Upload
daniela-hensley
View
218
Download
1
Tags:
Embed Size (px)
Citation preview
PERKEMBANGAN BAYI
Newborn are called Neonate. First four weeks of life (neonatal period)
◦ A time of transition from the uterus, where a fetus is supported entirely by the mother to an independent existence.
When neonate are first born:◦ Covered by fluid from amniotic sac◦ Blood from placenta◦ Brownish fluid from own faeces.◦ Covered with lanugo (fuzzy prenatal hair)◦ Covered with vernix caseosa (cheesy varnish)
Size and Appearance ◦ New babies have distinctive feature a large head
and a receding chin◦ On the head Fontanels (the soft spots)◦ Newborns have a pinkish cast skin so thin that it
barely covers the capillaries through which blood flows.
◦ Boys tend to be slightly longer and heavier than girls, and a firstborn child is likely to weigh less at birth than laterborns
Weight : 2.8 -3.2 kg Length : 51-53 cm (Boy > girl) Head Circumference: 30-33 cm Breathing:
◦ Initially fast, short & irregular◦ Later more stable & with rhythm
Blood pressure become stable in 10 days.
Medical and Behavioral Screening1. Apgar Scale2. The Brazelton Neonatal Behavioral
Assessment Scale3. Checks are also done for any structural
or physical deformities (eg. spinal defect, cleft palate)
Silver nitrate or tetracycline is usually dropped into neonate eyes to prevent from bacterial infection while passing through birth canal.
Apgar Scale is a standard measurement of a newborn’s condition
Introduced by Dr. Virginia Apgar Access newborn
1 min after birth 5 min after birth
Assess: Appearance (colour) Pulse (heart beat rate) Grimace (reflex) Activity (muscle tone) Respiration (breathing)
SignSign 00 11 22AAppearanceppearance Blue, paleBlue, pale Body pink, Body pink,
extremities extremities blueblue
Entirely PinkEntirely Pink
PPulseulse AbsentAbsent Slow (below Slow (below 100)100)
Rapid (over Rapid (over 100)100)
GGrimacerimace No No responseresponse
GrimaceGrimace Coughing, Coughing, sneezing, sneezing, cryingcrying
AActivityctivity LimpLimp Weak, inactiveWeak, inactive Strong, Strong, activeactive
RRespirationespiration AbsentAbsent Irregular, slowIrregular, slow Good, CryingGood, Crying
Score: Above 7 = (good/normal)Score: Above 7 = (good/normal)
4 -7 = average, need monitoring4 -7 = average, need monitoring
3 & Below = need immediate attention, high 3 & Below = need immediate attention, high risk situationrisk situation
◦The Brazelton Neonatal Behavioral Assessment Scale (NBAS) (Dr. Berry Brazelton) serves 3 purpose: As an index of neurological integrity after birth
To predict future development To assesses neonates' responsiveness to their physical and social environment
◦Screening done on 3rd day and repeat again after several days.
Test on four distinct areas:◦ Social behavior (interactive behaviors in the home)◦ Motor behaviors (reflexes & muscle activities)◦ Control of physiology (baby’s ability to quiet
himself)◦ Stress response (startle reaction)
High score a neurologically well developed infant
Low score a sluggish infant who need help in responding to social situations, or possible brain damage.
Reflexes an inborn, automatic response to a particular form of stimulation.
Full term newborns come equipped with a variety of reflexes for use in dealing efficiently with stimuli present in their environment.
Some reflexes are necessary for survival (eg. Rooting & sucking reflexes)
Reflexes are probably genetic in origin & include a timing mechanism that allows them to fade away after a period of time.
ReflexesReflexes Eliciting Eliciting StimulusStimulus
ResponseResponse DevelopmeDevelopmental ntal
durationduration
BabinskBabinskii
Gentle stroke Gentle stroke along sole of foot along sole of foot (heel - toe)(heel - toe)
Toes fan out: big Toes fan out: big toe reflexestoe reflexes
Disappears Disappears by end of by end of first yearfirst year
MoroMoro Sudden lost of Sudden lost of supportsupport
Arms extended, Arms extended, then brought then brought towards each othertowards each other
Disappear Disappear in 6 in 6 monthsmonths
Palmer Palmer GraspGrasp
Rod of finger Rod of finger pressed against pressed against infant’s palminfant’s palm
Object graspObject grasp Disappear Disappear in 3-4 in 3-4 monthsmonths
RootingRooting Object lightly Object lightly brushes infant’s brushes infant’s cheekcheek
Baby turns Baby turns towards object and towards object and attempts to suck attempts to suck
Disappear Disappear in 3-4 in 3-4 monthsmonths
SuckingSucking Insert Finger in Insert Finger in mouthmouth
Rhythmic suckingRhythmic sucking Disappear Disappear in 3-4 in 3-4 monthsmonths
WalkingWalking Held baby Held baby upright. Sole of upright. Sole of feet placed on feet placed on hard surfacehard surface
Infant step Infant step forward as if forward as if walkingwalking
Disappear Disappear in 3-4 in 3-4 monthsmonths
Stroke cheek near corner of mouth or object brushes the area
Infant respon by turning head toward stimulation
Disappears at 3 weeks when child begins to be able to voluntarily turn head
Helps infant find nipple
Hold infant horizontally on back and let head drop slightly or produce sudden loud sound against surface supporting infant
Infant response is to make an embracing motion by arching back, extending legs, throwing arms outward and then bringing them in toward the body
Disappear at 6 months
Probably in human evolution helped baby cling to mother
Spontaneous grasp of adult’s finger
Disappears at 3-4 months to allow reaching and grasping
Prepares infant for voluntary grasping
Turn baby's head to one side while lying on back
Infant responds by lying in a “fencing position” with one arm extended in front of eyes on side to which head is turned other arm is flexed
Disappears at 4 months
May prepare infant for voluntary reaching
PATTERNS OF GROWTH Children grow faster during the first
years, especially during the first few months.
This rapid growth rate tapers off during the second and third years
Influences on Growth Genes interact with environment, i.e. nutrition
and living conditions, general health and well-being
Well-fed, well-cared-for children grow taller and heavier than less well nourished and nurtured children
Better medical care, immunization and antibioticsbetter health
Nourishment ◦ Breast milk is almost always the best food for
newborns and is recommended for at least the first 12 months
◦ Parents can avoid obesity and cardiac problems in themselves and in their children by adopting a more active lifestyle for the entire family--and to breastfeed their babies
First 3 years of life is critical to baby’s brain development.
Before & after birth brain growth is fundamental to future development.
It is estimated that about 250,000 brain cells are form every minute in the uterus.
By birth, almost 100 billion nerve cell are formed, but not fully develop.
Smiling, babbling, crawling, walking, and talking are possible due to rapid development of the brain, particularly the cerebral cortex
Early experience can have lasting effects on emotional development and the capacity of the central nervous system to learn and store information
Sometimes corrective experience can make up for past deprivation
States of arousal are different degrees of sleep and wakefulness
Infants move in and out of 5 states throughout the day and night:◦ Regular sleep◦ Irregular sleep◦ Drowsiness◦ Alert Activity◦ Waking activity and crying
Striking individual differences in daily rhythms exist that affect parents’ attitudes toward and interactions with baby.
(Sensory &Perceptual Process)
24
25
Touch Hearing Vision Taste Smell
26
Touch seems to be the first sense to develop
Sensitivity to touch, pain, and temperature change is well-developed at birth.
Pain experienced during the neonatal period may sensitize an infant to later pain, perhaps by affecting the neural pathways that process painful stimuli
Reflexes reveal sensitivity to touch.Touch helps stimulate physical and
emotional development.
27
Babies are born with the ability to communicate their taste preferences to caregivers.
Infant facial expressions indicate they can distinguish among several tastes.
Newborns' rejection of bitter tastes is probably another survival mechanism, since many bitter substances are toxic
28
The responsiveness of infants to the smell of certain foods is similar to that of adults showed that some odor preferences are innate.
A newborn infant is attracted to the odor of her own mother’s lactating breast helps to find food source and to identify own mother a survival mechanism.
Newborns can identify the location of an unpleasant odor and turn head away.
A preference for pleasant odors seems to be learned in uterus and during the first few days after birth
29
Even newborns can smell, taste, and feel
These skills are useful in recognizing parents and in feeding
Lipsitt, Engen & Kye (1963) : Baby showed negative response to the smell of ammonia.
Steiner : Baby showed diff. facial expression when exposed to different type of scent.
Mac Farlane (1977): Baby can differentiate between own mother’s milk and other mothers’ milk.
Schmidt & Beauchamp (1988) : Baby’s ability to smell is almost equivalent to a 3 years old ability to smell.
Harris & friends: By aged 4 mths old, baby like the taste of salt 30
31
Well developed at birth Hearing is functional before birth ability to
discrimination sound develops rapidly after birth Hearing key to language development so
hearing impairments should be identified as early as possible ◦Infants respond with changes in heart rate to loud
sounds (even in the womb)◦Can hear wide range of sounds but are more
responsive to some than others.◦Newborns prefer complex sounds such as voices
and noises to pure tones.
32
Newborns prefer speech that is high-pitched and expressive.
Infants hear well, though not quite as accurately as adults
Infants’ hearing is best for sounds that have pitches in the range of human speech
Infants use sound to locate objects
4 – 6 months
Sense of musical phrasing
6 months“Screen out” sounds from non-native languages
7 – 9 months
Recognize familiar words, natural phrasing in native language
10 months
Can detect words that start with weak syllables
34
De Casper & Fifer (1980): Baby can differentiate mother’s voices from others thru’ baby sucking pattern.
Birnhold & Benacerraf (1983): 28th week baby showed his/her response thru facial expression.
Wertheimer (1961) : Baby able to follow source of sound thru’ the “clicker” test.
35
Vision is the least developed sense at birth Newborns cannot focus their eyes very well and
their visual acuity fineness of discrimination, is limited
Newborns explore their environment by scanning it for interesting sights & tracking moving objects.
They can’t yet discriminate colors, color vision will improve in a couple of months.
Visual perception is poor at birth but improves to 20/100 by age 6 months
Binocular vision using both eyes to focus Perception of depth and distance at 4 or 5 months
Brain development helps infants reach adult levels of vision skills:
2 months: Focus and color vision
6 months: acuity, scanning & tracking
6–7 months: depth perception
36
3 weeks Poor contrast sensitivity.Prefer large simple patterns
2 monthsCan detect fine-grained detail. Prefer complex patterns.
4 monthsCan detect patterns even if boundaries are not really present
12 months
Can detect objects if two-thirds of drawing is missing
37
Birth – 1
month Sensitivity to motion cues
2 – 4 months
Sensitivity to binocular cues
5 –12 months
Sensitivity to pictorial cues. Wariness of heights
38
39
Langlois & friends (1990): Babies are more attracted to attractive and beautiful human faces.
Fantz (1993): Babies prefer to look at pictures of human.
Aslin (1987): 4 days old babies can differentiate between green and red.
Babies prefer blue and red as compared to other colors.
Gibson & Walk (1960): Visual cliff experiment. 6 mth babies has already develop in-dept perception in visual.
40
41
42
By 1 month, can integrate sight and touch
By 4 months, can integrate sight and sound
4- and 7-month-olds can match facial appearance (boy or man) with sound of voice
Maturity affect infant perceptual and motor abilities.
Milestones of Motor Development Babies first learn simple skills and then combine
them into increasingly complex systems of action◦ Week 1 : Motor ability progress◦ Month 1 : Chin lift◦ Month 2 : Reach for object
Newborn are not able to control their body movement no coordination.
Most movements are due to inborn reflexes (rooting, moro, palmer grasp etc)
Humans begin to walk later than other species, possibly because babies' heavy heads and short legs make balance difficult
How Motor Development Occurs:Maturation in Context
According to Thelen, normal babies develop the same skills in the same order because they are built approximately the same way and have similar physical challenges and needs
Cultural Influences on Motor Development
Chances to explore their surroundings motor development likely to be normal
Some cultures actively encourage early development of motor skills
Training Motor Skills Experimentally
Gesell concluded that children perform certain activities when they are ready, and training gives no advantage
Interaction of biology and environment are involved in infant motor development
Baby's ability to interact with other people Develops thru regular interaction with
babies,:◦ Feeding◦ Cleaning◦ Caring/loving
Newborn can imitate facial expression.