Growth & Development Growth & Development ((ΙΙΙΙΙΙ))

Dr. Eva GauchanDr. Eva GauchanLecturerLecturerPaediatric DeptPaediatric Dept

Development - Fine motorDevelopment - Fine motor

Co - ordination of eyesCo - ordination of eyes Hand – eye coordinationHand – eye coordination Hand – mouth coordinationHand – mouth coordination Skills for manipulation with handsSkills for manipulation with hands

Test objectsTest objects

• Red ring on red string (6.5 cm diameter)• Pen torch• Red cubes (1"x1")• Pellet• Cup with handle• Spoon• Book with thick pages• Red pencil or crayon• Red ball (5.0 cm d)

Tests objectsTests objects• • PaperPaper

• • Wooden blocksWooden blocks

• • DollDoll

• • Mirror Mirror

• • Temple bell / rattleTemple bell / rattle

Shopping Cart

Blocks/Balls

Window House

Standard Toy Set

Eye co-ordinationEye co-ordination

Newborn - turns head & follows lightNewborn - turns head & follows light

4 weeks- regards lighted torch or a red 4 weeks- regards lighted torch or a red ring kept at a distance of 20-30 cmring kept at a distance of 20-30 cm

6 weeks – follows object side to side6 weeks – follows object side to side

Eye co-ordinationEye co-ordination

2-3 months – follows with steady eye 2-3 months – follows with steady eye movements and can converge & focus his movements and can converge & focus his eyeseyes

3 months- converges upon fingers of 3 months- converges upon fingers of hands & begins to reach out for objects at hands & begins to reach out for objects at that distancethat distance

4 months- macular fovea matures4 months- macular fovea matures

visual cortex differentiatesvisual cortex differentiates

accomodation ,mono-ocular accomodation ,mono-ocular fixationfixation

4-6 months – binocular vision develops4-6 months – binocular vision develops

Visual distance:Visual distance:

Birth: 20-30 cmBirth: 20-30 cm 3-4 months: 0.6-1 m3-4 months: 0.6-1 m 5-6 months: 1-1.6 m5-6 months: 1-1.6 m 9 months: 3.3 m9 months: 3.3 m 18 months: can follow with eyes small (3 18 months: can follow with eyes small (3

mm) object rolling at distance of 4 m awaymm) object rolling at distance of 4 m away

Hand – eye coordinationHand – eye coordination

3 months - hand regard3 months - hand regard

4 months – grasps red 4 months – grasps red dangling ringdangling ring

5 months-Takes cube from table5 months-Takes cube from table

Plays with toesPlays with toes

6 months- Transfer object from 6 months- Transfer object from hand-to- hand hand-to- hand

Hold feeding bottle Hold feeding bottle

Bidextrous graspBidextrous grasp

7 months – crude pincer grasp7 months – crude pincer grasp

10 months – pincer grasp10 months – pincer grasp

10 months-Poking with index 10 months-Poking with index fingerfinger

12 months – Points to objects 12 months – Points to objects desireddesired

12 months – fine pincer grasp12 months – fine pincer grasp

12-15 months – make tower of 2 cubes12-15 months – make tower of 2 cubes

18 months – make 18 months – make tower of 4 cubestower of 4 cubes

18 months- Enjoys 18 months- Enjoys pictures from the pictures from the booksbooks

2 yrs – 6 cubes2 yrs – 6 cubes

3 yrs – 10 cubes3 yrs – 10 cubes

Hand mouth coordinationHand mouth coordination

5 months – Hand mouth approach5 months – Hand mouth approach

12 months – feed with spoon with spilling12 months – feed with spoon with spilling

15 month – feed with spoon without spilling15 month – feed with spoon without spilling

18 month – feed with cup with slight spilling18 month – feed with cup with slight spilling

Skills for manipulation with handsSkills for manipulation with hands

Birth – grasp reflex Birth – grasp reflex present present

1-2 month-No grasp 1-2 month-No grasp reflexreflex

3 months-hand 3 months-hand loosely openloosely open

3-4 months – can 3-4 months – can hold objects with hold objects with ulnar approachulnar approach

5 months – radial 5 months – radial approachapproach

Handedness:Handedness:

Newborn: no hand preferenceNewborn: no hand preference Hand preference marked 1Hand preference marked 1stst two years two years Hand preference established 3-4 yearsHand preference established 3-4 years True dominance develops by 10 yrsTrue dominance develops by 10 yrs

DressingDressing 7 months: takes off socks7 months: takes off socks 10 months: raises arms10 months: raises arms 1 year- can indicate where hat goes, tries to remove 1 year- can indicate where hat goes, tries to remove

coat, tries to wear socks & shoes without successcoat, tries to wear socks & shoes without success

15 months- “NO” stage, dislikes dressing15 months- “NO” stage, dislikes dressing

18 months- Takes off pants, shoes, gloves ,socks, easy 18 months- Takes off pants, shoes, gloves ,socks, easy zips & big buttons etczips & big buttons etc

2 years- Puts shoes, socks and 2 years- Puts shoes, socks and pantspants

3 years- Dress and undress except shoe lace3 years- Dress and undress except shoe lace

5 years – Ties shoe 5 years – Ties shoe lacelace

6 years- interested in dressing6 years- interested in dressing 7 years- chooses own clothes7 years- chooses own clothes

Scribbling Scribbling

12 months – spontaneously scribbles12 months – spontaneously scribbles

Developmental stages of drawingDevelopmental stages of drawing

1-2 years: random scribble marks simply as a sensorimotor activity

ScribblingScribbling

15 months – imitate straight lines15 months – imitate straight lines

2-21/2 years: controlled scribbling. The child begins to develop some control of his fine motor abilities, and the scribbles gain some direction and control. After some experience with controlled scribbling, a child may name his picture a “motorcycle” or a “big wheel”, although there appears to be no resemblance. This is an intellectual accomplishment for the child, an indication that he is taking his first step toward being able to do representation

Developmental stages of drawing Developmental stages of drawing (continued)(continued)

ScribblingScribbling

2 yrs – draws 2 yrs – draws horizontal / vertical horizontal / vertical lineslines

3 yrs – draws circle3 yrs – draws circle 4 years-Draws 4 years-Draws

rectangle / + (plus), rectangle / + (plus), squaresquare

5 years-Draws 5 years-Draws triangle & ”X” signtriangle & ”X” sign

Developmental stages of drawing Developmental stages of drawing (continued)(continued)

2 1/2 -3 years: the face. The next major development is for the circle to become a face

3 ½ -4 years: arms and legs. The circle “person” develops sticks arms and legs, which protrude from the circle, or the head; there is no body yet

4 years: the body. The human figure begins to acquire a body. Gradually more and more body parts are added (hands, feet, hair, ears, etc.)

Developmental stages of drawing Developmental stages of drawing (continued)(continued)

5 years: the floating house: First “house” drawings usually resemble a face, with windows placed like eyes and door like a mouth. These first houses are usually somewhere in the middle of the paper and seem to be floating in space

5 ½ - 6 years: the house on a bottom line. The bottom of the paper is used as a baseline and the house rests on it

Developmental stages of drawing Developmental stages of drawing (continued)(continued)

5 ½ -6 years: a baseline supports the house. A baseline appears within the drawing and the house rests on it

6 -7 years: two-dimensional drawing. The baseline begins to take on the quality of a horizon, which indicates the child’s awareness of two-dimensional space

Picture bookPicture book

13 month – turn 2-3 13 month – turn 2-3 pages of bookpages of book

24 months – turn 24 months – turn pages one at a timepages one at a time

Social Social

● ● 4 weeks –regards mother’s face4 weeks –regards mother’s face

● ● 8 weeks-Social smile8 weeks-Social smile

● ● 3 months- Smile when spoken to/Follow a 3 months- Smile when spoken to/Follow a

person with eye / recognizes motherperson with eye / recognizes mother

6 months- Smiles and vocalizes 6 months- Smiles and vocalizes mirror imagemirror image

●● 7-9 months- liking ,disliking, fear of strangers 7-9 months- liking ,disliking, fear of strangers (stranger anxiety)(stranger anxiety)

9-10 months- Wave bye, bye9-10 months- Wave bye, bye

12 month- Stranger anxiety / concept of self12 month- Stranger anxiety / concept of self

plays simple ball gameplays simple ball game

12 month- separation anxiety12 month- separation anxiety

15-18 months-Domestic mimicry15-18 months-Domestic mimicry

15-18 months-Domestic mimicry15-18 months-Domestic mimicry

18 months- points to 3 parts of 18 months- points to 3 parts of the bodythe body

2 years- Demand constant 2 years- Demand constant attentionattention

2 yrs – Parallel play2 yrs – Parallel play

2 yrs – Parallel play2 yrs – Parallel play

2 yrs – Parallel play2 yrs – Parallel play

●● 3 yrs- knows gender3 yrs- knows gender

handednesshandedness

3-4 yrs :plays with peers3-4 yrs :plays with peers

HearingHearing

● ● Birth : Startling/ Birth : Startling/ Blinking /Stop Blinking /Stop cryingcrying

● ● 3 months: Turns 3 months: Turns head towards head towards sound (level)sound (level)

● ● 5 months: Turns 5 months: Turns head towards head towards sound below the sound below the level of earlevel of ear

6 -7 months: 6 -7 months: Response to nameResponse to name

Turns head towards Turns head towards sound at the level of sound at the level of ear ear

9 months: Turns 9 months: Turns head above level of head above level of earear

Distance at which sounds can be Distance at which sounds can be heard:heard:

6 months- 45 cm6 months- 45 cm 9 months- 1 m9 months- 1 m 18 months- 2 m18 months- 2 m

SpeechSpeech

● ● 3 months-Vocalizes when spoken to 3 months-Vocalizes when spoken to (cooing)(cooing)

● ● 6 months- says ba, da, ka,ma6 months- says ba, da, ka,ma

● ● 9 months – bisyllables (mama, baba)9 months – bisyllables (mama, baba)

● ● 12 months-two words with meaning12 months-two words with meaning

● ● 18 months- 10 words with meaning18 months- 10 words with meaning

● ● 2 years- 50 words with meaning2 years- 50 words with meaning

● ● 21-24 months –spontaneously join 3 21-24 months –spontaneously join 3 words together to make sentenceswords together to make sentences

● ● 36 months- tells a story36 months- tells a story

Toilet training/Bowel control:Toilet training/Bowel control:

Birth: reflex actBirth: reflex act 4 weeks: wakes up on passing stool4 weeks: wakes up on passing stool 4 months -Gastrocolic reflex weakens4 months -Gastrocolic reflex weakens 7 months- bowel movements irregular7 months- bowel movements irregular 10 mo- can sit on toilet seat 10 mo- can sit on toilet seat

12 months: grunts after passing stool12 months: grunts after passing stool 15- 18 mo : can walk to toilet15- 18 mo : can walk to toilet 2 yrs : toilet trainable2 yrs : toilet trainable 3 yrs : can postpone bowel movements3 yrs : can postpone bowel movements

Bladder control:Bladder control:

Birth: reflex actBirth: reflex act 4 weeks: cries when nappy wet4 weeks: cries when nappy wet 40 weeks: dry for 2 hrs40 weeks: dry for 2 hrs 24 months: dry by day24 months: dry by day 30-36 months: dry by night30-36 months: dry by night 4 yrs- dry by day & night4 yrs- dry by day & night