Q3: Developmental Milestones - Newborn & Infancy

Ma. Noemi V. Tanglao – Salazar, MD

Department of Pediatrics
Faculty of Medicine & Surgery - University of Santo Tomas
Head lag

Prenatal Development
• Most dramatic events in growth and development
occur before birth.
• Most vulnerable as well, since the uterus is
permeable to adverse social and environmental Preference for human face
influences while complex processes take place. • Primitive reflexes:
• The interplay of forces in the fetus influences the o Moro reflex
infant’s behavior at birth and may affect parent-child o Rooting, sucking and swallowing reflexes
interaction throughout. o Grasp reflex
• Visual: doll’s eye movement
Fetal Development
• Embryonic period: 14 days to 8 weeks, human-like
shape attained by 4 weeks, marked by the
development of rudiments of all major organ
systems.
• Fetal period: 9 weeks onwards, somatic changes
consist of increasing cell number and size and
structural remodeling of organ systems.
• Brain is formed at birth but myelination and synaptic
organization continues post-natally.

Pediatric Age Groups

• Neonate 0-28 days
• Infancy 0-2 years
• Preschool Age 2-5 years
• School Age 6-10 years
(Middle Childhood)
• Adolescence 10-20 years
0-2 months
DEVELOPMENTAL MILESTONES OF THE NEWBORN & INFANT • Cognitive Development
o Habituate to the familiar stimuli, but
Newborn increases their attention when the stimulus
Gross motor changes
• Normal posture: partial flexion o Can recognize facial expressions
• On ventral suspension: head droops • Emotional Development
• On prone: lies in flexed attitude o Basic trust vs. mistrust
• On pulled to sitting: marked head lag o Depends on attachment and reciprocal
maternal bonding
• On ventral suspension:
o head is already in line with body
• Tonic neck posture predominates
• Follows moving objects
• Beginning to smile
Ventral suspension
2-6 months
• Emergence of social smile (2 months)
• Primitive reflexes begin to disappear (4 months)
• “Social hatching” – becomes interested in a wider
world (4 months)
On prone • Primary emotions appear as distinct facial expressions
(anger, joy, fear, surprise)
• Increasing control of truncal flexion makes intentional
rolling possible.
• 7 months
o Transfers objects from one hand to the
Pulled to sitting other
o Creeps or crawls

rainwater@mymelody.com || 1st semester, AY 2011-2012

 • 10 months • Emotional Development
o Sits without support o “Rapprochement”
• Cognitive Development  Increased clinginess
o Complexity of play is a useful index of  Reaction to growing awareness of
cognitive development the possibility of separation
o A major milestone at 9 months is the  Separation anxiety
achievement of object permanence  Despite attachment to parent,
(constancy), an understanding that objects children use “no” as a way of
continue to exist even when not seen. declaring independence
• Emotional Development
o Stranger anxiety
Developmental Red Flags
o Tantrums make their first appearance
• Says repetitive consonant sounds • Concept of red flags – warning signs
like “mama” and “dada” – babbling (10 months) • Limit ages
inflections mimic native language o age when 100% of a particular population is
• Says a few words beside “mama” and “dada” (12 expected to exhibit a certain milestone at a
months) certain point in time
• Adept at non-verbal forms of communication
• Stranger anxiety Fine Motor
• Object permanence • 3 ½ months persistence of grasp reflex
• 7 months cannot hold an object with each
Second Year of Life hand
• Cognitive Development • 2 years cannot scribble
o Piaget – Sensory motor stage (12-18
months) Gross motor
o Exploration of the environment increases in • 4 ½ months cannot pull up to sit
parallel with improved dexterity • 5 months cannot roll over
o Toddlers manipulate objects in novel ways
• 9-10 months cannot stand holding on
to create interesting effects
• 15 months cannot walk independently
o Playthings are more likely to be used for
their intended purposes
Receptive Language (Cognitive)
• Emotional Development
• 2-3 months not alert to mother
o Erikson – autonomy and separation
• 8-9 months no interest in peek-a-boo
(12-18 mos)
• 12 months doesn’t search for hidden object
o Toddlers
appear “intoxicated” or ”giddy” with the
Expressive Language
ability to control distance between
• 5-6 months not babbling
themselves and parents but return for a
reassuring touch ( parents act as a secure
• 18 months less than three words with
meaning
base)
o Quality of the maternal – child relationship • 2 years no two-word phrases
may moderate negative effects of child care
arrangements when parents need to leave Social
for work • 3 months not smiling reciprocally
• 15 months- walks alone • 6-8 months not laughing at playful situations
o Jargons • 1 year hard to console
o Indicates needs by pointing • 2 years no eye contact or engagement
• 18 months- runs stiffly with other children or adult
o Identifies one or more parts of the body
o Feeds self
Reminder:
• 24 months
o Runs well • If a child shows any of the red flags in the different
o Circular scribbling developmental areas, then it is very important to
o Vocabulary balloons to about 100 words at know the reason why
2 years • What to do?
o Puts 3 words together to form phrases o Get a diagnosis
o Follows 2 step commands o Start intervention as early as possible
o Helps to undress
o Handles spoon well
• Cognitive Development
o End of the sensory-motor period (18
months)
o Cause and effect are better understood
rainwater@mymelody.com || 1st semester, AY 2011-2012