02 -development By dr.khalid hammasalh

GROWTH AND DEVELOPMENTGROWTH AND DEVELOPMENTGROWTH AND DEVELOPMENTGROWTH AND DEVELOPMENT

Dr.Khalid Hama salih,

Pediatrics specialist M.B.Ch.; D. C.H

F.I.B.M.S.ped

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DevelopmentDevelopment

• The term 'child development' is used to The term 'child development' is used to describe the skill and capacity of function describe the skill and capacity of function acquired by children between birth and about 5 acquired by children between birth and about 5 years of ageyears of age

• It is a qualitative change in the childIt is a qualitative change in the child’’s s functioning.functioning.

• It can be measured through observation. It can be measured through observation.

By understanding what to expect during each stage of developmentBy understanding what to expect during each stage of development, , parents can easily capture the teachable moments in everyday life to parents can easily capture the teachable moments in everyday life to enhance their child's language development, intellectual growth, social enhance their child's language development, intellectual growth, social

development and motor skillsdevelopment and motor skills..

NB/Chronological age, physical growth and NB/Chronological age, physical growth and developmental skills usually evolve hand in developmental skills usually evolve hand in hand. Just as there are normal ranges for hand. Just as there are normal ranges for changes in body size with age, so there are changes in body size with age, so there are ranges over which new skills are acquired. ranges over which new skills are acquired.

When considering developmental milestones:When considering developmental milestones: The The median agemedian age is the age when half of a standard is the age when half of a standard

population of children achieve that level; it serves as population of children achieve that level; it serves as a guide to when stages of development are likely to a guide to when stages of development are likely to be reached but does not tell us if the child's skills are be reached but does not tell us if the child's skills are outside the normal range. outside the normal range.

Limit agesLimit ages are the age by which they should have are the age by which they should have been achieved. Limit ages are usually 2 standard been achieved. Limit ages are usually 2 standard deviations from the mean. They are more useful as a deviations from the mean. They are more useful as a guide to whether a child's development is normal than guide to whether a child's development is normal than the median agesthe median ages

There are four fields of There are four fields of developmental skills todevelopmental skills to

These are: These are: A. gross motor A. gross motor B. vision and fine motor B. vision and fine motor C. hearing, speech and language C. hearing, speech and language D.social, emotional and behavioural.D.social, emotional and behavioural.

Gross motor skills are the most obvious initial Gross motor skills are the most obvious initial area of developmental progress. As fine motor area of developmental progress. As fine motor skills require good vision, these are grouped skills require good vision, these are grouped together; similarly, normal speech and together; similarly, normal speech and language development depends on reasonable language development depends on reasonable hearing and so these are also considered hearing and so these are also considered together. Social, emotional and behavioural together. Social, emotional and behavioural skills are a spectrum of psychological skills are a spectrum of psychological developmentdevelopment

gross motor development: an explosion of gross motor development: an explosion of skills during the first year of life ,large muscleskills during the first year of life ,large muscle

vision and fine motor development: more vision and fine motor development: more evident acquisition of skills from 1 year evident acquisition of skills from 1 year onwards onwards

hearing, speech and language: a big expansion hearing, speech and language: a big expansion of skills from 18 months of skills from 18 months

social, emotional and behavioural social, emotional and behavioural development: expansion in skills is most development: expansion in skills is most obvious from 2.5 years. obvious from 2.5 years.

PEDIATRIC ASSESSMENT PEDIATRIC ASSESSMENT INSTRUMENTSINSTRUMENTS

DENVER DEVELOPMENTAL SCREENING DENVER DEVELOPMENTAL SCREENING TEST(DDST)TEST(DDST)

BAYLEY SCALES OF INFANT BAYLEY SCALES OF INFANT DEVELOPMENT(BSID)DEVELOPMENT(BSID)

PEABODY MOTOR SCALES PEABODY MOTOR SCALES

GROSS MOTOR FUNCTION MEASURES GROSS MOTOR FUNCTION MEASURES (GMFM)(GMFM)

Birth• Gross motoGross motorr:The newborn's movement are :The newborn's movement are

random, diffuse and uncoordinated.random, diffuse and uncoordinated. Complete head lag

• Visio&Fine motorVisio&Fine motor. Holds hand in fist. Holds hand in fist• Bright lights appear to be unpleasant to Bright lights appear to be unpleasant to

newborn infant.Follow objects in line of visionnewborn infant.Follow objects in line of vision• Hearing &speechHearing &speech:The newborn infant :The newborn infant

responds to sounds with either cry or eye responds to sounds with either cry or eye movement, cessation of activity and / or startle movement, cessation of activity and / or startle reaction. reaction.

SocialSocial:The newborn infant expresses his :The newborn infant expresses his emotion just through cry for hunger, pain or emotion just through cry for hunger, pain or discomfort sensation. discomfort sensation.

66- - 8weeks8weeks gross motor gross motor ::Pelvis flatter

HeadControldeveloping but head noding

Curved back, needs supportCurved back, needs support

vision and fine motor vision and fine motor ::

Follows moving objects 180 degreFollows moving objects 180 degre

hearing,& speech hearing,& speech ::listens to voice and listens to voice and cooscoos

SocialSocial: : Smiles on social contactSmiles on social contact

4 months gross motor gross motor Lifts head and shoulders with weight on

forearms no head lag when pulled to sitting no head lag when pulled to sitting position,position,

vision and fine motor vision and fine motor reaches for and grasps reaches for and grasps objects andobjects andHolds a rattle and shakesPurposefullyHolds a rattle and shakesPurposefully

brings them to mouthbrings them to mouth hearing,& speech :hearing,& speech :Laughs out loud, exited at sight Laughs out loud, exited at sight

of food, may show displeasureof food, may show displeasure Social : Social : social contact isocial contact i

6 months

gross motor gross motor Arms extended supporting chest off couchSits with self proppingSits with self propping

Stands with support Roles over, creep-crawlsStands with support Roles over, creep-crawls vision and fine motor vision and fine motor Reaches for and grasps Reaches for and grasps

large objects, large objects, transfers object from Hand to hand transfers object from Hand to hand

Hearing,& speech Hearing,& speech forms polysyllabic vowel soundsforms polysyllabic vowel sounds Social:Social: Prefers mother, responds to changes in Prefers mother, responds to changes in

emotional contentemotional content of social contact of social contact

99 monthsmonths

gross motor: gross motor: Gets in to sitting position alone,crowlGets in to sitting position alone,crowl

Pulls to standing and standsholding onPulls to standing and standsholding on vision and fine motor: vision and fine motor: grasps objects with grasps objects with

thumb and thumb and forefinger (forefinger (Immature pincer graspImmature pincer grasp

Hearing,& speech :Hearing,& speech :Double babble: dada mama Double babble: dada mama babababa

Social :Social :responds to sound of name,responds to sound of name,waves bye byewaves bye bye

1212 monthsmonthsgross motor: gross motor: Stands, and walks withStands, and walks with

one handheldone handheld

vision and fine motor: vision and fine motor: Mature pincer graspGives Mature pincer graspGives bricks to examinerbricks to examiner

Hearing,& speech Hearing,& speech says a few words besides mama says a few words besides mama and dadaand dada

Social : Social : plays simple ball games, makes postural plays simple ball games, makes postural adjustments toadjustments to

dressingdressing

1515 monthmonth

gross motor gross motor Walks independently andWalks independently and

stoops to pick up objects stoops to pick up objects

vision and fine motor: vision and fine motor: Builds a tower of two Builds a tower of two cubescubes

Hearing,& speechHearing,& speech 10 words ;No Ta Teddy Bed 10 words ;No Ta Teddy Bed Dog, BottleDog, Bottle

Social : Social : Drinks from a cupDrinks from a cup

22 years ( 24 mo )years ( 24 mo );;

gross motor: gross motor: Runs up and down stairs one Runs up and down stairs one step at a timestep at a time

vision and fine motor: vision and fine motor: Scribbles with a pencilScribbles with a pencil Hearing,& speechHearing,& speech Linking two words Daddy Linking two words Daddy

gone, Teddy's tiredgone, Teddy's tired Social : Social : Toilet trained by day Spoon-feeding Toilet trained by day Spoon-feeding

selfself

3 year’s ( 36 mo);

gross motor: ; Rides tricycle, stands momentarily on one foot.

vision and fine motor:; copies a circle imitates a cross.

Hearing,& speech knows age and sex, counts three objects correctly.

Social; plays simple games with other children, washes Dresses self (except buttons)hands.

4 years (48 mo);

gross motor; Hops on one foot, uses scissors to cut out pictures.

vision and fine motor; Copies circle and square, draws a man with 2 to 4 partsbesides head.

Hearing&Language; counts up to4 accurately, tells story.

Social; plays with several children with the beginning of role play,goes to toilet alone

5 year ( 60 mo);

gross motor; Skips.

vision and fine motor; copies a triangle, names heavier of two weights.

Hearing&Languag; Repeats sentences of 10 syllables , counts 10 pennies correctly.

Social; dresses and undresses, asks questions about meaning of words.

Motor Skills-SummaryMotor Skills-Summary

Age 3-tricycle, copies circleAge 3-tricycle, copies circle

Age 4-hops, copies squareAge 4-hops, copies square

Age 5-skips, copies triangleAge 5-skips, copies triangle

school ageschool age

During school age, evidence of developmental During school age, evidence of developmental progression is predominantly through progression is predominantly through cognitive development, abstract thinking and cognitive development, abstract thinking and

skills of conceptualisationskills of conceptualisation , ,

Adolescence; is a period of development which involves with in it ;

Puberty; which is a biological process in which a child becomes an adult.

These changes include; development of secondary sexual characteristic, increase to adult size and development of reproductive capacity.

Adolescence has 3 stage; Early, middle, and late.

;

BiologicalPsychologicalSocial

Early adolescenceEarly pubertyFemales - breast bud, pubic hair development, start of growth spurtMales-testicular enlargement, start of genital growth

Concrete thinking but begin to develop moral concepts and awareness of their sexual identity

The early emotional separation from parents, start of a strong peer identification, early exploratory behaviours, e.g. may start smoking

Mid-adolescenceFemales - end of growth spurt, menarche, change in body shapeMales - sperm production, voice breaks, start of growth spurtAcneBlushingNeed for more sleep

Abstract thinking, but still seen as 'bulletproof', increasing verbal dexterity, may develop a fervent ideology (religious, political)

Continuing emotional separation from parents, heterosexual peer interest, early vocational plans

Late adolescenceMales - end of puberty, continued growth in height, strength and body hair

Complex abstract thinking identification of difference between law and morality, increased impulse control, further development of personal identity, further development or rejection of ideologies

Social autonomy, may develop intimate relationships, further education or employment, may begin or develop financial independence

Gross motor developmentGross motor development Prone positionProne position BirthBirthGenerally flexed postureGenerally flexed posture 6 weeks6 weeksPelvis flatterPelvis flatter 4 months4 monthsLifts head and shoulders with Lifts head and shoulders with

weight on forearmsweight on forearms 6 months6 monthsArms extended supporting Arms extended supporting

chest off couchchest off couch

Pull to sitPull to sitBirthBirth Complete head lagComplete head lag 6 weeks6 weeksHead control DevelopingHead control Developing 4 months4 monthsNo head lagNo head lag

Head ControlHead Control

Newborn Age 6 months

Sitting UpSitting Up

Age 2 months Age 8 months

AmbulationAmbulation

13 month old

Nine to 12-months