growth and development of infants

1. GROWTH AND
DEVELOPMENT OF INFANT

2. INTRODUCTION
⚫At no time in life are physical changes and
development achievement so dramatic as during
infancy.
⚫All body systems undergo progressive maturation.
⚫Acquision of fine and gross motor skills occurs in
an orderly head to toe and center to periphery
sequence.

3. BIOLOGIC GROWTH
Weight/
height
Head
circumfe-
rence
Pulse/
respir-
ation
Blood
pressure
Reflexe
s
1
month
4.4 ± 0.8 kg ;
gains above
680grm during
1st 6months.
increase 1.5
cm during 1st
6months.
130 beats
per min
80/ 50 mm
hg
Primitive
reflexes
53cm ± 2.5cm
; increases
about 2.5cm
during 1st
6months.
35breaths
per min

4. MOTOR DEVELOPMENT
⚫Depends on the maturation of the
muscular, skeletal and nervous system.
⚫Usually termed as “ gross motor and fine motor”
⚫Gross motor describes the acquisition of
increasing mobility and independent locomotion.
⚫Fine motor development evolves as the
reflexes, acquisition of motor dexterity.

5. 1st month
Gross motor:
⚫ Lies in flexed position
⚫ Head lags
⚫ Head sags forward in sitting position
⚫ Lift head periodically when held
⚫ Turns head to the side when prone
⚫ Makes crawling movements when prone.

8. Fine motor:
⚫ Holds hand in tight fists
⚫ Can grasp an object placed in the hand( palmer grasp
reflex) but drops it immediately.

9. SENSORY
sounds
⚫ Startled by
(Moro reflex)
⚫ Fixed on objects
brought in front of eye.
⚫ Blinking response to
a bright
bright light.
⚫ Follows
object.

10. 2 months
Gross motor:
⚫ Arms flexed, hips flexed,
legs extended, head on
side.
⚫ Less head lag, head lift
45 degrees, holds head
erect when held upright,
turns from side to back.
Fine motor:
⚫ Hands may be open.
a rattle briefly
placed in the
⚫ Holds
when
hands.

12. SENSORY
⚫ Turns head to side
when a sound occurs
⚫ Binocular fixation and
convergence to
objects.
⚫ Eyes follow moving
person nearby.

13. PLAY STIMULATION
⚫ Offer a rattle, pull from supine to sitting
position
⚫ Hold or dangle toy in front of infant.
⚫ Place in vertical infant seat so that
environment can be viewed.

14. BIOLOGIC GROWTH(3months)
Weight/
height
Head
circumfe
-rence ation
Pulse/ Blood Reflexe
respir- pressure s
3 5.7± 0.8 kg ;
month gains above
s 680grm
during 1st
6months.
60cm ± 2.cm ;
increases
about 2.5cm
during 1st
6months.
increase 1.5
cm during 1st
6months.
130 beats
per min
35breaths
per min
80/ 50 mm
hg
landau
reflexes

15. 3months
Gross motor:
⚫ Symmetric posture of head and body
⚫ Very slight head lag
⚫ Sits, back rounded,
knees flexed when
sitting
supported in
position.

16. Fine motor:
open or closed
⚫ Hands
loosely
⚫ Holds hand in front of
face and stares at them.
⚫ Active grasp
⚫ Carries object at will.
⚫ Reaches for bright objects
but misses.

17. SENSORY
⚫Turns head and looks in same direction to
locate sound.
⚫Binocular co ordination
⚫Looses interest in objects that are suddenly
removed from the field.
⚫Blinks at objects that threaten the eyes.

18. PLAY STIMULATION
⚫Same as 1 and 2 months.
⚫Holds bright toys in front of infant
to encourage reaching.
⚫Provide greater variety of toys as
baby shows interest in playthings.

19. 4 months
Gross motor:
⚫ Symmetric postures
predominant.
⚫ Holds head erect and
steady in sitting position
⚫ Lift head and shoulder at
90 degree attempts to roll
from front to back

20. Fine motor:
hand
⚫ Holds
predominantly
⚫ Brings hand together in
midline
⚫ Grasp object held near
hands.
⚫ Grasp with both hands

21. SENSORY
⚫Able to accommodate
to nearby objects
⚫Binocular vision well
established
⚫Beginning eye hand
coordination.

22. LANGUAGE
⚫Receptive: responds differently to
pleasant or angry voice, does not cry
when scolded.
⚫Expressive: laughs aloud, vocalizes
coo..And gurgles when spoken to,very
talkative to self, people or toys, can
vocalize consonants..b, g, h, k. n, p..

23. PLAY STIMULATION
⚫ Hold, touch and rock infant gently
⚫ Smile when talking and singing to infant
⚫ Encourage mutual eye contact
⚫ Shake rattle placed in infant’s eye
⚫ Offer toys for grasping.
⚫ Provide floating toys for bath.
⚫ Help infant sit up with support.

24. 5 months
(Signs of tooth eruption)
Gross motor:
⚫ Hold head erect and steady
while sitting
⚫ Able to sit for longer with
back straight
⚫ Can turn over from
abdomen to back
⚫ When supine puts feet into
mouth.

25. Fine motor:
⚫ Able to grasp object
voluntarily
⚫ Uses palmar grasp
into
⚫ Plays with toes
⚫ Takes object
mouth

26. SENSORY
⚫Able to sustain visual
inspection of an object
⚫Can localize sounds
made below ear

27. LANGUAGE
⚫Receptive: responds when own
name is spoken
⚫Expressive: squeals when happy or
excited, vocalizes displeasure when
a desired object is taken away,
consonants sounds increase,
sounds..goo..

28. PLAY STIMULATION
⚫Provide sufficient different
objects for play.
⚫Make various sounds near ear.
⚫Hold infant in standing
position.

29. BIOLOGIC GROWTH(6months)
Weight/ Head
height
rence ation
Pulse/ Blood Refle
circumfe- respir- pressure xes
6
Months
(2 lower
central
incisors
erupt)
7.4± 1 kg ;
gains about
340grm a
month.
65.5cm ± 3cm
; increases
about 1.25cm
during 1st
6months.
43cm,
increases
about 0.5cm
per month.
120 beats
per min
31breaths
per min
90/ 60 mm
hg
------

30. 6months
Gross motor:
⚫ Sits alone on hard surface
⚫ Back is straight when
sitting on chair
⚫ Lifts chest and upper
abdomen when prone.
⚫ Sustains most all of own
weight in standing
position.

31. Fine motor:
⚫ Begins to use fingers
to feed self
⚫ Retains transient hold
on two objects, one
in each hand.
⚫ Begins to transfer
objects from one
hand to the another.
⚫ Manipulates small
objects.

32. SENSORY
made
⚫ Localize sounds
above the ear
⚫ Retrieves a dropped
object that can be seen
and reached.
⚫ Enjoys small complex
visual stimuli
⚫ Moves in order to see an
object.

33. PSYCHOSOCIAL
⚫ Sense of trust
⚫ Recognize parents
⚫ Recognize strangers
⚫ Imitation of others is
beginning, sticking
tongue out
⚫ Knows what is liked
and disliked

34. INTELLECTUAL
⚫ Beginning of object
permanence: infant
briefly searches for a
dropped object.

35. LANGUAGE
⚫Receptive: recognizes familiar words
⚫Expressive: actively vocalizes
pleasure with cooing or crowing,
cries easily on slight with toy
withdrawal, shows enjoyment in
hearing own vocalization.
⚫Talks to image in mirror

36. PLAY STIMULATION
⚫ Encourage infant to look
in a mirror, repeats
names of parts of face,
such as mouth, nose and
eyes
⚫ Make funny faces
⚫ Repeat infant’s name
⚫ Use the word “no” only
when necessary.

37. 7months
Reflexes:
⚫ Sucking and rooting
reflexes disappeared.
⚫ Teething: upper central
incisors
lateral
erupt,
incisors
lower
erupt,
ultimate color of iris is
established.

38. Gross motor:
⚫Sits alone on hard
surface, leaning
forward on hands
⚫Lift head as if trying to
sit up when supine
⚫Control of trunk
⚫Sustains all of weight
on feet when held in
standing position

39. Fine motor:
⚫ Holds two toys at once
⚫ Approaches a toy and grasp
it with one hand(
unidextrous)
⚫ Transfer a toy from one
hand to the other usually
successfully
⚫ Imitates simple acts of
others
⚫ Bangs objects that are held.

40. SENSORY
⚫ Head turns in a curving arch to
localize sounds
⚫ Depth perception beginning to
develop
⚫ Fixates on very small objects
and details
⚫ Has preferences in taste for
food.

41. PSYCHOSOCIAL
Sense of trust
⚫ Shows increasing fear of strangers
⚫ Actively clings to a familiar person
when distressed.
⚫ Unhappy when caregivers usually
disappears
⚫ Emotional instability
⚫ Closed lips tightly when disliked food
is offered.

42. PSYCHO SEXUAL
⚫Oral stage
⚫Oral aggressiveness
is evidenced by
biting and chewing
⚫Discovers genitalia

43. LANGUAGE
⚫Receptive: recognizes own names,
responds with gestures to words such as
‘come’.
⚫Expressive: vocalizes eagerness,
vocalizes..m-m-m…when crying, imitates
simple noises and speech sounds,
vocalizes..da..ma..ba..

44. PLAY STIMULATION
⚫ Place toy under blanket and
encourage infant to find it.
⚫ Repeats simple sounds: dada,
mama..
⚫ Provide foods that can be
easily chewed and bitten
⚫ Encourage banging of toys
and clapping hands on objects.

45. 8MONTHS
•8months (beginning of a pattern in
bowel and bladder elimination)

46. GROSS MOTOR
⚫ Sits alone steadily
⚫ Pulls self into standing
position with help
⚫ Hand- eye coordination

47. FINE MOTOR
⚫ Holds two object while
looking at a third.
beyond range
⚫ Persistently reaches for
of
objects
grasp
⚫ Releases objects from
thumb
hands voluntarily
⚫ Complete
apposition

48. Contd.
.
⚫ Pincer grasp beginning to
develop using fingers
⚫ Eats finger foods, such as
crackers that can be held
in one hand
⚫ Drinks from cup with
assistance

49. SENSORY
⚫ recognizes familiar
words and sound.

50. PSYCHOSOCIAL
‘Sense of trust’
⚫ Greet strangers with coy,
turning away, crying or
even screaming
⚫ Separation or stranger
anxiety

51. Contd..
⚫ Affection for or love
of family
loved
⚫ Stretches arm to
family
members
⚫ Dislikes changing
clothing and diapers

52. INTELLECTUAL
⚫ Knows that objects are separate from
self
⚫Searches briefly for objects seen being
placed elsewhere.
⚫Abilities learned earlier are combined
deal with new
and extended to
situations.
⚫Object permanence

53. LANGUAGE
⚫Receptive: stops actively when own
name is spoken, beginning to understand
meaning of “no”.
⚫Expressive: shouts for attention, imitates
sound sequences, continuous syllables:
da, da…ma, ma

54. PLAY STIMULATION
⚫Hold, touch, and rock infant gently.
⚫Talk and sing to infant.
⚫Place infant in a sitting position
against a wall and encourage leaning
away from the wall to improve
a sitting
balance.
⚫Gently push infant from
position to improve balance.

55. 9MONTHS
⚫Upper lateral
incisors erupt

56. MOTOR DEVELOPMENT
Gross motor:
⚫Sits alone with good
coordination for longer
period of time
instead of
⚫Crawls
hitching
⚫Creeping
⚫Beginning to pull self to
standing position alone
while holding on to
furniture.

57. Fine motor:
⚫Bangs two object together
⚫Pokes object with fingers
⚫Uses thumb and index
finger in pincer grasp
⚫Has preference for use of
one dominant hand.

58. Contd..
⚫ Holds on bottle with good
hand month coordination
puts nipple in and with
draws it month at will.
⚫ Drinks from cup with
some spilling
⚫ Attempts to use a spoon
but spills contents.

59. SENSORY DEVELOPMENT
⚫ Head turns directly to
source of sounds.
⚫ Increased depth perception
⚫ Recognizes by looking or
moving toward familiar
objects when named.
⚫ Abl eto
through
follow
transition
objects
from
one place to another.

60. PSYCHOSOCIALDEVELOPMENT
Sense of trust
⚫Knows what “no”
means
⚫Beginning to play with
simple games
⚫Care giver is important
⚫Fears about being left
alone as when put into
the crib
⚫Covers face with arms
and hands when dislike.

61. INTELLECTUAL
⚫ Able to follow objects
through transition from one
place to another.

62. LANGUAGE
Receptive: stops actively in response to“no”.
⚫Beginning to respond to simple commands
given verbally
⚫Responds to adult anger.
Expressive: cries when scolded, echolalia
⚫association of words with persons or objects
says “mama, dada”

63. PLAY STIMULATION
⚫ Encourage exploration of
toys
⚫ Show infant large
pictures in books
⚫ Encourage to bang two
toys together.
⚫ Begin to play “ peek-a-
boo”.

64. 10MONTHS
⚫ Gross motor
⚫ Moves from prone to sitting position
⚫ May sit by falling down from a standing position
⚫ Pulls to standing position well, holding to he crib
rail or other support.
⚫ Cruises well
⚫ Make movements stepping forward when
two hands are held

65. Fine motor:
⚫ Pick small objects with
index fingers and thumb
(pincer grasp)
⚫ Releases the object after
holding it.
⚫ Brings the hand together.

66. PSYCHOSOCIALDVELOPMENT
Sense of trust
⚫ Expresses
emotions like
certain
anger,
sadness, jealousy, anxiety,
pleasure, excitement and
affection.
⚫ Plays social games with
adults

67. Contd..
⚫Improves the ability to
imitate others; imitates
facial expressions.
⚫Shows preference for one
toy over another.
⚫Looks at pictures in a
book with another person.
⚫Attracts the attention of
others by pulling on their
clothes.

68. LANGUAGE
Receptive: understands simple commands.
Expressive: may speak one word besides
Understand the meaning of bye, imitates
sounds of animal.

69. BIOLOGIC GROWTH(11months)
Weight/ Head
height
rence ation
Pulse/ Blood Refle
circumfe- respir- pressure xes
11
Months
(6- 8
deciduous
teeth)
10± 1.5 kg
74.5 cm
56cm
HC= CC
115 beats
per min
30breaths
per min
96/ 66 mm
hg babinski
reflex
disappe
ared

70. GROSS MOTOR
⚫Stand erect with minimal
support and lifts one foot to
take a step.
⚫Cruises: walks holding on to
furniture

71. FINE MOTOR
⚫ Explores toys and other objects more
carefully.
⚫ Remove covers from boxes.
⚫ Take toys out of box.
⚫ Put toy inside the box but may not let go yet.
⚫ Beginning to hold a crayon and make a mark
on the paper.

72. SENSORYDEVELOPMENT
⚫Tilt head back to see
upward.

73. PSYCHOSOCIALDEVELOPMENT
Sense of trust
⚫Shows pleasure when a desired act is
accomplished
⚫Becomes frustrated when activities are
restricted
⚫Asserts self among family members
⚫Seeks approval, avoids, disapproval.

74. LANGUAGE
Receptive: responds to
simple questions.
Expressive: imitates
specific speech sound
of other’s.

75. PLAY STIMULATION
⚫Provide opportunities
for placing small
objects into larger
objects and for taking
them out again.
⚫Play simple games
such as rolling a ball to
infant. Show infant
how to throw it back
⚫Place infant in a
walker.

76. 12 MONTHS
Gross motor:
⚫Stands alone for variable
length of time.
⚫Sit down from standing
position alone.
⚫Walks in few steps with
help or alone
⚫Improves competence in
motor skills through
practice

77. FINE MOTOR
⚫ Good pincer grasp
⚫ Picks up small bits of food
and transfers them to
mouth and enjoy eating
with fingers.
⚫ Attempts to put a small
pellet into a narrow
necked bottle but does not
succeed.
⚫ Release on or more objects
inside another object or
container.

78. Contd..
⚫ Attempts to put one block on top
of another but does not succeed.
⚫ Turns pages in a book but
usually not one at a time.
⚫ Drinks from a cup and eats from
a spoon but still requires some
help
⚫ Holds crayon to make a stroke or
mark on a piece of paper.

79. SENSORY DEVELOPMENT
⚫ Listen for recurring
sounds.
⚫ Full binocular vision well
established.
⚫ Discriminate simple
geometric forms, squares,
circle etc.
⚫ Visual acuity- 20/ 100 to
20/ 50.

80. PSYCHOSOCIAL DEVELOPMENT
Sense of trust
⚫ Emotions are more clearly interpreted
⚫ Attachment develop to primary care givers
⚫ Responds to requests for affection such as kiss or
hug.
⚫ Favorite toy begins to provide comfort.
⚫ Cooperate in dressing put arms through sleeves, feet
into shoes, take off soaks.

81. LANGUAGE
Receptive: responds with gestures and
action
Expressive: may speak 205 more words
besides
 understand many more words than
speak
 indicating ‘no’ shaking head.

82. PLAY STIMULATION
⚫ Provide large crayon for
drawing
⚫ Encourage infant to push a
chair or stroller around.
⚫ Provide push and pull toys
to encourage walking.
⚫ Encourage infant to walk.