2. An inRules/Laws of Development
1-Continuous process
2-Cephalocaudal ( Head control developed first )
3- Proximal to Distal ( Arm control first , fingers later )
4-Parallelism-sequence is same in all race/ethnic groups
5-Dissociation –Rate may be different
6-Mass activity has to change into specific response
7-Primitive reflexes has to disappear
8-CNS maturation and environment factors both affect
the development
• beyon
3. DQ =DEVELOPMENTAL AGE ( DA )
/Chronological age ( CA) × 100
< 70% is a red flag sign
4. 3 ms Neck holding/Head control
5–6 ms Roll over
6 ms Sit with support
8 ms Sit without support
9 ms Stand with support/crawls/cruising
around furniture
12 ms Stand without support
5. 15 ms Walks
18 ms Runs
2 yrs Walks upstairs with 2 feet each
step/walk backwards
3 yrs Walks upstairs with 1 feet each step
but coming down 2 feet each step/rides
tricycle/jumps
4 yrs Walks upstairs/downstairs with 1
feet each step/Hop
5 yrs Skips
14. 15
ms
Imitates scribbling Towers of 2
18
ms
Scribbling Towers of 4 Feed with spoon
without spillage
2 yr Vertical and circular
strokes
Towers of 6 Undress completely
3 yr Draw circle Towers of 9 Buttoning/unbuttoning
4 yr Draw square Build bridge Handedness
5 yr Draw Triangle Steps Ties the shoelace
20. 15ms Pointing
18ms Mimicking
2yrs Toilet training Indicates 6 body parts
3yrs Knows name/age/ gender
Sing rhymes/Knows 2
colours/ Dry by day
4yrs
Plays with several
children
Role playing / Knows 4
colours
5yrs
Understands opposites
(Eg-Fat & thin )
Dry by night
21. 3ms Cooing
4ms Squeals /Lough loud
6ms Monosyllables
9ms Bisyllables
12ms 1-2 words with meaning
18ms 10-20 words with meanings
2yrs 100 words/can join two words/I/Me/you
3yrs Sing rhymes/Speak in small sentences
4yrs Tell stories
5yrs Ask meaning of words/questions
22. Newbor
n
Startle reaction, facial grimace, change in HR
4 ms Turns head towards the source of sound
6 ms Can imitate sounds
8 ms Can respond to name
10 ms Turn the head diagonally, directly towards the source
of sound
1 yr Localise the sound source like adults
23. NB Monocular fixation in response to visual stimulus
1 ms Can follow an object up to 60*
2 ms Follow the objects/mother
3 ms Can follow an object up to 180
4 ms Binocular vision well established.
6 ms True coordination of the eyes and hands
3 yr Can identify basic colours .Vision screening using an illiterate
“E” chart
> 7 yr Titmus fly test for stereo-acuity
24. Milestones Not achieved by
Social Smile 2 months
Head control 4 months
Sit without support 8 months
Stand without
support
12 months
25. Test for Screening of Development
1-Denver Development Screening Test
(DDST II )
2-Bayley “S Scale of Infant Development
(BSID )
3-Development Observation Chart ( DOC )
4-Trivandrum Development Screening Chart
( TDSC)
Test for Assessment of Intelligence
Draw a MAN test
26. The intelligence quotient (IQ)
Mental age
--------------------- x 100
Chronological age
27. Grading IQ Remarks
Intelligent > 110
Normal 90 - 110
Borderline / average 70 – 90 Vulnerable to educational
problems
Mild / educable 50 – 70 Often need special classes
Moderate / Trainable 35 – 50 Trainable in workshop setting
Severe 20 – 35 Trainable for self care skills
Profund Below 20 Need custodian care
28. Female –Pubic Hair
Stage 1: Preadolescent
Stage 2: Darker lightly pigmented, straight, medial border of labia.
Stage 3: Darker, beginning to curl, increased amount
Stage 4: Coarse, curly, abundant but amount less than in adult
Stage 5: Adult feminine triangle, spread to medial surface of thighs
29. Female –Breast Development
Stage 1: Preadolescent
Stage 2: Breast and papilla elevated as small mound; areolar diameter
increased
Stage 3: Breast and areola enlarged, no contour separation
Stage 4: Areola and papilla form secondary mound
Stage 5: Mature, nipple projects, areola part of general breast contour
30. Stage Pubic hair
Scrotum/Testicular
volume
Penis
Stage – 1 Preadolescent
Preadolescent
(< 4 ml )
Preadolescent
Stage- 2
Scanty, long, slightly
pigmented
Scrotum,pink, texture
altered
(4-10 ml)
Enlarged
Stage- 3
Darker, starts to curl,
small amount
Larger
(10-15 ml)
Longer
Stage- 4
Resembles adult type but
less in quantity; coarse,
curly
Larger, scrotum dark
(15-20 ml )
Larger; glans and breadth
increase in size
31. Female 2nd sexual character sequence is:
Thelarche–Pubarche–Menarche (TPM)
Male 2nd sexual character sequence is: Testicular
enlargement—pubic hairs–axillary hairs–facial
hairs, Penile enlargement—spermarche
Delayed puberty: No 2nd sexual character in
female by 17 years (or no menarche by 16 yr)
and in male by 14 years.
Precocious puberty in girls: Thelarche before 8
years and menarche before 10 yr of age and in
boys pubertal onset before 9.5 yr.
