DevelopmentDevelopment• The term child development is used toThe term child development is used todescribe the skill and capacity of functiondescribe the skill and capacity of functionacquired by children between birth and about 5acquired by children between birth and about 5years of ageyears of age• It is a qualitative change in the childIt is a qualitative change in the child’’ssfunctioning.functioning.• It can be measured through observation.It can be measured through observation.
By understanding what to expect during each stage of developmentBy understanding what to expect during each stage of development,,parents can easily capture the teachable moments in everyday life toparents can easily capture the teachable moments in everyday life toenhance their childs language development, intellectual growth, socialenhance their childs language development, intellectual growth, socialdevelopment and motor skillsdevelopment and motor skills..
NB/Chronological age, physical growth andNB/Chronological age, physical growth anddevelopmental skills usually evolve hand indevelopmental skills usually evolve hand inhand. Just as there are normal ranges forhand. Just as there are normal ranges forchanges in body size with age, so there arechanges in body size with age, so there areranges over which new skills are acquired.ranges over which new skills are acquired.
When considering developmental milestones:When considering developmental milestones: TheThe median agemedian age is the age when half of a standardis the age when half of a standardpopulation of children achieve that level; it serves aspopulation of children achieve that level; it serves asa guide to when stages of development are likely toa guide to when stages of development are likely tobe reached but does not tell us if the childs skills arebe reached but does not tell us if the childs skills areoutside the normal range.outside the normal range. Limit agesLimit ages are the age by which they should haveare the age by which they should havebeen achieved. Limit ages are usually 2 standardbeen achieved. Limit ages are usually 2 standarddeviations from the mean. They are more useful as adeviations from the mean. They are more useful as aguide to whether a childs development is normal thanguide to whether a childs development is normal thanthe median agesthe median ages
There are four fields ofThere are four fields ofdevelopmental skills todevelopmental skills to These are:These are: A. gross motorA. gross motor B. vision and fine motorB. vision and fine motor C. hearing, speech and languageC. hearing, speech and language D.social, emotional and behavioural.D.social, emotional and behavioural.
Gross motor skills are the most obvious initialGross motor skills are the most obvious initialarea of developmental progress. As fine motorarea of developmental progress. As fine motorskills require good vision, these are groupedskills require good vision, these are groupedtogether; similarly, normal speech andtogether; similarly, normal speech andlanguage development depends on reasonablelanguage development depends on reasonablehearing and so these are also consideredhearing and so these are also consideredtogether. Social, emotional and behaviouraltogether. Social, emotional and behaviouralskills are a spectrum of psychologicalskills are a spectrum of psychologicaldevelopmentdevelopment
gross motor development: an explosion ofgross motor development: an explosion ofskills during the first year of life ,large muscleskills during the first year of life ,large muscle vision and fine motor development: morevision and fine motor development: moreevident acquisition of skills from 1 yearevident acquisition of skills from 1 yearonwardsonwards hearing, speech and language: a big expansionhearing, speech and language: a big expansionof skills from 18 monthsof skills from 18 months social, emotional and behaviouralsocial, emotional and behaviouraldevelopment: expansion in skills is mostdevelopment: expansion in skills is mostobvious from 2.5 years.obvious from 2.5 years.
PEDIATRIC ASSESSMENTPEDIATRIC ASSESSMENTINSTRUMENTSINSTRUMENTSDENVER DEVELOPMENTAL SCREENINGDENVER DEVELOPMENTAL SCREENINGTEST(DDST)TEST(DDST)BAYLEY SCALES OF INFANTBAYLEY SCALES OF INFANTDEVELOPMENT(BSID)DEVELOPMENT(BSID) PEABODY MOTOR SCALESPEABODY MOTOR SCALESGROSS MOTOR FUNCTION MEASURESGROSS MOTOR FUNCTION MEASURES(GMFM)(GMFM)
Birth• Gross motoGross motorr:The newborns movement are:The newborns movement arerandom, diffuse and uncoordinated.random, diffuse and uncoordinated. Completehead lag• Visio&Fine motorVisio&Fine motor. Holds hand in fist. Holds hand in fist• Bright lights appear to be unpleasant toBright lights appear to be unpleasant tonewborn infant.Follow objects in line of visionnewborn infant.Follow objects in line of vision• Hearing &speechHearing &speech:The newborn infant:The newborn infantresponds to sounds with either cry or eyeresponds to sounds with either cry or eyemovement, cessation of activity and / or startlemovement, cessation of activity and / or startlereaction.reaction.
SocialSocial:The newborn infant expresses his:The newborn infant expresses hisemotion just through cry for hunger, pain oremotion just through cry for hunger, pain ordiscomfort sensation.discomfort sensation.
66--8weeks8weeks gross motorgross motor ::Pelvis flatterHeadControldeveloping but head nodingCurved back, needs supportCurved back, needs support vision and fine motorvision and fine motor ::Follows moving objects 180 degreFollows moving objects 180 degrehearing,& speechhearing,& speech ::listens to voice andlistens to voice andcooscoos SocialSocial:: Smiles on social contactSmiles on social contact
4months gross motorgross motor Lifts head and shoulders with weight onforearms no head lag when pulled to sittingno head lag when pulled to sittingposition,position, vision and fine motorvision and fine motor reaches for and graspsreaches for and graspsobjects andobjects andHolds a rattle and shakesPurposefullyHolds a rattle and shakesPurposefully brings them to mouthbrings them to mouth hearing,& speech :hearing,& speech :Laughs out loud, exited at sightLaughs out loud, exited at sightof food, may show displeasureof food, may show displeasureSocial :Social : social contact isocial contact i
6months gross motorgross motor Arms extended supporting chest offcouchSits with self proppingSits with self proppingStands with support Roles over, creep-crawlsStands with support Roles over, creep-crawls vision and fine motorvision and fine motor Reaches for and graspsReaches for and graspslarge objects,large objects, transfers object from Hand to handtransfers object from Hand to hand Hearing,& speechHearing,& speech forms polysyllabic vowel soundsforms polysyllabic vowel sounds Social:Social: Prefers mother, responds to changes inPrefers mother, responds to changes inemotional contentemotional content of social contactof social contact
99monthsmonthsgross motor:gross motor: Gets in to sitting position alone,crowlGets in to sitting position alone,crowlPulls to standing and standsholding onPulls to standing and standsholding on vision and fine motor:vision and fine motor: grasps objects withgrasps objects withthumb andthumb and forefinger (forefinger (Immature pincer graspImmature pincer graspHearing,& speech :Hearing,& speech :Double babble: dada mamaDouble babble: dada mamababababaSocial :Social :responds to sound of name,responds to sound of name,waves bye byewaves bye bye
1212monthsmonthsgross motor:gross motor: Stands, and walks withStands, and walks withone handheldone handheldvision and fine motor:vision and fine motor: Mature pincer graspGivesMature pincer graspGivesbricks to examinerbricks to examinerHearing,& speechHearing,& speech says a few words besides mamasays a few words besides mamaand dadaand dadaSocial :Social : plays simple ball games, makes posturalplays simple ball games, makes posturaladjustments toadjustments todressingdressing
1515monthmonthgross motorgross motor Walks independently andWalks independently andstoops to pick up objectsstoops to pick up objectsvision and fine motor:vision and fine motor: Builds a tower of twoBuilds a tower of twocubescubesHearing,& speechHearing,& speech 10 words ;No Ta Teddy Bed10 words ;No Ta Teddy BedDog, BottleDog, BottleSocial :Social : Drinks from a cupDrinks from a cup
22years ( 24 moyears ( 24 mo(;(; gross motor:gross motor: Runs up and down stairs oneRuns up and down stairs onestep at a timestep at a time vision and fine motor:vision and fine motor: Scribbles with a pencilScribbles with a pencil Hearing,& speechHearing,& speech Linking two words DaddyLinking two words Daddygone, Teddys tiredgone, Teddys tiredSocial :Social : Toilet trained by day Spoon-feedingToilet trained by day Spoon-feedingselfself
3year’s ( 36 mo( ;gross motor: ; Rides tricycle, stands momentarily onone foot.vision and fine motor:; copies a circle imitates a cross.Hearing,& speech knows age and sex, counts three objects correctly.Social; plays simple games with other children, washesDresses self (except buttons)hands.
4years (48 mo(;gross motor; Hops on one foot, uses scissors to cut outpictures.vision and fine motor; Copies circle and square, draws a man with2 to 4 partsbesides head.Hearing&Language; counts up to4 accurately,tells story.Social; plays with several children with the beginningof role play,goes to toilet alone
5year ( 60 mo(;gross motor; Skips.vision and fine motor; copies a triangle, names heavier of two weig.Hearing&Languag; Repeats sentences of 10 syllables , counts 10 pcorrectly.Social; dresses and undresses, asks questions about meaning ofwords.
school ageschool ageDuring school age, evidence of developmentalDuring school age, evidence of developmentalprogression is predominantly throughprogression is predominantly throughcognitive development, abstract thinking andcognitive development, abstract thinking andskills of conceptualisationskills of conceptualisation,,
Adolescence; is a period of development which involves with init;Puberty; which is a biological process in which a child becomesan adult.These changes include; development of secondary sexualcharacteristic, increase to adult size and development ofreproductive capacity.Adolescence has 3 stage; Early, middle, and late.;
Biological Psychological SocialEarly adolescence Early pubertyFemales - breast bud, pubichair development, start ofgrowth spurtMales-testicularenlargement, start of genitalgrowthConcrete thinking but beginto develop moral conceptsand awareness of theirsexual identityThe early emotionalseparation from parents, startof a strong peeridentification, earlyexploratory behaviours, e.g.may start smokingMid-adolescence Females - end of growthspurt, menarche, change inbody shapeMales - sperm production,voice breaks, start of growthspurtAcneBlushingNeed for more sleepAbstract thinking, but stillseen as bulletproof,increasing verbal dexterity,may develop a ferventideology (religious, political(Continuing emotionalseparation from parents,heterosexual peer interest,early vocational plansLate adolescence Males - end of puberty,continued growth in height,strength and body hairComplex abstract thinkingidentification of differencebetween law and morality,increased impulse control,further development ofpersonal identity, furtherdevelopment or rejection ofideologiesSocial autonomy, maydevelop intimaterelationships, furthereducation or employment,may begin or developfinancial independence
Gross motor developmentGross motor development Prone positionProne position BirthBirthGenerally flexed postureGenerally flexed posture 6 weeks6 weeksPelvis flatterPelvis flatter 4 months4 monthsLifts head and shoulders withLifts head and shoulders withweight on forearmsweight on forearms 6 months6 monthsArms extended supportingArms extended supportingchest off couchchest off couch Pull to sitPull to sitBirthBirthComplete head lagComplete head lag 6 weeks6 weeksHead control DevelopingHead control Developing 4 months4 monthsNo head lagNo head lag