Physical and psycho motor development of children of different age groups

IVANO-FRANKIVSK NATIONAL MEDICALIVANO-FRANKIVSK NATIONAL MEDICAL
UNIVERSITYUNIVERSITY
CHAIR OF CHILDREN’S SURGERY ANDCHAIR OF CHILDREN’S SURGERY AND
PROPEDUTICSPROPEDUTICS OF PEDIATRICSOF PEDIATRICS
Physical and Psycho-motor Development of
Children of Different Age Groups. Principles
and Methods of Assessment of Physical
Development of Children. Semiotics of
Physical and Psycho-motor Development of
Children.

PLAN OF THE LECTURE
 Indications of physical development of mature
and premature child.
 Objective laws of increasing the mass and
length of the body, chest and head
circumference in different age periods.
 Semiotics of physical development disturbances.
 Notion about acceleration and deceleration.
 Psycho-motor development of children in
different ages.
 Semiotics of psycho-motor development
disturbances.

Physical development (PD)
is a dynamic process of growth (increase of the
mass and length of the body, different parts of
the body) and biological maturation of the child
in one or another period.
Physical development is a sum of morphological
and functional signs of the organism,
characterizing the height, mass, the shape of the
child’s body, its morpho-structural properties.

Physical development
 World Health Organization (WHO) considers physical
development of a child as a summing indicator of the
condition of health of a separate child and a population,
and indications of physical development of early age
children as a criterion of assessment of social-economic
development of a definite region or a whole country.
 WHO considers monitoring a physical development of
early age children one of the most effective measures,
carried out by medical workers on the decreasing the
degree of mortality and morbidity of early age children.

Indications of physical
development of a newborn child
 Average body mass of boys at birth is
3200-3400g, and that of the girls is 3100-
3300g, head circumference – 34-36cm,
chest circumference -32-34cm. The weigh
of a child is influenced by factors:
 the health of the mother, conditions of
living, food, work;
 the health of the fetus;
 constitutional and genetic factors.

Physiological loss of the body mass
 Develops in the first 4 days and is caused by:
 large extrarenal loss of water by evaporating through the skin,
through the lungs while breathing;
 discharge of the first feces and urine;
 vomiting of the swallowed around uterine waters;
 drying up of the umbilical remnant;
 starving in the first hours.
 There are 2 types of the mass increasing:
 “ideal” type – renovation of the body mass takes place on the
7-8th
day (is noted in 20-25% of newborns);
 Slowed-up type – in 75-80% of children, slow gradual
reconstruction of the primary weight of the body during 14-15
days.
 Physiological is considered loss of 9% of primary body mass.

Weighing of a child
 The body mass is measured on the scales for
weighing breast fed babies (shoot scale). For this
matter the scale is installed horizontally and evenly.
Then the wrap is weighed and put on the scale, a
naked baby by the head and shoulder blade is put
on the wide part and by the legs on the narrow part
of the scale. For determining the body mass from
the total weight is taken away the weight of the
wrap. The body mass of children older 3 years is
measured on medical scale. The child must stand
and step out from the scale under fixed unmovable
beam.

Objective laws of increasing the
body mass
 Up to 6 years:
 Body mass (BM) = Mass (M) at birth + 700xn
 After 6 months up to 1 year: BM= weight at 6
months+ 500x(n-6), where n – number of
months.
 Doubling of body mass comes in 4-5 months,
three times – in 1 year.
 After 1 year up to 10 years: BM= 10+2n.
 After 10 years: BM = 30+4(n-10), where
n – number of years.

Measuring the height
The length of the body under one year is measured with
horizontal height meter which represents a wide board
with a length up to 100cm and width – 40cm. Over the
board there is immovable oblique strip of wood, under
the board – movable plank, which easily moves. For
measuring the length of the body the baby is put on the
back, the top of the head being in touch with immovable
oblique plank. In this the head is fixed in the following
way: the upper end of external ear and the lower end of
eye orbit are in one vertical plane. The legs of the child
must be straight and stand close to the board of height
meter. The feet are bent under right angle, the movable
board of the height meter is taken close to them. The
distance between the planks presents the length of the
body.


Measuring the height
 The height of the children of older age is
measured with special height meter. The child
stands on the plane of the device and touches
its vertical board, which has 2 scales (for
measuring the height in sitting position to the
right and for the height in standing- to the left).
The child must stand straight, the arms
hanging down, heels together, touching with
heels , buttocks, and shoulder-blades the part
of the board with divisions. The head is held in
the way that the lower end of eye orbit and
upper end of external ear are in one plane.
The plank of height meter is moved down
without pressure up to the head. The height is
accounted from the lower end of the plank.

Objective laws of body length
increase
The medial body length of a mature newborn childThe medial body length of a mature newborn child
comprises 51-54 cm.comprises 51-54 cm.
In the first year of life the speed of growth of a childIn the first year of life the speed of growth of a child
changes every quarter: in the first quarter the heightchanges every quarter: in the first quarter the height
increases by 3cm every month, in the second –by 2,5cmincreases by 3cm every month, in the second –by 2,5cm
every month, in the third –by 2cm every year and in theevery month, in the third –by 2cm every year and in the
forth quarter – by 1-1,5 cm every month.forth quarter – by 1-1,5 cm every month.
During the first 2-4 years of life the body length increasesDuring the first 2-4 years of life the body length increases
by 8 cm every year and to the end of the 4th year itby 8 cm every year and to the end of the 4th year it
comprises 100cm. From the 5th year and up to thecomprises 100cm. From the 5th year and up to the
beginning of sexual maturation period the body lengthbeginning of sexual maturation period the body length
increases in average by 6 cm, and in pubertal period –byincreases in average by 6 cm, and in pubertal period –by
8-12 cm a year.8-12 cm a year.

Measuring the head
circumference
 For measuring the head circumference a
cm strip is put horizontally through the
occipital nodule in the back and on the
forehead over the eyebrows.

Objective laws of increasing of
the head circumference
In a mature newborn child the head circumferenceIn a mature newborn child the head circumference
is an average 34-36 cm.is an average 34-36 cm.
In the first half a year the head circumferenceIn the first half a year the head circumference
increases by 1,5 cm every month, in the secondincreases by 1,5 cm every month, in the second
– by 0,5 cm every month. In children at the age– by 0,5 cm every month. In children at the age
from1 to 10 years the head circumferencefrom1 to 10 years the head circumference
increases by 1cm every year. So, the headincreases by 1cm every year. So, the head
circumference of a child at the age of 6 monthscircumference of a child at the age of 6 months
comprises 43cm, 1 year – 46 cm, 5 years – 50comprises 43cm, 1 year – 46 cm, 5 years – 50
cm,10 years -55 cm.cm,10 years -55 cm.

 The chest circumference is measured in the state of
complete rest. A cm strip is put on the back under the
angle of shoulder blades, and in the front- along the
lower end near the nipple circles. In girls with developed
breast glands the cm strip is put on the level of upper
end of IY rib over the breast glands. The arms of the
child must be put down along the body. It is necessary to
follow that the child does not take up his shoulders, does
not take the arms in front or in the side.

Objective laws of chest
circumference increase
At the time when a mature child is born theAt the time when a mature child is born the
chest circumference comprises 32-34cm,chest circumference comprises 32-34cm,
during the first half a year it increases by 2during the first half a year it increases by 2
cm every month, second half a year – bycm every month, second half a year – by
0,5cm a month. At the age of 2-10 years0,5cm a month. At the age of 2-10 years
this index increases by1,5 cm every year,this index increases by1,5 cm every year,
in pubertal period – by 3cm a year. So, thein pubertal period – by 3cm a year. So, the
chest circumference comprises: at the agechest circumference comprises: at the age
of 6 months-45 cm, 1 year -48cm, 5 yearsof 6 months-45 cm, 1 year -48cm, 5 years
-55 cm, 10 years – 63cm.-55 cm, 10 years – 63cm.

Unevenness of child organism
growth in different age periods of
childhood is observed:
 1-4 years – the first period of roundness;
 The first period of stretching – 5-8 years;
 8-10 years – the second period of
roundness;
 The second period of stretching – 11-15
years.

Change of body proportions
of a child’s body
Embryo 2 mths Embryo 4 mths Newborn 2 years 6 years 12 years 25 years
Picture 7. Stages of body growth of a man:
The first 2 –before the birth (antenatal); the following 5 –after the birth (postnatal); age
changes of proportions of different parts of the body (according to Skemmon).

Assessment of physical
development
 is carried out by comparing of individual
indications of a child with normatives. The
first (fundamental), and in many cases the
only one method of assessment of
physical development of a child is carrying
on anthropometric research and
assessment of obtained data. In this 2
main methods are used: oriented
calculations and anthropometric
standards.

Method of oriented calculations
 is based on the knowledge of the main objective
laws of increase the body mass and length, the
head and chest circumferences. Corresponding
normative indices can be calculated for a child of
any age. Assumption interval of deviations of the
actual data from the calculated one comprises
+10% for average indications of physical
development. The method gives only
approximate picture about physical development
of children and is used by pediatrics, as a rule,
in a case of giving medical assistance at home.

Method of anthropometric
standards
 is more accurate as individual anthropometric indications
are compared with normative ones corresponding to the
age and sex of achild. Regional tables of standards are
of 2 types: sigmal and centile.
 While using the tables composed according to sigmal
standards method comparing of actual indications is
carried out with medial arithmetic value (M) for the given
sign of the same age-sex group, to which belongs the
given child. The obtained difference is expressed in
sigmas (b – is the medial quadratic deviation),
determining the degree of deviation of individual data
from their medial value.

Method of anthropometric
standards
 In using the tables, composed according to the
method of centile standards, it is necessary to
determine centile interval, to which belongs the
actual value of the sign, taking into account the
age and sex, and give the assessment. It is
simple in the use, does not require calculations,
makes it possible to assess interconnection
between different anthropometric indications and
is widely used.

The scale of assessment of physical
development of children with different
methods
Assessment of
physical development
Method of signal
standards
Method of centile
standards
Very high -- Over 97 centiles
High More than +δδ 90-97 centiles
Higher than average From M+1,1δδ to M+2δδ 75-90 centiles
Average М± 1δМ± 1δ 25-7525-75 centiles
Lower than average From М-1,1δ to М-2δFrom М-1,1δ to М-2δ 25-1025-10 centiles
LowLow From М – 2,1δ andFrom М – 2,1δ and
lowerlower
10-310-3 centiles
Very lowVery low -- Less than3Less than3 centiles

ASSESSMENT OF PHYSICAL DEVELOPMENTASSESSMENT OF PHYSICAL DEVELOPMENT
ORDER N 149 OF MPH OF UKRAINE “ABOUTORDER N 149 OF MPH OF UKRAINE “ABOUT
CONFIRMING CLI ICAL PROTOCOL OF MEDICA ofCONFIRMING CLI ICAL PROTOCOL OF MEDICA of
disturbances L CARE ABOUT A HEALTHY CHILD ATdisturbances L CARE ABOUT A HEALTHY CHILD AT
THE AGE UP TO 3 YEARS”THE AGE UP TO 3 YEARS”

Semiotics of height disturbances
Decrease of height can be caused by:
Diseases during pregnancy;
Hydrocephaly, microcephaly;
A number of diseases, when the nervous system and different organs
are disturbed;
Starvation, malabsorption;
Congenital heart and respiratory organs failure;
Kidney anomalies, tubulopathias;
Diseases connected with metabolism;
Endocrine diseases: hypothyrosis, hypophysial nanism, congenital
disturbances in the functions of adrenal glands- growing stops after 11-
12 years;
Hereditary diseases (Dawn disease, Shereshevski-Terner disease);
Diseases of the bones: chondrodystrophy- short extremities with
shortened proximal parts, the body is of normal size;
Uncompleted osteogenesis – multiple fractures.

Semiotics of height
disturbances
Semiotics of high stature
 Often such deviations are called acceleration, but in
acceleration the body structure is proportional, sexual
maturation has normal terms.

 - Giantism – overproduction of somatotrophic hormone
(STH) during the diseases of hypophysis. As a rule, in
parallel – hypofunction of sex glands (syndrome of
 Kleinfelter).
 Arachnodactilia (Morphan syndrome) –
mesodermadystrophy – high stature, thin body with long
and thin extremities. The arms spread is higher than the
length of the body, spiderlike fingers, chaotic joints.

Semiotics of changing the body mass
 Dystrophy: hypotrophy or paratrophy.
 Hypotrophy – decrease of body mass in normal height.
Reasons of hypotrophy:
 Alimentary character.
 Malabsorption syndrome.
 In older children – anorexia (under neuro-arthritic diathesis).
 Nervous anorexia.
 Mucoviscidosis.
 Celiakia.
 Violation of metabolism –Diabetes mellitus, nonsugar diabetes,
thyrotoxicosis, galactosemia.
 Intestinal infections.
 Tumors.
 Gastrointestinal tract (GIT) development anomalies, anomalies of
cardiovascular system development.

Semiotics of changing the
body mass
Degrees of hypotrophy
 1 degree -body mass deficit comprises 11-20%;
 2 degree - body mass deficit comprises 21-
30%;
 3 degree - body mass deficit comprises 31%
and more.

body mass
 Paratrophy – increase of the body mass.
 Reason – overfeeding, diseases of
metabolism and endocrine system.

body mass
 Hypostature – chronic violation of nutrition with steady
lacking of the child in body mass and in the stature. In
this nourishment of the baby can be totally
satisfactory. For hypostature is characteristic that the
child in his physical and psychomotor development is
behind of the same age children. Hypostature is
typical for children with congenital heart failure, grave
encephalopathy (diseases of central nervous system,
arising in the intrauterine period because of
unsatisfactory conditions for the development of fetus),
endocrine violations, some hereditary diseases. After
the reason of hypostature is eliminated the children
can overtake the same age healthy children in
physical development.

Physical culture and training the
children
 This is action of factors promoting increasing unspecific
reactivity and resistance and adaptation.
 Physiological basis of steeling the organism is stimulation of
defense reactions, active production of new conditioned
reflexes on steeling irritant. In this take part:
 The power of the epidermal layer.
 Blood supply, functions of sweat and sebaceous glands.
 The level of the main exchange.
 Skin temperature.
 Sympathetic adrenal system, protecting homeostasis.
 Integral effect of training is fitting the health of a person,
increasing the defense against catching cold and increasing
the labor ability.

Principles of training the
organism:
 Gradualness;
 Individuality - taking into account the age, climatic
conditions, state of health;
 Systemness;
 Continuousness - training effect is achieved in 2 months,
disappears in 2-3 weeks;
 Diversity ( to warmness and cold (short time intensive
cooling trains the process of heat giving out, weak and
medial - a process of heat production.
 So there is necessity not only in different factors, but
also in a diversity of the same factor (different
temperature regimens).

Psychomotor development of a
child
 Expresses the becoming of different areas of the nervous
system of a child in particular periods of life. The assessment
of psychomotor development of a child is carried out during
every prophylactic check up using a table, in which age
peculiarities of psychomotor development of a child are given.
 Assessment of psychomotor development of a child is carried
out on the following criteria:
 Motorics -purposeful manipulation activity of a child ;
 Statics -fixation and holding of definite parts of the body in
necessary position;
 Sensory reactions - formation of corresponding reactions on
light, sound, pain, touch;
 Speech - expressive speech and understanding the speech;
 Psychic development - positive and negative emotions,
formation of social age.

Peculiarities of PMD of newborn
children
 For newborns are characteristic uncoordinated
athetoselike movements of extremities, rigidness
of muscles, physiological hypertonus of
muscles-benders, loud cry. Hearing is
decreased, feeling of pain is weakened.
Besides, neuro-psychic development of a
newborn child is characterized by the presence
of a number of unconditioned reflexes.

Reflexes of newborn period
1) steady life long automatisms (exist during the whole life):
Swallowing;
Tendon reflexes of extremities;
Cornea;
Conjunctive;
Orbiculopalpebrale.
2) Transitory (exist after the birth and afterwards gradually
disappear):
Oral segmentary automatisms (swallowing, seeking, palm-oral-head
or Babkin reflex);
Spinal segmentary automatisms (defense, support, automatic
walking, catching reflex of Robinson, reflexes of Moro, Kernig,
crawling reflex of Bauer, reflexes of Babinski, Halant, Peres.

 Swallowing reflex lasts up to 10-12
months. It can be brought about putting a
baby’s dummy on a mouth of a newborn,
the baby makes swallowing movements.

 Seeking reflex - on stroking the baby’s skin in
the area of the angle of the mouth he moves
his head, moves down his lower lip and
moves his tongue to the irritant. Is kept by 3-
4 months.

 Palm-mouth-head reflex (Babkin) – in pressing
with big fingers on palms in the area of the
mounds of big fingers of a baby, he opens his
mouth and bend his head forward to the breasts.
Lasts 2-3 months.
 Defense reflex – if a newborn is put on his
abdomen he reflectory turns his head in side. Is
kept up to 2 months of life.

 A catching reflex - on touching the palms of the
baby with fingers he catches them and holds
firmly, in this the child can be lifted over the
plane. The reflex lasts for 3-4 months.

 Babinski reflex - on irritating
the sole of the baby on the
outside of the foot from the
heel to the base a big finger
slow straightening up of the
big finger and bending the
other fingers takes placer.
This reflex is supposed to
be physiological up to 2
years age.

 Supporting reflex acts in the
following way: the doctor holds
the baby with his
 armpit spaces from the back
and with the same fingers
protects the head. In lifting the
baby in this position he bends
the legs in knee and malleolus
joints. On dropping down the
baby on some support he
presses on it with a whole foot.
This reflex is physiological up
to 2 months period.

 Reflex of
 automatic walking -
on bending the
baby’s body in a
position of
protecting reflex he
makes steps
forward. The reflex
disappears in 2
months.

 Crawling reflex of Bauer -
in a position on the
abdolmen the baby tries to
lift his head and makes
crawling movements. If you
put your hands under the
baby’s feet he will actively
push off with legs from your
hands. The reflex lasts 4
months.

 Peres reflex - if the baby is put on
his side and move your hand from
the coccyx to the neck along the
bony parts of the spine this causes
short apnoe in the baby, then a
sharp cry, lordosis, bending of
extremities, hypertonus of the
muscles, sometimes defecation and
urination. This reflex is checked up
at the end of examination as it
causes pain in a baby. This reflex is
supposed to be physiological the
first 3-4 months of the baby’s life.

 the third group of reflexes, which are formed not at once
after the birth, but in the definite months of life. These
reflexes are called determining automatisms. This group
of reflexes includes the upper and lower posotonic
reflexes of Landau, simple cervical and trunk
determining reflexes, chain determining reflex from trunk
to trunk.
 The upper posotonic reflex of Landau - in a position of a
baby on the abdomen he rises his head, the upper part
of his trunk and, supporting with his hands, stays in this
position. This reflex appears at the age of 3-4 months.

Psychomotor development
Age Motility Statics Sensory
reactions
Speech Emotions
and social
behavior
1 month1 month PhysiologicalPhysiological
hypertone ofhypertone of
muscles ismuscles is
decreased,decreased,
atetoselikeatetoselike
movementsmovements
of extremitiesof extremities
fade. Expressedfade. Expressed
unconditionedunconditioned
reflexes.reflexes.
BeginsBegins
holdingholding
the headthe head
for somefor some
minutesminutes
in horizontalin horizontal
position,position,
lies on thelies on the
abdomenabdomen
at the end ofat the end of
the month.the month.
AppearsAppears
shorttimeshorttime
looking onlooking on
around thearound the
surroundingssurroundings
and hearingand hearing
fixation.fixation.
ArisingArising
simglesimgle
soundssounds
at theat the
end ofend of
a month,a month,
pronouncepronounce
vowelvowel
soundssounds
from ‘a’from ‘a’
to ‘e’.to ‘e’.
ReactsReacts
negativelynegatively
onon
strongstrong
soundsound
and lightand light
irritants.irritants.
Having seenHaving seen
a new face,a new face,
hehe
fixes on itfixes on it
for afor a
moment.moment.

reactions
Speech Emotions
and social
behavior
3 month3 month Majority ofMajority of
reflexes beginreflexes begin
to disappearto disappear
(seeking,(seeking,
Babkin,Babkin,
catching andcatching and
others).others).
Stretches outStretches out
for a toy.for a toy.
Muscular toneMuscular tone
is normalized.is normalized.
Holds theHolds the
head well.head well.
In theIn the
reaction onreaction on
soundsound
irritants andirritants and
brilliantbrilliant
subjectssubjects
appearsappears
fixing up hisfixing up his
eyes oneyes on
them, activethem, active
reaction.reaction.
Frequent,Frequent,
lastinglasting
sounds.sounds.
The firstThe first
chains ofchains of
soundssounds
“rrr”.“rrr”.
AnswersAnswers
withwith
complex ofcomplex of
excitementexcitement
onon
emotionalemotional
communicacommunica
tion. Socialtion. Social
smile.smile.

reactions
Speech Emotions
and social
behavior
4 month4 month AppearAppear
directeddirected
movements ofmovements of
arms: betterarms: better
takes a toy.takes a toy.
Turns fromTurns from
back to hisback to his
side.side.
DisappearDisappear
most ofmost of
reflexesreflexes
(Moro,(Moro,
crawling,crawling,
catching).catching).
In verticalIn vertical
positionposition
appear theappear the
firstfirst
manifestatimanifestati
ons ofons of
supportingsupporting
by theby the
legs. In alegs. In a
position onposition on
thethe
abdomen –abdomen –
confidentconfident
support onsupport on
thethe
forearms.forearms.
A complex ofA complex of
excitementexcitement
whilewhile
meetingmeeting
closeclose
relatives. Forrelatives. For
the first timethe first time
begins tobegins to
recognizerecognize
the mother.the mother.
LooksLooks
attentivelyattentively
on a toy inon a toy in
the hand.the hand.
Frequent,Frequent,
lastinglasting
singingsinging
likelike
differentdifferent
sounds.sounds.
Appear lipAppear lip
consonanconsonan
ts “m”,ts “m”,
“b”,“b”,
shouts ofshouts of
joy.joy.
LoudlyLoudly
laughs in alaughs in a
reply toreply to
emotionalemotional
oraloral
appeal.appeal.

reactions
Speech Emotions
and social
behavior
6 month6 month Actively turnsActively turns
from the backfrom the back
to theto the
abdomen,abdomen,
begins to turnbegins to turn
from thefrom the
abdomen onabdomen on
the back.the back.
CatchesCatches
purposefully apurposefully a
proposed toy,proposed toy,
puts it fromputs it from
one hand toone hand to
another.another.
In aIn a
position onposition on
thethe
abdomenabdomen
he ishe is
supportedsupported
by theby the
stretchedstretched
arms orarms or
fully openfully open
palms.palms.
Begins toBegins to
sit downsit down
throughthrough
turning onturning on
the backthe back
leaning onleaning on
the arm.the arm.
MoreMore
adequateadequate
reaction onreaction on
thethe
appearanceappearance
of theof the
mother,mother,
father or afather or a
strangestrange
person.person.
Follows withFollows with
the eyesthe eyes
after a toy,after a toy,
which fellwhich fell
down.down.
Speaking:Speaking:
consecuticonsecuti
veve
connectinconnectin
g ofg of
differentdifferent
expresseexpresse
dd
syllablessyllables
withwith
changingchanging
thethe
strengthstrength
of soundof sound
andand
stress ofstress of
the tone.the tone.
EmotionsEmotions
areare
differentiatdifferentiat
ed,ed,
stretchesstretches
his arms tohis arms to
be takenbe taken
on theon the
hands.hands.
DifferentlyDifferently
behavesbehaves
with closewith close
people andpeople and
strangers.strangers.

reactions
Speech Emotions
and social
behavior
8 month8 month Catches withCatches with
each hand aeach hand a
brick andbrick and
holds it firmlyholds it firmly
for some shortfor some short
time.time.
Crawls onCrawls on
thethe
abdomen,abdomen,
stretchingstretching
the armsthe arms
ahead.ahead.
UnassistedUnassisted
sits down,sits down,
lies down,lies down,
gets up.gets up.
After definiteAfter definite
bringing upbringing up
shows withshows with
hands “goodhands “good
bye”, with abye”, with a
nod of thenod of the
head gives ahead gives a
sign of agreesign of agree
-“yes” or-“yes” or
negation -negation -
“no”.“no”.
PrattlesPrattles
with joy,with joy,
pronouncpronounc
es thees the
soundssounds
“ba”,“ba”,
“ma”,“ma”,
“yes”.“yes”.
AdequateAdequate
emotionalemotional
reactionsreactions
on reply ofon reply of
conversatioconversatio
n. Followsn. Follows
the actionsthe actions
of the otherof the other
children,children,
laughs,laughs,
prattles.prattles.

reactions
Speech Emotions
and social
behavior
1010
monthmonth
The number ofThe number of
purposefullpurposefull
movementsmovements
increases:increases:
composes acomposes a
pyramid, putspyramid, puts
the toys inthe toys in
their places,their places,
etc. “Pincer”etc. “Pincer”
catching -catching -
takestakes
somethingsomething
with a thumbwith a thumb
and indexand index
finger.finger.
He can beHe can be
takentaken
supportedsupported
on oneon one
hand.hand.
Crawls onCrawls on
surfaces ofsurfaces of
differentdifferent
height,height,
manymany
childrenchildren
can standcan stand
supportedsupported
with somewith some
subject.subject.
MoreMore
expressedexpressed
and enrichedand enriched
are theare the
indicatedindicated
things.things.
Repeats theRepeats the
movementsmovements
of adultof adult
people,people,
“Speaks on“Speaks on
the phone”,the phone”,
“Mixes the“Mixes the
porridge”.porridge”.
ThrowsThrows
away a toy.away a toy.
The firstThe first
wordswords
appear,appear,
which thewhich the
childchild
understandsunderstands
. In the. In the
vocabularyvocabulary
there arethere are
somesome
words.words.
CorrectlyCorrectly
repeats therepeats the
words saidwords said
by an adultby an adult
person.person.
DifferentiatDifferentiat
ed mimicaled mimical
movementsmovements
, voice, voice
reactions.reactions.
Reacts onReacts on
everythingeverything
new. Playsnew. Plays
withwith
childrenchildren
with onewith one
toy.toy.

reactions
Speech Emotions and
social behavior
1212
monthmonth
Can playCan play
with toyswith toys
duringduring
an houran hour
or more.or more.
WalksWalks
along thealong the
furniture,furniture,
assistedassisted
on oneon one
hand orhand or
unassisteunassiste
d at all.d at all.
Fulfills moreFulfills more
and moreand more
complicatedcomplicated
demands ordemands or
requests,requests,
understandinunderstandin
g them.g them.
More andMore and
moremore
demonstratiodemonstratio
ns ofns of
reactions onreactions on
thethe
surroundingssurroundings
..
The first wordsThe first words
appear, whichappear, which
the childthe child
understands. Inunderstands. In
the vocabularythe vocabulary
there are somethere are some
words.words.
CorrectlyCorrectly
repeats therepeats the
words said bywords said by
an adultan adult
person.person.
Voabulary - 8-Voabulary - 8-
10 words.10 words.
Gives a toy toGives a toy to
another child,another child,
doing this hedoing this he
smiles or laughssmiles or laughs
and prattles.and prattles.
Seeks the toys,Seeks the toys,
which arewhich are
hidden. Onhidden. On
request herequest he
embraces theembraces the
parents, waitsparents, waits
for some praise,for some praise,
confirming hisconfirming his
success by asuccess by a
close person.close person.

 On the results of assessment of psychomotor
development of a child tactics is determined for
the following medical observation. If a child
fulfills all the actions characteristic for his age, it
is necessary to carry on consultation on the care
with the aim of development. If the child cannot
fulfill the proposed actions or there is delay in
appearing new skills, the mother must be taught
how to carry on studies with the child aimed at
development and how to use additional
stimulations for producing skills, which are
underdeveloped.

The doctor’s tactics according to the results of a
child’s psychomotor development assessment
Results of assessment Tactics
The indices of psychomotorThe indices of psychomotor
development are indevelopment are in
accordance with the child’saccordance with the child’s
age.age.
he following observation.he following observation.
Consultation on the care withConsultation on the care with
the aim of development.the aim of development.
Determined delay ofDetermined delay of
developing skills in a child ofdeveloping skills in a child of
1 month in the first year of1 month in the first year of
life.life.
Consultation on the careConsultation on the care
aimed at development andaimed at development and
carrying on correctioncarrying on correction
training. Repeated check uptraining. Repeated check up
in 1 month. If the revealedin 1 month. If the revealed
delay lasts by the repeateddelay lasts by the repeated
check up, there is a need incheck up, there is a need in
of a children’s doctor-of a children’s doctor-
neurologist’s consultation.neurologist’s consultation.

Results of assessment Tactics
Delay in arising the skills of 3Delay in arising the skills of 3
months in children at the agemonths in children at the age
from 1 to 2 years.from 1 to 2 years.
Consultation about the care aimedConsultation about the care aimed
at development and carrying onat development and carrying on
correction training.correction training.
Repeated check up in 1-3 months.Repeated check up in 1-3 months.
If determined the delay lasting,If determined the delay lasting,
there must be the children’s doctor-there must be the children’s doctor-
Delay in arising the skills of 6Delay in arising the skills of 6
months in children at the agemonths in children at the age
from 2 to 3 years.from 2 to 3 years.
Consultation on the care aimed atConsultation on the care aimed at
development.development.
Repeated check up in 2-6 months.Repeated check up in 2-6 months.
If the revealed delay is lasting, thereIf the revealed delay is lasting, there
is a need in children’s doctor-is a need in children’s doctor-
The doctor’s tactics according to the results of a
child’s psychomotor development assessment

Semiotics of psychomotor
development disturbances

Physical and psycho motor development of children of different age groups

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