Development

Department of Pediatrics
ILOS
1) Definition of development
2) Areas of development
a) Gross motor
b) Fine motor
c) Speech
d) Social
e) Sphincteric control
3) Case-based scenarios
4) Quiz
 WHAT IS DEVELOPMENT ?

• It’s the physical (Gross / Fine ), Visual, Speech, Sphincteric and Social
signs that help to
1) Screen for any delay or hidden problems
2) Follow up in each well care child visit
Ex: Head support, grasp and being dry at night
Delayed : >= 1 skill significantly bellow average of same age in same
population
 GUESS WHICH ONE IS THE ABNORMAL INFANT
• Mum came to you with Yehia, he is 9 m
old, she is anxious he did not walk even
supported and on examination he did
not smile and even he cried when you
examined him, you found that he can sit
without support but no walking nor
saying any words except papa mama.
• Mum came to with Yasser, he is 8
m old, she is anxious that his
feeding is not doing well you found
that he could not sit alone nor
grasp the toy you put in his hand,
yet he smiles to you and you felt he
was comfortable looking at you.
• This one need further follow up
 GROSS MOTOR DEVELOPMENTAL MILESTONES

2m Head in midline
Raise head in prone

4 m Head support
Support on forearm on prone
Rolls from prone to supine

6 m Sit supported
7m Sit unsupported

Rolls from supine to prone

9-10 m Crawl

Pull to stand / Cruises

12-15 m Creeps upstairs

Walk supported (might alone)

18 m Walk well alone
Run unsteadily

2 yrs Walk up and down stair one foot at a time

3 yrs Walk up and down stair alternating feet

Tricycle
4 yrs Hops

5 yrs Skips
 NORMAL OR DELAYED ????

Child 8 m old can sits supported, can hold his head up stably but cannot
stand well nor cruises on table or his mum legs, he can turn from supine
to prone and vice versa

Name two maneuvers here and when each can be achieved ??

Sits supported at 6 m hold his head at 4 m
 NORMAL OR DELAYED ????

Child 4 years can hops well and run fast, he likes to climb stairs as
adults up and down but he is not having fun when playing skipping as
he can not do it well

Name two maneuvers here and when each can be achieved ??

Hops well 4 years skips 5 years
 NORMAL OR DELAYED ????

Child 2 years old can run, but his mum said he did not crawl much
when he was young, he can go upstairs but ca not skips

Name two maneuvers here and when each can be achieved ??

Run 18 m skips 5 years
 FINE MOTOR DEVELOPMENTAL MILESTONES

5-6 m Grasp
Transfer large object to other hand or mouth

9-12 m Pincer grip

Leave object on request

18 m Scribbles
Build tower of 3 blocks
2 yrs Use spoon and fork
Build tower of six blocks

3 yrs Copy circle / undress completely

4 yrs Copy square / Dress completely

5 yrs Copy triangle / Ties shoes

 NORMAL OR DELAYED ????

Child 3 years can walk well, but can not skip, he draws good shape
circle but can not draw square nor triangle

Name two maneuvers here and when each can be achieved ??

Draw circle 3 years draw square 4 years
 NORMAL OR DELAYED ????

Child 2 years old can scribble well but can not draw a circle, he runs
well but can not hop, he can feed himself but can not dress himself

Name two maneuvers here and when each can be achieved ??

Draw circle 3 years dress himself 4 years
 NORMAL OR DELAYED ????

Child 1 year old can not hold toys with fingers, he has good head support
but can not sit unsupported, he can not even transfer objects between
hands

Name two maneuvers here and when each can be achieved ??

Head support 4 m sit unsupported 7 m
 SPEECH DEVELOPMENTAL MILESTONES
2m Smiles to touch and voice 3 yrs 3 word sentence/name/age

4m Laughs 4 yrs colours / ask Qs

6m Babbles 5 yrs tell story

9m word in two syllabus ma ma pa pa

12 m mama / Papa + 2-4 words

18 m 20 words / one step command

2 yrs 2 word sentence / Two step command

 NORMAL OR DELAYED ????

Child 3 years old says one word sentence, he can run well as well as
go upstairs and down stairs well, he plays alone and does not do
group playing

Name two maneuvers here and when each can be achieved ??

Group play 3 years one word sentence 1 year
 NORMAL OR DELAYED ????

Child 1 year old says mama and dada as well as his siblings names and
two toys he have but he can not walk alone well nor undress himself

Name two maneuvers here and when each can be achieved ??

Say mama 1 year undress himself 3 years
 SOCIAL DEVELOPMENTAL MILESTONES
3-5 m Recognize parents

6-7 m Recognize strangers

1 yr. Imitates actions / comes when called

2 yrs Parallel play 5 yrs likes household tasks

3 yrs Group play / shares

4 yrs play pretend games

 NORMAL OR DELAYED ????

Child 4 years old likes to play hide and seek with his friends, he can
eat and dress alone but he is weak in mathematics

Name two maneuvers here and when each can be achieved ??

Pretend play 4 years dress himself 4 years
VISUAL DEVELOPMENTAL MILESTONES

• Birth-1 m Fixes on an object

• 2m Follow past midline
SPHINCTERIC CONTROL

• 18 m Bowel control by night

• 2 yrs Bowel control by day
• 2.5 yrs Bladder control by day
• 3 yrs Bladder control by night
 NORMAL OR DELAYED ????
• Child 2 years old wet his bed at night but his bowels are well controlled
normal

• Child 3 years old wet his bed day and night

• delayed

• Child 1.5 years old wet his bed day and night
Normal
GUESS THE AGE? 9-12 M
GUESS THE AGE? 2 YEARS
GUESS THE AGE? 12-15 M
GUESS THE AGE? 9-12 M
GUESS THE AGE? 4 YEARS
GUESS THE AGE? 12-15
Feel free to ask any Q