Development
It is the process of functional and physiological maturation of the
individual. It is progressive increase in skill and capacity to function.
It is related to maturation and myelination of the nervous system. It
includes psychological, emotional and social changes. It is
qualitative aspects.
Assessment of Development
Normal development is a complex process & has a multitude of
facets. However, it is convenient to understand & assess
development under the following domains.
➢ Gross motor development
➢ Fine motor skill development
➢ Personal & social development
➢ Language
➢ Vision & hearing.
Motor development progress in an orderly sequence to
ultimate attainment of locomotion & more complex motor
tasks thereafter. In an infant it is assessed & observed as
follows:-
Neck holding Rolls over Sitting with own support
sitting without support Stand holding on Creeps well
Creeps upstairs Runs walks up and downstairs
Rides tricycle Hope on one foot
Age Milestone
3m Neck holding
5m Rolls over
6m Sits with own support
8m Sitting without support
9m Standing holding on (with support)
12m Creep well, stand without support
15m Walks alone creeps upstairs
18m Runs
2yr Walks up and down stairs
3yr Rides tricycle,
4yr Hops on one foot, alternate feet going downstairs.
Fine motor skill development
Fine motor development depend upon neural tract maturation.
Fine motor development promotes adaptive actives with fine
sensorimotor adjustments and include eye coordination, hand
eye coordination, hand to mouth coordination, hand skill as
finger thumb apposition, grasping, dressing etc.
Reaching out for the objects Reaching out for the objects
with both hands with one hand
Immature pincer graps Mature Pincer grasp Scribbling
Block skills Drawing skills acc to age
acc to age
Age Milestone
4m Reaching out for the objects with both hands
6m Reaching out for the objects with one hand
9m Immature pincer graps
12m Pincer graps mature
15m Imitates scribbling, tower of 2 blocks
18m Scribbles, tower of 3 blocks
2yr Tower of 6 blocks, vertical and circular stroke
3yr Tower of 9 blocks, copies circle
4yr Copies cross, bridge with blocks
5yr Copies triangle, gate with blocks
Personal and social development includes personal reactions to his
own social and cultural situations with neuromotor maturity and
environment stimulation. It is related to interpersonal and social skill
as social smile, recognition of mother, use of toys.
Age Milestone
2m Social smile
3m Recognizes mother
6m Recognizes strangers, stranger anxiety
9m Waves “bye bye”
12m Comes when called, plays simple ball game
15m Jargon
18m Copies parents in tasks
2yr Asks for food, drink, toilet
3yr Shares toys, knows full name and gender
4yr Plays cooperatively in a group, goes to toilet alone
5yr Helps in household tasks, dressing and undressing
Age Milestone
1m Alerts to sound
3m Coos ( musical vowel sounds)
4m Laugh loud
6m Monosyllables (ba, da, pa) sound
9m Disyllables ( mama, baba, dada) sound
12m 1-2 words with meaning
18m 8 -10 words vocabulary
2yr 2-3 word sentences, uses pronouns “I”, “Me”, “you”
3yr Ask question
4yr Says songs or poem, tell stories
5yr Asks meaning of words
Age Milestone
1m Fixates at mother as she talks to him
3-4m Fixate on objects shown to him( grasping with eyes)
4m Binocular vision
6m Adjusts its position to follows the objects of interest
1yr Can follow rapidly following objects
Age Milestone
newborn Respond to sound by startle, blink, cry, quiting, change in
ongoing activity
3-4m Turns his head towards the source of sound
5-6m Turns head to one side and downwards if a sound is made
below the level of ears
7m Turns head to one side and downwards if a sound is made
above the level of ears
10m Directly looks at source of sound diagonally
Healthy development, in all forms, particularly social/emotional,
communication, and behavior, should be monitored by parents and
physicians through screenings at each well visit.
➢ The Denver Developmental screening test •
➢ Baroda screening test •
➢ Trivandrum development screening test •
➢ Other test
-Woodside DST
-Cognitive adaptive test –
- Early language milestone etc.
Developed Denver, Colorado, Frankenburg and Dodds.(1967)
This simple, economic and useful test screens for developmental
delays during infancy and the preschool period.
Assess child development in four domains
- Gross motor (hops)
- Fine motor
- Language
- Social behaviour
➢ Consists 0f 125 items over the range from birth to 6 years.
Each item is scored as pass, fail or refused.
Items that can be completed by 75-90% of children but the child under
assessment fails he/she is called as cautions.
Items that can be completed by 90% of children but the child under
assessment fail he/she is called as Delay.
A normal score means no delay in any domain and no more than
caution.
A suspect score means one or more delay or 2 or more cautions.
A score of untestable means enough refused items that the score
would be suspect if they had been delays.
Developed by Dr. Promila Phatak with 25 test items primarily
for psychological aspects.
The test is relevant for age 0 to 30 months.
Gross motor, fine motor and cognitive aspects are evaluated
in 10 mints mainly by the psychologist.
It is simplified version of Baroda DST that can be used by the
health worker, nurses and pediatricians/ physicians.
It has17 test items relevant for 0 to 2 years of age.
The children are evaluated in three domains( gross motor, fine
motor and cognitive for 5 minutes only.