⇒ assess gait

let the child walk normally

observe the child walking in a straight line [tandem gait]

perform Romberg test; the student should let the child stand with feet close together and assess balance first with his eyes open and then closed

⇒ examination for eyes

inspect for nystagmus at rest

ask the child to follow a pen in all directions [pursuit eye movement] and see if nystagmus develops on movement

⇒ tests for coordination

finger to nose test or heel to chin [test, correct interpretation; no dysmetria/overshooting/tremor, bilaterally on right and left]

⇒ test for dysdiadochokinesia

perform rapid alternating movement

⇒ test speech

should talk with the child and see if there was monotonous speech

Down syndrome / trisomy 21

—> head circumference

—> low set ears

—> anterior fontanel exam

—> hands for simian crease

—> feet for space between toes