I never thought I’d say this, but we have too many “independent study times” this week. Self-directed learning is truly a double-edged sword.

Whether it’s the quarantine blues or just sheer laziness, I found myself with little to no motivation to study this afternoon.

The solution? Make studying creative!

My baby mnemonics

No matter how many times I sit through a lecture on developmental milestones, the key facts and red flags keep going through one ear and out the other.

One of our lecturers the other week had the brilliant idea of using visual mnemonics for the different developmental milestones. Dr. Cedeno, this is for you. Thank you for the challenge. 🥰

Back then, I was assigned to make a visual mnemonic for a 4-month old baby. This afternoon –stressed out, procrastinating, and bored all at the same time– I decided to simplify my drawing and make nine more.

I hope this helps other students or inspires others to make their own! This afternoon session of productivity and creativity was a breath of fresh air.

References: These are based on Nelson’s textbook of pediatrics, 21st edition, the IMCI guidelines on developmental screening, and also the Philippine Pediatric Society guidelines. I think it’s important to note that even within the same text, there can be inconsistencies. The average age of attainment and the upper limits differ depending on the source. Always treat patients as more than just a checklist!

What the visual aids mean

These visual aids obviously aren’t comprehensive; there are 4 or 5 or 7 development streams (depending on whom you ask). I challenged myself to incorporate at least 3 milestones total per age, covering more than one domain. It didn’t always work out that way.

Smiling 2-month old

• Description: a smiley face with “II” as the eyes.
• At around 1.5 months, babies learn to smile in response to voice and sound (social smiling)
• The roman numeral eyes (II) show how a 2 month old can visually fixate horizontally and vertically (in comparison, a 1bmonth old can fixate on a spot, and a 3 month old can follow circular movement)
• Babies can also follow moving objects up to 180 degrees (they can’t turn their heads for more; once they gain head tone, they can turn their heads to follow the sound even more).

Hungry 4-month old

• Description: it’s a baby with head turned to the right, looking at a piece of candy she is holding near her mouth. I tried.
• At 4 months old, babies normally have head tone (no more head lag; this is also seen in 3 month old babies when you try to pull them up).
• This also means there is no more asymmetric tonic neck reflex (the supine baby with head turned to the right will not extend her right arm and flex her left arm).
• Baby’s ready to eat! This includes smiling at the sight of food, discovering her hands and reaching out for objects.
• Baby’s hands are unfisted with voluntary grasp.
• So it’s super important for caretakers to watch out for foreign body aspiration. They can and will put everything in their mouths.

Sitting 6-month old

• Description: a sitting baby with a cute tummy.
• At around 5 months, babies have good truncal tone and the ability to roll over.
• They can sit up with decreasing or no support.

Crawling spider

• Description: a very lopsided number 8, with one circle as the head and another as the torso. She’s crawling on hands and knees.
• Spiders have 8 legs. At 8 months old, babies have joined the crawling club!
• This is due to good pelvic tone, so babies normally don’t drag themselves everywhere by their arms alone.
• Babies also might not smile at everyone due to stranger anxiety from 6 to 12 months.
• And if you try to magic their toy away in front of them, they’ll know and uncover the toy thanks to object permanence.
• They can pick up smaller objects with radial rake (radial palmar grasp develops from 6-7 months). They might also start developing their pincer grasp.

Wobbly X

• Description: it’s a wobbly number 10! In roman numeral form.
• Babies still need support as they stand and walk around (also known as cruising).
• Even their hands are little X’s –imagine they’re pincers, because this is the age where you’ll see a pincer grasp. Actually, pincer grasp begins developing earlier, around 8-9 months of age, but it gets refined by 10-12 months.
• With no visual tie whatsoever, 10 month old babies can also say mama and dada specifically, unlike 8 month old babies that will call anyone or anything as mama and dada.

First placer

• Description: it’s a baby with a serif ‘1’ torso, standing with stubby legs on top of a pedestal.
• At 12 months old, babies have their first word.
• They also take their first independent step into the wide world. Don’t be fooled by the steps of the pedestal; they can’t take stairs yet.
• They usually have wide-legged walking stance to keep themselves from falling over. Cute.

Missing 15 or 18 months…

• After 1 year old, just imagine that the podium will transform into stairs!
• Grossly, babies learn to crawl then walk up the stairs with one hand held, and also to stack up 6 cubes
• Vocabulary will blow up, and by 18 months, a baby can name more than 2 body parts. Yay!

Sticks spelling 24

• Description: the number 24 spelled out using sticks (one side colored, one side black) with the caption “baby loves sticks”.
• At 2 years old, babies can speak 2 to 3 word sentences, sometimes with subject/verb/object already. Referencing with an “I” comes later.
• They can also follow 2-step non-prepositional commands, but that’s not part of the drawing lol (they can do prepositional commands by 3 years old). Lo siento.
• In terms of pre-writing shapes, 24 month old babies can draw lines, hence the sticks.
• Half of the number is shaded, because babies at this age should be at least 50% understandable when speaking with unfamiliar adults (3 year olds should be 75% understandable and 4 year olds should be 100% intelligible).
• They also have a 50-word vocabulary (or thereabouts)

It’s a tricycle!

• Description: this is how I imagine tricycles look like. I think.
• It’s a receptive language red flag if the child can’t answer simple questions, like “what is this”.
• At 3 years old, young children can ride a tricycle. Not everyone has a tricycle, so maybe ask the baby to stand on one leg instead.
• Babies can draw circles and copy crosses, as in the wheels.
• The baby can count up to 3 of the same object, also as in these numbered wheels.

Negative space, number four

• Description: it’s an interior landscape of a toilet with a small window in the upper right corner. Part of the negative space creates the number 4.
• The toilet represents independent toileting, which the child should learn from 3 to 5 years old.
• This independence also includes feeding and dressing independence, as in holding a spoon, buttoning shirts, and putting on shoes.
• The window shows the ability to draw squares and crosses.
• The uneven lines throughout the drawing represents the ability to tell shorter versus longer lines.

A colorful pentagram house?

• Description: a colorful pentagram is divided into shapes, with a triangle roof, a door, and two irregular pieces for the front wall.
• To be clear, 5 year old babies can’t really draw pentagrams yet, but they can draw triangles as in the roof.
• The drawing is divided into spaces with different colors, as 5 year olds can now name 4 colors.
• And the bottom part of the pentagram is divided into 2 unequal parts, because children can now grasp concepts like which one is heavier.
• It’s almost a house if you squint. Children at this age love domestic play. (From 3 to 5 years old, the progression is from soli
• Time to go to preschool!!!

Sharing medical school tips

I think learning is best when it’s collaborative and creative. At ASMPH, there’s really a strong culture of helping each other up as much as possible.

Do you have any tips or tricks to share? Link them down below!

Stay safe and stay sane! 🥰