Title of the Lecture
Lecturer’s Name
Date of lecture in 01 Jan 2018 format
I. NORMAL DEVELOPMENT
 Stages
 Newborn (0-28 days)
 Infancy (0-1 year)
 Toddler (early: 1-2 years; late 2-3 years)
 Preschool (3-5 years)
 School-Age (6-10 years)
 Adolescence (10-19 years)
 There is a move to extend this period to 21 years because
adolescence is marked not only by biologic factors, but
also emotional and psychosocial factors that determines a
child’s maturity
 For now, we go with the WHO definition of 18 years + 364
days (19 not pedia anymore)
 Categorized into streams and domains
 Gross motor
 Fine motor
 Language (Receptive and Expressive)
 Personal Social / Adaptive Skills
 Goes through defined stages and phases which are constant for
normal children
 For each individual ability
→ Initial Age: age at which a few children first show the ability
→ Median Age: age at which 50% manifest the ability
 Reflects developmental milestones seen at baby books
 E.g. Independent ambulation at 12 months; head control at
3 months; social smile – 2 months
 Important to know since it spells the difference between if
the parents should get worried or not and you telling the
patient if development is normal or warrants further
investigation
→ Limit Age: age at which the majority show the ability
 Corresponds to red flags; deadline of age of attainment of
specific skill or ability because majority of children are
expected to show the skill by this age
A. NEWBORN (0-28 DAYS)
 Movement of baby is gross, generalized, undifferentiated
 When they move, every part moves
 Motor examination starts with observation of the tone then the
symmetry of the motor movement
 Check newborn’s posture if flexed
 At rest, there is normal tone if all extremities are flexed
 If extended, baby is characterized as hypotonic or floppy
 Reflexes [shown in video]
 Palmar and plantar grasp
 Stroking the palm of a baby's hand causes the baby to
close his or her fingers in a grasp.
 Rooting
 Begins when the corner of the baby's mouth is stroked or
touched.
 Baby turns his or her head and open his or her mouth to
follow and "root" in the direction of the stroking
 Moro reflex
 Also called startle reflex because it usually occurs when a
baby is startled by a loud sound or movement
 Suckle reflex
 When the roof of the baby's mouth is touched, the baby will
begin to suck.
 Baby can already see when they are born.
 They can fixate on short distances and show preference for
mother’s face
 Babies are expected to see up to 14 inches, approximately
the distance of the baby’s face from the mother’s when
he/she is breastfeeding
TG 01: Surname 1, Surname 2, Surname 3, Surname 4 [Editor’s Surname]
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Exam 01
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 In terms of receptive language or ability to understand
 Baby can pay attention or respond to a sound by turning
towards a sound or becoming quiet or stop movements to
attend to the sound
 Babies are able to recognize voice of mother
 Expressive language
 Crying – communicative in nature and has a purpose
 Babies are not spoiled if you pick them up when they are
crying. They need something and their needs must be met.
From Videos:
 From the moment they are born, a baby can see.
Newborns eyes are very sensitive to light. Dimming the
lighting will often help a baby be more able to open his
eyes and look at his new surroundings. Babies love to
look at patterns or bright objects and faces, especially
their parents faces
 Newborns are able to track objects with their eyes and by
turning their heads to keep it in view
 Will focus on faces and objects that are about 8-12 inches
away and when a rattle is shaking softly, a baby can turn
to see where the sound is coming from
 Babies cry is a very powerful way of communication. They
cry to communicate that they are hungry, cold, wet, need
to burp, tired, overstimulated, or just need you
 Paying attention to newborn’s cries will not spoil them.
Your response will teach her to trust you to meet her
needs. Your babies will gain a sense of security and
comfort
 Newborn’s hands is mostly fisted and will try to coordinate
bringing her hand to her mouth to suckle them, which
makes her feel calm and secure
 Newborns can hold on tightly with their fingers and toes,
but she can’t let go
B. INFANTS (0-1 YEAR)
 At 2 months, infants are expected to have the ff. abilities
 Show interest in visual and auditory stimuli
 Look at things around them already, may track toys, etc
with their eyes and heads
 Smile responsively (social and responsive smile)
 Smile in response to the overture of another
 Does not include baby’s smile before sleeping “may
nakitang anghel”
 Starts to show enjoyment in interaction with parents and
caregivers
 When you put them on their tummies, they can lift their head
more effectively and their neck and upper chest with some
support on their forearms
 There is some head control in upright position although not
yet very good
 There may be headlag when you pull them to sitting
 At 4 months
 More fun to play and take care of since they are able to
laugh, squeal, coo, hold head upright, easier to carry, can roll
over from front to back
 Can now open their hands voluntarily to grasp some things
 Previously, hands were clenched into a fist
 They may become very excited by toys such as a mobile
 6 months
 Sit upright with some support (good truncal and hip control)
 Fine motor: able to place hands midline, and is able to
transfer objects from hand to hand
 Capable of paying attention, listens to conversations of
others
 Able to reciprocate vocally; turns to audible sounds
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 Holding this child via the trunk and making the child stand
shows that the child can now bear weight. The knees start to
become tense (indicating increased strength)
 9 months
 Capable of putting things into containers
 Can point to objects
 Starts to realize that things which disappear eventually come
back
 Often throw food and toys; and look for where they end up
 Not being naughty
 Just done to explore the world and know where things go
 Can imitate actions
 Important way of learning
 Gestures such as waving bye-bye when people leave, and
shaking head for ‘no’
 Separation anxiety from parents begins at this stage
 May begin to pull body up to stand up on the crib
 Thumb and forefinger function improves; Hand-eye
coordination is better developed
 Can pick up things easily
 Begins to feed himself small objects
 Be careful for choking hazards
 Sitting without support such that the baby can reach for toys
without tumbling over
 May be crawling very well
 Begins to use sounds which approximate words

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