- 1. GROWTH AND DEVELOPMENTGROWTH AND DEVELOPMENTGROWTH AND
DEVELOPMENTGROWTH AND DEVELOPMENTDr.Khalid Hamasalih,Pediatrics
specialistM.B.Ch.; D. C.HF.I.B.M.S.ped
2. 22 3. DevelopmentDevelopment The term child development is
used toThe term child development is used todescribe the skill and
capacity of functiondescribe the skill and capacity of
functionacquired by children between birth and about 5acquired by
children between birth and about 5years of ageyears of age It is a
qualitative change in the childIt is a qualitative change in the
childssfunctioning.functioning. It can be measured through
observation.It can be measured through observation. 4. 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 toparents can easily capture the teachable moments in
everyday life toenhance their childs language development,
intellectual growth, socialenhance their childs language
development, intellectual growth, socialdevelopment and motor
skillsdevelopment and motor skills.. 5. NB/Chronological age,
physical growth andNB/Chronological age, physical growth
anddevelopmental skills usually evolve hand indevelopmental skills
usually evolve hand inhand. Just as there are normal ranges
forhand. Just as there are normal ranges forchanges in body size
with age, so there arechanges in body size with age, so there
areranges over which new skills are acquired.ranges over which new
skills are acquired. 6. When considering developmental
milestones:When considering developmental milestones: TheThe median
agemedian age is the age when half of a standardis the age when
half of a standardpopulation of children achieve that level; it
serves aspopulation of children achieve that level; it serves asa
guide to when stages of development are likely toa guide to when
stages of development are likely tobe reached but does not tell us
if the childs skills arebe reached but does not tell us if the
childs skills areoutside the normal range.outside the normal range.
Limit agesLimit ages are the age by which they should haveare the
age by which they should havebeen achieved. Limit ages are usually
2 standardbeen achieved. Limit ages are usually 2
standarddeviations from the mean. They are more useful as
adeviations from the mean. They are more useful as aguide to
whether a childs development is normal thanguide to whether a
childs development is normal thanthe median agesthe median ages 7.
There are four fields ofThere are four fields ofdevelopmental
skills todevelopmental skills to These are:These are: A. gross
motorA. gross motor B. vision and fine motorB. vision and fine
motor C. hearing, speech and languageC. hearing, speech and
language D.social, emotional and behavioural.D.social, emotional
and behavioural. 8. Gross motor skills are the most obvious
initialGross motor skills are the most obvious initialarea of
developmental progress. As fine motorarea of developmental
progress. As fine motorskills require good vision, these are
groupedskills require good vision, these are groupedtogether;
similarly, normal speech andtogether; similarly, normal speech
andlanguage development depends on reasonablelanguage development
depends on reasonablehearing and so these are also
consideredhearing and so these are also consideredtogether. Social,
emotional and behaviouraltogether. Social, emotional and
behaviouralskills are a spectrum of psychologicalskills are a
spectrum of psychologicaldevelopmentdevelopment 9. gross motor
development: an explosion ofgross motor development: an explosion
ofskills during the first year of life ,large muscleskills during
the first year of life ,large muscle vision and fine motor
development: morevision and fine motor development: moreevident
acquisition of skills from 1 yearevident acquisition of skills from
1 yearonwardsonwards hearing, speech and language: a big
expansionhearing, speech and language: a big expansionof skills
from 18 monthsof skills from 18 months social, emotional and
behaviouralsocial, emotional and behaviouraldevelopment: expansion
in skills is mostdevelopment: expansion in skills is mostobvious
from 2.5 years.obvious from 2.5 years. 10. PEDIATRIC
ASSESSMENTPEDIATRIC ASSESSMENTINSTRUMENTSINSTRUMENTSDENVER
DEVELOPMENTAL SCREENINGDENVER DEVELOPMENTAL
SCREENINGTEST(DDST)TEST(DDST)BAYLEY SCALES OF INFANTBAYLEY SCALES
OF INFANTDEVELOPMENT(BSID)DEVELOPMENT(BSID) PEABODY MOTOR
SCALESPEABODY MOTOR SCALESGROSS MOTOR FUNCTION MEASURESGROSS MOTOR
FUNCTION MEASURES(GMFM)(GMFM) 11. Birth Gross motoGross motorr:The
newborns movement are:The newborns movement arerandom, diffuse and
uncoordinated.random, diffuse and uncoordinated. Completehead lag
Visio&Fine motorVisio&Fine motor. Holds hand in fist. Holds
hand in fist Bright lights appear to be unpleasant toBright lights
appear to be unpleasant tonewborn infant.Follow objects in line of
visionnewborn infant.Follow objects in line of vision Hearing
&speechHearing &speech:The newborn infant:The newborn
infantresponds to sounds with either cry or eyeresponds to sounds
with either cry or eyemovement, cessation of activity and / or
startlemovement, cessation of activity and / or
startlereaction.reaction. 12. SocialSocial:The newborn infant
expresses his:The newborn infant expresses hisemotion just through
cry for hunger, pain oremotion just through cry for hunger, pain
ordiscomfort sensation.discomfort sensation. 13. 66--8weeks8weeks
gross motorgross motor ::Pelvis flatterHeadControldeveloping but
head nodingCurved back, needs supportCurved back, needs support
vision and fine motorvision and fine motor ::Follows moving objects
180 degreFollows moving objects 180 degrehearing,&
speechhearing,& speech ::listens to voice andlistens to voice
andcooscoos SocialSocial:: Smiles on social contactSmiles on social
contact 14. 4months gross motorgross motor Lifts head and shoulders
with weight onforearms no head lag when pulled to sittingno head
lag when pulled to sittingposition,position, vision and fine
motorvision and fine motor reaches for and graspsreaches for and
graspsobjects 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 sightLaughs out loud, exited at
sightof food, may show displeasureof food, may show
displeasureSocial :Social : social contact isocial contact i 15.
6months gross motorgross motor Arms extended supporting chest
offcouchSits with self proppingSits with self proppingStands with
support Roles over, creep-crawlsStands with support Roles over,
creep-crawls vision and fine motorvision and fine motor Reaches for
and graspsReaches for and graspslarge objects,large objects,
transfers object from Hand to handtransfers object from Hand to
hand Hearing,& speechHearing,& speech forms polysyllabic
vowel soundsforms polysyllabic vowel sounds Social:Social: Prefers
mother, responds to changes inPrefers mother, responds to changes
inemotional contentemotional content of social contactof social
contact 16. 99monthsmonthsgross motor:gross motor: Gets in to
sitting position alone,crowlGets in to sitting position
alone,crowlPulls to standing and standsholding onPulls to standing
and standsholding on vision and fine motor:vision and fine motor:
grasps objects withgrasps objects withthumb andthumb and forefinger
(forefinger (Immature pincer graspImmature pincer
graspHearing,& speech :Hearing,& speech :Double babble:
dada mamaDouble babble: dada mamababababaSocial :Social :responds
to sound of name,responds to sound of name,waves bye byewaves bye
bye 17. 1212monthsmonthsgross motor:gross motor: Stands, and walks
withStands, and walks withone handheldone handheldvision and fine
motor:vision and fine motor: Mature pincer graspGivesMature pincer
graspGivesbricks to examinerbricks to examinerHearing,&
speechHearing,& speech says a few words besides mamasays a few
words besides mamaand dadaand dadaSocial :Social : plays simple
ball games, makes posturalplays simple ball games, makes
posturaladjustments toadjustments todressingdressing 18.
1515monthmonthgross motorgross motor Walks independently andWalks
independently andstoops to pick up objectsstoops to pick up
objectsvision and fine motor:vision and fine motor: Builds a tower
of twoBuilds a tower of twocubescubesHearing,&
speechHearing,& speech 10 words ;No Ta Teddy Bed10 words ;No Ta
Teddy BedDog, BottleDog, BottleSocial :Social : Drinks from a
cupDrinks from a cup 19. 22years ( 24 moyears ( 24 mo(;(; gross
motor:gross motor: Runs up and down stairs oneRuns up and down
stairs onestep 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
DaddyLinking two words Daddygone, Teddys tiredgone, Teddys
tiredSocial :Social : Toilet trained by day Spoon-feedingToilet
trained by day Spoon-feedingselfself 20. 3years ( 36 mo( ;gross
motor: ; Rides tricycle, stands momentarily onone 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, washesDresses self (except
buttons)hands. 21. 4years (48 mo(;gross motor; Hops on one foot,
uses scissors to cut outpictures.vision and fine motor; Copies
circle and square, draws a man with2 to 4 partsbesides
head.Hearing&Language; counts up to4 accurately,tells
story.Social; plays with several children with the beginningof role
play,goes to toilet alone 22. 5year ( 60 mo(;gross motor;
Skips.vision and fine motor; copies a triangle, names heavier of
two weig.Hearing&Languag; Repeats sentences of 10 syllables ,
counts 10 pcorrectly.Social; dresses and undresses, asks questions
about meaning ofwords. 23. Motor Skills-SummaryMotor
Skills-SummaryAge 3-tricycle, copies circleAge 3-tricycle, copies
circleAge 4-hops, copies squareAge 4-hops, copies squareAge
5-skips, copies triangleAge 5-skips, copies triangle 24. school
ageschool ageDuring school age, evidence of developmentalDuring
school age, evidence of developmentalprogression is predominantly
throughprogression is predominantly throughcognitive development,
abstract thinking andcognitive development, abstract thinking
andskills of conceptualisationskills of conceptualisation,, 25.
Adolescence; is a period of development which involves with
init;Puberty; which is a biological process in which a child
becomesan adult.These changes include; development of secondary
sexualcharacteristic, increase to adult size and development
ofreproductive capacity.Adolescence has 3 stage; Early, middle, and
late.; 26. Biological Psychological SocialEarly adolescence Early
pubertyFemales - breast bud, pubichair development, start ofgrowth
spurtMales-testicularenlargement, start of genitalgrowthConcrete
thinking but beginto develop moral conceptsand awareness of
theirsexual identityThe early emotionalseparation from parents,
startof a strong peeridentification, earlyexploratory behaviours,
e.g.may start smokingMid-adolescence Females - end of growthspurt,
menarche, change inbody shapeMales - sperm production,voice breaks,
start of growthspurtAcneBlushingNeed for more sleepAbstract
thinking, but stillseen as bulletproof,increasing verbal
dexterity,may develop a ferventideology (religious,
political(Continuing emotionalseparation from parents,heterosexual
peer interest,early vocational plansLate adolescence Males - end of
puberty,continued growth in height,strength and body hairComplex
abstract thinkingidentification of differencebetween law and
morality,increased impulse control,further development ofpersonal
identity, furtherdevelopment or rejection ofideologiesSocial
autonomy, maydevelop intimaterelationships, furthereducation or
employment,may begin or developfinancial independence 27. Gross
motor developmentGross motor development Prone positionProne
position BirthBirthGenerally flexed postureGenerally flexed posture
6 weeks6 weeksPelvis flatterPelvis flatter 4 months4 monthsLifts
head and shoulders withLifts head and shoulders withweight on
forearmsweight on forearms 6 months6 monthsArms extended
supportingArms extended supportingchest off couchchest off couch
Pull to sitPull to sitBirthBirthComplete head lagComplete head lag
6 weeks6 weeksHead control DevelopingHead control Developing 4
months4 monthsNo head lagNo head lag 28. Head ControlHead
ControlNewborn Age 6 months 29. Sitting UpSitting UpAge 2 monthsAge
8 months 30. AmbulationAmbulation13month oldNine to 12-months
