Far Eastern University – Nicanor Reyes Medical Foundation Neonatal Period

Pedia Lec– Understanding Development in Children Domain Skills

Prone:
I. Development Arms/legs flexed; pelvis high
- Increased in the function and/or skills set of children Ventral suspension:
- Affected by Social and Environmental influences including the Head held below body
maternal nutrition status; substance use (both illegal and elicit); GROSS MOTOR Supine:
and physiological trauma Arms/legs semi-flexed
Pull to sit:
A. Theories of Development Complete head lag
1. Freud's psychosexual stage theory Held upright:
2. Erikson's psychosocial stage theory Legs extended
3. Kohlberg's moral understanding stage theory Grasp reflex
4. Piaget's Cognitive Development stage theory Drop object immediately
FINE MOTOR Hands down fisted
Book : Nelson’s textbook of Pediatrics 20th Edition( Pages 51-52) Sweeping movements
towards object
Expressive:
B. Principles of Development
LANGUAGE Crying/whimpering
1. Continuous process from Birth to Maturity
Receptive:
2. The sequence is the same in all children
Startled by loud sound
3. Intimately related to the maturation of Nervous System
4. Follows a Cephalo-Caudal Development
PERSONAL Gaze at faces, Colored objects
OR and Bright lights
C. Parameters of Human Development
SOCIAL
 Gross Motor Skills
- Pertains to body postures and large movement
1 Month
 Fine Motor and Visual Skills - Head lifted momentarily to plane of body
- Manipulation - Head lag when pulled to sitting position
- Visual competence in seeing and looking - Watches person
 Receptive Language - Follows moving object
- Auditory competence in hearing, listening and - Begins to smile
understanding
 Expressive Language 2 Months
- The use of language and speech - Raises head slightly farther
- Follows moving object 180 degrees
 Personal/Social skills - Smiles and coos on social contact
- Competence in organization of self - Tracking
i.e. Self-care
- Increasing voluntary acceptance of satisfactorily social 3 Months
standards - Lies with head in midline
- In prone, lifts head and upper chest with arms extended
II. Normal Development - Waves arms symmetrically hands loosely open
- Typical, usual, regular, acceptable for age-healthy or free of - Visually alert (can be given with colored toys)
abnormalities - Watches movement of own hands before face Finger play
- Clasps and unclasps hands (can hold rattles)
III. Delay - Holds rattle for a few moments when placed in hand
- Development is not as advanced as it should be - May turn eyes and/or head towards sound
- Rate of Development has been slower than what is usually - Vocalizes "aah", "ngah"
acceptable
4 Months
IV. Deviation - Lifts head and chest
- Development is atypical at any age level or is non-sequential - Symmetric posture predominates
over time - “No head Lag” when pulled to sitting, head steady
- Can sit with full support
V. Dissociation
- Discrepancies between the different streams of development Lagging seen in a 4 month old infant, may already be an indication
of Delay

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 6 Months “Milestone” Summary Table
- Looks at feet by raising head from pillow st
Neonatal Period (1 4 weeks)
- Sits with support Prone: Lies in flexed attitude; turns head from side to side;
- Rolls over, front to back and back to front head sags on ventral suspension
- Visually insatiable Supine: Generally flexed and a little stiff
- Palmar grasp, passes toy from hand to hand Visual: May fixate face on light in line of vision;
- Turns immediately to mother's voice “doll’s-eye” movement of eyes on turning of the body
- Laughs, squeals Reflex: Moro response active; stepping and placing reflexes;
grasp reflex active
- Babbling
Social: Visual preference for human face
- Puts hand to bottle and pats it when feeding st
At 1 month
- Shakes rattle
Prone: Legs more extended; holds chin up; turns head; head
lifted momentarily to plane of body on ventral
9 Months “Fetal Period” suspension
- Pulls to stand holding on to support for a few moments Supine: Tonic neck posture predominates; supple and relaxed;
- Attempts to crawl Inferior grasp used to pick up small objects head lags when pulled to sitting position
- Looks for fallen objects Visual: Watches person; follows moving object
- Babbles loudly ("mama", "papa") Social: Body movements in cadence with voice of other in
social contact; beginning to smile
- Shouts and listens nd
At 2 month
- Understands "no-no" and "bye"
Prone: Raises head slightly farther; head sustained in plane of
- Holds, bites, and chews a biscuit
body on ventral suspension
- Tries to grasp spoon when being fed Supine: Tonic neck posture predominates; head lags when
- Plays peek-a-boo and Hand Clapping (Object permanence) pulled to sitting position
- Has separation anxiety
- Have transition objects to remind them of their parents Visual: Follows moving object 180 degrees

Social: Smiles on social contact; listens to voice and coos

Stranger Anxiety, Tantrums, and Object Permanence can rd
be observed in a 9 month old At 3 month
Prone: Lifts head and chest with arms extended; head above
plane of body on ventral suspension
Supine: Tonic neck posture predominates; reaches toward and
st
1 Year misses objects; waves at toy
- Stands alone or walks alone Sitting: Head lag partially compensated when pulled to sitting
- May crawl upstairs position; early head control with bobbing motion;
- Picks up fine objects back rounded
- Drops and throw toys Reflex: Typical Moro response has not persisted; makes
defensive movements or selective withdrawal
- Knows and turns to own name
reactions
- Jargons loudly
Social: Sustained social contact; listens to music; says “ aah,
- Understands simple instructions ngah ”
- Pat-a-cake, bye bye th
At 4 month
Prone: Lifts head and chest, with head in approximately
The Prenatal Period and the 1st Year of life provide the platform for vertical axis; legs extended
remarkable growth and development Supine: Symmetric posture predominates, hands in midline;
reaches and grasps objects and brings them to mouth
Sitting: No head lag when pulled to sitting position; head
steady, tipped forward; enjoys sitting with full truncal
support
Standing: When held erect, pushes with feet
Adaptive: Sees pellet, but makes no move to reach for it
Social:
Social: Laughs out loud; may show displeasure if social
contact is broken; excited at sight of food
th
At 7 month
Prone: Rolls over; pivots; crawls or creep-crawls (Knobloch)
Supine: Lifts head; rolls over; squirms
Sitting: Sits briefl y, with support of pelvis; leans forward on
hands; back rounded
Standing: May support most of weight; bounces actively

Adaptive: Reaches out for and grasps large object; transfers

objects from hand to hand; grasp uses radial palm;
rakes at pellet
Language: Forms polysyllabic vowel sounds
Social: Prefers mother; babbles; enjoys mirror; responds to
changes in emotional content of social contact

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 th
At 10 month
Sitting: Sits up alone and indefi nitely without support, with
back straight
Standing: Pulls to standing position; “ cruises ” or walks holding
on to furniture
Motor: Creeps or crawls
Adaptive: Grasps objects with thumb and forefi nger; pokes at
things with forefi nger; picks up pellet with assisted
pincer movement; uncovers hidden
toy; attempts to retrieve dropped object; releases
object grasped by other person
Language: Repetitive consonant sounds ( “ mama, ” “ dada ” )
Social: Social: Responds to sound of name; plays peek-a-boo
or pat-a-cake; waves bye-bye
st
At 1 Year
Motor: Walks with one hand held (48 wk); rises
independently, takes several steps (Knobloch)
Adaptive: Picks up pellet with unassisted pincer movement of
forefi nger and thumb; releases object to other person
on request or gesture
Language: Says a few words besides “ mama, ” “ dada ”

Social: Plays simple ball game; makes postural adjustment to

dressing

Book : Nelson’s textbook of Pediatrics 20th Edition ( Pages 62 -70)

Yne sytivilibagon, Drogon.

“Fight for me Drogon.”

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