HD-5

UNIT- THREE

EARLY YEARS
PRENATAL DEVELOPMENT:

CONCEPTION-STAGES & INFLUENCE ON PRENATAL DEV.

CONCEPTION: Conception occurs when an egg from the mother is fertilized by a

sperm from the father. In humans, the conception process begins with ovulation,
when an ovum, or egg (the largest cell in the human body), which has been stored in
one of the mother's two ovaries, matures and is released into the fallopian tube.
Ovulation occurs about halfway through the woman’s menstrual cycle and is aided by
the release of a complex combination of hormones. In addition to helping the egg
mature, the hormones also cause the lining of the uterus to grow thicker and more
suitable for implantation of a fertilized egg.

If the woman has had sexual intercourse within one or two days of the egg’s
maturation, one of the up to 500 million sperm deposited by the man’s ejaculation,
which are travelling up the fallopian tube, may fertilize the egg. Although few of the
sperm are able to make the long journey, some of the strongest swimmers succeed in
meeting the egg. As the sperm reach the egg in the fallopian tube, they release
enzymes that attack the outer jellylike protective coating of the egg, each trying to be
the first to enter. As soon as one of the millions of sperm enters the egg’s coating, the
egg immediately responds by both blocking out all other challengers and at the same
time pulling in the single successful sperm.

The zygote: Within several hours of conception, half of the 23 chromosomes from the
egg and half of the 23 chromosomes from the sperm fuse together, creating
a zygote — a fertilized ovum. The zygote continues to travel down the fallopian tube to
the uterus. Although the uterus is only about four inches away in the woman’s body,
the zygote’s journey is nevertheless substantial for a microscopic organism, and fewer
than half of zygotes survive beyond this earliest stage of life. If the zygote is still viable
when it completes the journey, it will attach itself to the wall of the uterus, but if it is
not, it will be flushed out in the woman’s menstrual flow. During this time, the cells in
the zygote continue to divide: the original two cells become four, those four become
eight, and so on, until there are thousands (and eventually trillions) of cells. Soon the
cells begin to differentiate, each taking on a separate function. The earliest
differentiation is between the cells on the inside of the zygote, which will begin to form
the developing human being, and the cells on the outside, which will form the
protective environment that will provide support for the new life throughout the
pregnancy.

The Embryo: Once the zygote attaches to the wall of the uterus, it is known as
the embryo. During the embryonic phase, which will last for the next six weeks, the
major internal and external organs are formed, each beginning at the microscopic
level, with only a few cells. The changes in the embryo’s appearance will continue
rapidly from this point until birth

While the inner layer of embryonic cells is busy forming the embryo itself, the outer
layer is forming the surrounding protective environment that will help the embryo
survive the pregnancy. This environment consists of three major structures:
The amniotic sac is the fluid-filled reservoir in which the embryo (soon to be known as
a fetus) will live until birth, and which acts as both a cushion against outside pressure
and as a temperature regulator. The placenta is an organ that allows the exchange of
nutrients between the embryo and the mother, while at the same time filtering out
harmful material. The filtering occurs through a thin membrane that separates the
mother’s blood from the blood of the fetus, allowing them to share only the material
that is able to pass through the filter. Finally, the umbilical cord links the embryo
directly to the placenta and transfers all material to the fetus. Thus the placenta and
the umbilical cord protect the fetus from many foreign agents in the mother’s system
that might otherwise pose a threat.

The Fetus: Beginning in the ninth week after conception, the embryo becomes a fetus.
The defining characteristic of the fetal stage is growth. All the major aspects of the
growing organism have been formed in the embryonic phase, and now the fetus has
approximately six months to go from weighing less than an ounce to weighing an
average of six to eight pounds. That’s quite a growth spurt.

The fetus begins to take on many of the characteristics of a human being, including
moving (by the third month the fetus is able to curl and open its fingers, form fists,
and wiggle its toes), sleeping, as well as early forms of swallowing and breathing. The
fetus begins to develop its senses, becoming able to distinguish tastes and respond to
sounds. Research has found that the fetus even develops some initial preferences. A
newborn prefers the mother’s voice to that of a stranger, the languages heard in the
womb over other languages, and even the kinds of foods that the mother ate during
the pregnancy By the end of the third month of pregnancy, the sexual organs are
visible.

How environment affect vulnerable fetus? Prenatal development is a complicated

process and may not always go as planned. About 45% of pregnancies result in a
miscarriage, often without the mother ever being aware it has occurred (Moore &
Persaud, 1993). Although the amniotic sac and the placenta are designed to protect
the embryo, substances that can harm the fetus, known as teratogens, may
nevertheless cause problems.  Harmful substances that the mother ingests may harm
the child. Cigarette smoking, for example, reduces the blood oxygen for both the
mother and child and can cause a fetus to be born severely underweight. Another
serious threat is fetal alcohol syndrome (FAS), a condition caused by maternal
alcohol drinking that can lead to numerous detrimental developmental effects, including
limb and facial abnormalities, genital anomalies, and intellectual disability. Each year
in Canada, it is estimated that nine babies in every 1,000 are born with fetal alcohol
spectrum disorder (FASD), and it is considered one of the leading causes of intellectual
disability in the world today
The environment in which the mother is living also has a major impact on infant
development Children born into homelessness or poverty are more likely to have
mothers who are malnourished, who suffer from domestic violence, stress, and other
psychological problems, and who smoke or abuse drugs. And children born into
poverty are also more likely to be exposed to teratogens. Poverty’s impact may also
amplify other issues, creating substantial problems for healthy child development

Mothers normally receive genetic and blood tests during the first months of pregnancy
to determine the health of the embryo or fetus. They may undergo sonogram,
ultrasound, amniocentesis, or other testing (Figure 14.1). The screenings detect
potential birth defects, including neural tube defects, chromosomal abnormalities
(such as Down syndrome), genetic diseases, and other potentially dangerous
conditions. Early diagnosis of prenatal problems can allow medical treatment to
improve the health of the fetus.

BIRTH & NEONATAL DEVELOPMENT

The neonatal period is the first four weeks of an infant's life, whether the baby was
carried to term or born prematurely. It's a time of rapid change and development
where patterns for infancy, like feeding and bonding, are developed. It's also the period
when there are the most risk for post-birth complications or when birth defects or
congenital conditions may first be detected. 1 The neonatal period includes the prenatal
period, which is the initial period after the birth.

Newborns, also called neonates, are observed closely in the first few hours of
life. This is particularly true for premature births, which occur before the
37th week of pregnancy, or if there were any complications during the delivery.
A developing baby goes through important growth throughout pregnancy,
including in the final months and weeks. Premature babies can have immature
lungs, difficulty regulating body temperature, poor feeding, and slow weight
gain. In 2018, the preterm birth and low birth weight accounted for about 17% of
infant deaths before one year of age.

Immediately after birth, a medical team quickly checks the baby's vital signs,
alertness, and overall health. Supplemental oxygen and other emergency care may be
provided if the baby has breathing difficulties. You may hear the baby assigned an
Apgar score, which is based on: Color, Heart rate, Reflexes, Muscle tone, and
Breathing.

Numerical scores are added for each category and reevaluated every five minutes for
the baby's first 20 minutes of life. Low scores or problems in any of these areas may
result in the need for additional care for the baby. The goal is for the infant and their
parent to be together in this period and begin feeding and bonding.

RISKS & COMPLICATIONS:

The neonatal period is the riskiest period after birth. Worldwide, 2.4 million infants
died in the first month of life in 2019. 4 Death rates in this period have decreased over
the past few decades, but complications during pregnancy and delivery remain
significant, with 75% of infant deaths occurring in the first week of life.
With proper prenatal care, some complications or conditions may be identified before
delivery, and infants could be labeled as high risk before they are even born. This gives
medical teams adequate warning and time to make sure the tools necessary to care for
the infant are in place at the time of birth.

Even for infants who aren't labeled as high-risk before birth, healthcare providers will
watch the baby closely after birth, ideally noting any illness or complications within
the first two hours of life.

Possible complications or problems during the delivery process and neonatal period
include:

 Birth defects
 Birth injuries
 Breathing problems
 Infection
 Jaundice
 Low birth weight
 Low blood sugar
 Neurological problems like cerebral palsy or seizures
 Feeding difficulties
 Pneumonia from breathing in fluids during birth
 Temperature control problems
 Developmental delay
 Vision problems
 Hearing problems

Infants who require extensive care from premature birth or other neonatal
complications may need to receive treatment in a neonatal intensive care unit after
birth. If no complications occur, the delivery team begins to make plans to transition
babies to postnatal care hours after delivery. 3 Hospitals in the United States are
required to offer at least a 48-hour hospital stay after birth for a vaginal delivery and
96 hours for a cesarean deliver y

What happens in neonatal period: A lot happens during the neonatal period—
especially immediately after delivery.  The baby will undergo a number of tests and
screenings for common diseases, hearing problems, and more. They will also receive a
number of vaccinations.

1st week: In the first week after birth, you and your baby will be getting to know each
other. Bonding and feeding are the primary tasks in this first week.

2nd week: Sleep and feeding are erratic at this stage. Your baby may be having their
first growth spurt, having returned to their birth weight and then some.

3rd week: Feeding and sleeping schedules are still inconsistent, but your baby will
begin to refine its muscle control at this point. Most babies begin to lift their head and
should have regular "tummy time" to help develop strength.
4th week: You've officially reached the end of the neonatal period. For many parents,
feeding and sleeping become more routine at this stage.

SCREENING OF NEW BORN- APGAR SCORE – REFLEXES- NEURO PERCEPTUAL

DEVELOPMENT

The Apgar score is a quick way for doctors to evaluate the health of all newborns at 1
and 5 minutes after birth and in response to resuscitation.[It was originally developed
in 1952 by an anesthesiologist at Columbia University, Virginia Apgar, as way to
address the need for a standardized way to evaluate infants shortly after birth.
Today, the categories developed by Apgar used to assess the health of a newborn
remain largely the same as in 1952, though the way they are implemented and used
has evolved over the years.[3] The score is determined through the evaluation of the
newborn in five criteria: activity (tone), pulse, grimace, appearance, and respiration.
For each criterion, newborns can receive a score from 0 to 2
Objectives: Identify the physiological criteria used for calculating the Apgar score.
Describe the clinical relevance of the Apgar score. Outline the limitations of the Apgar
score. Explain the importance of coordinated collaboration and effective
communication among the inter-professional team members involved in the evaluation
and management of newborns using the Apgar score in fostering the best possible
standard of care to newborns and their families

NEURO PERCEPTUAL DEVELOPMENT: Perceptual development refers to how

children start taking in, interpreting, and understanding sensory input.
Perception allows children to adapt and interact with their environment through the
use of their senses. Children are born with the ability to see, hear, smell, taste, and
touch

Perceptual development refers to the process by which infants receive, interpret, and
understand sensory input. Like adults, infants encounter stimuli through the five
senses: hearing, sight, smell, taste, and touch. At one time it was believed that infants
experienced limited perception. For example, many believed that infants were born
without the ability to see or hear. While infants' sight distance is limited, infants are
born with the ability to see, hear, taste, smell, and touch.

In fact, perceptual development is particularly important during the first years of life.
The ability to distinguish between different sounds is needed for language
development. Perceptual development is also connected to physical development since
mobility is necessary to explore and play with objects. From infancy until early
childhood, perceptual development plays an important role as children explore,
interpret, and begin to understand their world.

The study of perceptual development begins with an understanding of the earthly

environment of energy and matter that is to be perceived by an infant. From there,
human perception connects to that environment with specialized sensory systems for
vision, audition, muscle positioning, touch, taste, and smell, selecting and
coordinating complex layers of information in order to quickly arrive at meaning. Many
perceptual abilities are present even before birth, and undergo rapid development.
Fascinating new research discoveries have been made that enable an understanding of
how perceptual meanings are formed, serving as a bridge between the environment
and higher levels of cognition.

Perception is the use of the senses to acquire information or knowledge about the
external world. Infants begin life with a number of abilities which support knowledge
acquisition and exploration. Following a discussion of two general views of perceptual
development, this entry covers the development of depth perception (kinematic,
binocular, and static-monocular cues), object perception (pattern perception, three-
dimensional object perception, partly occluded objects, size and shape constancy, and
event perception), and face perception. The findings suggest that infants’ perceptual
abilities are not at the same level of adults, but their perception of the world is
remarkably competent.

MILESTONES & VARIATIONS IN DEVELOPMENT:

Parents are instinctively interested in their child’s development and want to make sure

their child is progressing appropriately. As children grow, they pass through key
developmental milestones at certain ages. Tracking these milestones helps us gauge
how a child is progressing, although it's normal for children to learn these skills at
different rates.

Understanding what milestones are, and whether children are meeting them can help
parents identify problems early, or reassure them that their children are on track.
Learn about the main types of milestones, why they matter, and how you can use
them effectively to guide your parenting journey. Milestones involve physical, social,
emotional, cognitive, and communication skills that kids need to learn as they develop
and grow. Often these skills build on each other. For instance, first, a baby pulls up,
then they stand, followed by taking their first steps.

TYPES OF MILESTONES:

Physical Milestones

These milestones involve both large motor skills and fine motor skills. The large motor
skills are usually the first to develop and include sitting up, standing, crawling, and
walking. Fine motor skills involve precise movements such as grasping a spoon,
holding a crayon, drawing shapes, and picking up small objects.

For example, between the ages of 9 to 12 months, children begin to achieve physical
milestones such as standing up or even early walking. 2 However, as noted above, the
range of when these skills happen is large, with some kids walking as early as 9
months and others not taking their first steps until around 14 to 15 months or even
later. As long as they are eventually mastered, getting to these skills later in the
expected range do not normally have any lasting impact or reflect future impairments.

Cognitive Milestones:

Cognitive milestones are centered on a child's ability to think, learn, and solve
problems. An infant learning how to respond to facial expressions and a preschooler
learning the alphabet are both examples of cognitive milestones. Other examples
include looking for dropped objects and problem solving.

Social and Emotional Milestones

Social and emotional milestones are centered on children gaining a better

understanding of their own emotions and the emotions of others. These skills also
involve learning how to interact and play with other people and the development of
empathy.4
 Some examples include showing a preference for caregivers, expressing emotions via
facial expressions, and self-soothing.
Communication Milestones
These milestones involve both language and nonverbal communication. 2 A one-year-
old learning how to say their first words and a five-year-old learning some of the basic
rules of grammar are examples of important communication milestones. Other
communication milestones are making cooing sounds and looking toward the person
who is talking to them.

ENVIRONMENTAL FACTORS AFFECTING EARLY CHILDHOOD

Child growth and development are affected by 4 major types of environmental factors:
biological, physical, psychosocial, and familial
The family, school, or general environment a child lives and interacts with generally
affects their growth and development. In the early formative years, children pick up
things from their environment, learn how to solve problems, habits, and behaviors,
socialize, and general functioning. Consequently, studying the main environmental
factors affecting the growth and development of a child is necessary. These include
the social, emotional, economic, and physical environment.
The physical environment is the space and location in which the child grows,
affecting their health, learning, and behavior. In addition, research shows that effects
of the physical environment, such as housing, exposure to pollution, and
neighborhood quality, all affect the psychosocial aspect of the child. For example,
assume a child with disabilities getting access to a ramp to help them access various
areas of their home quickly. This example depicts the impact of the physical
environment on growth.
Social Environment
The social environment influences on child development are those that affect the
social relationships that children will form throughout their lives and the quality of
said relationships, whether with their families, or the neighborhood where they reside.
Some examples of a child's social environment include educational facilities, housing,
recreational facilities, and the places they spend most of their interactive social time.
During the preschool stage, children largely imitate the social behaviors around them,
mostly what they see people do in their daily environment. Exposure to their peers will
also enable them to handle school better, once they join. These observations affect
how they form relationships and interact with their peers.
Emotional Environment
The emotional environment in child development refers to how well their
interpersonal and relational needs are being met at home. This factor may include
learning what emotions are, understanding and communicating their feelings, learning
empathy, and developing appropriate ways to manage and handle their feelings and
those of others.

Children who grow up in less than ideal emotional environments tend to struggle in
the future and are unable to form meaningful relationships as they grow up and, in
extreme cases, get involved in crime. Studies have also linked poor emotional
environments to later mental health issues such as anxiety.

Economic Environment

The economic environment in child development essentially refers to the financial

situation in which a child grows up. Economic factors primarily affect child
development since child rearing is an expensive endeavor. Research asserts that the
most preventable negative impact on a child's development is a direct result of the
economic environment. There are claims that children from low-income families have
poorer health, and are more likely to perform poorly in school than their wealthier
counterparts.

ROLE OF PLAY IN ENHANCING CHILD DEV.

Play improves the cognitive, physical, social, and emotional well-being of

children and young people. Through play, children learn about the world and
themselves. They also learn skills they need for study, work and relationships such as:
confidence

Playing is a natural and enjoyable way for children to keep active, stay well and be
happy. Freely chosen play helps children and young people’s healthy development. To
have good physical and mental health and to learn life skills, they need various
unstructured play opportunities from birth until they’re teenagers.

Freely chosen play

Freely chosen play is when a child decides and controls their play following their own
instincts, imagination and interests.  They play without being led by adults. There’s no
right or wrong way to play. Freely chosen play improves children’s health, well-being
and development. Why play is important? Play improves the cognitive, physical, social,
and emotional well-being of children and young people. Through play, children learn
about the world and themselves. They also learn skills they need for study, work and
relationships such as: confidence, self-esteem, resilience, interaction, social skills,
independence, curiosity, coping with challenging situations.

Developing physical health through play

Physical play such as running, skipping and riding a bicycle helps children develop:
good physical fitness, agility, stamina, co-ordination, balance.
Developing social skills through play:

Playing can help children develop their social skills with others. By listening, paying
attention and sharing play experiences, this helps a child: explore their feelings,
develop self-discipline, learn how to express themselves, work out emotional aspects of
life,

Playful parenting: Through play, parents can connect fully with their children and
have fun.  A parent or caretaker can support and take part in their child’s play
activities but they shouldn’t direct what happens.

It’s important they give their children time, freedom and choice to play. If an adult
makes all the decisions about how, what and when their child plays, the child won’t
enjoy their play experiences.

Play and challenge: Children often want to create challenge and uncertainty in their
play. Through risky, challenging play, children test themselves and find out their own
limits. They learn how to deal with risk through play and can use these same skills
later in life. Parents should encourage their children from birth to extend themselves.
Teach them basic skills including: riding a bicycle, swimming, road safety

Explain that it’s important to learn from mistakes, to try again and to believe in
themselves.  Help them understand their limits and their boundaries. Allow them to
have fun in their play.

Play and digital technology

To make sure children have time for unstructured, freely chosen play every day,
parents should limit screen time. The younger the child, the less time they should be
using digital devices. Keep certain times and areas in the home technology-free zones
such as: meals, when outdoors, before bed, and bedrooms

Don’t use digital devices to distract your children or keep them quiet. Talk to your
children, play games or look at a book together. Join in your children’s screen time
and talk about their online activity.

END OF THIRD UNIT