
Infants < 1 year 20 – 30/min > 50/ min
Young child 2 – 5 years 20 – 30/min > 40/ min
Older child 6 – 9 years 15 – 20/min > 30/ min
Age Normal (PEWS)
Infants 1 – 12 months 30 – 50/ min
Toddlers 1 – 3 years old 20 – 40/ min
Pre-school 4 – 6 years old 17 – 33/ min
School age 7 – 12 years old 15 – 30/ min
3. Pulse rate in children
Age Normal
< 1 year 110 – 160/ min
2 – 5 years 95 – 140/min
5 – 12 years 80 – 120/min
> 12 years 60 – 100/min
Age Normal (Uptodate)
0 – 6 months 110 – 180/min
6 months - 1 year 110 – 160/ min
1 – 2 years 90 – 150/min
2 – 5 years 80 – 140/min
5 – 12 years 70 – 120/min
> 12 years 60 – 100/min
4. Blood pressure in children
Age Upper limit of normal of systolic BP
< 1 year 110 mmHg
2 – 5 years 120 mmHg
9
,II. Developmental milestones
1. Background
4 fields of developmental function
• Development milestones refers to acquisition of important developmental skills
• Normal pattern for acquisition of skills are
o Sequentially constant
o Varies in rate between children
Median age and limit age
• Median age
o A guide to the pattern to expect in normal development
o Refers to the age when half the population acquire the skill
• Limit age
o A guide to the necessity for further assessment and examination
o Refers to the age when a skill should have been acquired
o Calculated as “Mean + 2 SDs”
Adjustment for preterm infants
• Assessment of development age according to the expected date of delivery
• Correction is no longer required after about 2 years of age when number of weeks early
the child was born no longer a significant proportion of the child’s life
2. Developmental milestones by median age
Age Gross motor Vision and fine Hearing, speech and Social, emotional
motor language and behavioral
7 months Sits without Transfer objects from Turns to voices Puts food into mouth
support one hand to another Polysyllabic babble Fears strangers
1 year Stands Pincer grip 1st meaning word Drinks with a cup
independently Wave bye-bye
15 – 18 Walks Scribble 6 – 10 words Hold spoon and gets
months independently (18 months) food safely to mouth
(12 – 18 months)
2.5 years Runs and jumps Draws 4-word sentence Dry by day
Parallel play
10
, III. Hearing
1. Hearing checklist
Time Description Example
Shortly after birth Startles and blinks at sudden noise Slamming of door
By 1 month Notices sudden prolonged sound Vacuum cleaner
By 4 months Smiles to sound of parent’s voices even when it is
out of sight
By 7 months Turns immediately to voices
By 9 months Listens attentively to familiar everyday sound
Searches for quiet sounds out of sight
Show pleasure in babbling loudly and tunefully
By 12 months Respond to own name and other familiar words
Respond when you say “no” or “bye-bye”
2. Hearing screening for newborn infants
Evoked otoacoustic emission (EOAE)
• Advantages
o Simple and quick to perform
• Disadvantages
o Affected by ambient voice
o Not a test of hearing but a test of cochlear function
o Misses auditory neuropathy since CN VIII and brain are not tested
11
