Development

Lec (2) Pediatrics Dr.Ahmed Khalil

7/10/2018

Development : is an increase in function of processes related to body and mind (acquisition of learned skills which reflect the child’s genetic potential & environment) .
Development follows an orderly progress in a cephalic to caudal direction & also requires the loss of primitive reflexes.
There are 4 fields for developmental assessment:
Gross motor: using large groups of muscles to sit, stand, walk, run, keeping balance and changing positions.
Vision & fine motor: using hands to be able to eat, draw, dress, play, write, and the development of hand-eye coordination.
Hearing & speech: speech is production of intelligible sounds while language is the underlying mental action of speech.
Personal & social: Interacting with others, having relationships with family, friends, and teachers, cooperating, and responding to the feelings of others.

Emerging Patterns of Behavior during the 1st Year of Life:

NEONATAL PERIOD (1ST 4 Wk)
Prone: Lies in flexed attitude; turns head from side to side; head sags on ventral suspension
Supine: Generally flexed and a little stiff
Visual: May fixate face on light in line of vision; “doll’s-eye” movement of eyes on turning of the body
Social: Visual preference for human face

AT 1 MO

Prone: Legs more extended; head lifted momentarily to plane of body on ventral suspension
Supine: Tonic neck posture; head lags when pulled to sitting position
Visual: Watches person; follows moving object
Social: beginning to smile
AT 2 MO
Prone: head sustained in plane of body on ventral suspension
Supine: Tonic neck posture predominates; head lags when pulled to sitting position
Visual: Follows moving object 180 degrees
Social: Smiles on social contact; listens to voice and coos

AT 3 MO

Prone: Lifts head and chest with arms extended; head above plane of body on ventral suspension
Supine: reaches toward and misses objects; waves at toy
Sitting: Head lag partially; early head control with bobbing motion; back rounded
Social: Sustained social contact; listens to music; says “aah, ngah”

AT 4 MO

Prone: Lifts head and chest, with head in approximately vertical axis.
Supine: hands in midline; reaches and grasps objects and brings them to mouth
Sitting: No head lag when pulled to sitting position; head steady.
Standing: When held erect, pushes with feet
Social: Laughs out loud; excited at sight of food
AT 7 MO
Prone: Rolls over; crawls or creep-crawls
Supine: Lifts head; rolls over.
Sitting: Sits briefly, with support of pelvis; leans forward on hands; back rounded
Standing: May support most of weight; bounces actively
Adaptive: Reaches out for and grasps large object; transfers objects from hand to hand; grasp uses radial palm
Language: Forms polysyllabic vowel sounds
Social: Prefers mother; babbles; enjoys mirror.

AT 10 MO

Sitting: Sits up alone without support, with back straight
Standing: Pulls to standing position; “cruises” or walks holding on to furniture
Motor: Creeps or crawls
Adaptive: Grasps objects with thumb and forefinger; uncovers hidden toy; releases object grasped by other person.
Language: Repetitive consonant sounds “mama,” “dada
Social: Responds to sound of name; plays peek-a-boo; waves bye-bye

AT 1 YR

Motor: Walks with one hand held; rises independently, takes several steps
Adaptive: Picks up raisin with unassisted pincer movement of forefinger and thumb; releases object to other person on request.
Language: Says a few words besides “mama,” “dada
Social: Plays simple ball game; drink from a cup , makes postural adjustment to dressing.