Normal development

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Normal development

  1. 1. NORMAL DEVELOPMENT OF A CHILD <ul><li>Dr. M.V.SINGH </li></ul><ul><li>MD (Paeds), DCH </li></ul><ul><li>Assistant Professor </li></ul><ul><li>Department of Pediatrics </li></ul><ul><li>UP Rural Institute of Medical Sciences Saifai, Etawah </li></ul>
  2. 2. DEVELOPMENT <ul><li>Definition : Maturation of functions. Related to myelination of the nervous system. </li></ul><ul><li>Variety of skills and optimal functioning </li></ul>
  3. 3. RULES OF DEVELOPMENT <ul><li>Development proceeds in cephalo-caudal direction </li></ul><ul><li>Sequence of development remains same </li></ul><ul><li>Development in different spheres may be dissociated </li></ul>Spheres of developments are- Gross motor, Fine motor Language and Social
  4. 4. DEVELOPMENTAL HISTORY <ul><li>Take developmental history in 4 different spheres </li></ul><ul><li>Gross motor </li></ul><ul><li>Fine motor </li></ul><ul><li>Language </li></ul><ul><li>Social </li></ul>
  5. 5. DEVELOPMENTAL HISTORY <ul><li>Developmental history should be age and case appropriate </li></ul><ul><li>Details should be asked in younger children age up to 3 years of age </li></ul><ul><li>Details should also be asked in those with developmental delay, MR and seizures </li></ul>
  6. 6. DEVELOPMENTAL HISTORY <ul><li>Ask about major milestones which mother likely to remember </li></ul><ul><li>Index case’s development should be compared with the other siblings and children of his age </li></ul>
  7. 7. Gross Motor Mile Stones <ul><li>Neck holding – 3 months </li></ul><ul><li>Sitting with support – 5 months </li></ul><ul><li>Sitting without support – 8 months </li></ul><ul><li>Standing with support – 9 months </li></ul><ul><li>Walking with support – 10 months </li></ul><ul><li>Crawling (creeping) – 11 months </li></ul><ul><li>Standing without support – 12 months </li></ul><ul><li>Walking without support – 13 months </li></ul><ul><li>Running – 18 months </li></ul><ul><li>Walking upstairs – 24 months </li></ul><ul><li>Riding tricycles- 36 months </li></ul>
  8. 8. Fine Motor Mile Stones <ul><li>Grasp a ring – 4 Month </li></ul><ul><li>Bidextrous grasp – 5 Month </li></ul><ul><li>Palmer grasp – 7 Month </li></ul><ul><li>Pincer grasp – 9 </li></ul><ul><li>Feeding self with spoon with some spillage – 15 Month </li></ul><ul><li>Puts on shoes and shocks – 2 yr </li></ul><ul><li>Drawing a vertical line – 2 yr </li></ul><ul><li>Drawing a circle – 3 yr </li></ul><ul><li>Drawing a cross – 4 yr </li></ul>
  9. 9. Developmental Mile Stones: language <ul><li>Turn head to sound – 1 Month </li></ul><ul><li>Cooing – 3 Months </li></ul><ul><li>Monosyllables – 6 Months </li></ul><ul><li>Bisyllables – 9 Months </li></ul><ul><li>Two words with meanings – 12 Months </li></ul><ul><li>Ten words with meanings – 18 Months </li></ul><ul><li>Simple sentence – 24 Months </li></ul><ul><li>Telling a story – 36 Months </li></ul>
  10. 10. Developmental Mile Stones: Social <ul><li>Social smile – 2 Months </li></ul><ul><li>Recognizing mother – 3 Months </li></ul><ul><li>Smiles at mirror image – 6 Months </li></ul><ul><li>Waves “bye-bye” – 9 Months </li></ul><ul><li>Plays a simple ball game – 12 Months </li></ul><ul><li>Knows gender – 36 Months </li></ul>
  11. 11. DEVELOPMENTAL QUOTIENT(DQ) <ul><li>Developmental Quotient (DQ)= </li></ul><ul><li>Developmental age X 100 </li></ul><ul><li>Chronological age </li></ul><ul><li><70% indicates developmental delay </li></ul>
  12. 12. <ul><li>Developmental delay vs regression </li></ul><ul><li>Global developmental delay </li></ul><ul><li>Differential developmental delay </li></ul><ul><li>Delay in motor development: Hemiplegia, Paraplegia, CHD, Rickets, floppy infants </li></ul><ul><li>Delay in speech: hearing impairment hypothyroidism, autism </li></ul>
  13. 13. Red Flag Signs In Child Development <ul><li>Mile stones </li></ul><ul><li>No visual fixation </li></ul><ul><li>No vocalization by </li></ul><ul><li>No sitting without support by </li></ul><ul><li>No standing alone by </li></ul><ul><li>No walking alone by </li></ul><ul><li>No single words by </li></ul><ul><li>Lack of imaginative play </li></ul><ul><li>Age </li></ul><ul><li>2 months </li></ul><ul><li>6 months </li></ul><ul><li>9-10 months </li></ul><ul><li>16 months </li></ul><ul><li>18 months </li></ul><ul><li>18 months </li></ul><ul><li>3 yrs </li></ul>
  14. 14. thank you TIME TO WAKE UP

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