Which of the following is a below developmental task in a 3 year old child?

Appeared in: NORCET -4 , 2023

Explanation

The inability to use a spoon properly at 3 years of age is considered a developmental delay.
Most children can feed themselves with a spoon by 18 months and are proficient by 2 years of age.
By age 3, a child is expected to feed themselves well and may even begin using a fork.
Therefore, not having this skill means the child is performing 'below' the expected developmental level for their age.

Option B: Copying a square is a fine motor skill expected around age 4 to 5. A 3-year-old is expected to copy a circle, not a square.
Option C: A 3-year-old can typically stand on one foot only momentarily. The ability to balance on one foot for a sustained period (5-8 seconds) is a milestone for a 4-year-old.
Option D: A 3-year-old can go up stairs alternating feet, but typically goes down stairs by placing both feet on each step. Alternating feet while going down stairs is a skill that develops around age 4.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of developmental delays in a 3-year-old child based on standard milestones as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in developmental screening during well-child visits to identify potential delays early.
Identifying a 'red flag' like the inability to use a spoon at age 3 warrants further assessment and potential referral to an occupational therapist or developmental specialist.
Early intervention is key to addressing developmental delays and improving long-term outcomes for the child.

How to Approach the Question

First, identify the key parameters of the question: the child's age (3 years) and the required level of development ('below').
The term 'below' is a critical keyword, indicating you are looking for a sign of a developmental delay, not an age-appropriate or advanced skill.
Recall the standard developmental milestones for a 3-year-old in both fine motor (hand skills) and gross motor (body movement) domains.
Evaluate each option against these milestones.
Option A: 'Not use proper spoon'. Spoon use is mastered by 18-24 months. Not having this skill at 3 years is a delay.
Options B, C, and D describe skills that are either emerging at age 3 or are mastered at age 4 or 5. Therefore, a 3-year-old not performing them is normal.

Concept Tested & Keywords

Concept Tested: Identification of developmental delays in a 3-year-old child based on standard milestones.
Stem keywords: developmental task, 3 year old child
Lead-in keywords: below
Clinical cues: The keyword 'below' indicates the question is asking for a sign of developmental delay, not a task that is age-appropriate or advanced.

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E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 2794-2796

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 30-32

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 130-132

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Attempt every question from this paper in a timed mock, then review the full solution for each one.