GROWTH, GROWTH, DEVELOPMENT AND DEVELOPMENT AND

BEHAVIORBEHAVIOR

GROWTH, GROWTH, DEVELOPMENT AND DEVELOPMENT AND

BEHAVIORBEHAVIOR

Newborn ( neonatal) period: begins at birth and include the 1st month of life.

Physical examination: term newborn

• Average weights: 3.4 kg (7 ½ lb)

• Average length: 50cm (20 in)• head circumference: 35 cm

(14 in)

•Hearing is well developed

Behavioral state:• Quite sleep• Active sleep• Drowsy • Alert• Fussy• Crying

• Behavioral state determines an infant’s muscle tone, spontaneous movement, electroencephalogram pattern and response to stimuli.

Developmental milestones in the

first 2 yr of life

Gross motor:• Hold head steady

while sitting• Pulls to sit, with no

head lag• Brings hands

together in midline• Sits without support• Rolls back to

stomach• Walks alone• Runs

• 2 mos

• 3mos

• 3mos• 6mos• 6.5mos• 12mos• 16m0s

Fine motor:• grasps rattle• Reaches for object• Palmar grasp done• Transfers object

from hand to hand• Thumb-finger grasp

• 3.5mos• 4mos• 4mos• 5.5mos

• 8mos

Communication and language:

• Smiles in response to face, voice

• Monosyllabic babble• Inhibits to NO• Follows one-step command w/

gesture• Follows one-step command w/o

gesture• Say mama or dada• Points to object• Speaks first real word• Speaks 4-6 words• Speaks 10-15 words• Speaks 2 word sentences

• 1.5mos• 6mos• 7mos• 7mos

• 10mos

• 10mos• 10mos• 12mos• 15mos• 18mos• 19mos

cognitive:• Stares momentarily

at spot where object disappeared

• Stares at own hand• Uncovers toys• Egocentric symbolic

play • Uses stick to reach

toy• Pretend plays with

doll

• 2mos

• 4mos• 8mos• 12mos

• 17mos• 17mos

The first year of life• Age 0-2 months:

– Tremendous growth– Effective feeding routines– Predictable sleep-wake cycle

Physical development:• Weight decrease 10% below

birthweight in the first week as a result of excretion of excess extravascular fluid and limited intake.

• Infant regain or exceed birth weight by 2 weeks of age and should grow at approx 30 gms/day during the first month.

• Period of fastest postnatal growth.• Smiling occurs involuntarily.• Recognition memory.• Sleep and wakefulness are evenly

distributed throughout the 24hr day• Learning also occurs.

Cognitive development:

• Infants habituate to the familiar, attending less and less to repeated stimuli and increasing their attention when the stimulus changes.

• Infant can differentiate among patterns, colors and consonants.

• Recognize facial expression

Emotional development:

• Dependent on the environment to meet his or her need.

Age 2-6 month:• Voluntary social smile.• Increasing eye contact

Physical development:• Between 3 and 4 months of age, the

rate of growth slows to approx 20gm/day.

• By 4 month, birth weight is doubled.• Grasp reflex• Roll over• Regular sleep wake cycle

Cognitive development:

• Qualitative change• 4 months of age infants are

described as hatching socially• Explore their own bodies• Sense of self – first stage of

personality development

Emotional development and communication:

• Distinct facial expressions• Initiating games, increases social

development.

Ages 6-12 months• Shows advances in cognitive

understanding and communicative competence.

• Develop will and intentions

Physical development:• Growth slows more• By the first bday, birth weight has

tripled, length has increased by 50%, and head circumference has increased by 10cm.

• Sit unsupported (6-7mos)• Pivot while sitting (9-10mos)• Thumb finger grasp (8-9mos)• Neat finger grasp by 12 mos• Pulling to stand by 8mos• Walk by 1yr

• Motor achievements correlate with increasing myelinization and cerebellar growth.

• Tooth eruption occurs, usually starting with the mandibular central incisors

• Tooth development reflects skeletal maturation and bone age.

Cognitive development:

• At first everything goes into the mouth.

• A major milestone is the achievement at about 9 mos. Of object permanence (constancy)

Emotional development:

• Stranger anxiety• Poor weight gain• Tantrums

Communication:7mos adept of non verbal

communication9mos aware of the emotions8 and 10mos babbling takesSocial interactionFirst true word

The second year• Age 12-18mos:

– Physical development:• Growth rate slows further in the 2nd yr of

life• Appetite decline• Increase in head circumference of 2cm

over the yr.

Cognitive development:

• Exploration of the environment increases and mobility

• Playthings• Imitation of parents and older

children• Symbolic play

Emotional development:

• Predominant mood changes• Tantrum

Linguistic development:

• Infants speak their first words• Respond appropriately to several

simple statement• Points to major body parts and

uses 4-6 words spontaneously and correctly

Age 18-24 months:• Physical development:

– Height and weight increase at a steady rate, w/ gain of 5in and 5lb.

– By 24mos, children are about ½ of their ultimate adult height.

– Head growth slows slightly– 90% of adult head circumference is

achieved by age 2 yrs.

Cognitive development:

• Object permanence is firmly established

• Cause and effect are better understood

Emotional development:

• Separation anxiety• Self-conscious awareness

Linguistic development:

• Most dramatic development• Childs vocabulary balloons, the

beginning of grammar• Understand 2-step commands