Normal growth and development Flashcards
Phases of growth
1) Infantile phase - birth to 1 year (nutrition dependent; insulin and throxine important)
2) Childhood phase - 1y - 5y (dependent on growth hormone and thyroxine)
3) Mid-childhood phase - 5y - puberty (increased levels of adrenal androgens)
4) Pubertal phase (growth spurt caused by increasing levels of sex steroid)
Growth assessment
Height
Weight
Head circumference
Want to stay on same centile line
Essential to remember milestones
4-6 weeks: fixes faces, smiles
6-7 months: sits up unsupported
9 months: gets to a sitting position
10 months: pincer grip; waves bye
12 months: walks unsupported; 2-3 words with meaning
18 months: feeds self with spoon; points to things; tower 3-4 cubes; throws a ball without falling
24 months: sentences of 2-3 words; running; kicks a ball
Gross motor
Birth - prone flexed posture; complete head lag
6 weeks - head control developing; support to sit
4 months - no head lag on pulled to sit, lifts head/good head control lying on front, held sitting - lumbar curve
6 months - sits without support (?7-8 months, refer at 12), stands with support, grasps feet lying on back, rolls over, back straight sitting
9 months - gets into sitting position, pulls to standing and stands holding on, crawls
12 months - stands and walks with one hand held, cruises
15 months - walks independently (refer at 18m)
18 months - stoops to pick up objects
2 years - runs, up/downstairs holding rail
3 years - tricycle using pedals, up stairs not holding on
4 years - hops on one leg
Fine motor and vision
3 months - reaches out, holds rattle briefly, visually alert (esp faces), fixes and follows
6 months - palmar grasp, transfers, visually insatiable (looks everywhere)
9 months - points, early pincer
12 months - good pincer grip; gives brick, bangs toys together, should be no hand preference before this point
15 months - tower of 2, looks at book, pats page
18 months - scribbles; three-four block tower, turns several pages at a time
2 years - tower of six, vertical line, turns one page at a time
3 years - tower of nine, circle
4 years - cross
5 years - square
6 years - triangle
Speech, language and hearing
Newborn - startles
3-4 months - coos to self and others, turns to sounds
7 months - soft sounds
7-10 months - ‘double babble’ - mama, dada
12 months - single words other than mama, dada, knows own name, understands simple commands
18 months - 10 words; points when asked ‘where are you ears?’
20-24 months - linking 2-3 words, vocab increased
2 1/2 - 3 years - 3-4 word sentences, talks incessantly, “what” and “who” questions, knows colours, counts to 10
4 years - “why”, “when” and “how” questions
Social development
6 weeks - smiles responsively (refer at 10w)
3 months - laughs, enjoys handling
6 months - not shy, puts hand on bottle when being fed
9 months - shy, peekaboo, puts everything in mouth
12-15 months - waving, drinks from a cup, spoon, helps with dressing
18 months - holds cup and spoon, takes off hat and shoes (can’t put on), (-2y)imaginative play
2 years - competent with spoon and cup, puts on hat and shoes, parallel play, (-3y)toilet training
3 years - taking turns, spoon and fork
4 years - plays with others, dress/undress self except laces and buttons
5 years - knife and fork
Primative reflexes
Moro Walking/stepping Rooting Sucking Tonic neck/fencing Palmar grasp (and reverse) Upgoing plantar Swimming Babkin reflex
Red flag: baby
Not looking at parents face/objects Lack of smiling/eye contact Persistent head lag, late sitting Early feeding problems Abnormal or asymmetrical movements
Red flag: infant
Strong hand preference Inconsistent responses to sound Poor localisation Attention difficult to capture Loss of skills
Red flag: toddler
Persistent mouthing - beyond 18 months No speech by 18 monyths Persistent shaking/rattling of toys Short concentration Lack of pointing to share/repetitive play
Red flags: any age
Parental concern
Discrepancy between height, weight, HC
History of increasing gap between child’s developmental ability and his peers
Developmental regression (apart from minor regression socially in response to stress)
