The document outlines the process of child development, detailing various developmental milestones from infancy through early childhood, along with indicators of when to be concerned about delays. It emphasizes the role of occupational therapy in helping children achieve independence and functional development through assessments, goal setting, and tailored interventions, including sensory integration therapy. Additionally, it highlights the importance of family involvement and support in a child's developmental journey.

1. Child Development and
Occupational Therapy…
Debadutta Mishra & Deepti Chauhan,
Occupational Therapy Consultants, Jindal Steel & Power Ltd. Raigarh.

2. What is Child
Development???
 Child development is a
process every child goes
through.
 This process involves learning
and mastering skills like
sitting, walking, talking, skippi
ng, and tying shoes.
 Children learn these
skills, called developmental
milestones, during predictable
time periods.

3. Developmental Milestones
Skills for 0-6 Months When to be Concerned:
•When positioned on belly, raises head and shoulder •Can not lift head off surface (by 3 months)
•Rolls from front to back •Poor Head Control
•Reaches for objects with one hand •Stiff legs that move very little
•Visually tracks people and objects •Presents with head lag when pulled to sit
•Props on forearms (6 months) •Does not reach for toys with hands
•Unable to roll, bilaterally
•Can not play in midline or demonstrates hand
preference
Skills for 7-12 Months When to be Concerned:
•Rolls from back to belly (6-7 months) •Unable to sit independently and play with toys
•Creeps/crawls on stomach •Difficulty crawling or unable to crawl
•Sits independently
•Transitions from belly to sitting
•Crawls up stairs on belly
•Pulls to stand using furniture
•Stands at supported surface
•Cruises on furniture
•Walking/ambulation start to emerge

4. Skills for 13-18 months When to be Concerned:
• Independent with ambulation • Walks on toes or legs are very stiff
• Pushes to stand by going through 4 point and straight
• Stoops and recovers • Can’t stand independently
• Walks backwards • Can’t walk independently
• Walks sideways • Falls frequently
• Starts running but may fall frequently • By 15-18 months:
• Ascends stairs using step-to pattern with railing/support • Lowers to use hands or crawl up the
• Throwing a small ball overhead stairs
• Kicking a ball forward, with decreased control
• Seats self in small chair
• Climbs into adult chair
• Walks up/down stairs holding on to railing, with 2 feet
per
step (18 months)
Skills for 19-24 months When to be Concerned:
• Running becomes more controlled • Falls frequently when running
• Stands on one foot briefly • Not able to clear the floor when
• Walks on line/balance beam with 1 foot on the line jumping up
• Lowers to pick up objects from floor without falling • Can’t jump up keeping feet together
• Jumping up with both feet
• Jumping down from objects
• Walks up stairs, both feet per step without rail
• Walking backwards emerges

5. Skills for 2-3 years When to be Concerned:
• Ascends/descends stairs independently using step to pattern • Requires railing for
• Walking on a line/balance beam with improved balance ascending/descending stairs or uses
• Walking on tiptoes a step to pattern
• Jumping forward
• Rides a tricycle
• Catches playground ball, securing ball by bending arms
towards chest
• Throws ball overhand 3-7 feet
• Kicks ball forward 3-6 feet using opposing arm/leg
movements
Skills for 3-4 years When to be Concerned:
• Can sustain single leg stance for 5 seconds
• Can sustain static tiptoes for 3 seconds
• Kicks ball forward with control
• Catches ball with hands, without pulling ball to chest
• Throws ball at target
Skills for Ages 4+ When to be Concerned:
• Hopping on one foot
• Galloping and skipping start to emerge
• Jumps over objects
• Jumping-Jacks start to emerge
• Bounces and catches ball

6. Developmental delay
 Developmental delay occurs when
children have not reached these
milestones by the expected time period.
For example, if the normal range for
learning to walk is between 9 and 15
months, and a 20-month-old child has
still not begun walking, this would be
considered a developmental delay.

7. What Occupational Therapists
Do???
Help children reach their maximal functional level of
independence by facilitating development
When skill and strength cannot be developed or
improved, occupational therapy offers creative solutions
and alternatives for carrying out daily activities.

8. Pediatric Occupational Therapist
Assesses
 Motor and Sensory development
 Mobility
 Muscle tone and strength
 Posture and balance
 Oral motor skills & feeding
 Use of assistive devices

9. Setting the Goals
 Occupational Therapist sets two type of
Goals, known as Short term goals and
Long term goals.
 Short term goals are based of the
present functional level of the child
according to his age.
 Long term goals are based on the
predicted functional level of the child and
expectation of the parents.

10. Things to take care…
 Development occurs in a sequential fashion.
This means that a child will need to develop
some skills before he or she can develop new
skills.
 For example, children must first learn to crawl
and to pull up to a standing position before
they are able to walk.
 Each milestone that a child acquires builds on
the last milestone developed.

11. Development of plan
 According to the goals been set, OT
Plans out the Treatment Approaches
and Intervention

12. Implementation

13. Implementation

14. SENSORY
INTEGRATION
THERAPY

15.  SI theory is based on the hypothesis that in
order to develop a normal adaptive
response, the child must be able to
optimally receive, modulate, integrate and
process the sensory information.
 Many children with cerebral palsy and
other neurological conditions have
associated sensory difficulties.
 The SI approach attempts to facilitate the
normal development and improve the
child’s ability to process and integrate
sensory information.

16.  The objective of SI approach is not to
teach specific skills but to enhance the
brain’s capacities to perceive,
remember and motor plan.
 A therapeutic environment is created in
which the child gains rich sensory
motor experiences and engages the
child in challenging play activities in
such a way that the child is able to
overcome the challenge and adapts to
subsequently face more challenging
stimulus.

17. Sensory Integration Activities

20. Combination of these therapies
can….
 Promotes independence
 Increases participation
 Facilitates motor development &
function
 Improves strength
 Enhances learning opportunities
 Eases caregiving
 Promotes health & wellness

21. We can achieve our
goals only with the
help and support of
the family member
and care taker….

22. The Critical Role of the
Family
 Parents and families have the primary
role in children's development.
 Pediatric Occupational Therapists can
assist the family with enhancing the
child’s development through:
◦ Positioning during daily routines and
activities
◦ Adapting toys for play
◦ Expanding mobility options
◦ Using equipment effectively

23. Family Support
 Pediatric Occupational Therapists…
◦ Teach families about safety in the home
and community
◦ Provide information on the child’s physical
and health care needs
◦ Assist the child & family with transitioning
from early childhood to school, and into
adult life