Motor/Physical Development in Infancy/Toddlerhood

Positive experiences

Negative experiences

Words – babies whose parents talked to them more had larger vocabularies and learned to read sooner and better.

• Movement matters – too much time in playpens: show…………..

• Stress hurts – poverty, abuse, violence: harms the ……………that is responsible for emotion and memory.(confuses chemicals that regulate behavior, fear, and agression).

• Dendrites – a well connected brain is a forest of dendrites. In severely neglected children, there are few connections, affecting………………..

• A child’s brain uses twice as much glucose: the brain’s fuel.

• Myelin – a fatty coating that protects the axons in the brain, resulting in more efficient and faster communication among neurons.

• Babies have few myelinated axons – one reason why they cannot see well and do much with their hands except grasp.

• Undernourished children – have less myelination and prone to learning problems like a slow reader.

• Pruning – of unused or unneeded neurons help to promote thinking clearly, making fast associations, and reacting to threats and solving problems. Only connections that are reinforced over and over again will remain.

• Cerebral cortex – ¼” thick: has glial cells which provide nutrition and metabolic processes and also removes waste.

• KWASHIORKOR: A form of malnutrition caused by inadequate protein intake.Found:

in areas of faminewhere there is limited food supplylow levels of educationareas that lack knowledge or proper diet

Symptoms:large belly irritability lethargyloss of muscle mass fatiguedecreased immunity dermatitisthinning hair enlarged livervitiligo

• Treatment:

restore blood volume

stabilize blood pressure

vitamins & minerals

enzyme (lactase) to help milk intake

(Kwashiorkor is often a sign of child abuse and severe neglect)

• CRAWLING:

• 7-9 mths. – babies show understanding of near and far

• This task allows for the following:

1. It is easier to get around independently.

2. “setting event” – it sets the stage for other changes in the infant and his/her environment.

3. A new view of the world – where objects are, how big they are, can they be moved and how they look.

4. Helps them judge distances and perceive depth (people and objects look different close up than far away).

5. Gets them into new situations – warnings such as “come back” and “don’t touch.”

6. Social referencing –look for clues as to whether a situation is secure or frightening.

7. Fear of heights – a form of protection.

8. No longer “prisoners of place” – they can get around, developing self-esteem and self-confidence.

• JAUNDICE: - a condition in newborns caused by an accumulation of bilirubin in the body.

• Bilirubin – caused from a breakdown of red blood cells and then excreted in the liver.

• (Infants are born with an abundance of red blood cells).

• The baby’s liver is still immature, causing the yellow pigment in bilirubin to accumulate and deposit in the baby’s skin and eyes.

• Excess bilirubin caused by:– Baby born prematurely– Stressed after a difficult birth– Mother diabeticBreast-fed babies get more jaundice than

bottle-fed babies because breastfeeding “draws” out the bilirubin (excreted in the stool)

Usually lasts about 2 weeks and then goes away.

A slight elevation in bilirubin helps prevent bacterial infection in newborns. Babies with bilirubin and who are breastfed are more disease-resistant.

• Bilirubin – functions as an antioxidant in the brain.

• Treatment:• Frequent breast-feeding• Light therapy• Sunbathe the baby (15 mins. 3 times a day).

• COLIC:• When the baby cries 3 or more hours a day and it is

NOT due to hunger, a wet diaper, or other visible causes.

• Characteristics:

1. Healthy sucking reflex

2. Likes to be cuddled and handled

3. May spit up from time to time

4. May have normal stool

Causes:

1. milk allergy

2. gas

3. GERD – Gastroesophageal reflux disease

Treatment:

1. Walk with baby or use a rocking chair

2. Burp baby more during feedings

3. Put baby on belly and rub the back

4. Put baby in a swing

5. Take baby for a ride

Colic usually goes away by 3 months.

• Positional Plagiocephaly:• Also known as flattened head syndrome.• Causes1. Sleep in same position for too long2. Torticollis – neck muscles too tight/inadequate

tone; shorter on one side, causing the head to tilt in one way and the chin in the opposite direction.

3. Premature babies – more prone because their skulls are softer and spend lots of time in bed without being moved due to their fragility.

4. Mom’s belly – pressure of the mother’s pelvis on baby’s skull or because of a twin.

• Symptoms:1. Back of head flat2. Ear on flattened side pushed forward3. Child’s forehead may be assymetrical

Diagnosis:1. Examine baby’s head2. X’rays or CT Scan to see whether the bones

fused too soon.Treatment:

1. Reposition the child during sleep2. Move baby’s crib (something may be holding

their attention)3. Custom-molded helmet or head band in severe

cases.

• Reflexes:1. Primitive: sucking, rooting for the nipple.

2. Postural reflexes: reaction to changes in position or balance.(extended arms in parachute style to break a fall; tilted downward or forward).

3. Locomotor: walking; swimming.

Touch & Pain:

1. Touch is the 1st sense to develop and the most mature sensory system. (stroke a newborn’s cheek).

2. Smell & Taste:

Begins to develop in the womb. Taste preferences are innate

• Hearing:• Functional at birth• 1 month – can distinguish sounds as close as

“ba” and “pa.”• (Because hearing is the key to language

development, infants should be screened within the first 3 months of life for hearing impairment).

• Sight:Vision is least developed at birth.

1. 2 mths. – can tell red from green

2. 3 mths. – can identify blue

3. 4 mths. – can tell difference between red, blue, green, and yellow.

• 6 mths. – vision reaches 20/20 (a person can read letters on a specified line on a standard eye chart from 20 ft. away).

• 4-5 mths. – binocular vision begins to develop.

• Locomotion:

• 6 mths. – can sit without support.

• 9 mths. – can assume a sitting position without help.

• 3 ½ yrs. – most kids can balance briefly on one foot and begin to hop.

• Cultural Influences:

• African babies – more advanced than U.S. babies in walking, running, and sitting.

• Uganda – babies walk at 10 mths.

• U.S.A. – babies walk at 12 mths.

• France – babies walk at 15 mths.

• Many African and West Indian cultures have special “handling routines” – bouncing and stepping to strengthen babies’ muscles.

• Ache in eastern Paraguay – children do not walk until 18-20 mths.

• 8-10 yrs. – climb, indulge in play that enhance their motor skills.

• SIDS – death of an infant under 1 yr in which the death remains unexplained after a thorough investigation that includes an autopsy.

• Risk Factors: • Black (they have fewer brain receptors)• American Indian• Male• Low birth-weight• Premature

• SIDS mothers are:

• Young

• Had little or no prenatal care

• Smoked during pregnancy

• Evidence:

• Brain abnormalities

• Correlation between SIDS and unusual heartbeat which may be genetic.

• Defects in chemical receptors in the brain stem that receive and send messages that regulate heart beat, body temperature, etc. may prevent SIDS babies from waking when they breathe too much stale air containing carbon dioxide trapped under their blanket.

• (The brainstem of male babies have more serotonin using neurons but fewer serotonin receptors. Serotonin helps relay messages between neurons).

• There is a strong correlation between

sleeping on the stomach and SIDS.

• Cognitive Development:• Piaget’s 5 substages:1. 1-4 mths. – primary circular reactions:

repeating a pleasant bodily sensation first achieved by chance Ex.(sucking thumb, bottle).

2. 4-8 mths. – secondary circular reactions: new interest in manipulating objects. Ex. (repeatedly shaking a rattle to hear its noise; pushing pieces of dry cereal off the high chair and watch each piece as it falls; bouncing a ball).

3. 8-12 mths. – coordination of secondary schemes: use past experiences to solve new problems.

• Ex.(crawl to get something, grab, pushing a button to hear a special sound/song. (this marks the beginning of intentional behavior).

4. 12-18 mths. – Tertiary Circular reactions: experiment with new behavior (trial/error) to see what will happen. Ex. Baby in crib and girl show him book, he tries to get it but the bars around the crib does not let him.

Varying an action to get similar results. Ex.

Squeeze a rubber duck that squeaks when it was

stepped on).

5. 18-24 mths. - Mental Combinations: transition to pre-operational stage. They use symbols, gestures, words. Ex. Little girl given a tea set and pretends to serve tea to everyone. Ex. Trying to open a jar and kids open their mouth wider to represent what they are trying to do.

Peekaboo:- played across cultures and marked by exaggerated gestures and voice tones.

1. helps baby master anxiety when mother disappears.

2. Cognitive development – it is a way for babies to develop ideas about object permanence.

3. Social routine – helps babies learn rules that govern conversation, such as taking turns.

4. Provides practice in paying attention – a prerequisite for learning.

• Language Development:-

1. Literacy – the ability to read and write.

2. Language – communication system based on words and grammar.

3. Prelinguistic speech – utterance of sounds that are not words. Ex. Crying, cooing, bablbing.

4. 9-10 mths. – infants deliberately imitate sounds without understanding them.

5. 9-12 mths. – learn social gestures. Ex. Waving “bye-bye,” nodding to mean “yes.”

6. 13 mths. – elaborate representational gestures. Ex. Hold an empty cup to mouth to mean they want a drink; hold up arms to mean they want to be picked up.

7. 1st year – symbolic gestures: blowing to mean “hot;” sniffing to mean “flower”.

8. 18-24 mths. – a naming explosion occurs. They may go from 50 to 400 words.

9. First Sentences – when a toddler puts 2 words together. Ex. “Dolly fall.”

10. Early speech – underextension: restricting the meaning to only one object. Ex. Lisa’s uncle gives her a car and only that one is a car.

11. Overextension – Eddie jumps in excitement at the sight of the gray-haired man because every gray-haired man is his grandpa.

• Language Acquisition:

• Behaviorists : (NURTURE)

• Operant Conditioning – children are rewarded for proper language and proper language is reinforced. Little attention is paid to improper language.

• Classical Conditioning – “sit” develops meaning as it represents the physical act associated with it. When words are paired with the physical act, after repeated attempts, it will produce the act of sitting.

• Noam Chomsky – (NATURE)• Language is innate• The inner drive is so powerful that even in a poor

environment, children will learn to speak (unless severe mental or physical limitations).

• Since language is acquired quickly, learning alone does not account for it.

• LAD – an inborn reservoir filled with information about the rules of language.

• DYSLEXIA:• A specific learning disability that is neurobiological in origin

(migration of neurons to inappropriate places in the cerebral cortex) and characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities.

• Cognitive deficit=phonological• Performance deficit=decoding, fluency, spelling• Manifest Disability= reading• Derivative impact=comprehension

• Dyslexia is an impairment in the brain’s ability to translate images received from the eyes and ears into understandable language.

• Types of Dyslexia:1. Trauma Dyslexia- due to some form of brain trauma or

injury to the area of the brain that controls reading and writing (very rare).

2. Primary Dyslexia- dysfunction of the left side of the brain. Problems with reading, spelling, and writing as adults. Highly genetic and mostly in boys than girls.

3. Secondary or developmental dyslexia – due to hormonal development during early stages of pregnancy. Diminishes as the child matures.

4. Visual Dyslexia – number and letter reversals and inability to write symbols in the correct sequence.

5. Auditory Dyslexia – difficulty with sounds of letters or groups of letters. May sound jumbled or not heard correctly.

6. Dysgraphia – difficulty holding and controlling a pencil to make the correct markings on the paper.

• Related Disorders:1. Dyspraxia – difficulty in carrying out routine tasks

involving balance and fine motor-control.

2. Verbal Dyspraxia – difficulty in the use of speech sounds.

3. Dyscalculia – problems with fundamental and basic numerical skills. One may understand complex principles but not the simpler ones.

4. Scotopic Sensitivity Syndrome – difficulty reading black text on white paper, especially when the paper is shiny.

• Symptoms of Dyslexia:

1. Letter and number reversals

2. Difficulty copying from the board or a book

3. Disorganization of written work

4. May not be able to remember content even if it is from their favorite story or book.

5. Uncoordinated

6. Difficulty with organized sports or games

7. Difficulty with left and right

8. Difficulty moving to the rhythm of music

• Famous Dyslexics:1. Ann Bancroft

2. Henry Ford

3. Whoopi Goldberg

4. Anthony Hopkins

5. John F. Kennedy

6. Henry Winkler

7. Jay Leno

8. Tom Cruise

9. Cher

10. Robin Williams

11. Leonardo Da Vinci

12. George Washington

• Down’s Syndrome/(TRISOMY 21):• ( A developmental disorder characterized by an

extra or irregular chromosome in some or all body cells).

• Trisomy 21: The Origin of Down Syndrome

• People with Down Syndrome have an extra or irregular chromosome in some or all of their body’s cells. This causes physical and mental impairment. Many are mild to moderate below-normal intelligence.

• Cause: Extra or irregular chromosomes is due to abnormal cell division in the egg before or after it is fertilized by the sperm. Instead of cells dividing into “daughter” cells, they remain as the parent cell.

• Signs:1. Flat face2. Small ears and mouth3. Broad hands and feet4. Lack of muscle tone5. Head flat at back6. Eyes slope at the corners 7. Folds of skin near the inner corners of the eye

• IQ RangeClassification

• 140 and over Genius or near genius

• 120-140 Very superior intelligence

• 110-120 Superior intelligence

• 90-110 Normal or average intelligence

• 80-90 Dullness

• 70-80 Borderline deficiency

• Below 70 Definite feeble-mindedness

• Heart defects, intestinal abnormalities, and irregular ear and respiratory tract structures can cause added complications. Often have an IQ from 30-80.

• Diagnosis:1. Fetal ultrasound2. Maternal triple-screen test3. Karyotyping

1) Fetal ultrasound and maternal triple-screen tests are screening tests to determine if there is a possibility for Down Syndrome.

• Karyotyping can be done during pregnancy using Chorionic villus sampling or amniocentesis.

• (These procedures are slightly risky and is recommended if the mother is over age 35, had another child with Down Syndrome, had an abnormal ultrasound or triple screen test, or has a family history of the condition).

• Accuracy is about 98-99%• Karyotyping:

1. A microscope is used to examine the size, shape, and number of chromosomes in a sample of body cells.

2. Chromosomes in a cell are stained with a dye to make the bands of each chromosome visible. Banding helps to show differences in structure among the chromosomes and helps arrange them in pairs. Chromosomes are then photographed through the microscope.

• Amniocentesis – a long, thin needle is used to remove a sample of amniotic fluid and the chromosomes are checked for Down Syndrome.

• Chorionic Villus Sampling – a tiny tube is used to remove a small sample of the placenta.

• (Since mature red blood cells do not contain any chromosomes, karyotyping is usually done on white blood cells).

• Karyotyping is done to:1. Determine whether the chromosomes of an adult have

an abnormality that can be passed on to the child.2. Determine if chromosome defect is preventing a woman

from becoming pregnant or to miscarry.3. Determine if chromosome defect is present in a fetus or

infant or a stillborn.4. Determine the cause of a child’s birth defects or

disability.5. Determine the appropriate treatment for some types of

cancer.6. Identifying the sex of a person by determining the

presence of the Y chromosome (usually done when a newborn’s sex is not clear).

• Maternal Serum Triple Test:• A set of 3 blood tests performed during pregnancy to

assess the risk of birth defects in the unborn baby. Most accurate when performed between 16 and 18 weeks of pregnancy. Each test measures:

1. Alpha-fetoprotein (AFP)- a substance that the liver produces naturally. The level of AFP increases during pregnancy.* An abnormally high APF – risk for neural tube defect* An abnormally low AFP – increased risk for Down syndrome.

This procedure has a 60% accuracy.2. Human Chorionic Gonadotropin (hCG) – a hormone

produced by the placenta. The level of hCG increases steadily during the first 14-16 weeks of pregnancy, peaks around the 14th week, and then gradually decreases.

3. Estriol – a form of estrogen that increases during pregnancy. Produced by the placenta, can be detected as early as the 9th week of pregnancy and continues to increase until delivery.

(The maternal serum triple test is a screening test, not a diagnostic test. It indicates a suspicion of a problem and can help the woman to decide if to have another test, such as amniocentesis, to verify whether a birth defect is present).

• Treatment:• Medical checkups• Speech and language therapy• Physical and occupational therapy• Nutritional counseling• Vocational training• (Social opportunities, emotional support, and medical care

allow many to live into their 50s and 60s or even older).

Most people with Down Syndrome have a lifespan of 50-55 years.

Males are generally sterile

Women can get pregnant but will usually give birth to a child with Down Syndrome

• AUTISM: a pervasive developmental disorder, marked by profound deficits in social interaction, language, cognitive abilities, and restricted or repetitive activities and interests.

• People with autism usually have abnormal response to sensory stimuli: touch, sound, light.

• Onset –begins at birth but diagnosis is made usually between 4-6 years of age.

• Characteristics:-• Inability to develop normal socialization• Children “live in their own world”• May appear to “look through” people• Difficulty understanding and expressing emotions• Little desire to be held or cuddled• Disturbance in speech, language, and sound• Echolalia – a parrot-like repeating of what is said to them.• Abnormal relationships to objects – preference for sameness.

• Problems with “filtering-out process”- tone signals in department stores can be distressing.

• May appear deaf at other times.• May be fascinated with lights or colors.• Preoccupied with scratching or rubbing certain surfaces.• Some enjoy being thrown into the air or spinning

themselves around, or may wedge themselves into small spaces, or seek hard hugs or squeezes to obtain the sensory-feedback that they crave.

• May be able to read complex words but not simple ones.• (Some skills may appear at the expected time of

development and then disappear).

• Causes:1. Psychoanalytic theories –”refrigerator mothers” (cold

and detached). Children erect a “wall” to shut out their fears and the world’s aggression, but at the price of internal emptiness.

2. Biochemical imbalance – impairment of the reticular formation of the brainstem. Deficient in sensory input and motor output.

3. Autistics – have higher blood serotonin and higher platelet counts.

4. Viruses –rubella infection during pregnancy and birth defects from hazardous chemicals.

5. Variation of the gene HOXA1 on chromosome 7(associated with language disorders) and chromosome 15 doubles the risk for Autism.

6. At least 4 and many as 20 genes may be involved in autism.

• Treatment:• Homeopathic• Herbal• Vitamins• Hormone – Secretin• Gluten and Casein-free diets• Vitamin B6 with Magnesium• Dimethylglycine – antioxidant that increases energy,

enhances the immune system, increases eye contact and speech and decreases frustration levels.

• More recent – light and sound therapy/craniosacral therapy