INFANCY
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INFANCY
• The delivery of the fetus marks the start of infancy. The average newborn
weighs about 3,400 g (7.5 lb).
• Small fetuses, defined as those with a birthweight below the 10th
percentile for their gestational age, occur in about 7 percent of all
pregnancies.
• Premature infants are defined as those with a gestation of less than 34
weeks or a birthweight under 2,500 g (5.5 lb).
• Such infants are at increased risk for learning disabilities, such as dyslexia,
emotional and behavioral problems, mental retardation, and child abuse.
• With each 100-g increment of weight, beginning at about 1,000 g (2.2 lb),
infants have a progressively better chance of survival.
• A 36-week-old fetus has less chance of survival than a 3,000-g (6.6-lb) fetus
born close to term.
• Post-mature infants are defined as infants born 2 weeks or more
beyond the expected date of birth.
• Because pregnancy at term is calculated as extending 40 weeks from
the last menstrual period and the exact time of fertilization varies, the
incidence of post-maturity is high if based on menstrual history alone.
• The post-mature baby typically has long nails, scanty lanugo hair,
more scalp hair than usual, and increased alertness.
Developmental Landmarks
Reflexes and Survival Systems at Birth
• Reflexes are present at birth.
• They include the rooting reflex (puckering of the lips in response to
perioral stimulation), the grasp reflex, the plantar (Babinski) reflex,
the knee reflex, the abdominal reflexes, the startle (Moro) reflex and
the tonic neck reflex.
• In normal children, the grasp reflex, the startle reflex, and the tonic
neck reflex disappear by the fourth month. The Babinski reflex usually
disappears by the 12th month.
Reflexes and Survival Systems at Birth
• Survival systems breathing, sucking, swallowing, and circulatory and
temperature homeostasis are relatively functional at birth, but the
sensory organs are incompletely developed.
• Further differentiation of neurophysiological functions depends on an
active process of stimulatory reinforcement from the external
environment, such as persons touching and stroking the infant.
• The newborn infant is awake for only a short period each day; rapid
eye movement (REM) and non-REM sleep are present at birth. Other
spontaneous behaviors include crying, smiling, and penile erection in
males. Infants 1 day old can detect the smell of their mother's milk,
and those 3 days old distinguish their mother's voice
Landmarks of Normal Behavioral
Development
Adapted from Arnold Gessell, M.D., and Stella Chess, M.D
Motor and Sensory Behavior Adaptive Behavior Personal and Social Behavior
AGE
Hand-to-mouth reflex, grasping reflex Anticipatory feeding- Responsiveness to mother's
Rooting reflex (puckering lips in response to approach behavior at 4 days face, eyes, and voice within
perioral stimulation), Moro reflex (digital Responds to sound of rattle first few hours of life
extension when startled), sucking reflex, Babinski and bell Endogenous smile
reflex (toes spread when sole of foot is touched) Regards moving objects Independent play (until 2
Differentiates sounds (orients to human voice) momentarily years)
and sweet and sour tastes Quiets when picked up
Visual tracking Impassive face
Fixed focal distance of 8 inches
Makes alternating crawling movements
Birth to 4 Moves head laterally when placed in prone
Weeks position
4 wks Tonic neck reflex positions predominate Follows moving objects to the Regards face and diminishes
Hands fisted midline activity
Head sags but can hold head erect for a few Shows no interest and drops Responds to speech
seconds object immediately Smiles preferentially to
Visual fixation, stereoscopic vision (12 weeks) mother
16 wks Symmetrical postures predominate Follows a slowly moving Spontaneous social smile
Holds head balanced object well (exogenous)
Head lifted 90° when prone on forearm Arms activate on sight of Aware of strange situations
Visual accommodation dangling object
AGE Motor and Sensory Behavior Motor and Sensory Behavior Personal and Social Behavior
28 Sits steadily, leaning forward on hands One-hand approach and Takes feet to mouth
wks Bounces actively when placed in standing position grasp of toy Pats mirror image
Bangs and shakes rattle Starts to imitate mother's
Transfers toys sounds and actions
40 Sits alone with good coordination Matches two objects at Separation anxiety manifest
wks Creeps midline when taken away from
Pulls self to standing position Attempts to imitate scribble mother
Points with index finger Responds to social play, such
as pat-a-cake and peekaboo
Feeds self cracker and holds
own bottle
52 Walks with one hand held Seeks novelty Cooperates in dressing
wks Stands alone briefly
15 Toddles Points or vocalizes wants
mos Creeps up stairs Throws objects in play or
refusal
AGE Motor and Sensory Behavior Motor and Sensory Behavior Personal and Social Behavior
18 Coordinated walking, seldom falls Builds a tower of three or Feeds self in part, spills
mos Hurls ball four cubes Pulls toy on string
Walks up stairs with one hand held Scribbles spontaneously and Carries or hugs a special toy,
imitates a writing stroke such as a doll
Imitates some behavioral
patterns with slight delay
2 yrs Runs well, no falling Builds a tower of six or seven Pulls on simple garment
Kicks large ball cubes Domestic mimicry
Goes up and down stairs alone Aligns cubes, imitating train Refers to self by name
Fine motor skills increase Imitates vertical and circular Says no to mother
strokes Separation anxiety begins to
Develops original behaviors diminish
Organized demonstrations of
love and protest
Parallel play (plays side by
side but does not interact
with other children)
3 yrs Rides tricycle Builds tower of 9 or 10 cubes Puts on shoes
Jumps from bottom steps Alternates feet going up Imitates a three-cube bridge Unbuttons buttons
stairs Copies a circle and a cross Feeds self well
Understands taking turns
AGE Motor and Sensory Behavior Motor and Sensory Behavior Personal and Social Behavior
4 yrs Walks down stairs one step to a tread Copies a cross Washes and dries own face
Stands on one foot for 5 to 8 seconds Repeats four digits Brushes teeth
Counts three objects with Associative or joint play
correct pointing (plays cooperatively with
other children)
5 yrs Skips, using feet alternately Copies a square Dresses and undresses self
Usually has complete sphincter control Draws a recognizable person Prints a few letters
Fine coordination improves with a head, a body, and Plays competitive exercise
limbs games
Counts 10 objects accurately
6 yrs Rides two-wheel bicycle Prints name Ties shoelaces
Copies triangle
Language Development
• At birth, infants can make noises, such as crying, but they do not
vocalize until about 8 weeks.
• At that time, guttural or babbling sounds occur spontaneously,
especially in response to the mother.
• The persistence and further evolution of children's vocalizations
depend on parental reinforcement.
Language Development
Age and Mastery of Comprehension Mastery of Expression
Stage of
Develop
ment
0-6 mos Shows startle(Suddenly,Excited) response to loud or Has vocalizations other than crying
sudden sounds Has differential cries for hunger, pain
Attempts to localize sounds, turning eyes or head Makes vocalizations to show pleasure
Appears to listen to speakers, may respond with smile Plays at making sounds
Recognizes warning, angry, and friendly voices Babbles (a repeated series of sounds)(idle talk)
Responds to hearing own name
7-11 Shows listening selectivity (voluntary control over Responds to own name with vocalizations
mos responses to sounds) Imitates the melody of utterances(Something Spoken)
Attendin Listens to music or singing with interest Uses jargon (own language)
g-to- Recognizes no,hot,own name Has gestures (shakes head for no)
Languag Looks at pictures being named for up to 1 minute Has exclamation (oh-oh)
e Listens to speech without being distracted by other Plays language games (pat-a-cake, peekaboo)
sounds
Age and Stage of Mastery of Comprehension Mastery of Expression
Development
12-18 mos Shows gross discriminations between Uses single words (mean age of first word is 11 months; by
Single-Word dissimilar sounds (bells vs. dog vs. horn vs. age 18 months, child is using up to 20 words)
mother's or father's voice) Talks to toys, self, or others using long patterns of jargon
Understands basic body parts, names of and occasional words
common objects Approximately 25% of utterances are intelligible
Acquires understanding of some new All vowels articulated correctly
words each week Initial and final consonants often omitted
Can identify simple objects (baby, ball,
etc.) from a group of objects or pictures
Understands up to 150 words by age 18
mos
Age and Stage of Mastery of Comprehension Mastery of Expression
Development
12-24 mos Responds to simple directions (Give me the ball) Uses two-word utterances (Mommy sock,all
Two-Word Responds to action commands (Come here,Sit gone, ball here)
Messages down) Imitates environmental sounds in play
Understands pronouns (me, him, her, you) (moo,mmm, mmm,etc.)
Begins to understand complex sentences (When Refers to self by name, begins to use pronouns
we go to the store, I'll buy you some candy) Echoes two or more last words of sentences
Begins to use three-word telegraphic utterances
(all gone ball,me go now)
Utterances 26% to 50% intelligible
Uses language to ask for needs
Age Mastery of Comprehension Mastery of Expression
and
Stage
of
Develo
pment
24-36 Understands small body parts (elbow, chin, Uses real sentences with grammatical function words
mos eyebrow) (can, will, the, a)
Gramm Understands family name categories (grandma, Usually announces intentions before acting
ar baby) Conversations with other children, usually just
Formati Understands size (little one, big one) monologues(Comic stories and jokes as entertainment)
on Understands most adjectives Jargon and echolalia(Immediate repetitive echoing of
Understands functions (why do we eat, why do we word) gradually drop from speech
sleep) Increased vocabulary (up to 270 words at 2 years, 895
words at 3 years)
Speech 50% to 80% intelligible
P, b, m articulated correctly
Speech may show rhythmic disturbances
Age and Mastery of Comprehension Mastery of Expression
Stage of
Developme
nt
36-54 mos Understands prepositions (under, behind, Correct articulation of n, w, ng, h, t, d, k, g
Grammar between) Uses language to relate incidents from the past
Developme Understands many words (up to 3,500 at 3 yrs, Uses wide range of grammatical forms: plurals, past
nt 5,500 at 4 yrs) tense, negatives, questions
Understands cause and effect (What do you do Plays with language: rhymes, exaggerates
when you're hungry?, cold?) Speech 90% intelligible, occasional errors in the
Understands analogies (Food is to eat, milk is ordering of sounds within words
to________) Able to define words
Egocentric use of language rare
Can repeat a 12-syllable sentence correctly
Some grammatical errors still occur
Age and Mastery of Comprehension Mastery of Expression
Stage of
Developme
nt
55 mos on Understands concepts of number, speed, time, Uses language to tell stories, share ideas, and
True space discuss alternatives
Communica Understands left and right Increasing use of varied grammar; spontaneous
tion Understands abstract terms self-correction of grammatical errors
Is able to categorize items into semantic classes Stabilizing of articulation(Clarity of speech) f, v, s,
z, l, r, th, and consonant clusters
Speech 100% intelligible
Cognitive Development
• By the end of infancy (about 2 years), infants have transformed
reflexes into voluntary actions that are the building blocks of
cognition.
• They begin to interact with the environment, to experience feedback
from their own bodies, and to become intentional in their actions.
• By the end of the second year of life, children begin to use symbolic
play and language.
• Jean Piaget (1896-1980), a Swiss psychologist, observed the growing
capacity of young children (including his own) to think and to reason.
Piaget's Stages of Cognitive Development
Period of Development Cognitive Spatial Stages Cognitive Achievements
Gestational Fetus can learn sounds and respond
differentially to them after birth
Infancy: Birth-2 yrs Sensorimotor Infants think with their eyes, ears, and
Includes concepts: senses
Birth-1 mo Reflective; egocentric (newer research Newborns can learn to associate
refutes this) stroking with sucking
4-8 mos Secondary circular: looks for objects Newborns can learn to suck to produce
partially hidden certain visual displays or music
Period of Development Cognitive Spatial Stages Cognitive Achievements
8-12 mos Secondary circulation coordinated: Can remember for 1-mo periods
peek-a-boo, finds hidden objects Can play with parent by looking for
partially hidden objects
Memory improves
12-18 mos Tertiary circular: explores properties
and drops objects
18 mos-2 yrs Mental representation, make-believe Body parts used as objects
play; memory of objects Can stack one object within another
Remembers hidden objects
Drops objects over crib(a baby bed)
Knows animal sounds; names objects
Knows body parts and familiar pictures
Can understand causes not visible.
Early Childhood: 2-5 yrs
Period of Cognitive Spatial Stages
Developme
nt
2-7 yrs Preoperational Preschoolers use symbols
Includes concepts: Development of language and make believe
Egocentrism: I want you to eat this too. No sign of logic
Animistic: I'm afraid of the moon. 3-yr-olds can count 2-3 objects; know colors and
Lack of hierarchy: Where do these blocks go? age
Centration: I want it now, not after dinner. 4-yr-olds can fantasize without concrete props
Irreversibility: I don't know how to go back to that
room.
2-5 yrs Transductive reasoning: We have to go this way 5- to 6-yr-olds get humor; understand good and
because that's the way Daddy goes. bad; can do some chores(A difficult task)
Middle Childhood
Period of Cognitive Spatial Stages Cognitive Achievements
Development
6-11 yrs Concrete operational 7- to 11-yr-olds have good memory; recall;
6 yrs onward 7-11 Includes concepts: can solve problems
yrs Hierarchical classification :arranges cars by types Children begin to think logically
Reversibility: can play games backward and forward Understand conservation of matter
(e.g., checkers, triple kings) Frozen milk same amount as melted
Conservation: lose two dimes and look for same Can organize objects into hierarchies
Decentration: worry about small details, obsessive Children seem rational and organized
Spatial operations: likes models for directions
Horizontal decalage: conservation of weight, logic
Transitive inference syllogisms(trick); compare
everything, brand names important
Adolescence
Period of Cognitive Spatial Stages Cognitive Achievements
Development
Adolescence: 11-19 Formal operational Abstraction(separate, withdraw) and reason
yrs Includes concepts: Can think of all possibilities
11 yrs onward Hypothetical-deductive reasoning; adolescent quick
thinking or excuses
Imaginary audience: everyone is looking at them
Personal fable: inflated opinion of themselves
Propositional thinking logic
Emotional Development
Gestational-Infancy: 0-2 years
Stages First Seen Emotional Skills Emotional Behavior
0-2 mos onward Love, evoked by touching Social smile and joy shown
Fear, evoked by loud noise Responds to emotions of others
Rage, evoked by body restrictions All emotions there
Brain pathways for emotion forming
Self-regulation of emotions starts Laughter possible and more control over
Brain pathways of emotion growing smiles; anger shown
3-4 mos onward
7-12 mos Self-regulation of emotion grows Able to elicit more responsiveness
Increased intensity of basic three Denies to cope with stress
Stages First Emotional Skills Emotional Behavior
Seen
1-2 yrs Shame and pride appear; envy, embarrassment Some indications of empathy starting; expressions of
appear feeling: I like you, Daddy I'm sorry Likes attention and
Displaces onto other children approval; enjoys play alone or next to peers
Early Can understand causes of many emotions Empathy increases with understanding
Childhood: 2-5 Can begin to find ways for regulating emotions and More response and less reaction; self-regulation: Use
yrs 3-6 yrs for expressing them your words to say that you are angry with him
Identifies with adult to cope Aggression becomes competition
By age 5, shows sensitivity to criticism and cares
about feelings of others
Middle Can react to the feelings of others Ego rules until age 6
Childhood: 5-11 More aware of other's feelings Empathy becomes altruism: I feel so bad about their
yrs fire, I'm going to give them some of my things Superego
7-11 yrs dominates