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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