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S2 Lec 2: Growth and Development (Part 2) by Dr. Maria Cielo B.
September 6, 2010
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ai Malijan
M GROWTH • Available learning experiences
n • A process
Re • Increase in size or mass
F. • By multiplication or by enlargement of THEORIES AND MODELS OF DEVELOPMENT
co component cells • Physiologic development (Organogenesis)
Ri • Whole individual or a part • Cognitive Development (Piaget)
• Psychosexual Development (Freud)
DEVELOPMENT
fie
• A process • Psychosocial Development (Erickson)
ul
• Growing and acquiring skills in an orderly or • Neurodevelopment (Gesell)
predictable pattern •
Pa
Moral Development (Kohlberg)
vs • Due to maturation and experience
Vi • Increase in skills and complexity of function PHYSIOLOGIC DEVELOPMENT (ORGANOGENESIS)
ne
le SIGNIFICANCE OF DEVELOPMENT THE PERIODS OF DEVELOPMENT
Ar • Permits early detection of delays and deviance
a • Allows the health professional to help the PRENATAL PERIOD POSTNATAL PERIOD
ň parents understand their observations. Ovul 0-14th day Infancy Birth to 2
ar years
Embr 14th day to 8th Early 2 to 6 years
Ni
BASIC LAWS THAT GOVERN DEVELOPMENT
• Development goes through defined stages and yo week (end) Childhoo
g
an phases. d
ad • Development infers change. Fetal 9th week to birth Late 6 – 10 years
D • Development is seen as an increase in function Childhoo (female)
er and ability. d 6 – 12 years
h • Development involves maturation. (male)
ac • Development and maturity takes time. Adolesce 10 – 18 years
nce (female)
12 – 18 years
e
BASIC PRINCILES
T (male)
ar • Development is a continuous process
intimately related to the central nervous
be
system (from conception to maturity) . COGNITIVE DEVELOPMENT
(Piaget’s Theory)
• Development follows a definite sequence
co
Ri although the rates may differ. • Touches on the basic concepts of education
and deals with the processes of learning
ie • Development is intimately related to the
ck maturation of the nervous system • Development is considered to occur as a result
of the interaction of
• Development follows a cephalocaudal pattern.
o Maturation – differentiation and
Ni
• Development proceeds from gross and
elaboration of the CNS
ad
undifferentiated skills to precise and refined .
Gl o Experience – interaction with the
• Certain primitive reflexes have to be lost
Je physical world
before the corresponding voluntary movement
nz o Social Transmission – the effect of care
is acquired.
Ay and education upon the nature of the
experience
h FACTORS AFFECTING DEVELOPMENT
o Equilibration – self-regulation
at • Biological endowment
• 2 aspects of adaptation:
K o Intellectual
o ASSIMILATION
o o Physical size
o Health conditions  Ability to accept and integrate
experiences
Jh
o Nutritional status
h o ACCOMODATION
• Environmental influences
a  The modifications provoked by
o Relative strengths can be affected
n the experiences
by the environment
o Opportunities to practice the skill
e
PSYCHOSEXUAL DEVELOPMENT
o Culture/ practices
Gi
o (Freud’s Theory)
• Theories lead to the understanding of the
Ed • Human Relationships child’s emotional growth.
e o Adult attitudes
ll o Nurturing caregivers
ce
Jo Page 1 of 8
k
ar
M
h
ac
R
• Freud et al revealed those strong influences, of
”
“G which we are normally not aware, which
n control our emotional development and
h stability, attitudes and reactions and
Jo interpersonal relationships.
n • Continuity of influences
Ia • Early childhood experiences may have
a profound consequences later on.
• The existence of sexuality in infants
n
• Sexual behaviour involves an interplay
Ni
between excitation and satisfaction
g • FINE MOTOR SKILLS
A PSYCHOSOCIAL DEVLOPMENT
n (Erickson’s Theory)
e • Places emphasis on the social interactions and
Bi less on the sexual matters
• The psychosocial development of individuals
depend on the social relations established at
various points in life
• Based on Erickson, the following are important
for children:
o To have an awareness and stability
which is appropriate for their level of
development
o That this awareness and stability is
achieved by balancing opposing
influences, and that the behaviour at
any age is a reflection of their success
in achieving this balance
o That the direction of the equilibrium
varies at different ages
o That periods of transition from one
orientation to another are times of
crisis and stress
NEURODEVELOPMENTAL THEORY
(Gesell’s Theory)
• The various responses and behaviours of
babies and children emerge gradually.
PERMANENT
RESPONSES
TEMPORARY
• Responses may be classified as:
• PERMANENT
o when the responses have appeared
they persist as a constant feature of
the child’s behaviour repertoire.
o If absent - delayed
• TEMPORARY
o when the response appear for a period
and they are superseded by another
type of response
o If absent – either delayed development,
accelerated development or weakness
of the response that is overlooked
• Based on Gesell’s theory, the pattern of
development is so uniform.
• Principles:
o Development follows a definite
sequence although the rates may
differ.
o Development follows a cephalocaudal
pattern.
o Development proceeds from gross and
undifferentiated skills to precise and
refined.
DOMAINS OF DEVELOPMENT
• LOCOMOTOR (GROSS MOTOR) SKILLS
o Posturing of the head, trunk and
extremities
o Gross movement
o Well-coordinated movements of the
small muscles
o Manipulation using the hands
o Coordinated with vision
• LANGUAGE SKILLS
o The art of communication
o The ability to understand another
person (receptive language)
o The ability to make oneself understood
(expressive language)
• PERSONAL-SOCIAL
o Affected by the environment and
culture
o Demonstrates neuromuscular
coordination
o Activities of daily living
o The ability to get along well with other
people
• ADAPTIVE SKILLS
o Closely related to intelligence
o The ability to utilize and manipulate
objects
o the use of motor and sensory
coordination in the solution of practical
problems
o the resourcefulness in adjusting to new
situations
THE FIRST YEAR OF LIFE
• Physical growth, maturation and psychological
reorganization occur rapidly.
• Changes occur in outbursts and not as a
smooth transition.
THE FIRST YEAR OF LIFE:
GROSS MOTOR SKILLS
• During the first few months, gross motor
evaluation describes the motor activities of the
infant in the following positions:
o Supine
 Neonates arms and legs are in
a flexed position
 Head begins to be raised in
anticipation of being pulled to
sit
 Pulling the baby into sitting
position (with head lag , then
without head lag
 Independent sitting
(protective reflexes at 8 - 9
months)
o Prone
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  Head stabilization is observed
with extension of the neck THE FIRST YEAR OF LIFE:
 Ability to support the chest LANGUAGE SKILLS
with the forearms • COMMUNICATION SKILLS
 Ability to support the chest o movement of heads, eyes, arms
with the hands o Vocalization (at birth)
 Motor skills above the waist is o Crying
more proficient than below o Cooing
 Moves by hauling themselves o Babbling (repetitive vocalization)
or scooting o Syllables
 While on prone, they creep o 2-syllable repetitions (non-specific
(movement involving arms and “mama’ and “dada”)
the legs with the trunk on the o Vocalization and imitation of sounds
floor) o Echolalia
o Upright
 Anti-gravity position THE FIRST YEAR OF LIFE
AT 0-2 MONTHS
 Stepping reflex: (no pelvic PHYSICAL DEVELOPMENT Weight loss of 10%
stability)
during the first week of
 Positive supportive reflex life but exceeds birth
o ROLLING weight after 2 weeks.
 Suppression of the fencing Movements are largely
reflex (ATNR’s) uncontrolled.
o CRAWLING Smiling is involuntary.
o PULL TO STAND Crying occurs in
o CRUISING response to stimuli but
o STANDING: Readiness to stand often obscure. (peaks at
without support – appearance of the 6 weeks)
parachute reflex
o WALKING WITH , then WITHOUT COGNITIVE Stimuli – visual, tactile,
SUPPORT DEVELOPMENT olfactory and auditory
(from the caregivers)
Habituation and renewed
THE FIRST YEAR OF LIFE: attention, recognition of
FINE MOTOR SKILLS differences between
• Hands are closed most of the time similar patterns
• (+) Grasp reflex EMOTIONAL Basic trust – urgent
• Disappearance of the grasp reflex allows the DEVELOPMENT needs are regularly met
object to be touched and held.
• Appearance of the ASSYMMETRIC TONIC
REFLEX (Fencing reflex) AT 2 – 6 MONTHS
• The early arm movements become more Emergence of voluntary
purposeful. social smiles and
• Disappearance of the ATR allows the hands to increasing eye contact.
be in the midline. Range of motoric and
social control and
• Things are brought to the face
cognitive engagement
• Holding objects in the 2 hands
increases dramatically.
• Passing objects from one hand to another Mutual regulation takes
• Knocking the objects together the form of social
• Holding Objects interaction
o Palmar grasp
o Ulnar side PHYSICAL DEVELOPMENT Rate of growth slows
o Radial side Early reflexes that inhibit
o Finger-thumb apposition voluntary movement
• Releasing Objects recede (ATNR, grasp
o accidental release reflex)
o voluntary release (end of the 1st year) Head control improves to
o searching for dropped objects (object allow gazing.
permanence – 8 to 9 months) Visual maturation
improves.
• Once voluntary release is established, casting
Sleep requirements – 12 –
appears.
14 hours per day.
• Puts cube into a cup and takes them out of it.
• Finding a cup under a cup. COGNITIVE DEVELOPMENT “hatching socially”, being

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 interested in a wider world
Exploring their bodies
(cause and effect)
Voluntary actions
generate predictable
tactile and visual
sensations
Sense of self
EMOTIONAL Interaction with increasing
DEVELOPMENT AND sophistication and range
COMMUNICATION Emotions – distinct facial
expressions
Face-to-face interactions –
sharing emotional states –
first step in the
development of
communication and also
developing expectations
about social relationships
AT 6 – 12 MONTHS
Increased mobility and
exploration of the
inanimate world
Advances in cognitive
understanding and
communicative
competence
Issues of attachment and
separation
Development of will and
intention – challenging
caregivers
PHYSICAL DEVELOPMENT Ability to sit without
support (7 months) and to
pivot while sitting (9 – 10
months) - enables the
child to manipulate
objects
Emergence of the pincer
grasp (9 months)
Crawling at nine months
and walking before the
first birthday
Enables the child to
explore but provides new
physical dangers as well
as opportunities for
learning
COGNITIVE DEVELOPMENT At first everything goes
into the mouth.
Objects are picked up,
inspected, passed on form
one hand to another,
banged, dropped and
mouthed.
Each action represents an
idea about what things
are for (schema – Piaget)
Intrinsic drive for mastery
– security,
experimentation,
competence
OBJECT CONSTANCY –
major milestone at 9
months
EMOTIONAL Object constancy
DEVELOPMENT corresponds with
qualitative changes in
communicative and social
development
Looking back and forth
between a stranger and a
parent
Separations are more
difficult
With a new demand for
autonomy – manifested as
tantrums
(conflict between drive for
autonomy and mastery
with parental control and
limitation)
COMMUNICATION At 7 months – adept at
nonverbal communication,
expressing a range of
emotions, vocal tone and
facial expressions.
Babbling at 8 to 10
months, followed by
multiple syllables and
inflections
Appearance of first true
word (sound used
consistently to refer to a
specific object or person)
appears simultaneously
with the discovery of
object constancy.
Shared focus and
attention – between child
and caregiver
YEAR 1 TO YEAR 5
• Rapid development of the motor and language
skills
• To explore and to control their environment
• Enables them to wean from their mother
• Rapid spurt of motor activity
• Motor skills and greater ease and precision to
explore his environment
YEAR 1 TO YEAR 5:
GROSS MOTOR SKILLS
• Walking
o Upper acceptable limits is 18 months
• Running
o Well established by the second
birthday
• Negotiating steps
o Walking up without support, alternating
feet
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 o Walking down without support and control play
alternating feet 4 Constantly
• One leg skills questioning
o Standing on one leg Recounting
• Jumping experiences
o Stepping down from the stairs is less Exaggerates,
complicated than standing long jump enjoys fantasy
• Catching and throwing stories
5 Carries out Speech is fluent
YEAR 1 TO YEAR 5: complex and
FINE MOTOR SKILLS commands grammatically
• MANIPULATION SKILLS correct
o Manipulation of cubes
o Manipulation of pencil and paper THE SECOND YEAR OF LIFE
AT 12 – 18 MONTHS
 Scribbling with Palmar grip
Emergence of symbolic
 Scribbling with Ulnar grip
thought causes a
 Tripod grip reorganization of
o Handedness behaviour
 Handedness begins to show PHYSICAL DEVELOPMENT Early walking is not
during the second year associated with advanced
o Imitating and copying of symbols development in other
 Imitating < Copying domains.
o Drawing Infants toddle with a wide
 Reflects their draftsmanship, based gait, knees bent
perceptual awareness , and the arms flexed at the
knowledge and understanding elbow. Feet falls flat on
of the world around them and the floor.
their feelings Eventually refinements
 The mental age is computed lead to better gait –
based on the details of the swinging of the arms on
drawing (points) the side while walking.
YEAR 1 TO YEAR 5: Ability to stop, pivot and
LANGUAGE SKILLS stoop without toppling
• Stimuli over.
o As the child grows older the ability to COGNITIVE DEVELOPMENT Object exploration
interpret and respond to stimuli gets accelerates because
more complex manipulation using the
• Awareness hands become mature.
• Interpretation The toddler combines
• Response objects to produce
interesting effects.
• RECEPTIVE LANGUAGE
Playthings are used for
o Infants pay attention to sounds
intended purposes.
o Recognize sounds
Imitation is an important
o Recognize and understand words
mode of learning.
• EXPRESSIVE LANGUAGE EMOTIONAL Once the child starts
o Vocal and non-vocal DEVELOPMENT walking, the child’s mood
o Verbalizations (vocalizations are LINGUISTIC changes markedly.
modified to reproduce word sounds) DEVELOPMENT Orbiting around parents,
using a parent as a secure
base.
YEAR 1 TO YEAR 5: Receptive language
LANGUAGE SKILLS precedes expressive
AGE IN YEARS RECEPTIVE RECEPTIVE language .
2 Listening to More than 50 First words at 12 months
songs words Pointing to body parts and
Combining objects at 15 months
words Jargoning
Jargoning Communication of wants
Echolalia and ideas continue to be
Joins in nursery non-verbal
rhymes and
songs
3 Used to direct THE SECOND YEAR OF LIFE

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 AT 18 TO 24 MONTHS
PHYSICAL DEVELOPMENT Motor development is
incremental with
improvements in balance
and agility and the
emergence of running and
stair climbing
COGNITIVE DEVELOPMENT End of the sensorimotor
period
Object permanence is
firmly established
Cause and effect are
better understood.
Toddler shows flexibility in
problem solving
Symbolic transformation
not only on body but also
on doll
EMOTIONAL From independence to
DEVELOPMENT rapprochement (growing
awareness of the
possibility of separation
hence clinginess)
Use of transitional objects
(stuffed toys, etc.)
Self-conscious awareness
and internalized standards
of behaviour
LINGUISTIC Labelling objects coincides
DEVELOPMENT with the advent of
symbolic thought.
Pointing to objects to
know their names.
Vocabulary balloons from
10 to 15 to 100 or more
words
Able to combine words
Understanding 2-step
commands
Emergence of language
marks the end of the
sensorimotor period
As the toddler learns to
use symbols to express
ideas and solve problems,
the need for cognition
based on direct sensation
and motoric manipulation
wanes.
THE PRESCHOOL YEARS
2 TO 5 YEARS OLD
PHYSICAL DEVELOPMENT Most walk with a mature
gait and run steadily at
the end of the 3rd year.
Wide range of motoric
activities – throwing,
catching, kicking balls,
riding bikes, climbing, etc.
Handedness is usually
established by the 3rd year
LINGUISTIC Vocabulary increases to
DEVELOPMENT 2000.
From telegraphic 2-word
sentences to 3-word
phrases and sentences
incorporating the
grammatical rules.
Language is a critical
barometer of both
cognitive and emotional
development.
Delays in langue may
contribute to problems of
socialization, behaviour
and learning
Preschool language
development lays the
foundation for later
success in school
COGNITIVE DEVELOPMENT Corresponds to the
preoperational stage
Characterized by magical
thinking, egocentrism
(inability to take the other
person’s point of view)
and thinking that is
dominated by perception
PLAY Marked by increasing
complexity and
imagination
Scripts, re-enactment
From solo or parallel play
at 1-2 years old to
cooperative play (3-4
years old) to organized
group play
Play becomes governed
by rules.
Fairness is taken to mean
equal treatment
regardless of
circumstantial differences.
EMOTIONAL Challenge – accepting
DEVELOPMENT limits while maintaining a
sense of self-direction,
reigning in aggressive and
sexual impulses and
interacting with a
widening circle of adults
and peers.
Children learn what
behaviours are acceptable
and how much power they
wield.
Inability to control some
aspect of the external
world often results in a
loss of internal control
(tantrums).
They normally experience
complicated feelings
towards their parents:
intense love, jealousy,
resentment, fear, that
anger may lead to
abandonment.
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THE EARLY SCHOOL YEARS
6 to 12 YEARS
PHYSICAL DEVELOPMENT The Middle Childhood Or
Latency Stage
The child can consider
multiple factors that
enable them to evaluate
themselves and perceive
others’ evaluation of
themselves.
Self-esteem becomes a
central issue.
Erickson: Industry vs.
Inferiority
Increasing separation
from the parents and
finding acceptance in the
peer group and
negotiating challenges in
the outside world.
Muscular strength,
coordination and stamina
increase
Ability to perform
complex-pattern
movements
SOCIAL AND EMOTIONAL Children apply rules based
DEVELOPMENT on observable phenomena
Piaget: Concrete
operational stage
Schooling: attention and
receptive language affect
each other
First 2 years of
elementary schooling:
reading, writing, basic
math
Third or fourth grade: use
of the fundamentals to
learn increasingly
complex materials
Intellectual activity
extends beyond the
classroom.
Becoming experts in the
field of their own choosing
COGNITIVE AND LANAUGE Sexual energies are
DEVELOPMENT channeled away toward
the pursuit of socially
accepted
accomplishments.
Social and emotional
development proceeds in
3 contexts: home, school
and neighborhood.
Regular chores provide an
opportunity to contribute
to the family in a
meaningful way.
Siblings play critical roles
as competitors, loyal
supporters and role
models.
School – development of
techer adn peer
relationships allowing
social competence
Issues of conformity
“Dress rehearsals” – hero
worship and adoption of
adult-like dress and
mannerisms
EMERGING PATTERNS OF BEHAVIOR
15 MONTHS
MOTOR Walks alone,
crawls upstairs
ADAPTIVE Makes a tower of 3 cubes;
makes a line with crayon;
inserts pellet in bottle
LANGUAGE Jargon;
follows simple commands;
may name a familiar
object (ball)
SOCIAL Indicates some desires or
needs by pointing;
hugs parents
18 MONTHS (1 ½ years)
MOTOR Runs stiffly
Sits on small chair
Walks up the stairs with
one hand held
Explores drawers and
waste basket
Makes a tower of 4 cubes;
Imitates scribbling;
imitates a vertical stroke
Dumps pellet from bottle
10 words (average)
Names pictures
Identifies one or more
parts of the body
SOCIAL Feeds self
Seeks help when in
trouble
May complain when wet
or soiled
Kisses parent with pucker
24 MONTHS (2 years)
MOTOR Runs well
Walks up and down the
stairs, one step at a time
Climbs on furniture
Jumps
ADAPTIVE Makes a tower of 7 cubes;
Circular scribbling;
imitates a horizontal
stroke
Folds paper once
imitatively
LANGUAGE Puts 3 words together
(subject, verb, object)
SOCIAL Handles spoon well
Often tells immediate
experience
Helps to undress
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 Listens to stories with
pictures
30 MONTHS (2 ½ years)
MOTOR Goes up stairs in
alternating feet
ADAPTIVE Makes a tower of 9 cubes;
Circular scribbling; makes
vertical and horizontal
strokes (but will not join
them together)
Imitates circular stroke,
forming a closed figure
LANGUAGE Refers self to pronoun “I”;
Knows full name
SOCIAL Helps put things away
Pretends in play
36 MONTHS (3 years)
MOTOR Rides tricycle
Stands momentarily on
one foot
ADAPTIVE Makes a tower of 10
cubes;
Imitates construction of
“bridge” of 3 cubes
Copies a circle
Imitates a cross
LANGUAGE Knows age and sex;
counts 3 objects correctly
Repeats 3 numbers
Repeats a sentence of 6
syllables
SOCIAL Plays simple games (in
“parallel” play with other
children)
Helps in dressing
(unbuttons and puts on
shoes)
Washes hands
48 MONTHS (4 years)
MOTOR Hops on one foot
Throws a ball overhand
Uses scissors to cut out
pictures
Climbs well
ADAPTIVE Copies a bridge from
model
Imitates construction of a
“gate” of 5 cubes;
Copies a cross and a
square
Draws a man with 2 – 4
parts besides head
Names longer of 2 lines
LANGUAGE Counts 4 pennies correctly
Tells a story
SOCIAL Plays with several children
with beginning of social
interaction and role-
playing
Gets to toilet alone
60 MONTHS (5 years)
MOTOR Skips
ADAPTIVE Draws a triangle from
copy
Names heavier of 2
weights
LANGUAGE names 4 colors
Repeats sentences of 10
syllables
Counts 10 pennies
correctly
SOCIAL Asks questions about
meaning of words
Domestic role-playing
METHODS OF
DEVELOPMENTAL SURVEILLANCE
• Denver Development Screening Test
• Gesell Development Scales
• CAT – CLAMS
• Bayley Scales of Infant Development
• Draw-a-Person Test
DENVER DEVELOPMENT SCREENING TEST
• Assesses the developmental status in children
0 – 6 years of age
• Gross Motor
• Fine Motor-Adaptive
• Language
• Personal-Social
• Pass or Fail
GESELL DEVELEOPMENT TEST
• Compares the maturity of the child that of the
chronological age
• DEVELOPMENTAL QUOTIENT:
o DQ = (
• Has clinical diagnostic orientation (diagnosis
and evaluation of abnormalities
• Motor, adaptive, language and personal-social
CAT-CLAMS
• CAT (Clinical Adaptive Test)
o Problem solving skills
• CLAMS (Clinical Linguistic and Auditory
Milestone Scale)
o language skills (receptive and
expressive)
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