develomental skills and Global development delay

GROWTH Increase in physical size , height and weight of the body

DEVELOPMENTFUNCTIONAL and

PHYSIOLOGICAL maturation of systems and organs

Leading to developing of new skills , adaptation ability and assuming responsibilities

Denotes maturation of brain. Leading to increase in Mental, Physical, Social and Emotional abilities of the child.

Normal development The brain comprises 100 billion neurons

at birth , each neuron develop about 15000 synapses by 3 years of age.

CHILD DEVELOPMENTAge – related development terms are: -

Newborn (1st 4 wks after birth)Infant (1 – 12 m)Toddler, early childhood, preschool (1 – 4 yrs)

School – aged child (5 – 12 yrs)Adolescent (12 – 20 yrs)

1. Directional Pattern:– Cephalocaudal Pattern ( Head to Tail)– Proximal to Distal (Midline to peripheral)– Mass to specific (Differentiation)

2. Sequential Pattern:.- Sequence of development is the similar in all

children but differs in rate ( slow in DS)- There is personal variation

DEVELOPMENT

Why emphasize early detection of

Development Delay1- start early intervention and treatment.

2- supply the parent an explanation for their inquiries about difficulties with their children as feeding, handling, sleeping, and temperament.

3- to look for associated findings for managing

Developmental milestones 5’s

Global Developmental DelayGDD

Significant delay* in two or more of the following five developmental skills:

Who should be screened for development delay ?

All young children especially those with risk factor All young

At birthGross motor

Fine motor CognitiveSocialLanguage

Crying to indicate need. Eg. Crying for breast milk

Follows moving objects or light

Crying the only language

At ONE MONTHGross motor


Raised head on prone slightly

Tight palmar grasp

ALERT TO SOUND

REGARDS FACE

Crying

At TWO MONTHSGross motor


Visual fixation and follows near by objects

SOCIAL SMILE

COO

At TWO MONTHSGross motor


Holds head in midline,then falls from supine or to 45º from prone

3 monthsGross motorFine motorCognitiveSocialLanguage

Supports head when held erect

Opens hands spontaneously

Increase interest in his surroundings e.g.

Swings at and reaches for dangling toys

At FOUR/ FIVE MONTHSGross motor


Rolls front to back, then back to frontSupports on wrists when prone (sphinx like)Grasps hands together

Knows mother

LAUGHING

6 months Gross motor

Fine motorCognitiveSocial Language

Sits momentary, supported.

Transfer objects from hand to hand.use 4 fingers

Understand objects and know what to expect of them.e.g Bottle means feeding time.Recognizes strangers

Show likes and dislike

Babbles(“ba, ba” sounds)

06mo_04.mov

7 monthsSits without support

8 monthsCrawl (Lion

like)


Fine motor CognitiveSocial Language

Creeps or crawls or pulls to stand

Pincer graspShows interest in picture books. Watches activities of others with interest.

Plays peek-a-boo

Repetitive sounds mama dada

SELF Dependence

Feeds self

10 monthsBye-bye, Stand

supported

11 monthsWalk

supported

12 monthsGross motor

Fine motorCognitiveSocial Language

Stands unsupported

Release an object when commanded

Responds to simple instructions. Uses trial-and-error to learn about objects. Knows what "no" means and reacts.

Comes when called. Plays simple game

1-2 meaning full words

Respond to his name

15 months 4-6 words Follows commands

without gesture ScribblesWalks

independently

Drinks from cup

Imitates activity

Send kisses


Fine motor/self dependence

CognitiveSocial language

Walks up stairs with one hand heldSeats himself in small chair

Feeds from a spoon

Enjoys simple picture books. Explores environment. Knows the names of parts of his (4)body. Index pointer

Mimics action of others

At least 6 words

2years (19-24months)Gross motorFine motorCognitiveSocial/ self

dependenceLanguage

Runs. Kicks large ball. Squats. Walks up and down stairs 2 feet per step.

Turns picture book pages one at a time.

Recognises details in pictures. Uses own name to refer to self. Match two objects together by colour, shape or size. Builds tower of 6 cubes.

Plays with others. Tantrum. Spoon-fed and drinks from cup. Aware of physical needs.

Joins 2-3 words in sentences. Talks to self continuously. Speaks >20 words, and accumulate new words very rapidly.

) ( اجتماعى يوم 40ضحك الرأس رفع و شهر 2المناغاة الرأس شهور 3تثبيت االم على شهور 4التعرف الصدر و الراس شهور 4رفع ) الوجه ) النوم من شهور 4التقلب[ لألشياء الوصول شهور 4محاولة

التأخر فى ظهور عالمات النمو التطورية

بصوت شهور 5الضحك ) ( الظهر وضع من شهور 5التقلب مستندا شهور 6الجلوس بمفرده شهور 7الجلوس االصوات بعض ترديد فى شهور 7بدء شهور 8الحبو القلم وضع شهور 9مسك


بمساعدة شهور 10الوقوف باليد با التلويح شهور 10 باى بمساعدة شهور 11السير بمفرده شهر 12 كلمة 3-2/ الوقوف بمفرده معتدال/ السير السالم/ الجلوس طلوع

شهر 18 بمساعدة30 –40 من جمل و شهر 24كلمة 2كلمة


3years (25-36months)Gross motorFine motorCognitiveSocialLanguage

Steer tricycle. Can jump off lower steps. Goes upstairs 1 foot per step and downstairs 2 feet per step.

Relates present activities and past experiences. Can sort objects into simple categories. Understand simple stories.

Plays co-operatively. Undresses with assistance. Imaginary companions. Uses spoon and fork.

Speaks in sentences of 4words. Talks to himself when playing. At least 50% of his words are understandable.

3 years Gives full name, age and sexNames 2 colors, , all body parts

Throws ball overheadWalks upstairs, alternating feetPuts on shirt

Copies circleDraws person with 3 partsImitates horizontal and vertical lines

4years (37-48months)Gross motorFine motorCognitiveSocialLanguageKnee crossing. Go downstairs one foot per step. Can turn sharp corners when running.

Builds a tower of 10 cubes. Imitates gate with cubes. Copies a cross.

Counts up to 20. Asks meanings of words. Draw recognisable house.

Argues. Dresses and undresses with assistance. Attends to own toilet needs. Developing a sense of humour. Wants to be independent.

Uses correct grammar most of the time. Uses prepositions. "Why" is a favourite word during this period.

4 yearsCounts 4 objectsIdentifies some numbers and lettersCopies squareDraw person with 6 partsHops on one footDresses with little assistanceUnderstands prepositions


Well-developed ball skills. Walk on thin line. Hops on both feet.

Builds steps with 3-4 cubes. Copy adult’s writing. Colours pictures carefully.

Writes name. Draws a detailed person. Matches most colours. Understands numbers.

Chooses own friends. Dresses and undresses alone. Cares about others.Copes well with personal needs.

Fluent speech. Talks about the past, present and future with a good sense of time.

5 yearsPrints first nameCounts to 10Asks meaning of wordsSkipsTies shoesPlays competitive games


Walks heel to toe along a line.

Knows right from left and number of fingers.

Draws with precision and to detail. Developing reading skills well. May write independently.

Stubborn and demanding. Eager for fresh experiences. May be quarrelsome with friends. Dramatic group play.

Talk fluently and with confidence. Can pronounce majority of the sounds of his language.

Screening

Investigation (cont.)

Primitive ReflexesReflexAge DisappearsDescription

Palmar grasp3-4 moPressing against palm causes flexion of the fingers

Plantar grasp4-6Pressing against sole of foot causes flexion of the toes

Rooting3-4Stroking perioral skin causes mouth to open and turn

Galant2-3Stoking along paravertebral area causes lateral flexion of the trunk to stimulated side

Moro4-6Sudden movement of the head causes symmetric abduction and extension of the arms followed by adduction and flexion

Asymmetric tonic neck - Fencing

4-6Turning the head to one side causes extension of arm on same side, and flexion on opposite side.

Placing/stepping

VariesDorsum of foot touches the underside of the table, the infant places the foot on the table top.

9 months baby only coo, can’t sit, with sissoring and increased deep tendon reflexes, social smile. What is ur diagnosis?

Question

early spastic CP with global developmental delay

9 months baby with ability to hold things between thumb and index , say dada and papa , able to crawl. Parents are anxious . what is ur opinion?

Question

Assure the parent. He is a normal child as regard his developmental milestones achievement

TREATMENTEarly interventionRehabilitationtt of association

Early Intevention Programs (EIPBRAIN

PLASTICITY

Management

Management

DS Rehabilitation

Health & Medicine

develomental skills and Global development delay