This document discusses child development from birth through adolescence. It covers the major areas of development - gross motor, fine motor, language, social/emotional - and provides typical milestones for various age groups like sitting up alone by 6 months and walking by 12-15 months. The document also mentions tools for assessing development like the Denver Developmental Screening Test and discusses prolonged development during school age and the biological, psychological, and social changes of adolescence.

1. GROWTH AND DEVELOPMENTGROWTH AND DEVELOPMENTGROWTH AND DEVELOPMENTGROWTH AND DEVELOPMENT
Dr.Khalid Hama
salih,
Pediatrics specialist
M.B.Ch.; D. C.H
F.I.B.M.S.ped

2. 22

3. DevelopmentDevelopment
• The term 'child development' is used toThe term 'child development' is used to
describe the skill and capacity of functiondescribe the skill and capacity of function
acquired by children between birth and about 5acquired by children between birth and about 5
years of ageyears of age
• It is a qualitative change in the childIt is a qualitative change in the child’’ss
functioning.functioning.
• It can be measured through observation.It can be measured through observation.

4. By understanding what to expect during each stage of developmentBy understanding what to expect during each stage of development,,
parents can easily capture the teachable moments in everyday life toparents can easily capture the teachable moments in everyday life to
enhance their child's language development, intellectual growth, socialenhance their child's language development, intellectual growth, social
development and motor skillsdevelopment and motor skills..

5.  NB/Chronological age, physical growth andNB/Chronological age, physical growth and
developmental skills usually evolve hand indevelopmental skills usually evolve hand in
hand. Just as there are normal ranges forhand. Just as there are normal ranges for
changes in body size with age, so there arechanges in body size with age, so there are
ranges over which new skills are acquired.ranges over which new skills are acquired.

6.  When considering developmental milestones:When considering developmental milestones:
 TheThe median agemedian age is the age when half of a standardis the age when half of a standard
population of children achieve that level; it serves aspopulation of children achieve that level; it serves as
a guide to when stages of development are likely toa guide to when stages of development are likely to
be reached but does not tell us if the child's skills arebe reached but does not tell us if the child's skills are
outside the normal range.outside the normal range.
 Limit agesLimit ages are the age by which they should haveare the age by which they should have
been achieved. Limit ages are usually 2 standardbeen achieved. Limit ages are usually 2 standard
deviations from the mean. They are more useful as adeviations from the mean. They are more useful as a
guide to whether a child's development is normal thanguide to whether a child's development is normal than
the median agesthe median ages

7. There are four fields ofThere are four fields of
developmental skills todevelopmental skills to
 These are:These are:
 A. gross motorA. gross motor
 B. vision and fine motorB. vision and fine motor
 C. hearing, speech and languageC. hearing, speech and language
 D.social, emotional and behavioural.D.social, emotional and behavioural.

8.  Gross motor skills are the most obvious initialGross motor skills are the most obvious initial
area of developmental progress. As fine motorarea of developmental progress. As fine motor
skills require good vision, these are groupedskills require good vision, these are grouped
together; similarly, normal speech andtogether; similarly, normal speech and
language development depends on reasonablelanguage development depends on reasonable
hearing and so these are also consideredhearing and so these are also considered
together. Social, emotional and behaviouraltogether. Social, emotional and behavioural
skills are a spectrum of psychologicalskills are a spectrum of psychological
developmentdevelopment

9.  gross motor development: an explosion ofgross motor development: an explosion of
skills during the first year of life ,large muscleskills during the first year of life ,large muscle
 vision and fine motor development: morevision and fine motor development: more
evident acquisition of skills from 1 yearevident acquisition of skills from 1 year
onwardsonwards
 hearing, speech and language: a big expansionhearing, speech and language: a big expansion
of skills from 18 monthsof skills from 18 months
 social, emotional and behaviouralsocial, emotional and behavioural
development: expansion in skills is mostdevelopment: expansion in skills is most
obvious from 2.5 years.obvious from 2.5 years.

10. PEDIATRIC ASSESSMENTPEDIATRIC ASSESSMENT
INSTRUMENTSINSTRUMENTS
DENVER DEVELOPMENTAL SCREENINGDENVER DEVELOPMENTAL SCREENING
TEST(DDST)TEST(DDST)
BAYLEY SCALES OF INFANTBAYLEY SCALES OF INFANT
DEVELOPMENT(BSID)DEVELOPMENT(BSID)
 PEABODY MOTOR SCALESPEABODY MOTOR SCALES
GROSS MOTOR FUNCTION MEASURESGROSS MOTOR FUNCTION MEASURES
(GMFM)(GMFM)

12. Birth
• Gross motoGross motorr:The newborn's movement are:The newborn's movement are
random, diffuse and uncoordinated.random, diffuse and uncoordinated. Complete
head lag
• Visio&Fine motorVisio&Fine motor. Holds hand in fist. Holds hand in fist
• Bright lights appear to be unpleasant toBright lights appear to be unpleasant to
newborn infant.Follow objects in line of visionnewborn infant.Follow objects in line of vision
• Hearing &speechHearing &speech:The newborn infant:The newborn infant
responds to sounds with either cry or eyeresponds to sounds with either cry or eye
movement, cessation of activity and / or startlemovement, cessation of activity and / or startle
reaction.reaction.

13.  SocialSocial:The newborn infant expresses his:The newborn infant expresses his
emotion just through cry for hunger, pain oremotion just through cry for hunger, pain or
discomfort sensation.discomfort sensation.

14. 66--8weeks8weeks
 gross motorgross motor ::Pelvis flatter
HeadControldeveloping but head noding
Curved back, needs supportCurved back, needs support
 vision and fine motorvision and fine motor ::
Follows moving objects 180 degreFollows moving objects 180 degre
hearing,& speechhearing,& speech ::listens to voice andlistens to voice and
cooscoos
 SocialSocial:: Smiles on social contactSmiles on social contact

15. 4months
 gross motorgross motor Lifts head and shoulders with weight on
forearms no head lag when pulled to sittingno head lag when pulled to sitting
position,position,
 vision and fine motorvision and fine motor reaches for and graspsreaches for and grasps
objects andobjects andHolds a rattle and shakesPurposefullyHolds a rattle and shakesPurposefully
 brings them to mouthbrings them to mouth
 hearing,& speech :hearing,& speech :Laughs out loud, exited at sightLaughs out loud, exited at sight
of food, may show displeasureof food, may show displeasure
Social :Social : social contact isocial contact i

16. 6months
 gross motorgross motor Arms extended supporting chest off
couchSits with self proppingSits with self propping
Stands with support Roles over, creep-crawlsStands with support Roles over, creep-crawls
 vision and fine motorvision and fine motor Reaches for and graspsReaches for and grasps
large objects,large objects, transfers object from Hand to handtransfers object from Hand to hand
 Hearing,& speechHearing,& speech forms polysyllabic vowel soundsforms polysyllabic vowel sounds
 Social:Social: Prefers mother, responds to changes inPrefers mother, responds to changes in
emotional contentemotional content of social contactof social contact

17. 99monthsmonths
gross motor:gross motor: Gets in to sitting position alone,crowlGets in to sitting position alone,crowl
Pulls to standing and standsholding onPulls to standing and standsholding on
 vision and fine motor:vision and fine motor: grasps objects withgrasps objects with
thumb andthumb and forefinger (forefinger (Immature pincer graspImmature pincer grasp
Hearing,& speech :Hearing,& speech :Double babble: dada mamaDouble babble: dada mama
babababa
Social :Social :responds to sound of name,responds to sound of name,waves bye byewaves bye bye

18. 1212monthsmonths
gross motor:gross motor: Stands, and walks withStands, and walks with
one handheldone handheld
vision and fine motor:vision and fine motor: Mature pincer graspGivesMature pincer graspGives
bricks to examinerbricks to examiner
Hearing,& speechHearing,& speech says a few words besides mamasays a few words besides mama
and dadaand dada
Social :Social : plays simple ball games, makes posturalplays simple ball games, makes postural
adjustments toadjustments to
dressingdressing

19. 1515monthmonth
gross motorgross motor Walks independently andWalks independently and
stoops to pick up objectsstoops to pick up objects
vision and fine motor:vision and fine motor: Builds a tower of twoBuilds a tower of two
cubescubes
Hearing,& speechHearing,& speech 10 words ;No Ta Teddy Bed10 words ;No Ta Teddy Bed
Dog, BottleDog, Bottle
Social :Social : Drinks from a cupDrinks from a cup

20. 22years ( 24 moyears ( 24 mo(;(;
 gross motor:gross motor: Runs up and down stairs oneRuns up and down stairs one
step at a timestep at a time
 vision and fine motor:vision and fine motor: Scribbles with a pencilScribbles with a pencil
 Hearing,& speechHearing,& speech Linking two words DaddyLinking two words Daddy
gone, Teddy's tiredgone, Teddy's tired
Social :Social : Toilet trained by day Spoon-feedingToilet trained by day Spoon-feeding
selfself

21. 3year’s ( 36 mo( ;
gross motor: ; Rides tricycle, stands momentarily on
one foot.
vision and fine motor:; copies a circle imitates a cross.
Hearing,& speech knows age and sex, counts three objects correctly.
Social; plays simple games with other children, washes
Dresses self (except buttons)hands.

22. 4years (48 mo(;
gross motor; Hops on one foot, uses scissors to cut out
pictures.
vision and fine motor; Copies circle and square, draws a man with
2 to 4 parts
besides head.
Hearing&Language; counts up to4 accurately,
tells story.
Social; plays with several children with the beginning
of role play,
goes to toilet alone

23. 5year ( 60 mo(;
gross motor; Skips.
vision and fine motor; copies a triangle, names heavier of two weig.
Hearing&Languag; Repeats sentences of 10 syllables , counts 10 p
correctly.
Social; dresses and undresses, asks questions about meaning of
words.

24. Motor Skills-SummaryMotor Skills-Summary
Age 3-tricycle, copies circleAge 3-tricycle, copies circle
Age 4-hops, copies squareAge 4-hops, copies square
Age 5-skips, copies triangleAge 5-skips, copies triangle

25. school ageschool age
During school age, evidence of developmentalDuring school age, evidence of developmental
progression is predominantly throughprogression is predominantly through
cognitive development, abstract thinking andcognitive development, abstract thinking and
skills of conceptualisationskills of conceptualisation,,

26. Adolescence; is a period of development which involves with in
it;
Puberty; which is a biological process in which a child becomes
an adult.
These changes include; development of secondary sexual
characteristic, increase to adult size and development of
reproductive capacity.
Adolescence has 3 stage; Early, middle, and late.
;

27. Biological Psychological Social
Early adolescence Early puberty
Females - breast bud, pubic
hair development, start of
growth spurt
Males-testicular
enlargement, start of genital
growth
Concrete thinking but begin
to develop moral concepts
and awareness of their
sexual identity
The early emotional
separation from parents, start
of a strong peer
identification, early
exploratory behaviours, e.g.
may start smoking
Mid-adolescence Females - end of growth
spurt, menarche, change in
body shape
Males - sperm production,
voice breaks, start of growth
spurtAcneBlushing
Need for more sleep
Abstract thinking, but still
seen as 'bulletproof',
increasing verbal dexterity,
may develop a fervent
ideology (religious, political(
Continuing emotional
separation from parents,
heterosexual peer interest,
early vocational plans
Late adolescence Males - end of puberty,
continued growth in height,
strength and body hair
Complex abstract thinking
identification of difference
between law and morality,
increased impulse control,
further development of
personal identity, further
development or rejection of
ideologies
Social autonomy, may
develop intimate
relationships, further
education or employment,
may begin or develop
financial independence

28. Gross motor developmentGross motor development
 Prone positionProne position
 BirthBirth
Generally flexed postureGenerally flexed posture
 6 weeks6 weeks
Pelvis flatterPelvis flatter
 4 months4 months
Lifts head and shoulders withLifts head and shoulders with
weight on forearmsweight on forearms
 6 months6 months
Arms extended supportingArms extended supporting
chest off couchchest off couch
 Pull to sitPull to sit
BirthBirth
Complete head lagComplete head lag
 6 weeks6 weeks
Head control DevelopingHead control Developing
 4 months4 months
No head lagNo head lag

30. Head ControlHead Control
Newborn Age 6 months

33. Sitting UpSitting Up
Age 2 months
Age 8 months

34. AmbulationAmbulation
13month old
Nine to 12-months