Chapter 20: Caring for the Developing Child (Newborn + Infants)

Question 1

Nature

Answer 1

describes the traits inherent in the infant at birth: biologically imposed idiosyncratic factors that create what and how each person is

Question 2

Nurture

Answer 2

the influence of external events such as parenting received, culture, or the “times” in which a child lives

Question 3

Growth

Answer 3

the continuous adjustment in the size of the child, internally and externally

Question 4

Development

Answer 4

refers to the ongoing process of adapting throughout the life span

Question 5

Growth & Development

Answer 5

-each child grows and develops at their own pace
-occurs in a orderly sequence, and each child should progress through the predictable stages within a certain time frame
-continuous process from conception to death
>for the child, growth “spurts” tend to be followed by periods of “rest” because it takes plenty of energy to continue the growth process; the period of rest allows the child to incorporate the new growth or newly developed skill into his or her personal repertoire more completely before attempting the next level

Question 6

Cephalocaudal

Answer 6

progression from head-to-toe; top to bottom

• development proceeds in a cephalocaudal direction
  ex: the baby’s brain develops quickly; therefore, the head grows first in comparison to the rest of the body
• the child gains head and neck control before learning to grasp or sit up

Question 7

Proximodistally

Answer 7

children develop from near to far and midline to periphery
>ex: the torso develops before the arms and legs, and development proceeds to the hands and feet and then to the fingers and toes

Question 8

Three Primary Considerations for Growth and Development

Answer 8

How growth and development proceeds

1. Cephalocaudal
2. Proximodistally
3. Gross Motor to Fine Motor Skills

Question 9

Gross Motor to Fine Motor Skills

Answer 9

> Gross Motor skills (running, jumping, riding a bike) provide the foundation for fine motor development (eating, coloring, or buttoning a shirt)

Question 10

Touchpoints

Answer 10

-T. Barry Brazelton created
“periods during the first 3 years of life during which children’s’ spurts in development result in pronounced disruption in the family system”
-ex: an early touchpoint is noted in the 4 month old infant who becomes aware of surroundings; this interest in the environment will disrupt meals as the infant searches out the sounds that are heard; sleep may also be disrupted because of the new awareness, and the infant may awaken at night
>”the cost of each new achievement can temporarily disrupt the child’s and even the whole families progress”
-touchpoints give parents the tools to help the child develop in a healthy manner
-touch points represents a positive and well-integrated way of conceptualizing developmental progress

Question 11

Touchpoint examples: Birth to 3 years

Answer 11

> Pregnancy to 7 months: parents are concerned with who the child will be. Choice time to develop a rapport with the parents before the child is born
Newborn: soon after birth the newborn is assessed for his ability to habituate, or remain calm in a chaotic environment
3 Weeks: infant starts to learn to self-calm. Parents debate use of pacifier versus thumb
6 to 8 Weeks: infant reacts differently to each parent through facial expression and physical movements
4 Months: infant cycles through light and deep sleep several times a night as he learns to sleep through the night. This is important to avoid sleep problems
7 Months: naps and bedtime are interrupted by the constant practice of new physical skills such as sitting and crawling
9 Months: increasing independence (e.g. crawling and cruising) makes the infant more dependent as separation anxiety takes hold
12 Months: all foods become finger foods. Parents must often give up on the idea of a “rounded diet” because the child now controls what is eaten and when
15 Months: the word “no” becomes prevalent. Toddlers demonstrate frustration at not being able to talk
18 Months: the child tests the limits of parents and caregivers and learns appropriate behavior through consistent limit-setting and consequences
2 Years: the child has now developed gender identity and behaves accordingly
3 Years: learning to handle anger and aggression is paramount. Children may regress and exhibit temper tantrums as they process these emotions

Question 12

Sigmund Freud

Answer 12

believed development was most influenced by biological instincts; these instincts were psychosexual in nature, meaning that the child progresses through developmental stages based on resolution of conflicts surrounding urges and rules
>also described development of three essential aspects of personality: id, the ego, and the superego

Question 13

Sigmund Freud: id, ego, and superego

Answer 13

> id: initial aspect, emotional part; present at birth and unregulated (the infant responds to all stimuli emotionally; the infant cries, laughs, or coos automatically and without thought), id is part of the personality that relies on instinct
Ego: begins to develop during the first year, to provide balance between the competing id and reality; ego provides a sense of identity separate from others and promotes the ability of the child to function individually
between ages 3 and 6, serves to help regulate behavior; functions as a center for conscience, and a sense of what and how the child perceives self.

Question 14

Personality: id

Answer 14

-initial aspect
-emotional part of personality
-present at birth and is unregulated
>ex: the infant responds to all stimuli emotionally. The infant cries, laughs, or coos automatically and without thought
-part of the personality that relies on instinct

Question 15

Personality: Ego

Answer 15

-develops during first year of life
-provides balance between the competing id and reality
-provides a sense of identity separate from others
-promotes the ability of the child to function individually
>during infancy, the ego helps the baby begin to learn that the mother is not simply an extension of his body
>during adolescence, the ego provides a balance, this time between the id and the superego; when the adolescent refuses to drink alcohol with friends because it is against the child’s conscience and the law, it shows that ego has prevailed

Question 16

Personality: Superego

Answer 16

• develops between ages of 3 and 6
• in this stage, child develops cognitively and learns about rules and the needs of others
• superego functions as a center for conscience, and a sense of what and how the child perceives itself
  ex: the young child obeying the parents’ rules by picking up toys even though the child would rather continue playing
• child is learning that there is a difference between right and wrong and that the child is not the “center of the universe” as previously believed
• child knows that a “good” boy or girls obeys parents

Question 17

Freuds Stages of Psychosexual Development

Answer 17

• Oral Stage (Birth to 1 year)
• Anal Stage (1 to 3 years)
• Phallic Stage (3 to 6 years)
• Latency Stage (6 to 12 years)
• Genital Stage (12 to 18 years)

Question 18

Psychosexual Development: Oral Stage

Answer 18

Birth to 1 year

• the infant is fixated on oral curiosity (whatever he can put in the mouth)
• the infant derives pleasure from, and relieves anxiety through, oral sensations (e.g. the infant sucks on his mother’s breast or bottle and is fed and pleasured)
• the infant puts his fist in his mouth or uses a teething ring
• children often use pacifiers or thumbs to decrease anxiety and increase comfort

Question 19

Psychosexual Development: Anal Stage

Answer 19

1 to 3 years

• by the time the child reaches this stage, the child is ready to control elimination.
• some children readily use the “big kid” potty; others resist
• this is a time of increasing control in other areas of the child’s life; the child recognizes that this newfound control can run a collision course with the world, and hence the term, “terrible twos”.
  ex: the child explores, asserts, and learns boundaries about where to play safely. The child may struggle against these boundaries by escaping the backyard and running down the street

Question 20

Psychosexual Development: Phallic Stage

Answer 20

3 to 6 years

• by early childhood, sexual differences is discovered
• the child begins to compare both the male and female bodies simply out of curiosity
  ex: the child notices that girls are physically different form boys
• during this time, a girl child wants to push mommy aside and marry daddy, or vice versa

Question 21

Psychosexual Development: : Latency Stage

Answer 21

6 to 12 years

• Freud believed that the child takes a “break” psychosexually during this period of development
• this allows the child to focus more intently on other aspects of growth and learning
  ex: the child spends time with his other same-gender friends, excelling in sports or video games
• at this age, the child presumably has little interest in issues of sexuality

Question 22

Psychosocial Development: Genital Stage

Answer 22

12 to 18 years

• by the time the child reaches puberty, sexuality and relationships are the focus
  ex: this is a time for exploring relationships and developing a sense of romanticism

Question 23

Erik Erikson

Answer 23

focused on influence of social interaction

• stages of development
• mastery of each stage requires that the individual achieve a balance between two tasks (conflicting variables)
• each stage represents a crisis that must be resolved to move onto the next stage in a healthy manner

Question 24

Erik Erikson’s Stages of Development

Answer 24

• Trust versus Mistrust
• Autonomy versus Shame and Doubt
• Initiative versus Guilt
• Industry versus Inferiority
• Identity versus Role Confusion

Question 25

Erik Erikson’s Stages of Development: Trust versus Mistrust

Answer 25

occurs between birth and 1 year
task= infant to recognize that there are people, generally parents, who can be trusted to take care of basic needs
-the infants struggle is evidenced in the recognition that not everyone or every situation is “safe”
-through trust, the infant learns to have confidence in personal worth and well-being along with connectedness to others
>failure = leaves a sense of hopelessness and disconnectedness; examples of disconnect can be seen in infants with failure to thrive or with attachment disorders
-difficulty in trusting can be even seen in adults who have problems maintaining significant relationships

Question 26

Erik Erikson’s Stages of Development: Autonomy versus Shame and Doubt

Answer 26

occurs between 1 and 3 years
task= the child to balance independence and self-sufficiency against the predictable sense of uncertainty and misgiving when placed in life’s situations
-it is the time for the child to establish willpower, determination, and a can-do attitude about self
>ex: happens when the toddler wants to choose clothing and dress independently
-the struggle happens when the parents allow the child to make personal choices yet expect the choices to be socially acceptable
-at this stage, the child is able to do many new things and wants to explore everything
-this newfound independence is accompanied by new rules that may cause internal conflict
-the child must develop personal abilities while struggling with both fears and wishes
>the child has self-doubt later in life if this stage is not successfully met

Question 27

Erik Erikson’s Stages of Development: Initiative versus Guilt

Answer 27

occurs between 3 and 6 years
-task= to develop the resourcefulness to achieve and learn new things without receiving self-reproach
-it is difficult for a young child to resolve the conflict between wanting to be independent and needing to stay attached to parents
-ex of initiative: the child’s learning of new songs, games, or jokes
-the child feels confident in trying new things
-important that parents and teachers encourage this initiative to help the child develop a sense of purpose
>if initiative is discouraged or ignored, the child may feel guilt and a lack of resourcefulness

Question 28

Erik Erikson’s Stages of Development: Industry versus Inferiority

Answer 28

occurs between 6 and 12 years
-the child develops a sense of confidence through mastery of tasks
-this sense of accomplishment can be counterbalanced by a sense of inadequacy or inferiority that comes from not succeeding
-the realization that the child is competent is one of the important building blocks in the development of self-esteem
-Industry is evident when the child is able to do homework independently and regulate social behavior
-performing the prescribed tasks at school or home also shows industry
>if the child cannot accomplish the realistic expected tasks, the feeling of inferiority may result

Question 29

Erik Erikson’s Stages of Development: Identity versus Role Confusion

Answer 29

occurs between 12 and 18 years
-a time of forging ahead and acquiring a clear sense of self as an individual in the face of new and at times conflicting demands or desires
-the adolescent want to define “what to be when I grow up”
-the adolescent concentrates on goals and life plans separate from those of peers and family
-at this point, the adolescent child has the ability to think about self as well as others and proceeds accordingly
>an adolescent who is unable to make decisions about possible career choices, a personal belief and value system, and sexual orientation, may develop a weak sense of self and incapable of committing to an identity; this indecision leads to role confusion

Question 30

“What to Say”– When a parent inquires about the development of her child

Answer 30

when parents ask the nurse about a delay in her child’s development, the nurse can respond by saying “it is important to note that your child may not have reached the “appropriate” developmental stage based on chronological age alone. There may be events or variables that delay your child’s attempts to move forward, such as an illness”

Question 31

Jean Piaget

Answer 31

cognitive theories

• discussed cognition (thought) and how it influences development
• developed 4 stages: sensorimotor stage, preoperational stage (preconceptual and intuitive), concrete operational, and formal operational stage

Question 32

Jean Piaget: Sensorimotor Stage

Answer 32

initial period

• from birth to age 2
• the primary means of cognition is through the senses
• the child takes in and processes information strictly on a physiological and emotional level

Question 33

Jean Piaget: Preoperational Stage

Answer 33

from 2 to 7 years
-child begins to use cognitive processes to respond to the world physically
-the development of motor skills and is divided into 2 substages: preconceptual (2 to 4 years) and intuitive (4 to 7 years)
>child is still not capable of logical thinking, but because of an increased ability to use words and actions together, the child is increasingly able to connect cognitively with the world

Question 34

Jean Piaget: Concrete Operational Stage

Answer 34

from 7 to 11 years

• child is able to organize thoughts in a logical order
• child is able to categorize and label objects
• possible for the child to solve concrete problems

Question 35

Jean Piaget: Formal Operational Stage

Answer 35

final stage of cognitive development

• from 11 to 15 years
• uses abstract reasoning to handle difficult concepts and can analyze both sides on an issue

Question 36

Newborn and Infant: Reflexes and Neurological Development

Answer 36

primitive reflexes are those adaptive and innate mechanisms that protect the developing infant while the brain is maturing
-there are several reflexes present at birth or shortly after and help determine normal or altered neurological development; these usually naturally disappear by 9 months
-at birth, the lower portions of the nervous system, the spinal cord and the brainstem, are already developed; these are necessary for the infant to sustain body functions and primitive reflexes
>as the infant matures, the higher sections of the nervous system become more developed
ex: the limbic system and cerebral cortex are responsible for ongoing learning that occurs during the life span

Question 37

Important Reflexes upon assessment of newborn

Answer 37

• Rooting: infant’s head turns and begins to suck when his cheek or lower lip is stroked
• Sucking: sucking motion of lips, mouth, and tongue, allows the infant to take in sustenance
• Moro: startle response with sudden jarring causes extension of the head. the arms abduct and move upward. The hands form a “C”
• Grasping: this is noted when the palms of the hands or soles of the feet are stroked causing fingers or toes to curl inward
• Babinski: this is the turning in of the foot and fanning out of the toes when the sole of the foot is stroked

Question 38

Newborn Sensory Development: Touch

Answer 38

• touch; first sense to development; ability to feel objects, textures, and other people opens up the newborns world of learning
• important for the newborn to experience soft, comforting textures

Question 39

Newborn Sensory Development: Pain

Answer 39

as a protective device

• if has a pain experience, he reacts to pain with the whole body by quickly extending and then retracting the extremities
• infant also cries

Question 40

Newborn Sensory Development: Smell and Taste

Answer 40

begin developing in utero and intrinsically connected

• infant responds to smells within the first few days and have an innate preference for sweet tastes
• infants can recognize their mothers smell long before they achieve visual recognition

Question 41

Newborn Sensory Development: Hearing

Answer 41

well developed at birth

• newborn can immediately recognize the difference between male and female voices and generally turn toward the female voice
• by second week, can recognize sound of mothers voice
• ability to discriminate sounds develops quickly, contributing to language development
• by 3 months, the infant jabbers and begins to imitate sounds
• next few months, infant becomes more adept at responding to and imitating familiar sounds by smiling and cooing

Question 42

Newborn Sensory Development: Vision

Answer 42

least developed senses at birth

• newborns fascinated with faces and with designs or objects that resembles faces
• able to remember an object but only in the exact form originally seen (e.g. if the child sees sister in pigtails, the child does not recognize sister with hair down)
• most attracted to bright colors and to black and white
• generally has poor peripheral vision until 10 weeks of age
• within the first 3 months, the infant will watch faces intently, follow moving objects, and recognize familiar objects and people at a distance
• beginnings of eye-hand coordination
• binocular vision (ability to use both eyes to see) develops at about 4 or 5 months of age
• capacity to distinguish colors and to see things in the distance develops throughout the first 7 to 12 months

Question 43

Newborns/ Infants: Physical Development: Weight

Answer 43

• growth is rapid
• infants gain 1.5 pounds (680 g)/ month
• double their weight by 6 months
• and triple their weight by 1 year

Question 44

Newborns/Infants: Physical Development: Height

Answer 44

increases by 1 inch (2.5 cm)/ month for the first 6 months and slows during second 6 months

Question 45

Newborn/Infant: Physical Development: Head

Answer 45

newborns head is proportionally larger than the rest of the body; cephalocaudal course of development

• newborns head grows rapidly during the first month as the brain grows
• by the time reaches 1 year, the head and chest circumferences are about the same

Question 46

Newborn/Infant: Physical Development: Motor Skills

Answer 46

for the infant to move or perform actions (motor skills), must have adequate muscle development
-at birth, movement is involuntary
-gross motor skills (ability to use large muscles for movement) are first to develop in newborn and infant
-by end of the first 3 months of life, the infant can raise his head and chest while lying on his belly and stretch the legs out and kick from a prone position, and roll from side to side
-can turn completely at 6 or 7 months of age
-by 8 to 9 months, infant begins to crawl, and then by using high objects, the infant can begin pulling up
-once mastered an upright position, he may begin to cruise (walking while holding furniture) or attempt to walk unaided
-fine motor skills (use of muscles to accomplish minute tasks like pinching or picking up food) build on the gross motor skills
>fine motor skills that develop between 6 and 12 months include, ability to stack large objects, scribble, bang on pots and pans, and transfer objects from one hand to another and back again

Question 47

Newborn/Infants Cognitive Development

Answer 47

-infancy corresponds to Piaget’s sensorimotor stage of development
-infant uses 5 senses to explore and learn about the world
-ex: infant learns that lip smacking when hungry leads to a full stomach. when the infants belly is full, physical needs are met, and the infant can then begin to explore the environment; the infant learns that he can have an impact within that environment
>must achieve 3 tasks during this phase: separation, object permanence, and mental representation

Question 48

Separation

Answer 48

the infant recognizes that there is no merging with or attachment to familiar people (family members)

Question 49

Object Permanence

Answer 49

the infant knows that an object or person still exists even if covered up or removed from sight; this is why infants respond strongly to peek-a -boo

Question 50

Mental Representation

Answer 50

the infant has the ability to use symbols to communicate

Question 51

Piaget Recognized 6 substages within the sensorimotor stage that describe mental representation

Answer 51

1. Use of Reflexes: present at birth, majority of reflexes are necessary for survival and disappear during first 9 months
2. Primary circular reactions: (1 to 4 months): takes place when the infant responds to things that give pleasure; infants response encourages caregivers to continue providing pleasurable experiences
3. Secondary circular reactions: begins when the infant recognizes cause and effect. ex: the actions that the infant can perform independently begin to capture his attention (e.g. shaking a rattle)
4. Coordination of secondary schemes: (8 to 12 months): begins when infant becomes deliberate with his actions. the infant intentionally seeks out objects. the infant now knows that pushing a button starts the music on a toy. the infant also develops object permanence
   >Next 2 take place during Toddler Stage:
5. Tertiary circular reactions: making interesting things last such as hitting a drum with a stick and making the rat-a-tat-tat sound
6. Mental combinations: problem solving such as putting a toy down to open a drawer

Question 52

Infants/Newborns: Language Development

Answer 52

• communicate through language of crying to indicate physical discomfort or loneliness
• as a mother or father responds to cries, the infant learns to communicate more deliberately
• infant’s early speech is characterized by crying, babbling, and imitation
• influences on language development include maturation of the brain and the degree and quality of social interaction
• if families respond favorably to the infants sounds, like “ba” for bottle or “da” for daddy, the infant is more likely to repeat these sounds, thus bringing the infant closer to the native language

Question 53

Newborn/Infant: Psychosocial Development

Answer 53

in infants, the first displays of emotions, crying and smiling, are related to physiological needs rather than psychological stimuli

ex: the newborn wails loudly when physically uncomfortable and smiles involuntarily during sleep; however, by the time the baby is 2 weeks of age, the smiles begin to signify contentment and elicit a positive family response
- corresponding with Erikson’s trust versus mistrust, the nurse recognizes that this is a critical time for the newborn to absorb the whole environment along with related experiences
- caretakers role= respond to the infant in such ways as to engender a sense of security and well-being; infants role= develop a sense that his caretakers are reliable and present

Question 54

Newborn/Infant: Discipline

Answer 54

helps correct misbehavior and molds character
-infants learn about safe boundaries and trusting relationships through effective discipline
-nurse helps parents determine how they plan to discipline their child now and later on as the child grows and develops
-early forms of discipline take place when the caregiver molds and structures daily routines and responds to the infant’s needs
-limit-setting functions to accumulate the infant to the world and to keep the infant out of harms way
>parents learn from own experiences
>parents should be taught what to expect at each of the developmental stages and how to recognize appropriate strategies for teaching and limit setting

Question 55

Anticipatory guidance

Answer 55

a way of providing caregivers with information and examples about what to expect in the future regarding their child’s next developmental phase

• teach parents that infants do not misbehave on purpose
• exploration and crying are normal behaviors for infants
• the purpose of discipline at this age (newborn/infant) is to keep the child safe
• parents can use a firm tone of voice or facial expression while telling the child “no” or “stop” as she reaches for the stove; this helps the infant know that there are limits to her actions
• the infant can be redirected to a similar experience

Question 56

Anticipatory Guidance For Infants: Nutrition

Answer 56

• review breast and bottle feeding guidelines
• introduction of solid foods (4-6 months)
• encourage self-feeding when appropriate
• finger foods
• weaning to a cup (9-12 months)
• family meal time
• change to whole milk at 12 months

Question 57

Anticipatory Guidance for Infants: Health Promotion

Answer 57

• signs and symptoms of illness: vomiting, diarrhea, fever, dehydration, and jaundice
• immunizations
• recommended CPR training
• review emergency procedures
• oral health: brushing with non-fluoride toothpaste after eruption of first tooth
• schedule first dentist appointment

Question 58

Anticipatory Guidance for Infants: Focus on Safety

Answer 58

• safety guidelines for crib
• place car seat in back of car in a rear-facing position
• position on back for sleeping to decrease risk of sudden infant death syndrome
• do not leave infant unattended
• install smoke detectors
• lower crib mattress and childproof environment as child becomes more mobile
• close supervision
• discourage use of baby walkers

Question 59

Anticipatory Guidance: Sleep-Wake Patterns

Answer 59

• expected patterns at each month of age
• expectations for sleeping through the night
• naps
• establishment of nighttime rituals

Question 60

Anticipatory Guidance for Infants: Cognitive and Emotional Development

Answer 60

• age-appropriate toys and interactive games
• talk and sing to infant
• read stories
• respond to infant cries
• face to face time

Question 61

Anticipatory Guidance for Infants: Motor Development

Answer 61

• support head and neck
• supervised “tummy time” to increase neck, arm, and torso strength
• provide safe space for child to move about
• provide opportunities for sitting, crawling, and walking

Question 62

Anticipatory Guidance for Infants: Discipline

Answer 62

• discuss discipline versus punishment
• limit-setting
• apply rules consistently

Question 63

Developmental Milestones for the Infant: Birth to 1 month

Answer 63

> Physical Growth:
-Height: 19-21 inches
-Weight: 7.5 lbs
-Head Circumference: 13-14 inches
-Chest Circumference: 12-13 inches
Gross Motor Skills:
-reflexes present, absence of head control, but can momentarily hold the head in midline, head lag when the newborn is pulled from a lying to a sitting position, assumes flexed position, when supine assumes tonic neck flex position, kicks legs and waves arms, rounded back when sitting, rolls over accidentally
Fine Motor Skills:
-hands predominately closed, strong palmar and plantar grasp reflexes
Cognitive, Sensory, and Language:
-uses all 5 sense to explore the world; touch (first sense to develop); smell (recognizes mother and has a taste preference for sweets); Hearing well developed (becomes quiet when hears a familiar voice); Limited visual acuity 20/100, fascinated with faces, follows moving objects, contrasting colors (black and white); Language (cries to express unmet needs); smiles during sleep
Psychosocial and Play:
-Psychosocial: learns to relieve anxiety through oral sensations, (breastfeeding, sucking on fist); begins to learn to trust caregivers
-Play: interactions with parents and caregivers; mobiles

Question 64

Developmental Milestones of the Infant: 1 to 2 Months

Answer 64

> Physical Growth:
-Weight: increases 1.5 lbs/ month
-Height: increase 1 inch/ month
-Head Circumference: increased 0.5 inches/ month
Gross Motor Skills:
-less head lag when pulled to sitting position, when prone can slightly life head off floor, improved head control, turns and lifts head from side to side when prone, some head control when upright
Fine Motor Skills:
-holds hands open, grasp reflex absent, can pull at clothes and blanket, bats at objects
Cognitive, Sensory, and Language:
-when supine follows dangling toys, visually searches for sound, when crying can be consoled easily by being held or spoken to, turns head to sound; Language: coos, has social smile
Psychosocial and Play:
-Psychosocial: same as birth to 1 month, learns to calm self
-Play: solitary play stimulates sensorimotor development with simple imitative games, interaction with parents and caregivers through games such as patty-cake and peek-a-boo

Question 65

Developmental Milestones for Infant: 3 to 6 months

Answer 65

> Physical Growth:
-Weight: double the birth weight by 6 months
-Height: increases by 1 inch/ month
Gross Motor Skills:
-can hold head more erect when sitting, still some bobbing, by 6 months steady head control, only slight head lag, by 6 months no head lag, raises head to 45-90 degrees off floor, in sitting position (tripod) back is straight and balances head well, sits alone by 8 months, when held in a standing position can bear some weight, by 8 months readily bears weight, rolls from back to side and then abdomen to back, when supine puts feet to mouth, begins to creep on hands and knees
Fine Motor Skills:
-plays with toes, clutches own hands, inspects and plays with hands, pulls blanket over face, rakes objects, grasps objects with both hands (palmar grasp), shakes rattle and holds bottle, eventually able to put objects in container and bang them together, carries objects to mouth, transfer objects from hand to hand
-reaches and bangs toys on table, likes mirror images
Cognitive, Sensory, and Language:
-follows object 180 degrees, develops binocular vision, locates sound by turning head, beginning eye-hand coordination, pursues dropped object visually, see small objects, responds to name, recognizes parent’s voice and touch; by 6 months differentiates between parents, language: coos, babbles, and laughs; by 6 months may say “dada” and “baba”, begins to distinguish emotion based on tone of voice
Psychosocial and Play
-Psychosocial: same as 1 to 2 months
-Play: solitary play stimulates sensorimotor development with simple imitative games, interaction with parents and caregivers through games such as patty-cake, peek-a-boo, and songs

Question 66

Developmental Milestones of the Infant: 9-12 months

Answer 66

> Physical Growth:
-Weight: Triple the birth weight
-Height: increases 1 inch / month
-Head and Chest circumference: the same at 1 year
Gross Motor Skills:
-creeps on hands and knees, pulls self to standing position, stands while holding onto furniture and begins to cruise, stands alone, changes from prone to sitting position, can reach backwards while sitting, can sit down from standing position alone, begins to walk holding hand and then independently, takes first step
Fine Motor Skills:
-uses pincer grasp, hand dominance now evident, releases and rescues an object, when sitting purposely reaches around back to retrieve an object, can randomly turn pages in a book, can make a simple mark on paper, waves bye-bye nd plays patty-cake, begins to feed self, finger foods
Cognitive, Sensory, and Language:
-increasing depth perception, moves toward sound, thoroughly explores and experiences objects, points to simple objects, language: says “mama”, “dada”, and “uh-oh”, understands a few words, responds to own name, exhibits stranger anxiety, begins to extinguish colors, increasing ability to see things in the distance
Psychosocial and Play
-Psychosocial: completes Erikson’s stage of trust versus mistrust, able to calm self
-Play: solitary play stimulates sensorimotor development with simple imitative games; interaction with parents and caregivers through games such as patty-cake, peek-a-boo, songs, finger painting, ball rolling, high chair fishing