At around three years of age, the public health care system here in Sweden likes to check up on kids’ development. Ingrid had her 3-year check yesterday. It was quite interesting.

There was the weighing and measuring, of course, plus some talk about eating habits and physical activity. (92.5cm and 15.5kg, which is a bit too chubby, so we’re going to keep a strict eye on sweets here, and try to find more ways to encourage physical activity.)

Then there was a very quick evaluation of gross motor ability – kick a ball (to check her balance) and jump up and down (to check the Achilles tendons).

The rest of the time was spent on cognitive and language skills.

First she was asked to draw something, and then to explain what she drew. (Ingrid’s drawing had some rather shapeless blobs that she said were a snail, a snail’s house, and a sun.)

Then six photos were put on the table in front of her, face down. She chose one at a time, turned it over, said what it was, and then had to answer a few questions about the picture. For example, when she picked up a photo of a mug, she was asked what goes in a mug (“a drink!”), what she likes to drink (“juice”) and what mum drinks (“she prefers milk”), and more in that vein.

She had some trouble giving the “right” answers about a photo of a woollen hat.
“Where does the hat go?”
“On the shelf.”
… at which point the nurse looked quite puzzled so I explained that indeed Ingrid’s hats mostly lie on the shelf because she’s so warm-blooded and rarely wears a hat, so the nurse could adjust her questions. (“Where do we put the hat when it’s really cold? On the foot?” – “No! On the head!”)

It was interesting to see what kind of things the questions aimed to uncover. General language skills were part of it – understanding spoken language and being able to respond – but also making sense of the world, understanding relationships between things, rules, how things “usually” work, etc.

It was also interesting to see how clearly Ingrid was aware that the nurse had specific expectations, and how uncomfortable she got when she couldn’t figure out the “right” answer. There was a photo of a ball, and the nurse asked her what we do with balls. “Throw them,” Ingrid said. What else? What can we do with our feet? The answer she wanted was “kick”, and Ingrid didn’t understand that that’s what she was fishing for, and got visibly squirmy and tense.

The verdict was, not unexpectedly, that her language skills were just fine. Not that there was any doubt about that.