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Child Development at 18 months
- 2. Introduction Difficult area to grasp People learn differently Visual, auditory and kinaesthetic learners Interactive quizzes
- 3. Developmental Areas Gross motor Fine motor Speech and language Social and emotional
- 4. Gross motor Walking and running Walks upstairs Carries toy Kick a ball forward
- 5. Fine motor Scribbles with a pen Builds a 3 brick tower Starting to brush teeth with help Imitates housework
- 6. Speech and Language 6-10 words Can name body parts Can point to 2 pictures
- 7. Social and emotional Imitate housework Feed with a spoon Temper tantrums Object permanence No gender specific play
- 8. Warning signs Unable to stand without support No spontaneous vocalisation Still putting objects in mouth
- 9. PROPERTIES On passing, 'Finish' button: Goes to Next Slide On failing, 'Finish' button: Goes to Next Slide Allow user to leave quiz: After user has completed quiz User may view slides after quiz: At any time User may attempt quiz: Unlimited times
- 10. Summary Gross motor Fine motor Speech and language Social and emotional Warning signs
- 11. References Lingam, S. and Harvey, D. 1988. Manual of Child Development. New York: Churchill Livingstone Strobel, S. et al 2007. The Great Ormond Street Colour Handbook of Paediatrics and Child Health. London: Manson Publishing Ltd Lissauer, T. and Clayden, G. 2001 Illustrated Textbook of Paediatrics. 2nd Edition. London: Mosby International Limited Buckler, J.M.H. 1997 A Reference Manual of Growth and Development. 2nd Edition. Oxford: Blackwell Science Ltd Aldgate, J., Rose, W., Jones, D., Jeffery, C. 2006. The Developing World of a Child. London: Jessica Kingsley Publishers Dixon, S. and Stein, M. 2006. Encounters with Children- Pediatric Behaviour and Development. 4th Edition. Philadelphia: Mosby Inc.
Editor's Notes
- The following presentation will run through child development at 18 months. This will hopefully be useful as a study aid for paediatric learning.
- As child development is a difficult area of medicine to grasp yet a vital aspect of paediatric examination, it is important that each student finds their own way of learning to best suit them. This may be in the form of visual, auditory, kinaesthetic or in many cases a mixture of all three. There are a number of different techniques that can improve student learning by helping them retain information more easily. Examples of these are writing lists, drawing or looking at pictures, colour coding their paragraphs and taking part in interactive quizzes. This presentation contains a combination of all three learning methods to ensure that each student finds this presentation helpful, and further enhance student learning.
- The four major areas of child development are gross motor, fine motor, speech and language and social and emotional. Hearing is incorporated within the speech and language category, and vision is included within fine motor. This presentation will be separated into these four categories with another section on developmental warning signs, crucial to the correct paediatric diagnosis.
- All children by the age of 18 months should be able to walk, and most children will also be running and walking backwards. In general, children will also have started to walk upstairs by this age, usually with two feet on each step. Advanced children may be walking with one foot on each step. They also like to climb onto chairs by themselves. You will often find children around this age like to carry their toys with them in their arms, and like to hand them out to other people. It is common for them to squat down to pick up their toys as that is the only way they know to bend down. Most children will begin kicking a ball at around 18 months also. The following video clip is an example of an 18 month old child walking and running.
- By 18 months children will certainly have mastered pincer grip and will usually be scribbling with pens on paper. It is unlikely that they will be drawing any specific shapes but they will definitely be scribbling in circles or lines. They can also turn pages of a book themselves. Following a demonstration, they will be able to copy someone building a three brick tower, possibly a four brick tower if they are more advanced. They will be trying to brush their teeth themselves but needing help from their parents. Most children of this age are very observant and enjoy imitating their parents doing the housework and the cooking. Vision is also incorporated within the fine motor category, and at the age of 18 months, children will be able to fix and follow objects and it should already be apparent whether or not they have vision problems. The following video clip is an example of pincer grip and scribbling at 18 months
- A good target for an 18 month old is to have a vocabulary of around 6-10 words but be able to understand a lot more. They continually jabber all the time. They often learn body parts first and are able to point to parts of their body when asked. They can usually identify some words, usually animals or colours, and when asked can recognise them in pictures. They can obey simple instructions like ‘close the door’. Hearing is also incorporated into speech and language and by this age, any hearing problems or difficulties will have been found.
- At 18 months, children enjoy attention from everyone around them and they no longer have stranger anxiety. They are interested in everyone and everything. They enjoy other people’s company and like to talk to everyone around them. They begin to spoon feed themselves and want to be more independent. They also like to take their shoes and socks off themselves. At this age, they begin to indicate their need for the toilet, and know when they need to go. Some children at this age can understand object permanence but for many, this is still a confusing concept which they are only beginning to grasp. They have not yet developed gender specific play, which will often distress parents because their son likes playing with dolls and their daughter plays with cars however this is completely normal for this age.
- There are a number of red flags that parents and doctors should look out for when assessing the development of a child. These are signs that indicate something more sinister than slow development. The most important warning sign to look out for at 18 months is if a child is unable to stand without support. It is also worrying if children cannot walk by this age. If this is the case, there is more often than not underlying pathology and this will need to be investigated. Often parents feel that because their child is developing normally in other areas, not walking is nothing serious, but this is usually incorrect. Often children with cerebral palsy or Duchene's Muscular Dystrophy have next to normal social and emotional development, as well as speech and language however their motor development is far behind normal. If a child is unable to use pincer grip by 18 months, this should be further investigated as they should be mastering this dexterity by 12-15 months. It is important to find out if the child was originally a bottom shuffler because often children who moved around on their bottom become lazy and are slower at learning to walk. If children have a limited vocabulary, no spontaneous vocalisation, are still putting things in their mouths or can’t understand simple commands, this poor speech and language development is usually due to an underlying cause which must be investigated immediately.
- In summary, child development is a difficult area of medicine to grasp and many students and doctors find it hard to understand and remember. This presentation has gone over the developmental milestones of an 18 month old child with regards to gross motor, fine motor, speech and language and social and emotional. It has also explained the red flag warning signs that should make you further investigate an 18 month old child. This has hopefully given a clearer understanding of child development and if you want further information there are references on the following slide of useful textbooks and websites.