Module 2: Physical and Motor Development of Children and Adolescents

Overview

This module presents the physical and motor development of children and adolescents. It discusses the comparative
physical changes in height and weight as a child grows, together with the changes in motor development

Objectives

Upon completion of this module, the students are expected to:

1. Identify the physical and motor development in children and adolescent;

2. Describe brain development during childhood and adolescence;
3. Give the factors affecting development;
4. Differentiate exceptional development in terms of:
a. Physical and sensory disabilities
b. Attention deficit hyperactivity disorders

Pretest

A. Supply the chart with the characteristics of Physical and Motor Development of Children and Adolescent

Early Childhood Middle Childhood Adolescence

1. Overall growth is clearly in height and weight measures

2. There is a sharp increase in height and weight seen among girls aged 9 ½ and 14 ½ , and in boys
between 10 ½ and 16.
3. Between the ages of 6 ½, 8 ½ and 10 years in girls and approximately half a year later at 7, 9, and 10
½ in boys, growth occurs in spurts
4. The secondary changes include the growth of pubic hair, the development of breast in females and
growth in facial hair in males
5. The male develops wider shoulder, longer legs relative to his height.
6. Among school-aged children, this development is seen in the fine motor coordination as exemplified in
writing, drawing, cutting and other related school tasks.
7. First grade children can print all letters of the alphabet on to cursive writing
8. At this stage, children acquire hard eye coordination.
9. Coordination both in fine motor skills and those involving large-muscle improves.

B. Supply the chart with the characteristics of Brain Development of Children and Adolescent

Early Childhood Middle Childhood Adolescence

1. Brain development proceeds at an uneven pace occurring between 3 and 10 months and between 15
and 24 months
2. Ninety five percent of brain growth is reached by the time a child reaches the age of 9
3. There are two major brain growth spurts one occurring between ages 13 to 15 and the second brain
growth spurts around age 17.
4. There is quantitatively different neural network during growth spurt that occurs between ages 13 and 15
which enable teen to think abstractly and to reflect their cognitive processes.
 5. Cell pruning process continuous to develop in the childhood phase that involves the selective
elimination of excess cells and the cutting back of connections
6. The neurons are nourished by glial cells which is responsible for the increase in brain size
7. Numerous neurogical and psychological studies point to major changes in brain organization occurring
between ages 13 and 15.
8. Significant change is observed which shows the ability to identify and act a relationship between objects
in space.
9. Improvements associated with the noted improvements in fine motor skills and eye-hand coordination
occur at ages 6 and 8

Learning Focus
Additional Learning Focus presented on PPT –
1. Physical Development of the Brain, the Body, and Motor Skills
2. Attention Deficit Hyperactivity Disorder (ADHD).ppt
3. ADD.ppt

I. Physical and Motor Development

A. Early Childhood. Overall growth is clearly in height and weight measures. While there is no indication that
height is correlated with professional accomplishments, life insurance statistics have established a
positive correlation although there is no direct evidence pointing to tall people becoming brighter,
creative, and superior to shorter people.
 Growth is manifested at the earliest stage, usually following a cephalocaudal trend in the lengthening of the
neck and torso, followed by the legs. Brain and neck develop earlier than legs and trunks, following the
proximodistal pattern, development occurs from the center outward: Example, the internal organs develop
earlier than the arms and hands.
 According to Tanner (1990 as cited by Hethering-ton, et al., 2006) genetic factors strongly influence
physical characteristics. However, growth is not seen as influenced only by genetic factors but also by
nutrition, physical and psychological disorders and even climate. When placed under the same
environmental condition, individual growth curves tend to assume similarities. It is when placed with
unfavorable conditions, like inadequate nutrition, that growth rates become depressed seriously (Pollitt,
1994 as cited by Hetherington et al., 2006).
 It is between ages 6 and 12 that children grow 2 to 3 inches high and adds 6 pounds each year. At this
stage, large muscles are coordinated and they acquire more skills rendering them able to engage in
activities requiring motor coordination added strength and speed like bike riding. It is also during this stage
that children acquire hard eye coordination. With the hand-eye coordination they arc able to engage in
activities involving vision with body movements such as shooting a basketball or playing the piano or violin.
 Among school-aged children, this development is seen in the fine motor coordination as exemplified in writ-
ing, drawing, cutting, and other related school tasks. The uses of the hands are made possible by the so-
called maturation of the wrists which is an earlier occurrence among girls than boys (Tanner, 1990 as cited
by Bee and Boyd, 2002).
 Motor development improves with age. Such motor skills involve large muscle movements along with fine
motor skills, controlled by small muscles. Examples of fine motor skills are in-hand manipulation and bi-
manual coordination. There are however few sex differences that are noted in the pre-school years.

B. Middle Childhood. Between the ages of 6 '/*, 8 l/a, and 10 years in girls and approximately half a year later at
7, 9, and 10 1/2 in boys, growth occurs in spurts. There have been secular trends in growth in that children of the
present generations are heavier than before. As a matter of fact, the number of overweight has doubled in the last
2") years.

 Motor development. As children age, coordination both in fine motor skills and those involving large-
muscle improves. The fact that first grade children can print all letters of the alphabet on to cursive writing
is a strong indication. Even gross motor skills and hand-eye coordination arc improved with agility and
balance added.
C. Adolescence. The early sign of maturation is the adolescent growth spurt. There is a sharp increase in height
and weight seen among girls aged 9 1 /2 and 14 I /2, and in boys between 101/2 and 16. Usually adult height is at-
tained at age 14 or 15 for girls and 18 for boys.
  Manifestations of growth differ among boys and girls. The male develops wader shoulder, longer legs
relative to trunk and longer forearms relative to the upper arms and his height. On the part of the females
there is a widening of the pelvis to make child bearing easier. There is also an accumulation of layers of fat
under the skin that results to a more rounded appearance.
 Other obvious signs of growth are eyes growing faster, so that myopia or nearsightedness results when the
eyeball is so lengthened that it focuses images in front of the retina rather than on it. The lower jaw* usually
becomes stronger and thicker along with incisors of both jaws becoming more upright.
 Puberty brings about the physical differences that differentiate females and males, For instance in the
reproductive system itself. We sec in females the growth of lire ovaries and in males, that of the testes.
These constitute primary sex characteristics.
 The secondary changes include the growth of pubic hair, the development of the breasts in females and
growth of facial hair in males.
 The principal sign however of sexual maturation in boys is the sperm in the urine. Boys become ferule as
soon as sperm is present in the urine.
 Spermarche is the first ejaculation of semen containing ejaculate for the males.
 Menarche is the beginning of the menstrual cycle for the female. Actually, menstruation which is the
shedding of tissue from the lining of the womb is the most dramatic sign of sexual maturation for girls.

II. Brain Development

 A. Early Childhood. The brain continues to develop after birth. It doubles in weight after 6 months at which
time it weighs about half that of the adult brain. Brain development proceeds at an uneven pace occurring
between 3 and 10 months and between If) and 24 months. There are 100 billion neurons or brain cells
present at birth which conduct nerve impulses. The neurons are nourished by glial cells which is
responsible for the increase in brain size. These glial cells outnumber neurons 10 to I but are smaller then
neurons, thus, making up only about half of the brain tissue (Cech and Martin, 1995 as cited by Cobb.
2001;,
 Another important Junction of the glial cells, is the production of myelin, a fatty substance that forms the
covering out from the cell body by which the neuron makes contact with other nerve cells, thereby
transmitting neural messages. It is myelin substance that conducts impulses at higher speeds.
 Myelination of nerve fibers grows at different paces for different parts of the brain. The first to be
myelinated is the peripheral nervous system connecting the sensory perception, brain muscles, spinal
cord, and the internal organs and glands. The myelination of these organs enables the newborn to
process information, like receiving and acting on it from the various sensory systems. However, the fibers
in the optic tract, responsible for vision are exempted. At birth, these are the least mature (Cech and
Martin, 1995 as cited by Cobb, 2001).
 The number of neurons is constant following birth. Usually; there is no increase but neurons continue to
develop with age. The length of axons increases and tiny hranchlikc fibers or dendrites at the end of axon
increase in density over the first two years of life.
 The sensory- and motor areas are the primary sites of brain growth during the first spurt, associated with
the noted improvements in fine motor skills and eye-hand coordination. Such improvement occurs at ages
between 6 and 8. Il is in the second spurt of brain growth that the focus of development sliifts to the frontal
lobes of the cerebral cortex (Van der Molcn and Molcnaar, 1994 as cited by Bee and Boyd, 2002).
 Myelination continues through middle childhood in particular the reticular formation and the nerves linking
the reticular formation to the frontal lobes. Of significance is the reticular formation because it controls
attention. It is well documented that the ability to control attention increases significantly during middle
childhood (Lin, Hsiao and Chen, 1999 as cited by Bee and Boyd, 2002).
 The particular kind of concentration, referred to as selective attention is a result of the continuous myelina-
tion that allows the frontal lobes and reticular formation to work together. It is for this reason that children
aged 6 to 12 can have selective retention.
 Selective attention allows children to focus cognitive ability on the elements of a problem or situation. For
example, in cases where teacher changes the form and color of a material regularly used as part of the
work activities, once presented, the child will not spend time thinking about the change. The focus will still
be on the kind of work activities to be done, which very likely will come in the form of instructions. Full
 myelination of the reticular formation and the frontal lobes enables the children between ages 6 and 12 to
function more like adults in the presence of possible distractions.

B. Middle Childhood. Ninety five percent of brain growth is reached by the time a child reaches the age of 9.
Such growth is characterized by interrelated processes, namely: cell proliferation and cell pruning. Cell
proliferation takes place during the first several years of life. It consists of the over production of neurons
and interconnections. On the other hand, cell pruning is a continuous process in the childhood phase. It
involves the selective elimination of excess cells and the cutting back of connections. The two processes
afford fine-tuning of neural development through experience such that frequent interconnections are
retained while the infrequent are pruned.

 Actually, the demands of the growth processes give way to changes in the brain metabolism.
 In the middle childhood, the neurons of the association areas - parts of the brain where sensory, motor,
and intellectual functions are linked are myelinized to some degree.
 Another significant change in middle childhood is the ability to identify and act a relationship between
objects in space. This results from the lateralization of spatial perception, occurring at the right cerebral
hemisphere. For-example, imagining or picturing a person, head down or describing a classroom,
clockwise or counterclockwise is a spatial perception. Lateral perception in particular of faces and objects
starts at age 0. However, complex lateral perception is not very strongly lateralized not until age 8.
 A behavioral lest of die lateralization of spatial perception involves relative right-left orientation, or die abil-
ity to identify- what is right and what is left. This kind of test can be administered to children aged 8 who
can really identify or can differentiate right from left, though only older children meaning diose aged 10 to
11 will most likely understand the difference between statements like "'Jose is on my right'' or "It's on my
left.'* The increased efficiency by which older children learn math concepts and problem strategies is
explained by lateral spatial perception (Van der Molen & Molenaar, 1994 as cited by Bee & Boyd, 2002).
C. Adolescence. In the teenaged years, there are two major brain growlh spurts one occurring between ages
13 to 15 (Spreen, Risser, & Eclgell 1995 as cited by Ree & Boyd 2002) and die second brain growth spurt
beginning around age 17 and which continues into early adulthood (Van der Molen and Molenaar, 1904; Bee
mid Boyd, 2002). In the first spurt, the cerebral cortex becomes thicker and neuronal pathways become more
efficient. There is more energy produced and consumed by the brain during this spurt than in the years
following (Fischer and Rose, 1991 as cited by Bee and Boyd, 2002). The spurts take place in parts of the brain
that control spatial perception and motor functions. That is why mid-teens; adolescents' abilities in these areas
far exceed those of school-aged children.

 It was believed that a qualitatively different neural network emerges during the brain growth spun (hat
occurs between ages 13 and 15, which enables teens to think abstractly and lo reflect on their cognitive
processes (Fischer and Rose, 1994 as oiled by Bee and Boyd, 2002). Numerous neurological and
psychological studies point to major changes in brain organization occurring between ages 13 and 15.
Qualitative shifts however in cognitive functioning appear after age 15.
 The second brain growth spurt has the frontal lobes of the cerebral cortex as locus of development (Dimes
and Rose, 1999 as cited by Bee and Boyd, 2002). Among older teens dealing with problems requiring
cognitive functions is easier than with younger teens.
Environmental Influences on Development of the Brain

 Life's experiences whether better or worse have lasting effects on the capacity of the central nervous
system to learn and store information. This is why an enriched environment can enhance the growth and
structure of the brain. For instance, chronic malnutrition especially during the prenatal period can have
adverse effects on the brain. Actually brain damage is attributed to bad effects of having to live in bad
environments.
 As early as the 195()'s experiments had been conducted on rats and other animals. Those living in
enriched cages and given the chance to deal with stimulating apparatuses were found to have heavier
brains, more connective cells, and good brain cell connections. Those raised in standard cages or were
isolated have lesser connections.
 The midbrain and the medulla are the most fully developed at birth. These parts regulate vital functions like
heartbeat and respiration, as well as attention, sleeping, walking, elimination, and movement of the head
 and neck. These are actions a newborn performs moderately well. The least developed part of the brain at
birth is the cortex, the convoluted gray matter wrapped around the midbrain and is involved in perception,
body movement, thinking, and language (Bee and Boyd, 2002).
 Lateralization. The corpus callosum, grows, and matures during the early childhood years at a faster rate than
in any other period of life. It is the brain structure through which the left and right side of die cerebral cortex
communicate. As this structure grows the functional specialization of the left and right hemispheres of the
cerebral cortex is achieved. This process is called lateralization.
 Among humans 95% of brain functions are laterized through a pattern called left-brain dominance. The
remaining small portion of the functions that account for 5% are reversed. The pattern is called right brain
dominance. In some people the pattern can be mixed dominance where some functions follow the typical
pattern while some are reversed.
 There is a weak association between handedness and brain lateralization. It is believed that the prevalence
of right handedness is a result of genetic inheritance through a dominant gene common in the human
population, copy of it may be received from both parents (Talan, 1998 as cited by Bee and Uoyd, 2002).
III. Factors Affecting Development: Maternal Nutrition, Child Nutrition, Early Sensory Stimulation

Human development is affected by both genetic and environmental influences.

 Maternal Nutrition. One important factor affecting development is maternal nutrition. Mother supplies all the nutri-
ents to the inborn fetus through the food intake so that she should take care of her diet for her sake and that of
the fetus. It is important that she gets a continuous supply of fresh vegetables, fruits, minerals, and vitamins
needed.
 Child Nutrition. Adequate nutrition contributes to a continuous brain growth, rapid skeletal, and muscular
development. It is not the amount of food that children eat but what they cat that contributes to healthy living.
A healthy diet includes an adequate supply of fruits and vegetables, whole grains, food rich in protein and
calcium like meat and dairy products. Colorful foods, such as oranges, apples, tomatoes, and green
vegetables are not only appealing but also highly nutritious.
 Early Sensory Stimulation. Children under 6 years of age tend to be farsighted, because their eyes have not
matured and are shaped differently from those of adults. After that age, the eyes not only are more mature but
can focus better.

Factors That Affect Growth

 Genetic History. According to Lynne Levitsky, M.D., chief of the pediatric endocrine unit of Massachusetts
General Hospital in Boston, the child's genetic history influences to a large extent his growth. As a matter of
fact, it is number one in the list. By just looking at the parents' height, the rate of growth of the child can
more or less be predicted.
 Nutrition, It is another factor that affects growth. "Without a good diet, kids won't grow normally," says Jo
Anne Hattner, R.D., a pediatric specialist at the American Dietetic Association. Sometimes parents miss
an assuring and wholesome calories for the child, thus, derailing his chances for a healthy diet. Children,
no matter how fat should never be put on diet. He must have in his diet, nutritious food but less on juice or
soda which can interfere with the child's appetite for food rich in needed nutrients.
 Medical Conditions. Children born with or develop serious medical conditions can have stunted growth if not
treated. Some of these are: gastrointestinal disorders such as celiac disease; food allergies; thyroid
problems; hormone deficiency: heart, kidney or liver ailments; and certain chromosomal abnormalities. It
is important that medications are monitored closely. There arc stimulants like Ritalin prescribed for ADHD
which have been found to have adverse effects on growth. The problem that accrues from stimulants is
more often dose-related and is usually easily fixed, says Barry B. Bercu, M.D., head of endocrine, dia-
betes, and metabolism department at All Children's Hospital, in St. Petersburg, Florida.
 Exercise. Regular physical activity promotes growth by strengthening bones and muscles. However, caution
should be observed in doing high-impact sports like running and gymnastics because they too, can impede
growth if done excessively. Moreover, they can cause trauma to developing bones.
 Steep. About 70 to 80 percent of growth hormone is secreted during sleep, says Paul Sacnger, M.D., a pediatric
endocrinologist at Children's Hospital at Montefiore Medical Center, in New York City.
  Emotional Well-Being. Children must be nurtured with love, patience, and understanding. They need a
supportive family environment. When children experience anxieties brought by emotional neglect and too much
tension growth is also stunted. The condition called "psycho-social growth failure" by doctors - is extremely rare,
but its consequences are as real as malnutrition.
IV. Exceptional Development: Physical Disabilities, Sensory Impairments, Learning Disabilities, and Attention Deficit
Hyperactivity Disorders

A. Physical Disabilities. The physically handicapped have impairments that are temporary or permanent such
as: paralysis, stiffness or lack of motor coordination of bones, muscles or joints so that they need special
equipment or help in moving about.

Crippling disabilities include the following:

 impairment of the bone and muscles systems which affects mobility and manual dexterity difficult and
impossible as in the case of the amputees and those with severe fractures:
 impairment of the nerve and muscle systems making mobility awkward and uncoordinated as in cerebral
palsy; and
 deformities or absence of body organs and systems necessary for mobility like in the case of the club-foot
and paraplegics.
It is evident that growth is affected by physical disabilities like orthopedic handicaps, dysfunction of the
neuromuscular system, and congenital deformities. These are contributory factors in the making of the group of
exceptional children called the crippled.

Causes of Handicaps

 Prenatal factors. These are factors that affect normal development before and after conception virtually
lasting up to the first trimester or the third trimester of life. Specifically these include the following;
o Genetic or chromosomal aberrations. This results from blood incompatibility of the husband and wife.
There is a transfer of defective genes from parent to offspring
o Prematurity. Birth of the fetus is usually earlier than the ninth month of pregnancy.
o Infection. This is caused by bacteria or virus on the fetus in the womb of the mother, the germs
usually come from highly communicable diseases like rubella and venereal diseases. The neo-
natal sepsis is caused by infection either directly from the mother or the outside environment like
poorly sanitized delivery room, infected hospital gadgets, and many others.
o Malnutrition. Insufficient intake of food nutrients necessary to sustain growth and development of
the fetus and the mother.
o Irradiation. Pertains to the exposure of the pregnant mother to radioactive elements like x-ray.
Exposure of the mother also affects the fetus.
o Metabolic disturbances. Inability of the mother or the fetus to make use of food intake.
o Drug abuse. Entry of large quantities of medicines into the body thus affecting the fetus. Thalido
mide used by mothers has affected thousands of babies who were born without limbs and other
extremities.

 Perinatal factors. These are factors that cause crippling conditions during the period of birth.

o Birth injuries. These arc injuries suffered by the newborn baby. Injury to die spine will cause pa-
ralysis (kernicterus).
o Difficult labor. Hard and prolonged labor before the actual birth which interrupts the oxygen in
take of mother to fetus.
o Hemorrhage. Profuse bleeding of the mother during birth which might be caused by damage of the
uterus.

 Postnatal factors. These are factors causing crippling conditions after birth.

o Injections. These are caused by illness like diphtheria, typhoid,

meningitis, encephalomyelitis, and rickets in infants.
o Tumor and abscess in the brain. They destroy the brain cells connected with movement thus impairing
mobility;
 o Fractures and dislocations. These are destructions of mobility organs either through falls and other
accidents causing bone fractures or dislocation.
o Tuberculosis of the bones. TB germs are likely to attack the bones of the very young causing crippling
conditions.
o Cerebrovascular inquiries. These are injuries in the head region enough to cause brain damage.
o Post-seizure or post-surgical complications. These are convulsions after the delivery of the baby which causes
crippling conditions.
o Arthritis, rheumatism. These are diseases affecting the spinal column and the muscles of locomotion
at the back.
B. Sensory Impairments. In terms of severity of impairment, there are two classes of visual handicaps, visual im-
pairment and blindness.

1. Visual impairment. It is a visual problem that calls for specific modification or adjustments in the student's
educational programs. Major and minor alterations can be done in the instructional environment de-
pending upon the kind of impairment.
2. Blindness is the inability of the person to see anything. When vision is 20/200 or less in the better eye with correction
or when the visual field is significantly less than what is normal, then there is blindness. The measure
20/200 means that a person can see at 20 feet what a normally sighted individual can see at 200 feet.
 Visually impaired refers to those who were previously labeled blind and partially sighted. Those with visual
impairment lack sufficient vision to effect a normal functioning in school.
 Visually handicapped is a form of visual impairment which, even with correction, still cannot achieve a normal
educational performance. The term includes the partially seeing and the blind.
 Partially sighted children are those with "low vision". They arc able to use print, with or without aids, as their
main medium for performing in school.
 Low vision students are able to see but the visual impairment interferes with using vision for learning.
 Blind students are those with so little vision and can learn through the use of Braille.
The most common visual problems which confront students are visual acuity problems. They are as follows:
1. Reduced visual acuity - poor sight
2. Amblyopia - lazy eye
3. Hyperopia - farsightedness
4. Myopia - nearsightedness
5. Astigmatism - imperfect vision
Other visual impairments which may affect students are the following:
1. Nystagmus. Rapid, involuntary side movement of the eyeball.
2. Cataracts, The lens of the eye changes from a clear, transparent structure to a cloudy or opaque one.
3. Macular degeneration. The central part of the retina which is called macula is affected. The remaining
peripheral vision can see large objects and colors but not to read.
4. Diabetic retinopathy. It is the leading cause of new cases of blindness and characterized by hemorrhaging of
the tiny vessels of the retina. As a consequence, vision is blurred or distorted.
5. Glaucoma. It is characterized by increased pressure within the eye, gradual loss of vision, beginning with the
peripheral vision.
6. Retinitis Pigmentosa. It is an inherited condition which begins with the loss of night vision and leads to
gradually decreasing peripheral vision. The dark pigment of the retina, essential for vision, is slowly lost
causing a gradual reduction in the visual field.
7. Retinopathy of prematurity (deterioration of the retina). This is caused by the high level of oxygen required for
survival of premature infants who would not have previously survived.
Visual impairments impact on the individual's development. Students with visual impairments are visually
uncoordinated in their movement caused by the inability to develop the needed physical skills. The appearance
is awkward since they are not able to pay attention to their personal appearance, thus, have to be reminded of
their posture.
Sensory deprivation also exists in terms of the reception of sounds from the environment. When the auditory problem
is severe and beyond correction, it is considered an auditor)' handicap. This will affect the range and volume of
sounds (hat can be received by the individual. When hearing is impaired, there is limited functioning of the
auditory system.

Hearing impairment is a generic term for hearing disability which may cither be mild or profound. Hearing
impairment subsumes the terms deaf and hard of hearing.

Deaf individuals are those whose hearing disability precludes successful processing of linguistic information
through hearing with or without a hearing aid. The deaf student's development of speech and language as well as
his primary basis of communication are not through hearing (Ross, 1982 as cited by Bauer and Shea, 1989 as
cited by Acero, et al., 2004).

Hard of hearing individuals are those who use hearing aid and therefore can have hearing adequate for the
processing of linguistic information.

Deafness can either be prelingual or postlmgual and sensory.

 Prelingual is deafness present at birth or occurring before language or speech development.

 Postlingual deafness occurs after speech or language development.
 Sensory neural deafness is caused by the physical impairment of the inner ear, the peripheral
hearing nerve, and other parts of the auditory system that extends to the cortex of the brain.
Hearing impairment is not only the handicap of not being able to hear. It encompasses emotional problems,
problems in socialization, in learning disabilities, and in the general day-to-day experience only a hearing impaired
can comprehend.

Causes of Deafness

1. Prenatal causes
a. toxic conditions
b. viral diseases - mumps, influenza, rubella
c. congenital defects such as lack/closure of the external canal or even the ear, ossification of the three little
bones in the ear and the oval window.
2. Perinatal causes
a. injury sustained during delivery such as pelvic pressure injury resulting from use of forceps and intracranial
hemorrhage
b. anoxia or lack of oxygen due to prolonged labor
c. heavy sedation due to overdose of anesthesia in twilight deliveries
d. blockage of the infant's respiratory passage

3. Postnatal causes
a. diseases, ailments, conditions such as meningitis, external otitis (inflammation of the outer ear), otitis
media (often characterized by running, discharging ear($) or the infection of the middle ear), impacted or
hardened earwax (cerumen) which may lead to infection
b. accidents/trauma falls, head bumps, over exposure to high frequency sounds and extremely loud
explosions, puncturing of eardrum, difference in pressure between air outside and that one inside the
middle ear due to changes in altitude, undrained water in the ear due to frequent swimming
4. Other causes
a. heredity
b. prematurity
c. malnutrition
d. Rh factor - blood incompatibility' of parents
e. overdosage of medicine

Classification of Hearing Impaired Children

Hearing impairment can be classified according to age at onset of deafness, language development, place of
impairment, and degree of hearing loss.
1. According to age at onset of deafness
a. congenially deaf - those born deaf
b. adventitiously deaf those born with normal hearing but became deaf due to accident or illness
2. According to language development
 a. Prelingually deaf - those born deaf but lost hearing before speech and language were developed.
b. Posdingually deaf - those who became deaf after the development of speech and language.
3. According to place of impairment
a. conductive hearing loss - impaired hearing due to interference in sound transmission to and
through sense organ, in particular in the outer or middle car
b. sensory neural hearing loss impairment due to the abnormal inner ear or auditory nerve or both
c. mixed hearing loss a combination of the conductive and sensory neural hearing loss. This is
sometimes called a flat loss as depicted in the audiogram.
4. According to degree of hearing loss
a. slight
b. mild
c. moderate
d. severe
e. profound

C. Learning Disabilities
 Learning disabilities include problems among children related to disorders in understanding or
using spoken and/or written language. Such disorders manifest in the inability to listen well,
process information readily, and inability to talk, read, write, spell and even add numbers.
 Learning disabilities are also referred to as perceptual handicaps, brain injury, brain dysfunction,
developmental aphasia and specific sensory motor dysfunction. A disabled child is usually of
normal intelligence but does not meet the age-level expectations.
 At the preschool level, learning disabilities may come in the form of problems related to pre-
academic skills, gross motor, fine motor, visual, auditory, and tactile/kinesthetic perception, and
expressive language.
 The learning disabilities could be symptoms of worldwide problems. Today, such is called sensory
integration or sensory dysfunction.
 Sensory integration refers lo the ability of die individual to process information coming from the
environment and makes use of the information in the process. The senses are: auditory, tactile, vestibular)'
(balance center in the inner ear), proprioceptive (muscles, joints, and tendons;, and visual.
This definition provides identification of students qualified for educational services depending on three
conditions:
1. Normal intelligence. This refers to child's performance at above normal range using non-verbal measures
which include language concepts.
2. Academic achievement deficit. Condition where child shows academic achievement deficit in at least one
subject, such as oral expression, listening, comprehension, mathematical calculation, and spelling.
Further, a major discrepancy between expected achievement and ability is considered. This should not be
a result identified and generally accepted handicapping conditions.
3. Absence of other handicapping conditions (exclusion criteria). There must be no manifestation of visual or
hearing impairment, mental retardation, severe cases of emotional disturbance, and cultural neglect
The different types of learning disabilities are:
 dyslexia reading
 dysgraphia - writing
 visual agnosia - sight
 motor aphasia speaking
 dysarthria stuttering
 auditory agnosia - hearingc
 olfactory agnosia – smelling
 dyscalculia - math
Three general causes of learning disability

 Problematic pregnancies, occurring before, during, and after deliver)- causing injury- whether minimal
or severe to brain and brain dysfunction.
 Biochemical imbalance caused by intake of food with artificial food colorings and flavorings
 Environmental (actors caused by emotional disturbance, poor quality of instruction and lack of motivation.

Attention Deficit Hyperactivity Disorder (ADHD)

 Attention deficit hyperactivity disorder interferes with an individual's ability to focus (inattention), regulate
activity level (hyperactivity), and inhibit behavior (impulsivity). Among children and adolescents, it is one of
 the most common learning disorders. The young with ages 9 to 17 arc affected for at least six months and
arc more common in boys than girls. This syndrome is manifested early in the preschool or early
elementary years but can persist into adolescence and occasionally into adulthood.
 Children with ADHD need assessment from health care professionals with the help of parents and teachers.
There is no specific test for ADHD but it can be diagnosed through a series of psychological test, physical
examination, and observing child's behaviors in day to day selling. Recently, ADHD has been classified into
three subtypes:
a. Predominantly inattentive
b. Predominantly hyperactive-impulsive
c. Combined type
 Children with inhibited behavior, inattentive, and without focus tend to be withdrawn, polite, and shy. In the
absence of hyperactivity, they are likely referred to as having Attention Deficit Disorder (ADD).
 ADD and ADHD are therefore categorized as different disorders in the presence of symptomatic differences.

Table 1 Behavioral Difference between ADHD and ADD

ADHD ADD
Decision Making Impulsive Sluggish
Attention-Seeking Show off Egotistical Modest Shy-Often
Relishes in being the socially
worst withdrawn!
Assertiveness Bossy Under-assertive
Overly polite and
Often irritating docile

Recognizing Intrusive Honors boundaries

boundaries
Occasionally Usually polite and
rebellious obedient
Popularity Attract new friends but Bonds but does not
has difficulty bonding easily attract friends
Associated diagnoses Oppositional defiance Depression
Conduct Disorder

What Causes ADHD?

 ADHD is a neurologically based medical problem caused by a number of factors. The exact
causes are however unknown. According to some research studies, the disorder results from an
imbalance in certain neurotransmitters (most likely dopamine and serotonin). These substances
help the brain to achieve focus and regulate behavior. Certainly, parents and teachers do not
cause this disorder, but may lessen or worsen the effects of the disorder,
 ADHD is associated with symptoms in children like difficult pregnancies and problem deliveries.
The risk is compounded by maternal smoking and exposure as well to environmental toxins. Other
studies indicate that the ADHD brain consumes less glucose - its main fuel source - especially in
me frontal lobe regions (Zametkin, Mor-dahl, Gross, King, Semple, Rumsey, Hamburger and Co-
hen, 1990; Sousa, 2006). Brain studies of this disorder have also suggested the genetic
component as a source.
Is ADHD inherited?

 Probably, when the disorder run in families, there is very likely to have genetic predispositions.
Usually, children with ADHD have at least one close relative who has ADHD. The genetic component
is attributed to die gene responsible for coding the neuron receptors for the key neurotransmitter
dopamine. Dopamine helps the brain focus with intent to learn.
Is it possible to have ADHD-like behavior and not ADHD?
  Yes. There are children who manifest the symptoms of the disorder but actually do not have the
disorder. However, there are other causes like the inability to adjust and adapt to what is acceptable
behavior in school or even in some environments.

Can Schools Inadvertently Enhance ADHD-like Behavior?

Most children are to cope with changes in the environment that come at a pace faster than what they
expect. For that matter, schools are expected to come up with instructional approaches that will provide better
opportunities to learn effectively. Schools and classroom operations can inadvertently create or enhance
ADHD-like behavior in students when:
• Teachers tend to cover curriculum too fast, not realizing students need more time
• Teachers resort to teacher talk as the prevailing mode of instruction without regard for the students learning
preferences (some are visual learners, some kinesthetic and the like)
• Room arrangements provide isolation, like row by row formation rather than collaboration (students in this kind
of classroom situation have the tendency to make mischief)
• Discipline is arbitrary and unfair coming from different kinds of teachers with different personalities and rules
and expectations
• There are few opportunities to move around (too much stuff to cover, so students just sit and listen)
• Classroom atmosphere is not conducive to learning (it's either too hot or too dark)
• There is no interaction taking place, the reason why boredom sets in
• Classroom emotional climate causes stress

Learning Activities

Activity 1:
a. On a half size cartolina, draw or paste a picture of a CHILD and list the common physical and motor
development on the left side and the common brain development on the right side. (for BEEd students)
b. On a half size cartolina, draw or paste a picture of an ADOLOSCENT and list the common physical and
motor development on the left side and the common brain development on the right side. (for BSEd
students)

CHILD ADOLESCENT

Physical Brain Physical Brain

& Motor Development & Motor Development
Development Development

Activity 2:

A. Classroom Observation
 Most children are to cope with changes in the environment that come at pace faster than what they expect,
so schools are expected to come up with instructional approaches that will provide better opportunities to
learn. That’s why schools and classroom operations should create or enhance teaching-learning behavior.

You are to observe a classroom in the elementary or high school classes and study the following situations. Make a
narrative report and present it to the class:

1. Schedules of subjects and activities;

2. Room arrangements. (arrangement of chairs or tables)
3. Written or posted classroom rules or disciplinary obligations of pupils or students
4. Classroom space (Are there enough space for the learners to move? Are there too much stuff that
occupy greater space?)
5. Classroom atmosphere (are there enough ventilation and light?)
6. Classroom emotional climate

Post test

Name: _________________________ Course & year:_________________

A. Matching type: match A with B

A B
______ 1. Reduced visual acuity a. imperfect vision
______ 2. Amblyopia b. nearsightedness
______ 3. hyperopia c. lazy eye
______ 4. myopia d. poor sight
______ 5. astigmatism e. farsightedness
______ 6. dyslexia f. math
______ 7. dysgraphia g. smelling
______ 8. visual agnosia h. hearing
______ 9. motor aphasia i. stuttering
______ 10. dysarthia j. speaking
______ 11. auditory agnosia k. sight
______ 12. olfactory agnosia l. writing
______ 13. dyscalculia m. reading
______ 14. visually impaired n. these are temporary or permanent impairments
such as paralysis, stiffness or lack of motor
coordination of bones muscle or joints

______ 15. visually candicapped o. these includes problems among children related to
disorders in understanding or using spoken/written
language

______ 16. partially sighted p. refers to those who were previously labeled blind
and partially sighted
______ 17. low vision q. is a form of visual impairment which even with
correction, still cannot achieve a normal educational
performance
______ 18. blindness r. are those with “low vision” and are able to use print,
with or without aids as their main medium for
performing in school
______ 19. physical disabilities s. they are able to see but the visual impairment
interfere with using vision for learning
______ 20. learning disabilities t. is the inability of the person to see anything and can
learn through the use of Braille only.

B. Identification: Identify the following statements (factors affecting development and exceptional development)

___________________ 1. this is one important factor affecting development through the mother’s supply of all the
nutrients to the inborn fetus during the food intake so that she should take care of her diet for
 her sake and that of the fetus.
___________________ 2. This includes adequate nutrition that contributes to a continuous brain growth, rapid
skeletal and muscular development of a child such as supply of fruits and vegetables, whole
grain, food rich in protein and calcium.
___________________ 3. This factor influences to a large extent of a child’s growth
___________________ 4. These are gastrointestinal disorders such as celiac diseases; food allergies; thyroid
problems; hormone deficiency, heart, kidney or liver ailments and certain chromosomal
abnormalities that have adverse effect on growth
___________________ 5. This is a regular physical activity that promotes growth by strengthening bones and
muscles.
___________________ 6. a state of partial or full unconsciousness in people, during which voluntary functions
are suspended and the body rests and restores itself, or a period spent in this state
wherein 70-80% percent of growth hormone is secreted
___________________ 7. this result from blood incompatibility of the husband and wife or the transfer of defective
genes from parent to offspring
___________________ 8. birth of fetus is usually earlier that the ninth month of pregnancy
___________________ 9. this is caused by bacteria or virus on the fetus in the womb of the mother, the germs
usually come from highly communicable diseases like venereal diseases
___________________ 10. insufficient intake of food nutrients necessary to sustain growth and development of the
fetus and the mother
___________________ 11. pertains to the exposure of the pregnant mother to radioactive elements like x-ray that
affects the fetus
___________________ 12. inability of the mother or the fetus to make use of food intake
___________________ 13. entry of large qualities of medicines into the body thus affecting the fetus
___________________ 14. these are injuries suffered by the newborn baby
___________________ 15. hard and prolonged labor before the actual birth which interrupts the oxygen intake of
mother to fetus

C. Discussion

1. Why is it important for a teacher to be aware of the various development processes the children
undergo in terms of:

a. physical and motor development;

b. brain development; and
c. exceptional development such as physical and sensory disabilities, attention deficits and
hyperactivity disorders?