Normal Development Flashcards
Factors influencing normal development?
Genetic (esp. important or cognitive development), nutritional and environmental (determines how much of the genetic potential is engaged)
Principles of development?
It is a continuous process in which the sequence is the same for different children but the RATE VARIES; maturation of the immune system occurs during it
In which direction does normal development occur?
Cephalocaudal direction, i.e: head control first and this is followed by trunkal control and, finally, lower limb control
4 key areas of development?
- Gross motor
- Fine motor and vision
- Language and hearing
- Social behaviour and play
Some key milestones for gross motor development?
3 months - head control 6 months - sitting balance 9 months - crawling 12 months - standing 18 months - runs Stairs (2 feet/tread) - 24 months Stairs (alternate feet) - 36 months Hops - 48 months
Primitive reflexes in motor development?
Sucking and rooting (turning into a touch)
Palmar and plantar grasp
ATNR (asymmetrical tonic neck reflex) - protection from rolling off of an unstable surface (en garde stance)
Moro - stretching out arms when released
Stepping and placing (child is unable to walk but, when put in the correct position, they make the motions for walking)
When and why is the ATNR lost?
Normally lost ~3-4 months, to prevent this reflex getting in the way of voluntary movements later in life
It may not be lost, e.g: in cerebral palsy
Normal variants from crawling?
Most children crawl but other normal variants:
• Bottom-shuffle (it is common for these children to walk slightly later on, i.e: ~16-18 months)
• Rolling
• Commando crawl
Describe sequence of head lag
The head leans back when the child is lifted (this is why parents should support the head); later on, this head lag lessens until they can support their own head
Describe development of sitting posture
From 3 months, start to develop a straighter spine and sitting posture until they can eventually support themselves (~6 months)
At this time, they should also develop parachutes, i.e: they can their hands to the side to aid stability when sitting
Describe development of crawling
At ~6 months, should be able to lift head and upper chest and, by ~12 months, this will have developed into 4-point crawling
This is why “tummy-time” is important for a child to learn this skill
Describe development of walking
At ~12 months, should be able to cruise (move around while holding onto furniture)
13 months is the average age for walking but 18 months is the cut-off, beyond which it is considered a red flag
At ~12 months, should be able to pick up a toy without falling
What to do if a child is not walking beyond the age of 18 months?
Check CREATINE KINASE
Not walking can be investigated earlier if there are other signs of abnormal development
Some key milestones for fine motor and vision development?
3 months - hand regard in midline (bringing hands to the midline and moving them)
6 months - palmar grasp
9 months - scissor grasp
12 months - pincer grasp
18 months - tower of 3-4 bricks
24 months - tower of 6-7 bricks and able to scribble
36 months - tower of 9 bricks and can copy a circle
48 months - can draw a simple man
Cautions with interpreting hand regard in midline?
This is not reliable for ruling out visual impairment; it can provide false reassurance, even though visually impaired children can often do this
