Growth and Development: Infancy Early Childhood Middle Childhood Adolescent
Growth and Development: Infancy Early Childhood Middle Childhood Adolescent
Infancy
Middle Childhood
Neonate Infancy
Birth to 1 month
1 month to 1 year
1-3 years 3-6 years
Late Childhood
Early Childhood
Toddler
Preschool
Growth is an orderly process, occurring in systematic fashion. Rates and patterns of growth are specific to certain parts of the body. Wide individual differences exist in growth rates. Growth and development are influences by are influences by a multiple factors.
Principles Continued
Development proceeds from the simple to the complex and from the general to the specific. Development occurs in a cephalocaudal and a proximodistal progression. There are critical periods for growth and development. Rates in development vary. Development continues throughout the individual's life span.
Growth Pattern
Growth Patterns
The childs pattern of growth is in a head-to-toe direction, or cephalocaudal, and in an inward to outward pattern called proximodistal.
Early detection of deviation in childs pattern of development Simple and time efficient mechanism to ensure adequate surveillance of developmental progress Domains assessed: cognitive, motor, language, social / behavioral and adaptive
The acquisition of gross motor skill precedes the development of fine motor skills. Both processes occur in a cephalocaudal fashion
Head control preceding arm and hand control Followed by leg and foot control.
Newborn: barely able to lift head 6 months: easily lifts head, chest and upper abdomen and can bear weight on arms
Head Control
Newborn
Age 6 months
Sitting up
2months old: needs assistance 6 months old: can sit alone in the tripod position 8 months old: can sit without support and engage in play
Sitting Up
Age 2 months
Age 8 months
Ambulation
9 month old: crawl 1 year: stand independently from a crawl position 13 month old: walk and toddle quickly 15 month old: can run
Ambulation
13 month old
Nine to 12-months
Newborn has very little control. Objects will be involuntarily grasped and dropped without notice. 6 month old: palmar grasp uses entire hand to pick up an object 9 month old: pincer grasp can grasp small objects using thumb and forefinger
Speech Milestones
1-2 months: coos 2-6 months: laughs and squeals 8-9 months babbles: mama/dada as sounds 10-12 months: mama/dada specific 18-20 months: 20 to 30 words 50% understood by strangers 22-24 months: two word sentences, >50 words, 75% understood by strangers 30-36 months: almost all speech understood by strangers
Hearing
BAER hearing test done at birth Ability to hear correlates with ability enunciate words properly Always ask about history of otitis media ear infection, placement of PET tubes in ear Early referral to MD to assess for possible fluid in ears (effusion) Repeat hearing screening test Speech therapist as needed
6-month-old
12-month-old
Unable to sit alone by age 9 months Unable to transfer objects from hand to hand by age 1 year Abnormal pincer grip or grasp by age 15 months Unable to walk alone by 18 months Failure to speak recognizable words by 2 years.
1 year old: transfer objects from hand to hand 2 year old: can hold a crayon and color vertical strokes
3 year old: copy a circle and a cross build using small blocks 4 year old: use scissors, color within the borders 5 year old: write some letters and draw a person with body parts
Toddler
Toddler
Toddlers
Stranger anxiety should dissipate by age 2 to 3 years Temper tantrums: occur weekly in 50 to 80% of children peak incidence 18 months most disappear by age 3 Sibling rivalry: aggressive behavior towards new infant: peak between 1 to 2 years but may be prolonged indefinitely Thumb sucking Toilet Training
Pre-School
Buttoning clothing Holding a crayon / pencil Building with small blocks Using scissors Playing a board game Have child draw picture of himself
Pre-school tasks
Inability to perform self-care tasks, hand washing simple dressing, daytime toileting Lack of socialization Unable to play with other children Able to follow directions during exam Performance evaluation of pre-school teacher for kindergarten readiness
Pool Safety
School-Age
Writing skills improve Fine motor is refined Fine motor with more focus
Building: models legos Sewing Musical instrument Painting Typing skills Technology: computers
School performance
Ask about favorite subject How they are doing in school Do they like school By parent report: any learning difficulties, attention problems, homework Parental expectations
School failure Lack of friends Social isolation Aggressive behavior: fights, fire setting, animal abuse
8 to 10 years: team sports Age ten: match sport to the physical and emotional development
School Age
Greater ability to concentrate and participate in self-initiating quiet activities that challenge cognitive skills, such as reading, playing computer and board games.
13 to 18 Year Old
Adolescent
As teenagers gain independence they begin to challenge values Critical of adult authority Relies on peer relationship Mood swings especially in early adolescents
Adolescents
Adolescent Teaching
Relationships Sexuality STDs / AIDS Substance use and abuse Gang activity Driving Access to weapons
Adolescents