Growth and Development during Infancy, Lecture notes of Childhood Development

Download Growth and Development during Infancy and more Lecture notes Childhood Development in PDF only on Docsity! GROWTH AND DEVELOPMENT DURING INFANCY GROWTH- denotes an increased physical size or a quantitative change. DEVELOPMENT- indicates an increase in skill or the ability to function or a qualitative change. NEWBORN PERIOD Observation of any asymmetric movement or altered muscle tone and function may indicate a significant central nervous system abnormality or a nerve palsy resulting from the delivery and requires further evaluation. Primitive neonatal reflexes are unique in the newborn period and can further elucidate or eliminate concerns over asymmetric function. The most important reflexes to assess during the newborn period are as follows: The Blink Reflex > to protect the eye from any object coming. The Rooting Reflex > using hand stroke to find the nipple at feeding time. The Sucking Reflex > when lips touched, make baby sucking motion The Swallowing Reflex > gag, cough, sneeze to maintain clear airway. The Palmar Grasp Reflex > grasp an object in their palm by quickly closing them. The Babinski Reflex > newborn’s foot stroke “J” heel upward. The Moro Reflex - or (startle) > stimulates the action of trying to ward of the attacker and then covering up to protect the baby. The Plantar Grasp Reflex > the based of the toes , the toes grasp like the finger. 1 MONTH OLD PHYSICAL ● Weight gain of 150 to 210 g (5 to 7 oz) weekly for first 6 months ● Height gain of 2.5 cm (1 inch) monthly for first 6 months ● Head circumference increases by 1.5 cm (0.5 inch) monthly for first 6 months ● Primitive reflexes present and strong ● Doll's eye reflex and dance reflex fading ● Obligatory nose breathing (most infants) GROSS MOTOR ● Assumes flexed position with pelvis high but knees not under abdomen when prone ● Can turn head from side to side when prone; lifts head momentarily from bed ● Has marked head lag, especially when pulled from lying to sitting position ● Holds head momentarily parallel and in midline when suspended in prone position ● Assumes asymmetric tonic neck flex position when supine ● When held in standing position, body is limp at knees and hips ● In sitting position, back is uniformly rounded, with absence of head control FINE MOTOR ● Hands predominantly closed ● Grasp reflex strong ● Hand clenched on contact with rattle FINE MOTOR ● Hands predominantly closed ● Grasp reflex strong ● Hand clenches on contact with rattle SENSORY ● Able to fixate on moving object in range of 45 degrees when held at a distance of 20 to 25 cm ( 8 to 10 inches) ● Visual acuity approaches 20/100 ● Follows light to midline ● Quiets when hear a voice VOCALIZATION ● Cries to express displeasure ● Makes small, throaty sounds ● Makes comfort sounds during feeding SOCIALIZATION AND COGNITION ● Is in sensorimotor phase—stage I, use of reflexes (birth to 1 month old), and stage II, primary circular reactions (1 to 4 months old) ● Watches parent's face intently as she or he talks to infant 2 MONTHS OLD PHYSICAL ● Posterior fontanel closed ● Crawling reflex disappears GROSS MOTOR 5 MONTHS OLD PHYSICAL ● Beginning signs of tooth eruption ● Birth weight doubles GROSS MOTOR ● No head lag when pulled to sitting position ● When sitting, able to hold head erect and steady ● Able to sit for longer periods when back is well supported ● Back straight ● When prone, assumes symmetric positioning with arms extended ● Can turn over from abdomen to back ● When supine, puts feet to mouth FINE MOTOR ● Able to grasp objects voluntarily ● Uses palmar grasp, bi-dextrous approach Plays with toes ● Takes objects directly to mouth ● Holds one cube while regarding a second on SENSORY ● Visually pursues a dropped object ● Is able to sustain visual inspection of an object ● Can localize sounds made below ear VOCALIZATION ● Squeals ● Makes cooing vowel sounds interspersed with consonant sounds (e.g., ah-goo SOCIALIZATION AND COGNITION ● Smiles at mirror image ● Pats bottle or breast with both hands ● More enthusiastically playful but may have rapid mood swings ● Is able to discriminate strangers from family ● Vocalizes displeasure when object is taken away ● Discovers parts of body 6 MONTHS OLD PHYSICAL ● Growth rate may begin to decline ● Weight gain of 90 to 150 g (3 to 5 oz) weekly for next 6 months ● Height gain of 1.25 cm (0.5 inch) monthly for next 6 months ● Teething may begin with eruption of two lower central incisors ● Chewing and biting occur GROSS MOTOR ● When prone, can lift chest and upper abdomen off surface, bearing weight on hands ● When about to be pulled to a sitting position, lifts head ● Sits in high chair with back straight ● Rolls from back to abdomen ● When held in standing position, bears almost all of weight ● Hand regard absent FINE MOTOR ● Re-secures a dropped object ● Drops one cube when another is given ● Grasps and manipulates small objects ● Holds bottle ● Grasps feet and pulls to mouth SENSORY ● Adjusts posture to see an object ● Prefers more complex visual stimuli ● Can localize sounds made above ear ● Will turn head to the side and then look up or down VOCALIZATION ● Begins to imitate sounds ● Babbling resembles one-syllable utterances— ma, mu, da, di, hi ● Vocalizes to toys, mirror image ● Takes pleasure in hearing own sounds (self reinforcement) SOCIALIZATION AND COGNITION ● Recognizes parents; begins to fear strangers ● Holds arms out to be picked up ● Has definite likes and dislikes ● Begins to imitate (cough, protrusion of tongue) Excites on hearing footsteps ● Briefly searches for a dropped object (object permanence beginning) ● Frequent mood swings, from crying to laughing, with little or no provocation 7 MONTHS OLD PHYSICAL ● Eruption of upper central incisor GROSS MOTOR ● When supine, spontaneously lifts head off surface ● Sits, leaning forward on both hands ● When prone, bears weight on one hand ● Sits erect momentarily ● Bears full weight on feet ● When held in standing position, bounces actively FINE MOTOR ● Transfers objects from one hand to the other ● Has uni-dextrous approach and grasp ● Holds two cubes more than momentarily ● Bangs cubes on table Rakes at a small object SENSORY ● Can fixate on very small objects ● Responds to own name ● Localizes sound by turning head in a curving arch ● Beginning awareness of depth and space ● Has taste preferences VOCALIZATION ● Produces vowel sounds and chained syllables—baba, dada, kaka ● Vocalizes four distinct vowel sounds ● “Talks” when others are talking SOCIALIZATION AND COGNITION ● Increasing fear of strangers; shows signs of fretfulness when parent disappears ● Imitates simple acts and noises ● Tries to attract attention by coughing or snorting ● Plays peek-a-boo ● Demonstrates dislike of food by keeping lips closed ● Exhibits oral aggressiveness in biting and mouthing ● Demonstrates expectation in response to repetition of stimuli 8 MONTHS OLD PHYSICAL ● Begins to show regular patterns in bladder and bowel elimination Parachute reflex appears GROSS MOTOR ● Begins to show regular patterns in bladder and bowel elimination ● Parachute reflex appears FINE MOTOR ● Has beginning pincer grasp using index, fourth, and fifth fingers against lower part of thumb Releases objects at will ● Rings bell purposely ● Retains two cubes while regarding third cube ● Secures an object by pulling on a string ● Reaches persistently for toys out of reach VOCALIZATION ● Makes consonant sounds t, d, w Listens selectively to familiar words ● Utterances signal emphasis and emotion ● Combines syllables, such as dada, but does not ascribe meaning to them SOCIALIZATION AND COGNITION ● Increasing anxiety over loss of parent, particularly mother, and fear of strangers ● Responds to word “no” ● Dislikes dressing, diaper change