INTRODUCTION TO CHILD

DEVELOPMENT

Dr. Javeria Saleem

CHILD DEVELOPMENT: AN INTRODUCTION
 EARLY CHILD DEVELOPMENT

Child development refers to how a child becomes able to do more

complex things as they get older.
Development is different than growth.Growth only refers to the child
getting bigger in size.
What are developmental milestones?
Developmental milestones are a set of functional skills or age-specific
tasks that most children can do at a certain age range. Your
pediatrician uses milestones to help check how your child is
developing. Although each milestone has an age level, the actual age
when a normally developing child reaches that milestone can vary quite
a bit. Every child is unique!
 EARLY CHILD DEVELOPMENT

• Early Child Development (ECD) includes the following domains of

development:
Gross Motor
Fine Motor
Social (adaptive) and socio-emotional
Language (Expressive and Receptive)
Cognition
 EARLY CHILD DEVELOPMENT

Gross motor: using large groups of muscles to sit, stand, walk, run, etc.,
keeping balance, and changing positions.
Fine motor: using hands to be able to eat, draw, dress, play, write, and do
many other things.
Language: speaking, using body language and gestures, communicating, and
understanding what others say.
Cognitive: Thinking skills: including learning, understanding, problem-
solving, reasoning, and remembering.
Social: Interacting with others, having relationships with family, friends, and
teachers, cooperating, and responding to the feelings of others.
 GROSS MOTOR

• LARGE movements, which use large muscle groups in the body

Can you think of some more examples?

 GROSS MOTOR

2-4 MONTHS 6 MONTHS 12 MONTHS 24 MONTHS

• Can hold head up • Starts to sit by • Pulls self to stand • Kicks a ball
• Starts to push down themselves • May stand alone • Begins to run
when stood on legs • Support weight when
standing (bouncing)
 FINE MOTOR

• SMALL movements, which use fingers and hands

Can you think of some more examples?

 FINE MOTOR

2-4 MONTHS 6 MONTHS 12 MONTHS 24 MONTHS

• Follows objects/faces • Brings things to • Can put things in and • Can build tower of
• Brings hands in front mouth out of cup bricks
of face • Grasps large toy • Uses pincer grasp • Scribbles
 SOCIAL

• Participating in daily activities

Can you think of some more examples?

 SOCIAL

2-4 MONTHS 6 MONTHS 12 MONTHS 24 MONTHS

• Smiles in response • Recognizes parents • Can hold a spoon with • Puts hands out to be
• Frolics in response to • Will take porridge porridge washed
being played with from spoon • Stretches to be picked • Indicates needs a
up wee/poo
 LANGUAGE

• Developing both receptive and expressive language

Can you think of some more examples?

 LANGUAGE

2-4 MONTHS 6 MONTHS 12 MONTHS 24 MONTHS

• Laughs/chuckles • Looks in direction of • Responds to his or her • Unclear talk/jabber in

sound name sentences
• 2/4 syllable babble • Says 2 or more words
• Says one word (sometimes together)
• Follows one stage
command
 Why developmental assessment?

Early detection of deviation in child’s pattern of development

Simple and time efficient mechanism to ensure adequate surveillance of

developmental progress

Domains assessed: are cognitive, motor, language, social / behavioral and adaptive
 Red Flags in infant development

• Unable to sit alone by age 9 months

• Unable to transfer objects from hand to hand by age 1 year
• Abnormal pincer grip or grasp by age 15 months
• Unable to walk alone by 18 months
• Failure to speak recognizable words by 2 years.
 Issues in parenting - toddlers

 Stranger anxiety – should dissipate by age 2 ½ to 3 years

 Temper tantrums: occur weekly in 50 to 80% of children – peak incidence 18
months – most disappear by age 3
 Sibling rivalry: aggressive behavior towards new infant: peak between 1 to 2
years but may be prolonged indefinitely
 Thumb sucking
 Toilet Training
 Red flags: preschool

 Inability to perform self-care tasks, hand washing simple dressing, daytime

toileting
 Lack of socialization
 Unable to play with other children
 Able to follow directions during exam
 Performance evaluation of pre-school teacher for kindergarten readiness
 School Years

Ask about favorite subject

How they are doing in school
Do they like school
By parent report: any learning difficulties, attention problems, homework
Parental expectations
Red flags: school age
School failure
Lack of friends
Social isolation
Aggressive behavior: fights, fire setting, animal abuse
 Adolescent

As teenagers gain independence they begin to challenge values

Critical of adult authority
Relies on peer relationship
Mood swings especially in early adolescents
Adolescent behavioral problems
Anorexia
Attention déficit
Anger issues
Suicide
 Adolescent Teaching

Relationships
Substance use and abuse
Gang activity
Driving
Access to weapons
 DEVELOPMENTAL ASSESSMENT

SCREENING OF DEVELOPMENTAL DELAYS BY:

DDST ( infancy & preschool years)
MDAT ( Malawi development assessment tool)
Bayley’s development scale
Gesell’s criteria
From 2 – 2.5 years
• A child can
• Jump from a height of 12” with one foot leading
• Jump off the floor with both feet
• Balance on one foot
• Takes short running steps on toes
• Throws a 9.5 ball 4-5 feet
What is childhood disability?
And what are we looking for in developmental screening?
 What is childhood disability and what are we
looking for when using the Child Development
Monitoring Tool?

• Children who have a disability are defined as:

• those who have a limitation of their ability to function to enable them to
function and carry out developmentally appropriate activities and participate,
as desired, in society.
 Physical disabilities
• This may include disabilities which affect the ability to move arms and
legs.

• Cerebral palsy – a condition where an injury/damage to a child’s brain (at

the time of birth or before or after birth including due to infection) may
cause the child to find it difficult to move their arms or their legs or both.
Children can be affected just in their lower limbs or on one side of their
body or their whole body can be affected.
Hydrocephalus:
• A condition where a child may have a very large head due to the fluid in the
brain not draining through the body. This is often associated with Spina Bifida.
Children with hydrocephalus can have cerebral palsy as well or they can have
very floppy legs if they have associated Spina Bifida.
Spina Bifida
• A condition where a child may have a lesion on their spine which
often causes floppiness in the lower limbs and can affect the ability
for the child to walk and can also affect their ability to pass urine and
stools on their own.
Other motor disorders
• Muscle disorders, birth injuries affecting one upper limb and Talipes
(where the feet are pointing inwards)
Language disorders
• This may include disabilities where the child finds it difficult to talk or finds
it difficult to understand language.

• Hearing problems: ** The most common reason for children not to be

speaking at the right time. This is important to identify early.
• Autism – a child who does not feel that they need to communicate may not
speak – this is called autism. These children often have other features that
we see in autism. For example, they can be very repetitive and they may
seek lots of sensory input (touching, smelling, tasting odd things).
• Global developmental delay – Some children are just delayed in all areas of
their development and this is particularly noticed in their language
development. These children sometimes have been born with a genetic
reason for this and may have other features that make them look a little
different than most children.
Learning difficulties and Global Developmental
Delay:
• Children who have difficulties in ALL AREAS of development but
particularly cognition, learning, language and fine motor skills may
have

• Global Developmental Delay. These children often go on to have

learning difficulties, behaviour problems and may also be autistic.
Social interaction and socio-emotional
disabilities:
• Children who have difficulties with social interaction may have Autsim
particularly if they have other features such as repetitive behaviour
and are very sensory seeking (interested in touching, smelling, tasting
odd things or overwhelmed by noises, tastes, smells and touch).
• Children who have socio-emotional difficulties may have had poor
interaction or issues during the early period of life in their families.
Some children with other disabilities and with global developmental
delay are likely to have some behavioural difficulties.
Sensory disabilities:
• Hearing impairment – children may be born or may acquire a hearing
impairment and may be able to get treatment with a hearing aid.

• Visual impairment – children may be born or may acquire a vision

impairment and may be able, in some cases, to get treatment from an
ophthalmologist or even may need glasses.
Epilepsy

• Some children are born with seizures or may acquire them after an
illness or later in life.
• Some of these children have associated developmental delay or
difficulties.