S.B.D.

S COLLEGE OF NURSING
AHERWAN, RATIA

SUBJECT: PAEDIATRIC NURSING

TOPIC: DEVELOPMENTAL TASK, DEVELOPMENTAL MILESTONES AND
SPECIAL NEEDS OF INFANT (0 TO 6 MONTHS)

SUBMITTED TO: - SUBMITTED

BY: -
 IDENTIFICATION DATA: -

Name of the student teacher : Ms. Janet Chaudhary

Class : P .BSc Nursing 1st Year

Name of the Subject : Paediatric nursing

Name of the unit : Unit I

Name of the Topic : Developmental task, developmental milestones and special needs of infant (0 to 6 months).
Group of the students : Post- basic Nursing 1st Year

Size of the Group : 23

Date and Time : 26/11/09 at 09:30am – 10:30 am

Duration of teaching : 1 hour

Method of Teaching : Lecture cum Discussion

A.V. Aids : PowerPoint Slides, Transparency, Flash cards

Previous knowledge of the Group : Post- basic Nursing 1st Year students has some knowledge about developmental task,
developmental milestones and special needs of infant.

General Objectives : At the end of the class the students will be able to understand and gain depth
knowledge about the developmental task, developmental milestones and special needs of infant.
 TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVES

1 min To introduce INTRODUCTION: -

self SELF- INTRODUCTION: -
My name is Janet Chaudhary,
M. Sc Nursing 1st year student of
M .M College of nursing.

INTRODUCTION OF THE TOPIC: -

2 min To introduce
the topic Growth and development are
continuous and orderly processes
that have predictable sequences.
Although the rate of progress may
vary, all human beings go through
the same stages on their way to
their physical increase in size and
the maturation of neuromuscular
function. Developmental milestones
are the set of functional skills or age
specific tasks that an average child
is able to do when he reaches a
specific age.

1 min To announce ANNOUCEMENT OF THE TOPIC:

the topic
So today, I am going to discuss with
the topic the developmental task,
developmental milestones and
special needs of infant.
 TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

3 min To define GROWTH- Growth refers to an increase in physical size of PowerPoint slides Define growth
growth and the whole or any of its parts and can be measured in and
development. inches or centimetres and in pounds or kilograms. development.

DEVELOPMENT- Development refers to a progressive

increase in skill and capacity to function. It causes a
qualitative change in the child’s functioning.

2 min To explain the PRINCIPLES OF GROWTH AND DEVELPMENT: - PowerPoint slides State the
principles of 1. Cephalocaudal principle of
growth and 2. Proximodistal direction. growth and
development 3. As the child matures, general movements become development.
more specific. Generalized muscle movements
occur before fine motor control is possible.

5 min To explain THEORIES OF DEVELOPMENT: - OHP transparency Briefly explain

briefly the the theories of
theories of development.
1. PSYCHOSEXUAL DEVELPMENT (FREUD)
development
2. PSYCHOSOCIAL DEVLOPMENT (ERIKSON)
3. COGNITIVE DEVELOPEMNT (PIAGET)
4. KOHLBERG’S THEORYOF MORAL
DEVELOPMENT
5. FOWLER’S THEORY CONCERNING THE
DEVELOPMENT OF FAITH
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

To define the DEFINITION: -

topic According to Robert Havisghurst: -“A developmental
task is one that arises predictably and consistently at or
about a certain period in life of the individual. ”

PURPOSES OF DEVELOPMENTAL TASKS:

 Acts as guidelines to help parents, family members
and health care givers to know what child should
learn at specific age.
 Serves as motivating force for children to learn what
social group expects to learn at that specific age.
 It forewarns parents of what will be expected of
children in the immediate and remote future
 Helps in identification of delay in a timely manner
when children are not able to achieve the task.

IMPORTANCE OF DEVELOPMENTAL TASKS:

Even though it is essential that each child should master
the developmental tasks appropriate for his or her age. But
not all children are able to do so. The failure to
developmental tasks lead to the following conditions in
child: -
 Inferior complex in a child.
 Makes the mastery of newer developmental tasks
more difficult.
 The child/ individual is socially disapproved and
results in social rejection
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

DEVELOPMENTAL MILESTONES: -
Developmental milestones can be defined as a set of
functional skills or age specific tasks that an average child
is able to do when he reaches a specific
age.Developmental milestones can be easily identifiable
skills like rolling over, skills, sitting etc.

CLASSIFICATION OF MILESTONES: -
 Motor development
 Language development
 Psychosocial development
 Sensory development
 Psychosexual development
 Spiritual development
 Intellectual development
 Moral development

DEVELOPMENTAL MILESTONES OF INFANT (0 TO 6

MONTHS): -

1 MONTH: -

PHYSICAL/ BIOLOGICAL: -
 Length increases 1.5 cm / month
 Head circumference increases 1.5 cm/ month
 Reflexes- rooting, swallowing, moro, sucking etc.
 Physiologic immaturity
 Breathes through nose.
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

MOTOR DEVELOPMENT: -
GROSS MOTOR: -
 Lies in flexed position
 When prone pelvis is elevated but knees are
beneath abdomen
 Head lags when baby pulled from a supine to a
sitting position
 Head sags forward when baby is held in sitting
position
 Turns head to the side when prone
 Makes crawling movements when prone to flat
surface
 Pushes with feet against a hard surface to move
forward.

FINE MOTOR: -

 Holds hands in tight fists

 Can grasp an object placed in the hand but drops it
immediately

SENSORY MOTOR: -
 Startled by sounds
 Attentive to speech of others
 Indefinite stare at surroundings
 Fixates on objects brought in front of eyes
 Protective blinking in response to bright light
 Follows a bright object to the midline of vision if 6 to
8 inches from eyes
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

PSYCHOSOCIAL DEVELOPMENT: -
 Beginning development of sense of trust
 Totally egocentric
 Complete dependence on care givers usually
mother
 Bonding progresses
 Establish eye contact
 Smiles briefly
 Quiets, cuddles and molds when held
 Perceives self and parents as one

PSYCHOSEXUAL DEVELOPMENT: -
 Oral stage- oral dependent- need for sucking
pleasure.

SPIRITUAL DEVELOPMENT: -
 Feelings of trust, warmth and security form the
foundation for the later development of faith
INTELLECTUAL DEVELOPMENT: -
 Infants uses reflexes to begin to make associations
between act and sequential response
 Cannot distinguish self and environment
 Begins to repeat actions of own body voluntarily

MORAL DEVELOPMENT: -
 Preconventional morality stage 0 (0 to 2 years)

RECEPTIVE LANGUAGE: -
 Responds to human voices
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

EXPRESSIVE LANGUAGE: -
 Opens and closes mouth as adult speaks
 Utters small throaty sounds
 Utters sounds of comfort when feeding
 Cry patterns developing

PLAY STIMULATION: -
 Hold, touch infant gently
 Talk and sing to infant at close contact
 Provides pacifier for sucking pleasure
 Respond to cry signals
 Provide regular periods of affectionate play when
infant is alert and responsive

2 MONTHS: -

PHYSICAL/ BIOLOGICAL DEVELOPMENT: -

 Posterior fontanel closes at 6 to 8 weeks of age

MOTOR DEVELOPMENT: -
GROSS MOTOR: -

 Less fixed prone position, arm flexed, legs extended

 No head drop when suspended in prone position
 Less head lag when pulled from a supine to a sitting
position
 Lifts head almost 45 degrees above a flat surface
when lying prone
 Turns from side to back
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

FINE MOTOR: -
 Hands may be open
 Holds a rattle briefly when placed in the hand.

SENSORY DEVELOPMENT: -
 Turns head to side when a sound occurs t ear level
 When on back, follows a dangling object or moving
light beyond the midline of vision
 Beginning binocular fixation
 Eyes follow moving person nearby

PSYCHOSOCIAL DEVELOPMENT: -
 Sense of trust
 Distinguishes “mother” or primary caregiver from
others
 Eye to eye contact
 Has learned that crying brings attention

PSYCHOSEXUAL DEVELOPMENT: -
 Oral stage

SPIRITUAL DEVELOPMENT: -
 Undifferentiated

INTELLECTUAL DEVELOPMENT: -
 Sensorimotor stage substage II- primary circular
reaction (1 to 4 months)

MORAL: -
 Preconventional morality Stage 0 (0 to 2 years)
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

RECEPTIVE LANGUAGE: -
 Alert expression when listening
 Direct definite regard
 Soothed by caregiver’s , mother’s voice

EXPRESSIVE LANGUAGE: -
 Cry patterns develop
 Crying becomes differentiated
 Responds vocally to caregiver’s voice “ah”, “eh”

PLAY STIMULATION: -
 Offer a rattle
 Hold or dangle toy in front of infant to encourage
eye movement
 Place in vertical infant seat so that the environment
can be viewed from different angle
 Outings in carriage or car if not done earlier.

3 MONTHS: -

PHYSICAL/ BIOLOGICAL: -
 Grows 1.5 cm/ month
 Palmar reflex absent
 Landau reflex appears.

MOTOR DEVELOPMENT: -
GROSS MOTOR: -
 Symmetric posture of head and body
 Very slight head lag when pulled from supine to
sitting position.
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

 Sits, back rounded, knees flexed when supported in

sitting position
 Holds head erect and steady

FINE MOTOR: -
 Hands open or closed loosely
 Holds hands in front of face and stares at them
 Holds object put in hand with active grasp
 Carries hand or object to mouth at will
 Reaches for bright objects but misses them

SENSORY DEVELOMENT: -
 Turns head and looks in same direction to locate
sound
 When on back turns eye to a dangling object
 Binocular coordination
 Regards toy dangled in midline of chest promptly
 Loses interest in objects that are suddenly removed
from the perceptual field
 Blinks at objects that threaten the eyes

PSYCHOSOCIAL DEVELOPMENT: -
 Sense of trust
 Recognizes and smell in response to caregiver’s
face
 Stops crying when familiar person approaches
 Interested in surroundings
 Smiles back in response to another’s smile
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

PSYCHOSEXUAL DEVELOPMENT: -
 Oral stage

SPIRITUAL DEVELOPMENT: -
 Undifferentiated

INTELLECTUAL DEVELOPMENT: -
 Sensorimotor stage : - sub stage II: primary circular
reaction (0 to 4 months)

MORAL DEVELOPMENT: -
 Preconventional morality stage 0 (0 to 2 years)

RECEPTIVE LANGUAGE: -
 Looks in direction of speaker

EXPRESSIVE LANGUAGE: -
 Cries less
 Showa pleasure in making many sounds
 Vocalizes in response to others- coos and chuckles
 May laugh aloud

PLAY STIMULATION: -
 Encourage infant to raise head when in prone
position
 Pull baby to sitting position, thus encouraging head
control
 Hold bright toys in front of infant to encourage
reaching
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

4 MONTHS: -

PHYSICAL / BIOLOGICAL: -
 Drools between 3- 4 months of age, indicating
increased saliva
 Tonic neck reflex, moro, rooting reflex absent and
extrusion reflex fading

MOTOR DEVELOPMENT: -

GROSS MOTOR: -
 Symmetric body postures
 Sits with adequate support
 Holds head erect and steady when placed in sitting
position
 Lifts head and shoulders at a 90 degrees angle
when on abdomen and looks around
 Attempts to roll or actually rolls over from front to
back
 Sustains small portions of own weight when held in
standing position
 Activates arms at sight of proffered to

FINE MOTOR: -
 Holds hand predominately open
 Brings hands together in midline, plays with finger
 Grasp object held near hand
 Grasp objects with both hands
 Objects are carried to mouth
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

SENSORY DEVELOPMENT: -
 Follows moving objects well with eyes
 Fairly good binocular vision
 Looks briefly for toy that disappears
 Can focus on small objects
 Beginning hand- eye coordination
 Comforts self by sucking thumb or pacifier

PSHYCHOSOCIAL DEVELOPMENT: -
 Sense of trust
 Smiles in response to smiles of others
 Initiates social play by smiling
 Shows evidence of wanting social attention
 Breathes heavily when excited.

PSHCOSEXUAL DEVELOPMENT: -
 Oral stage
SPIRITUAL DEVELOPMENT: -
 Undifferentiated

INTELLECTUAL DEVELOPMENT: -
 Sensorimotor stage: substage II and III
Repeats reaction that affect an object to get a response

MORAL: -
 Preconventional morality stage 0 (0 to 2 years)
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

RECEPTIVE LANGUAGE: -
 Responds differently to pleasant or angry voices
 Does not cry when scolded

EXPRESSIVE LANGUAGE: -
 Laughs aloud
 Vocalizes socially
 Very “talkative” to self, people or toys
 Can vocalize consonants b, g, h, k, n, p

PLAY STIMULATION: -
 Smile gently and singing to infant
 Laugh when infant laugh
 Echo sound that infant makes
 Shake rattle place in infant’s hand
 Provide floating toys for bath
 Help infant to sit up with support
 Hold infant in standing position

5 MONTHS: -

PHYSICAL/ BIOLOGIC: -
 Weight atleast twice the birth weight
 Physical growth slowing down
 Can breathe from mouth when nose is obstructed
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

MOTOR DEVELOPMENT: -
GROSS MOTOR: -
 Sit with slight support
 Balances head well when sitting
 Pushes whole chest off a flat surface when prone
 Rolls from back to front
 Sustains more to own weight when held in standing
position
 Pulls feet up to mouth when supine

FINE MOTOR: -
 Uses thumb in partial appositions to fingers more
skilfully
 Tries to obtain objects beyond reach
 Grasps objects with whole hand, either right or left
 Holds one object while looking at another

SENSORY DEVELOPMENT: -
 Localizes sounds made below the ear
 Looks after a dropped object
 Inspects objects visually for a lengthening period of
time
 Can fixate on object more than 3 feet away
 Visual acuity 20/200
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

PSYCHOSOCIAL DEVELOPMENT: -
 Smiles at self in mirror
 Begins to discriminate family members from
strangers
 Accepts an object from another person
 Plays enthusiastically
 Plays with own feet

PSYCHOSEXUAL DEVELOPMENT: -
 Undifferentiated

INETELLECTUAL DEVELOPMENT: -
 Sensorimotor stage : substage III ( secondary
circular reaction ) 4 to 8 months

MORAL DEVELOPMENT: -
 Preconventional morality stage 0

RECEPTIVE LANGUAGE: -
 Responds when own name is spoken

EXPRESSIVE LANGUAGE: -
 Squeals when happy or excited
 Vocalizes displeasures when a desired object is
taken away
 Consonant sounds increases
 Sounds like vowel appears with consonants such as
“goo”
 Begins to mimic sounds
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

PLAY STIMULATION: -
 Provide sufficient different objects for play
 Make various sounds bear ear
 Hold infant in standing position and bounce to
exercise legs and to develop balance

6 MONTHS: -

PHYSICAL/ BIOLOGIC: -
 Length increases 1.25 cm/ month
 Head circumference 43 cm. Increases about 0.5 cm/
month during second months
 Teething two lower central incisors erupt
 Begins to bite and chew
MOTOR DEVELOPMENT: -
GROSS MOTOR: -
 Sits lone briefly if placed in a favourable leaning
position on hard surface
 Back is straight when sitting in high chair
 Springs up and down when sitting
 Lifts chest and upper abdomen when prone, putting
the weight on the arms and hands
 Turns completely over

FINE MOTOR: -
 Grasp with simultaneous flexion of fingers
 Retains transient hold on two objects one in each
hand
 Drops one object when another is offered
 Begins to bang objects that are held
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

 Holds own bottle but may prefer for it to be held

SENSORY DEVELOPMENT: -
 Localizes sounds made above the ear
 Retrieves a dropped object that can be seen and
reached
 Enjoys more complex visual stimuli
 Moves in order to see an object

PSYCHOSOCIAL DEVELOPMENT: -
 Sense of trust
 Recognizes parents
 Recognizes strangers as different from family
members
 Begins to extend arms to be picked up
 Knows what is likes and dislikes

PSYCHOSEXUAL DEVELOPMENT: -
 Oral stage
SPIRITUAL DEVELOPMENT: -
 Undifferentiated

INTELLECTUAL DEVELOPMENT: -
 Sensorimotor stage : substage III: secondary
circular reaction.
 Beginning of object permanence when infant briefly
searches for a dropped object

MORAL DEVELOPMENT: -
 Preconventional morality stage 0
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

RECEPTIVE LANGUAGE: -
 Recognizes familiar words

EXPRESSIVE LANGUAGE: -
 Actively vocalizes pleasure with cooing or crowing
 Cries easily on slight or no provocation
 Vocalizes several well- defined syllables
 Shows enjoyment in hearing own vocalization
 Talks to image in mirror

PLAY STIMULATION: -
 Encourage infant to look in a mirror
 Make funny faces for infant to imitate
 Talk to infant about own and surrounding activity
 Use the word “no” only when necessary
 Provide sound making toys

SPECIAL NEEDS OF INFANT (0 TO 6 MONTHS): -

 Emotional- social need: - The kind of person the

infant will become depends largely upon the
characteristics of the parents, their relations with
each other and emotional atmosphere of their home.
The infant receives feelings of love and security or
of anxiety and insecurity from their parents. Today it
is believed that the unique individual capacities of
each infant exert a direct influence on the parent-
infant interactions in meeting these needs.
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

 Love and security: - Infants who feel loved attempt

to respond and therefore receive more
demonstration of love in return. They smile at their
caregivers, usually the parents and the parent smile
back to them. If infants do not have a loving,
intimate, warm and continuous relationship with their
parents, they may develop feelings of excessive
anxiety. These feelings of insecurity may form the
basis for less than optional physical, emotional and
mental health later in their lifetimes.

 Dependance progressing to independence: -

Neonates are totally dependent at birth. During the
first year of life, their beginning independence is
seen in attempting to feed themselves and in
cooperating in dressing

 Biological needs: - Infants have their own

physical- biological needs as all other family
members. The natural rhythms of an infant must be
given consideration in planning the family’s daily
schedule. These rhythms of sleeping, waking,
feeding and exercise will change as the infant
becomes older. If the mother is not employed she is
able to devote time to her infant at periods that fit
into her routine but, if she works it may be
necessary to adapt the infant’s schedule to the
hours when she is free or to enlist the father or
another family member as a substitute.
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

STUDY RELATED TO GROWTH AND DEVELOPMENT: -

 A study related to the feeding practice of babies
and correlating it with their growth and
development.
B. Selvakumar, B. Vishnu Bhat

The present study was conducted among 150 healthy

babies< 2 years of age attending the Paediatric OPD/
under-five clinic in JIPMER, a tertiary care hospital, with
the aim of studying the feeding practice of babies and
correlating it with their growth and development.
Information about the feeding pattern and development
were obtained from the mother/ the guardian using a
graded questionnaire. The anthropometric parameters
were measured and analysed with refined parameters like
Z score of weight, Weight-for-Height percent etc using
CDC2000 anthropometric charts as reference.
Developmental progress was quantified using the
Trivandrum Developmental Screening Chart (TDSC).

The mean duration of exclusive breast feeding was 6.26

months (range 0 – 22). Presence of malnutrition was quite
high (42.3% by Z score and 40% by Weight-for-Height),
though overnutrition was present to a lesser extent (7.3%
by Weight-for-Height). Significant differences in the Z score
of weight were observed between babies exclusively
breast fed for 4-6 months and for> 6 months (P value =
0.001) while significant differences in development were
seen between babies exclusively breast fed for <3 months
and the others (P value = 0.003 & 0.032).
TIME SPECIFIC CONTENT TEACHING- LEARNING ACTIVITY EVALUATION
OBJECTIVE

Though most of the babies were breast fed exclusively for

4-6 months, babies weaned after 6 months are likely to be
malnourished, while babies exclusively breast fed for< 3
months are likely to have a delay in achieving milestones.
http://www.indmedica.com/journals.php?journalid=13&issueid=106&articleid=1465&action=article

CONCLUSION: -
The period of growth and
development extends throughout
the life cycle; however the period in
which the principal changes occur is
from conception to the end of
adolescence. Growth and
development are continuous and
orderly processes that have
predictable sequences. Although the
rate of progress may vary, all
human beings go through the same
stages on their way to their physical
increase in size and the maturation
of neuromuscular functions.
SUMMARY: -

Today I have discussed with you the topic developmental milestones and special needs of infant (0 to 6 months).

 Introduction
 Principles of growth and development
 Theories of development
 Development task
 Purposes of development tasks
 Importance of developmental task
 Categories of developmental task
 Developmental milestones
 Classification
 Milestones at 1 month
 Milestones at 2 month
 Milestones at 3 month
 Milestones at 4 month
 Milestones at 5 month
 Milestones at 6 month
 Special needs of infant (0 to 6 months)
 Study related to growth and development
BIBLIOGRAPHY: -

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