Melissa D. David BSN2Y2-2 I.

INFANTS AND TODDLERS

Making sounds other than crying Rolling from stomach to back and back to stomach Beginning to sit up Grasping, reaching and transferring toys from hand to hand Reacting to sounds and responding voices Difficulty sucking Not gaining height and weight Not responding to sounds and voices Not beginning to make sounds other than crying Stiff limbs/overall tightness Weak limbs Not using hands to play with toys Not smiling in response to others Not imitating sounds Not babbling different sounds Not saying a few words Not pointing and vocalizing to request to meet needs Not responding to name or to simple words such as bye or no. Not standing, crawling and sitting on own Not picking up small objects Not playing with parents, siblings and toys

By 6 Months

By 12 Months

Babbling with 6 7 different consonant sounds such as m or d Imitating sounds and saying a few words Responding to simple words such as no and bye Gesturing and vocalizing to request Creeping, crawling and cruising Sitting alone Pulling to a stand Picking up small objects and banging objects on the table Playing pat a cake or peek a boo Holding out objects to "show" Feeding self small bits of cereal Playing with caregivers Exploring and touching a variety of textures Responding to simple requests such as "give me the ball" Listening to simple rhymes and songs Tasting foods with a variety of textures Imitating and saying a few words (10 15 words) Jabbering in a way that sounds

By 18 Months

Not responding to simple requests Not listening to stories or songs Not imitating and saying words Not walking independently Not playing with toys and caregivers

like language Walking without support Playing in a typical way with toys Showing affection Looking at books and turning pages Scribbling with a crayon Putting objects in container Using a spoon with some spilling and drinking from a cup Using more words and putting words together Showing interest in and playing with a variety of toys Pointing to a few pictures of familiar people or objects and body parts Obeying simple two part commands Speech can be understood about 65% of the time Running, jumping, climbing, kicking and throwing Using crayon to make lines and circular scribbles Building a 4 6 block tower and putting pegs in a peg board Says no often Engaging in parallel and pretend play Playing alone for a few minutes Removing clothes Using 34 word sentences frequently Answering simple questions such as What is your name? or Where are you going? Following 2 step directions Speech is understood by people outside the family most of the time Walking up and down stairs Building 8 block tower, snipping with scissors, and placing square pegs in a board Expressing emotions Interest in playing with others but may not share well

Not showing a variety of emotions Not scribbling or putting objects in a container Not self-feeding Avoiding textures

By 24 Months

Not putting words together Not obeying simple commands some of the time Not physically active Not scribbling or building with blocks Not showing interest in toys and social or pretend play Not expressing affection Not beginning to undress self Sensitive to or avoiding a variety of textures

By 30 Months

Not talking in simple sentences or answering simple questions Speech is difficult to understand Physically awkward or clumsy or inactive Not feeding and dressing self Not interested in social play and playing with a variety of toys Not expressing a variety of emotions

Putting on some clothing independently, feeding self with utensils, washing/drying hands Has vocabulary of at least 300 words, expressively Is intelligible about 80% of the time Relating experiences using short grammatical sentences Climbing, catching, riding a trike, jumping, going up and down stairs alone and running well Actively playing with a variety of toys including puzzles, books, pegs, crayons and blocks Feeding self and dressing and undressing with minimal assistance Playing simple interactive games and enjoying playing with others Beginning to obey simple rules Limited vocabulary Difficult to understand Leaving endings off words Not answering simple questions or relating experiences Not speaking in simple 4 word sentences Physically awkward or clumsy or inactive Not playing with a variety of toys Not obeying simple rules Not interested in playing with other children

By 36 Months

II.

PRESCHOOL

Physical Physically active Rule of Three: 3 yrs, 3 ft, 33 lbs. Weight gain: 4-5 lbs per year Growth: 3-4 inches per year Physically

Cognitive Ego-centric, illogical, magical thinking Explosion of vocabulary; learning syntax, grammar; understood by 75% of people by age 3 Poor understanding of time, Play:

Social

Emotional Self-esteem based on what others tell him or her Increasing ability to control emotions; less emotional outbursts Increased frustration tolerance

Possible effects of maltreatment Poor muscle tone, motor coordination Poor pronunciation, incomplete sentences Cognitive delays; inability to concentrate Cannot play cooperatively; lack curiosity, absent imaginative and fantasy play Social immaturity: unable to share or negotiate with

imaginative, may involve fantasy and imaginary friends, takes turns in games

and fine motor skills; social skills; experiment with social roles; reduces fears

active, cant sit still for long Clumsy throwing balls Refines complex skills: hopping, jumping, climbing, running, ride big wheels and tricycles Improving fine motor skills and eye-hand coordination: cut with scissors, draw shapes 3 3 yr: most toilet trained

value, sequence of events Vivid imaginations; some difficulty separating fantasy from reality Accurate memory, but more suggestible than older children Primitive drawing, cant represent themselves in drawing till age 4 Dont realize others have different perspective Leave out important facts May misinterpret visual cues of emotions Receptive language better than expressive till age 4

Wants to please adults Development of conscience: incorporates parental prohibitions; feels guilty when disobedient; simplistic idea of good and bad behavior Curious about his and others bodies, may masturbate No sense of privacy Primitive, stereotypic understanding of gender roles

Better delay gratification Rudimentary sense of self Understands concepts of right and wrong Self-esteem reflects opinions of significant others Curious Self-directed in many activities

peers; overly bossy, aggressive, competitive Attachment problems: overly clingy, superficial attachments, show little distress or over-react when separated from caregiver Underweight from malnourishment; small stature Excessively fearful, anxious, night terrors Reminders of traumatic experience may trigger severe anxiety, aggression, preoccupation Lack impulse control, little ability to delay gratification Exaggerated response (tantrums, aggression) to even mild stressors Poor self esteem, confidence; absence of initiative Blame self for abuse, placement Physical injuries; sickly, untreated illnesses Eneuresis, encopresis, self stimulating behavior rocking, head-banging

III.

SCHOOL AGE Cognitive Use language as a communication tool Perspective taking: 5-8 yr: can recognize others perspectives, cant assume the role of the other 810 yr: recognize difference between behavior and intent; age 10-11 yr: can accurately recognize and consider others viewpoints Concrete operations: Accurate perception of events; rational, logical thought; concrete thinking; reflect upon self and attributes; understands concepts of space, time, dimension Social Friendships are situation specific Understands concepts of right and wrong Rules relied upon to guide behavior and play, and provide child with structure and security 5-6 yr: believe rules can be changed 7-8 yrs: strict adherence to rules 9-10 yrs: rules can be negotiated Begin understanding social roles; regards them as inflexible; can adapt behavior to fit different situations; practices social roles Cognitive Self esteem based on ability to perform and produce Alternative strategies for dealing with frustration and expressing emotions Sensitive to others opinions about themselves 6-9 yr: have questions about pregnancy, intercourse, sexual swearing, look for nude pictures in books, magazines 10-12 yr: games with peeing, sexual activity (e.g., strip poker, truth/dare, boy-girl relationships, flirting, some Possible effects of maltreatment Poor social/academic adjustment in school: preoccupied, easily frustrated, emotional outbursts, difficulty concentrating, can be overly reliant on teachers; academic challenges are threatening, cause anxiety Little impulse control, immediate gratification, inadequate coping skills, anxiety, easily frustrated, may feel out of control Extremes of emotions, emotional numbing; older children may selfmedicate to avoid negative emotions Act out frustration, anger, anxiety with hitting, fighting, lying, stealing, breaking objects, verbal outbursts, swearing Extreme reaction to perceived danger (i.e., fight, flight, freeze response) May be mistrustful of adults, or overly solicitous, manipulative May speak in unrealistically glowing terms about his parents

Physical Slow, steady growth: 3 -4 inches per year Use physical activities to develop gross and fine motor skills Motor & perceptual motor skills better integrated 10-12 yr: puberty begins for some children

Can remember events from months, or years earlier More effective coping skills Understands how his behavior affects others

Takes on more responsibilities at home Less fantasy play, more team sports, board games Morality: avoid punishment; self interested exchanges

kissing, stroking/rubbi ng, re-enacting intercourse with clothes on)

Difficulties in peer relationships; feel inadequate around peers; overcontrolling Unable to initiate, participate in, or complete activities, give up quickly Attachment problems: may not be able to trust, tests commitment of foster and adoptive parent with negative behaviors Role reversal to please parents, and take care of parent and younger siblings Emotional disturbances: depression, anxiety, post traumatic stress disorder, attachment problems, conduct disorders