Due to increase in cell number by multiplication & increase in cell size
* Significant delay is defined as performance of ≥ 2 SDs below the mean on age-appropriate, standardized norm-referenced testing
develomental skills and Global development delay
GROWTH Increase in physical size , height and weight of the body
DEVELOPMENT FUNCTIONAL and PHYSIOLOGICAL maturation of systems and organs Leading to developing of new skills , adaptation ability and assuming responsibilities Denotes maturation of brain. Leading to increase in Mental, Physical, Social and Emotional abilities of the child.
Normal development The brain comprises 100 billion neurons at birth , each neuron develop about 15000 synapses by 3 years of age.
CHILD DEVELOPMENTAge – related development terms are: - Newborn (1st 4 wks after birth) Infant (1 – 12 m) Toddler, early childhood, preschool (1 – 4 yrs) School – aged child (5 – 12 yrs) Adolescent (12 – 20 yrs)
DEVELOPMENT 1. Directional Pattern:– Cephalocaudal Pattern ( Head to Tail)– Proximal to Distal (Midline to peripheral)– Mass to specific (Differentiation) 2. Sequential Pattern:.- Sequence of development is the similar in all children but differs in rate ( slow in DS)- There is personal variation
Why emphasize early detection of Development Delay 1- start early intervention and treatment. 2- supply the parent an explanation for their inquiries about difficulties with their children as feeding, handling, sleeping, and temperament. 3- to look for associated findings for managing
Global Developmental Delay GDDSignificant delay* in two or more of the following five developmental skills:
Who should be screened for development delay ?All young children especially thosewith risk factor All young
At birthGross motor Fine motor Cognitive Social Language Crying to indicate Follows moving Crying the only need. Eg. Crying objects or light language for breast milk
At ONE MONTHGross motor Fine motor Cognitive Social LanguageRaised head on Tight palmar ALERT TO Cryingprone slightly grasp SOUND REGARDS FACE
At TWO MONTHSGross motor Fine motor Cognitive Social Language Visual fixation and SOCIAL SMILE COO follows near by objects
At TWO MONTHSGross motor Fine motor Cognitive Social LanguageHolds head inmidline,thenfalls fromsupine or to45º from prone
3 monthsGross motor Fine motor Cognitive Social LanguageSupports head Opens hands Increase interest inwhen held erect spontaneously his surroundings e.g. Swings at and reaches for dangling toys
At FOUR/ FIVE MONTHSGross motor Fine motor Cognitive Social LanguageRolls front to Knows mother LAUGHINGback, then back tofrontSupports on wristswhen prone(sphinx like)Grasps handstogether
6 monthsGross motor Fine motor Cognitive Social LanguageSits momentary, Transfer objects Understand Show likes and Babblessupported. from hand to objects and know dislike (“ba, ba” sounds) hand.use 4 what to expect of fingers them.e.g Bottle means feeding time. Recognizes strangers 06mo_04.mov
9 monthsGross motor Fine motor Cognitive Social Language SELF DependenceCreeps or crawls Shows interest in Plays peek-a- Repetitive soundsor pulls to stand Pincer grasp picture books. boo mama dada Feeds self Watches activities of others with interest.
12 monthsGross motor Fine motor Cognitive Social LanguageStands Release an object Responds to Comes when 1-2 meaning fullunsupported when simple called. Plays words commanded instructions. simple game Uses trial-and- error to learn about objects. Knows what "no" means and reacts. Respond to his name
15 months 4-6 words Follows commands without gesture Scribbles Walks independently Drinks from cup Imitates activity Send kisses
18 monthsGross motor Fine Cognitive Social language motor/self dependenceWalks up stairs Feeds from a Enjoys simple Mimics action of At least 6 wordswith one hand spoon picture books. othersheld ExploresSeats himself in environment.small chair Knows the names of parts of his (4)body. Index pointer
2years (19-24months)Gross motor Fine motor Cognitive Social/ self Language dependenceRuns. Kicks large Turns picture book Recognises details Plays with others. Joins 2-3 words inball. Squats. Walks pages one at a in pictures. Uses Tantrum. Spoon- sentences. Talks toup and down stairs time. own name to refer fed and drinks self continuously.2 feet per step. to self. Match two from cup. Aware Speaks >20 words, objects together by of physical needs. and accumulate colour, shape or new words very size. rapidly. Builds tower of 6 cubes.
التأخر فى ظهور علمات النمو التطورية 04 يوم ضحك ) اجتماعى ( 2 شهر المناغاة و رفع الرأس 3 شهور تثبيت الرأس 4 شهور التعرف على الم 4 شهور رفع الراس و الصدر التقلب من النوم )الوجه( 4 شهور محاولة الوصول للشياء 4 شهور
التأخر فى ظهور علمات النمو التطورية 5 شهور الضحك بصوت التقلب ) من وضع الظهر ( 5 شهور 6 شهور الجلوس مستندا 7 شهور الجلوس بمفرده بدء فى ترديد بعض الصوات 7 شهور 8 شهور الحبو 9 شهور مسك وضع القلم
التأخر فى ظهور علمات النمو التطورية 01 شهور الوقوف بمساعدة 01 شهور التلويح باليد باى با 11 شهور السير بمساعدة 21 شهر الوقوف بمفرده / 2-3 كلمة السير بمفرده / الجلوس معتدل / طلوع السلم بمساعدة 81 شهر 03– 04 كلمة و جمل من 2 كلمة 42 شهر
3years (25-36months)Gross motor Fine motor Cognitive Social LanguageSteer tricycle. Can Relates present Plays co- Speaks in sentencesjump off lower activities and past operatively. of 4words.steps. experiences. Can Undresses with Talks to himselfGoes upstairs 1 sort objects into assistance. when playing.foot per step and simple categories. Imaginary At least 50% of hisdownstairs 2 feet Understand simple companions. Uses words areper step. stories. spoon and fork. understandable.
3 years Gives full name, age and sex Names 2 colors, , all body parts Throws ball overhead Walks upstairs, alternating feet Puts on shirt Copies circle Draws person with 3 parts Imitates horizontal and vertical lines
4years (37-48months)Gross motor Fine motor Cognitive Social LanguageKnee crossing. Go Builds a tower of Counts up to 20. Argues. Uses correctdownstairs one foot 10 cubes. Imitates Asks meanings of Dresses and grammar most ofper step. Can turn gate with cubes. words. Draw undresses with the time.sharp corners when Copies a cross. recognisable house. assistance. Attends Uses prepositions.running. to own toilet "Why" is a needs. Developing favourite word a sense of humour. during this period. Wants to be independent.
4 years Counts 4 objects Identifies some numbers and letters Copies square Draw person with 6 parts Hops on one foot Dresses with little assistance Understands prepositions
5years (49-60months)Gross motor Fine motor Cognitive Social LanguageWell-developed Builds steps with Writes name. Chooses own Fluent speech.ball skills. Walk on 3-4 cubes. Draws a detailed friends. Talks about thethin line. Hops on Copy adult’s person. Matches Dresses and past, present andboth feet. writing. most colours. undresses alone. future with a good Colours pictures Understands Cares about others. sense of time. carefully. numbers. Copes well with personal needs.
5 years Prints first name Counts to 10 Asks meaning of words Skips Ties shoes Plays competitive games
6years (61-72months)Gross motor Fine motor Cognitive Social LanguageWalks heel to toe Knows right from Draws with Stubborn and Talk fluently andalong a line. left and number of precision and to demanding. Eager with confidence. fingers. detail. Developing for fresh Can pronounce reading skills well. experiences. majority of the May write May be sounds of his independently. quarrelsome with language. friends. Dramatic group play.
Primitive Reflexes Reflex Age Disappears DescriptionPalmar grasp 3-4 mo Pressing against palm causes flexion of the fingersPlantar grasp 4-6 Pressing against sole of foot causes flexion of the toesRooting 3-4 Stroking perioral skin causes mouth to open and turnGalant 2-3 Stoking along paravertebral area causes lateral flexion of the trunk to stimulated sideMoro 4-6 Sudden movement of the head causes symmetric abduction and extension of the arms followed by adduction and flexionAsymmetric tonic 4-6 Turning the head to one side causes extension of arm on same neck - side, and flexion on opposite side. FencingPlacing Varies Dorsum of foot touches the underside of the table, the infant/stepping places the foot on the table top.
Question 9 months baby only coo, can’t sit, with sissoring and increased deep tendon reflexes, social smile. What is ur diagnosis? early spastic CP with global developmental delay
Question 9 months baby with ability to hold things between thumb and index , say dada and papa , able to crawl. Parents are anxious . what is ur opinion? Assure the parent. He is a normal child as regard his developmental milestones achievement
TREATMENTEarly inter ventionRehabilitationtt of association
Management Early Intevention Programs (EIP BRAIN PLASTICITY