Development

.
Growth – Net increase in size or mass of
tissues

Development – maturation of functions

related to maturation and myelination of
nervous system
PRINCIPLES OF DEVELOPMENT
1. Continous process
2. Sequence same,Rate varies
3. Related to maturation of nervous system
4. Mass activity replaced by individual
responses
5. Cephalocaudal
6. Primitive reflex lost before voluntary
movement acquired
Certain primitive reflexes have to be lost
before relevant milestones are attained,eg
palmar grasp is lost before voluntary
grasp is attained
Factors affecting development
Prenatal Maternal factors
Intelligence of Drug/Alcohol abuse
parents PIH
Parental attitude Hypothyroidism
Involvement Malnutrition
Education Chorioamnionitis
Desire for the child Intrauterine
Genetic factors infections
Chromosomal
anomalies
Metabolic diseases
Factors affecting development
Neonatal factors Social factors
LBW/Prematurity
Parenting
Neonatal seizures
Poverty
Post neonatal Lack of stimulation
factors Abuse and violence
Nutritional
Brain insult
 Infection
 Trauma

Endocrine(hypothyr
oid)
Associated
impairments
 Normal development
Gross motor Fine motor
•Acquisition of skills to facilitate •Skills for manipulation with
control of body and development hand and eye co ordination
of locomotion
•Joined function of nervous
•Depends on integrity of nervous system, musculoskeletal system
and loco motor systems and cognitive capacity

Personal and social Language

and general
understanding
Reveals interpersonal and
social skills
Vision and hearing
Gross motor
Supine and pull to sit
Observe for control of head and curvature of
spine
NB – complete head lag, rounded back

Gradual development of head control and

decrease of spine curvature
Head control-starts at 6 wks week,mild lag at
12 wks

20 wks – Complete neck control

Ventral suspension
NB – Head flops down
6 wks – Head in horizontal plane momentarily
8 wks – Head in horizontal plane
12 wks – Head above horizontal plane
Prone position
NB – Turns head to one side
4 wks – lift chin up momentarily in midline
8 wks – Face lifted up at 45°
12 wks – bear weight on forearms, chin and
shoulder off the couch, face up to 90°
n
5 months – Roll over
6 months – support on extended arms, lift head
and greater part of chest
8 months – crawling (abdomen on the ground)
10-11 months – Creeping (abdomen off the
ground)
Rolling over(5 mon)
Crawling (8mon )
Creeping(10-11mon)
 Sitting

2 months-sits with support back rounded with

others
4 months-sits with support back straight

6 months – Sitting with support by himself

(tripod)
8 months – Sitting without support
10-12 months – Pivot in sitting
Sitting without support(8mon)
Pivot(10-12 mon)
Standing and walking
6 months – Bear all his weight when made to
stand
9 months – stand holding to furniture and pulls
himself to standing position
11 months-Cruising around furniture
12 months – Stand without support,Take first
step
13 months – Walking independently
18 months – Runs, Crawls up or downstairs
Standing with support (9 mon)
Cruising around furniture(11 mon)
Stand without support(12 mon)
2 yrs – Walk backwards, climb upstairs
both feet at one step
3 yrs – climb upstairs with one foot per
step, Ride a tricycle
4 yrs – Move down the stairs one foot per
step, Hop on one foot
5 yrs - Skipping
Walking without support ( 13 mon)
Creeps upstairs (15 mon)
Rides tricycle ( 3 yr)
Climbs upstairs with one foot per step
(3 yrs)
Goes downstairs one foot per step (4 yrs)
Skipping( 5 yr)
Fine motor
Hand eye coordination

3 mon – Hand regard

4-5 mon- Bidextrous approach
 6 month –voulatary palmar grasp
7 months – Unidextrous approach, Transfer
object from one hand to other
Bidextrous approach ( 5 mon )
Unidextrous approach ( 7 mon )
Hand to hand transfer of objects ( 7
mon)
10 month – Assisted pincer grasp
1 yr – Unassisted pincer grasp
Hand to mouth coordination
5 months – mouthing: stops by 1 yr
15 months- Feed self from cup with spilling
18months – Feeding from cup without spilling
Mouthing( 5 mon )
Feeds self with spilling ( 15 mon )
Feeds self without spilling ( 18 mon )
Advanced hand skills
15 months – Buld tower of 2 cubes; Scribbles
on a paper
18 months – Tower of 3-4cubes,turn pages 2-3
at a time
2 yrs – Unscrew lids,, Tower of 6 blocks,
scribbles in circular pattern, turn pages one at
a time, put on shoes or socks
3 yrs – Tower of 9 cubes, Copies circle, Can
dress and undress
4 yrs – Copies cross and square
41/2 yr-copies square
5 yrs – Copies triangle, Can tie shoelaces
Scribbling ( 15 mon )
Tower of nine cubes ( 3 yr )
Buttoning cloth fully (4 yr)
Personal and social
– 1 month – Intent regard of mother
– 2 months – Social smile
– 3 months – Recognizes mother
– 6 – 7 months – Stranger anxiety, smiles
at mirror image, imitates actions of
others like coughing
– 9 months – Waves “bye – bye”
Social smile (2 mon )
Smile at mirror image ( 6 mon )
Waves bye-bye ( 9 mon )
12 months – Can understand simple
questions, Comes when called, Plays
simple ball game
18 months – Copies parents in tasks
2 yrs – Ask for food, drink etc.,parallel
play,dry by day
3 yrs – Shares toys, knows name and
gender,dry by night
4 yrs – Plays cooperatively in a group, Left
and right discrimination,
5 yrs – Help in house hold activities
Language
1 month – alert to sound
3 months – Cooing
4 months – Laugh aloud
6 months – Monosyllabls(ba,da,pa)
9 months- bisyllables(mama,dada,baba)
12 months – 1- 2 words with meaning
18 months – 10 words
2 yrs –Simple sentences with 2 – 3 words,
Use pronouns
3 yrs – Continually ask questions,name 2
colour
4 yrs – Tells stories, sings song/rhyme
5 yrs – Asks meaning of words, name 4
colour
Vision

Birth – Fix on objects, Follow objects to

45°
4 wks – Follow 90°
12 wks – Follow 180°
 4 months – “Grasping with the eyes”
(Fixate intently on an object)
Hearing

Birth – Responds to sound by startle, blink,

cry or change in ongoing activity
3 months – Turn his head to source of sound
Red flags signs in development
No visual fixation or following by 2 months
No vocalization by 6 months
Not sitting without support by 9-10months
Not standing alone by 16months
Not walking alone by 18months
No single words by 18months
Lack 0f imaginative play at 3 yrs
Loss of comprehension,single words or
phrases at any age
Development indicates acquisition of skills
for optimal functioning

Development is a continuous process that

gradually replaces initial disorganized
mass by more specific and willful activity
Much of the milestones depend on
caretaker’s interaction and opportunities
provided to the child

Receptive ability and understanding

precedes expressive ability in language
development

Adequate sensory inputs are essential for

normal development
References:-
1) Illingworth

2) O.P. Ghai
Thank