Development and Milestones

Problems to discuss

What is normal child development - definitionsInfluences on developmentMilestonesPercentile chartsBasic life support - extra

Normal child development - definitions

Auxology – science of development and environmental influences on it

Development (pre & postnatal) :GrowthSpecialization / DifferentiationMaturation

Postnatal development – stages :

1) Newborn2) Infant3) Toddler4) Pre – school

SchoolAdolescent

Influences on development

1. Intrinsic factors :- genes- parents’ age- number of pregnancies

2. Environmental factors- nutritional- economic and social (deprivation !)- geographical

Developmental Milestones

Important developmental skills (0 – 5 years of age)[later cognition and abstract thinking]

Median and limit age of acquisitionSequence of progressRemember prematurely born !Variation in the pattern of

development

Locomotorpattern

variation

Category of milestones (fields of development)

1) Gross motor2) Vision and fine motor3) Hearing, speech and language4) Social, emotional and behavioral

Progress should be similar in each field !

(global delay vs specific delay)

Gross motor – median age

1) Raises head – 6 – 8 weeks2) Sits without support – 6 – 8 months3) Crawling – 8 – 9 months4) Cruises around furniture – 10

months5) Walks unsteadily – 12

months6) Walks steadily – 15

months

Milestones

Gross motor

Vision and fine motor – median age

1) Follows face by turning head - 6 weeks

2) Reaches out for toys – 4 months3) Palmar grasp – 4 – 6

months4) Transfer toys from one hand to another 7

months5) Pincer grip – 10

months6) Draw line – 2 years

Milestones

Vision and fine motor

Hearing, speech and language – median age

1) Vocalizes alone or when spoken to, coos and laughs – 3 – 4 months

2) Turn to soft sounds out of the sight – 7 months3) Two to three words – 12 months4) Simple phrases – 20 - 24

months5) Talks constantly – 2,5 – 3

years

Milestones

Hearing, speech,

language

Social, emotional and behavioral – median age

1) Smiles responsively – 6 weeks2) Waves bye – bye – 10 – 12

months3) Drink from a cup with two hands – 12 months4) Symbolic play – 2 years5) Interactive play – 2.5 – 3 years

Milestones

Social, emotional, behavioura

l

Limit ages - proposal

Fields of development with limit ages

Fields of development with limit ages

Centile charts - characteristics

- method of assessment- growth, weight, head circumference- lines (centiles) 3, 10, 25, 50, 75, 90,

97- centiles 3 and 97 are limits- centile 50 (median)

Centile chart

for weight

Boys

Centile chart

for height

Boys

Heightvelocity

chart

Centilechart

Height

Age Months

Father 185 cm

Boy 181,1 cm

Mother 165 cm

Boys

Final height (Tanner) in cm:Boys = (father + mother + 13) : 2 Girls = (father + mother – 13) : 2

Pediatric basic life support

Pediatric problems mean respiratory problems (rarely

primary cardiac problems) !!!

Primaryrespiratory

problem

Secondarycardiacproblem

Pediatric

BasicLife

Support

Basic Life Support – Airways & Breathing

Trained resuscitator

Basic Life Support - Circulation

Trained resuscitator