CRITERIA:

Infant Milestones Babies grow at an amazingly fast rate during their first year of life. In addition to babies physical growth in height and weight, babies also go through major achievement stages, referred to as developmental milestones. Developmental milestones are easily identifiable skills that the baby can perform, such as rolling over, sitting up, and walking. These milestones are usually classified into 3 and categories: motor development, social/emotional language development,

Format Promptness Neatness Content References

5% 5% 10% 70% 10% -----------------

development.

TOTAL :

100%

Babies tend to follow the same progression through these milestones; however, no two babies go through these milestones at exactly the same time. Babies also spend different amounts of time at each stage before moving on to the next stage. A health care provider monitors babies as they progress through these developmental milestones. Contact a health care provider if any concern about babys development arises. Physical Development The rapid changes seen during infancy will never be encountered again throughout the life span. As the body matures, skill development progresses in an orderly fashion to enable the infant to respond to and cope with the world. Gross and fine motor skills develop in a cephalocaudal (head to toe) and proximal-distal (central to peripheral) fashion; gross motor abilities develop before fine motor abilities. The infants physical growth is influenced by genetics, the environment, ethnic background and biology. Physical growth patterns include weight, height and head circumference changes. The infants growth measurements should be plotted on a growth chart and, overtime, compared to the infants own growth curve. Weight and Height During the first 6 month of life, the infants birth weight typically doubles. The approximate weight gain is 1.5lb per month or 5-7 oz per week. By the age of 12 months of age, the infants birth weight will be tripled. Height increases during the first 6 months by approximately 1 inch per month. The rate of growth in height slows to approximately 0.5 inch (1.5cm) per month by 12 months of age, resulting in almost a 50% increase in height from the birth length. Head Growth The size of the head changes rapidly during infancy, reflecting rapid brain growth. By the age of 12 months, the infants brain will be two-thirds the size of an adults brain. During the first 6 months of life, head circumference will increases by approximately 0.5inch (1.3cm) per month. During the second 6 months of life, head circumference will slow to approximately 0.25inch

(0.6cm) per month. As the head grows, the fontanels gradually close; the posterior fontanel closing by 2 months of age and the anterior fontanel closing by 12-18 months of age.

Motor Development Motor development is strongly related to physical, cognitive and social development. Motor growth includes gross and fine motor development, which provides the infant with the means and freedom to explore the environment. Gross Motor Gross motor development is the ability to use large muscles to maintain balance and postural control or locomotion.

AGE 2-3 months

GROSS MOTOR SKILL Some head lag when pulled to sitting position Holds head up and supports weight on forearms when prone Some head bobbing while supported in sitting position Rolls from abdomen to back Tonic neck and Moro reflexes disappearing

4-6 months

Good head control with no head lag, holds chest and abdomen up with weight supported by hands while in prone position Sits with support Rolls from back to abdomen Bears weight in standing position with support Sits alone without support Bears weight with some support Moves from prone to sitting to standing position without assistance Stands alone without support Goes from crawling to creeping to cruising Attempts to walk alone

7-8 months 9-12 months

Fine Motor As development progresses, the infant begins to utilize the hands and eyes to explore and manipulate the environment. Fine motor development is the ability to coordinate hand-eye movement in an orderly and progressively manner.

AGE 2-3 months

FINE MOTOR SKILLS Follows object past midline Holds hands open Regards own hands and fingers when held in front of face Places hand in mouth Briefly reaches at a dangling object Reaches for objects beyond grasp Looks from object to hand and back again Places object in mouth Uses whole hand to grasp object Plays actively with hands and feet Holds objects securely and bangs them together Actively drops objects Transfers object between hands Pincer grasp beginning Releases object at will Dominant hand preference emerging True pincer grasp present Can self-feed finger foods Can place small objects into a container Can remove small objects from a container Can hold and mark with a crayon Can turn multiple pages in a book

4-5 months

6-7 months

8-9 months

10-12 months

Psychosexual Development Psychosexual development is based on the individuals need to seek pleasure. The individual must be able to balance pleasure seeking with societal expectations. According to Freuds Theory, the infant is in the oral stage of development, during which the need for pleasure dominates life. Oral stimulation or sucking is the central focus of this stage. According to Freud, feeding or nutritive sucking becomes the most important source of pleasure and satisfaction.

Psychosocial Development The psychosocial development of an infant, as defined by Erikson, is centered on the concept of trust versus mistrust. According to Erikson, trust is developed when the basic needs of feeding, clothing and comforting are met by the caretakers. If these needs are not met, the infant will develop a mistrust of others. The quality of the caregiver-infant interaction while providing care also plays a major role. If the caregiver consistently demonstrates nurturing behaviors such as talking, playing, smiling, dressing, and comforting, the infant will develop a

strong sense of trust. if the infants needs are met in a consistent manner by the caregiver or alternative child care provider, trust in the self as well as trust in others and the surrounding environment will develop. If not, the infant will eventually develop a sense of mistrust.

Cognitive Development According to Piaget, an infant is in the sensorimotor stage of cognitive development when knowledge is acquired about an object through interaction with that object and use of the senses. The major task for the infant, according to Piaget, is object permanence, where the infant learns an object is not an extension of the self and continues to exist even when it cannot be seen. Substage 1 Description The newborn learns about the world through repetitive use of involuntary reflexes such as rooting, sucking or crying will provide the infant with cause-and-effect experiences 2 Primary circular reactions occur between 1-4 months of age; the infants random movements become voluntary actions. The infant becomes an active observer of the world but continues to be dominated by the need for pleasure 3 Between 4-8 months of age, secondary circular reaction progresses. This is characterized by becoming more aware of the surrounding environment and mastery of voluntary actions. The infants actions are more intentional and not solely directed by pleasure, as the infant learns through repetitive actions to create interesting sights and sounds and begins to focus on the effects of the actions 4 The infant applies newly mastered skills to new experiences during 812 months called coordination of secondary schema and is able to put several events together to accomplish an end result

Language Development Communication enables the infant to express needs, emotions and attitudes and involves central nervous system maturation, cognitive abilities and social interaction. The infants initial means of communication is through crying and smiling. The infants ability to communicate through language follows a predictable course. As maturation progresses so do the language abilities. During infancy, receptive language (the ability to understand words) is greater than expressive language (the ability to speak words). By the end of the first year, the infant can say several words such as da-da and ma-ma as well as understand simple commands such as bye-bye, poin your belly and no-no.

AGE Birth-2months

EXPRESSIVE SKILLS Crying Comfort sound with feeding Coos Vocalizes to familiar voice Vocalizes during play and pleasure Squeals Laughs aloud Less crying Uses vowels and sounds that resemble syllables

RECEPTIVE SKILLS consonant Sounds elicit startle reflex Turns sounds Prefers human voice Watches speaking mouth Shifts sounds Understands own name Uses sound to get attention Associates activity Responds Understands words Recognizes members names Recognizes name Understands commands bye) (say simple byeobjects by to simple familiar family commands (no-no) words with gaze between and looks for

3-6 months

7-9 months

(ma, mu, ba, ga, ah, da) Increases vowel and consonant sounds Uses two-syllable sounds (baba, dada) Talks along with others

10-12 months

Says mama and dada to identify caregivers Repeats sounds made by others Makes intentional gestures Learns 3-5 words

Health Promotion The health status of an infant, a major concern for caregivers, is based on the ability to adapt to rapid changes. Therefore, the caregiver needs to know the expected physical, emotional and developmental growth patterns of an infant.

Temperament Temperament is the way a child interacts with the surrounding environment. Children are thought to be genetically endowed with specific temperamental characteristics, which, when

combined with caregivers personality, produce a characteristic pattern of social interaction between the child and the environment. TYPE Easy CHARACTERISTICS Difficult Slow-towarm-up Easy going and adapts rapidly to stimuli Has an overall positive mood Likes to be around people Sleeps and eats well Has regular and predictable behaviors Adapts slowly to stimuli Has an overall negative mood Requires a structured environment Likes people but can do well alone Seems to be in constant motion Has irregular patterns of behavior Adapts slowly to stimuli but is watchful Quietly withdraws and usually moody Primarily a loner and socially shy Oversensitive and slow to mature Primarily inactive Reacts passively to changes in routine

Sleeping Pattern Infants have variable sleep patterns that are influenced by temperament, satisfaction with feelings, caregivers responses to periodic awakenings and environmental conditions. As the child matures, the sleep-wake cycle evolves into a pattern of being awake during the day and asleep at night. AGE Newborn 1 month 4 months 6 months 1 year AWAKE 7.5 hours 8.5 hours 9 hours 9.25-9.75 hours 10.25 hours DAY SLEEP 8 hours 6.75 hours 4.5 hours 3.25-4 hours 2.25 hours NIGHT SLEEP 8.5 hours 8.75 hours 10.5 hours 11 hours 11.5 hours

Physical Development Despite the many factors, such as genetic background, environment, health, gender and race that affect growth in the first year of life, the healthy infant progresses in a predictable pattern. By the end of the year, the dependent infant who at 1 month of age had no teeth and could not roll over, sit or stand blossoms into an emerging toddler with teeth who can sit alone,

stand and begin to walk alone. The growth seen in the prenatal development of the fetus continues.

Head and Skull At birth, an infants head circumference averages about 13.75 inches (35cm) and is usually slightly larger than the chest circumference. The chest measures about the same as the abdomen at birth. At about 1 year of age, the head circumference has grown to about 18 inches (47cm). the chest also grows rapidly, catching up to the head circumference at about 5-7 months of age. From then on, the chest can be expected to exceed the head in circumference.

Fontanels and Cranial Sutures The posterior fontanel is usually closed by the 2nd or 3rd month of life. The anterior fontanel may increase slightly in size during the first few months of life. After the 6 th month it begins to decrease in size, closing between the 12th and the 18th months. The sutures between the cranial bones do not ossify until later childhood.

Eruption of Deciduous Teeth Calcification of the primary or deciduous teeth starts early in fetal life. Shortly before birth, calcification begins in the permanent teeth that are the first to erupt in later childhood. The first deciduous teeth usually the lower central incisors, usually erupt between 6-8 months of age.

Neuromuscular Development As the infant grows, nerve cells mature and fine muscles begin to coordinate in an orderly pattern of development. Average rates of growth and development are useful for purposes of making comparisons. Few landmarks call for special attention, and their absence may indicate the need for additional environmental stimulation.

Psychosocial Development The give-and-take of life is experienced by the infant who actively seeks food to fulfill feelings of hunger. The infant begins to develop a sense of trust when fed on demand. However, the infant eventually learns that not every need is met immediately on demand. Slowly the infant becomes aware that something or someone separate from oneself fulfills ones needs.

Gradually, as the result of the loving care of the family caregivers, the infant learns that the environment responds to desires expressed through ones own effort and signals. The infant is now aware that the environment is separate from self.

Motor Development Gross Motor Birth to 4 weeks, able to catch and holds objects in sight that crosses his visual fields. Can turn head from side to side when lying in a prone position and when in prone position, can move extremities in a crawling position. At 6 weeks, tries to raise shoulders and arms when stimulated and can hold head up when in prone position. When the infant reach 10-12 weeks, he has no Moro reflex anymore and has symmetrical body positioning. At 16 weeks, he plays with his hands and brings objects to his mouth. He can balance his head and body for short periods in sitting position. At 20 weeks, he is able to sit up, can roll over, bear weight on legs when held in a standing position and is able to control head movements. When he reaches 24 weeks, his Tonic neck reflex disappears and he can now sit alone in a high chair and can now roll over and then back to abdomen. At 28 weeks, he can reach without visual guidance and can lift head up when in supine. At 32 weeks, he can now crawl around and can pull toy towards himself and when the infant reaches 40 weeks, he can now stand alone and can begin to walk alone. Fine Motor From birth to 4 weeks, grasp reflex is very strong and can flex the hands. At 6 weeks, can now open his hands and less flexions are noted. At 10-12 weeks, no grasp reflex anymore, pulls on clothes, blanket but does not reach for them. At 16 weeks, he can now grasp objects with 2 hands and eye-hand coordination begins. When the infant reach 20 weeks, he can now hold one object while looking for another one and can grasps voluntarily and brings them to his mouth. At 24 weeks, can hold bottle well and he tries to retrieve a dropped article. At 28 weeks, can hold cup, can transfer objects from one hand to the other. At 32 weeks, pincer grasp is developed and can stand up while holding on. Lastly when the infant reaches 40 weeks to 1 year, then the infant can holds a tool on one hand and works on it on the other hand. Can now put toys in a box after demonstration and can now hold a crayon to scribble on a paper.

AGE Birth4weeks

PHYSICAL

PERSONAL-

LANGUAGE Cries upset

COGNITION

SOCIAL Weight gain of Some smiling 5-7oz (150- Begins 270g) per week

when At 1 month, sucking activity with associated pleasurable sensation

Eriksons stage Makes

Height gain of 1 per month for the months Head per month Moro, Babinski, rooting, tonic 6weeks and neck first 6

of

trust

vs.

enjoyment sounds during meal times

mistrust

reflexes present Tears appear Smiling response familiar stimuli

in Cooing to predominant Smiles to familiar voices

Primary circular reactions Begins to repeat actions

10-12 weeks

Posterior fontanel closes

Babbling Aware of new Makes noises Beginning environment Less crying Smiles significant at when to of stimuli

of

coordinated

spoken responses to different kinds

16 weeks

Moro, reflexes

others rooting Responds stimulus Sees

to Laughs aloud Sounds bottle, k, g and b

Likes social situations

and tonic neck disappear;

n, Defiant, bored if unattended

squeals, laughs environment and shows Visually looks for an object interest show Smiles at self in Cooing noises mirror Cries when when objects limits are set or Squeals delight

drooling begins Aware of new

20 weeks

May

signs of teeth

with that has fallen

24 weeks

Birth

are taken away weight Likes to be Makes sounds Secondary circular reactions picked up from strangers Plays Boo Peek-aguh,bah, family Sounds are pronounced Repeats actions that affect p, an object of object permanence

doubles; weight 5 oz(90-150g)

gain slows to 3- Knows per week Height slows to per month

m, b and t Beginning

Knows likes and Babbling

Teething begins lower 28 weeks central

dislikes with Fear strangers of

sounds

incisors Lower lateral Imitates simple Babbling incisors are acts no preferences and dislikes for food Dislikes and change Afraid strangers Fear separating of from of decreases to Duplicates ma-ma and pa-pa sounds followed in the Responds next month by upper incisors central Shows

32 weeks

Teething continues

diaper Combines clothing syllables has attributing meaning them to but trouble

40 year

Birth

mother weight Does things to Words emerge Coordination of secondary Says and da-da schemes; masters barrier to ma-ma reach meanings goal, symbolic to follow

weeks- 1 tripled; has 6 attract attention teeth; Babinski Tries reflex disappears Anterior to Imitates parents when being read

with meaning

fontanel closes Looks for objects between now not in sight and 18 months Nutrition During the first year of life, the infants rapid growth creates a need for nutrients greater than at any other time of life. The Academy of Pediatrics Committee on Nutrition has endorsed breast-feeding as the best method of feeding infants Age 1-3 Months

Between 1-3 months of age, babies begin the transformation from a totally dependent newborn to active and responsive babies. Many of the newborn reflexes are lost by this age. Babies vision changes dramatically and they become more aware and interested in their surroundings. They might follow moving objects, recognize familiar objects and people at a distance, and start using their hands and eyes in coordination. At this age, babies usually turn toward familiar voices and smile at their parents faces or other familiar faces. They also begin to coo (make musical vowel sounds, such as ooo or aaa).

The neck muscles become stronger during these first few months. At first, babies can only hold their heads up for a couple of seconds while on their stomachs. The muscles are strengthened each time the head is held up. By age 3 months, babies lying on their stomachs can support their heads and chests up to their forearms. Arm and hand movement develops fast during this stage. What was once a tight, clenched fist is now an open hand grabbing and batting at objects. Babies explore their hands by bringing them in front of their face and putting them in their mouths. By the end of this period, most babies have reached the following milestones:

PHYSICAL DEVELOPMENT

1 MONTH OLD: The child gains 150-210 g weekly for the first 6 months. The height increases 2.5 cm monthly for the first 6 months. And head circumference increases by 1.5 cm for first 6 months. Primitive reflexes are present and strong. Obligatory nose breathing is noted. 2 MONTHS OLD: Posterior fontanel is closed. And crawling reflex disappears. 3 MONTHS OLD Primitive reflexes fading. GROSS MOTOR

1 MONTH OLD: Assumes flexed position neither with pelvis high but knees nor under abdomen when prone. Can turn his head from side to side when in prone position. In sitting position, has uniformly rounded back, absence of head control.

2 MONTHS OLD Limbs relax and stretch partially; lifts head 45 degrees; head wobbly while held sitting; muscle twitches lessen; hands partially unfold; swipes aimlessly; holds rattle briefly. 3 MONTHS OLD Stretches limbs all the way out; holds head about 45 degrees; pushes down on legs when feet are placed on a firm surface; supports upper body with arms when lying on stomach;

hands open, makes swiping reaches but still misses more than hits; holds and shakes rattle longer; grabs clothing and hair of others; sucks fingers and fists; plays with hands. FINE MOTOR

1 MONTH OLD Babys Hands are predominantly closed. Their grasp reflex is strong. And they clench their hand when they are contact with rattle. 2 MONTHS OLD Hands are often open and grasp reflex is fading. 3 MONTHS OLD Baby holds rattle but will not reach for it. Grasp reflex is absent. Holds kept loosely open. Clutches own hand and pulls at blanket and clothes.

SENSORY DEVELOPMENT

1 MONTH OLD They can able to fixate on moving object in range of 45 degrees when held at distance of 20-25 cm. Their visual acuity approaches 20/100. They can follow light to midline. And the keep quit when they hear voice.

2 MONTHS OLD Binocular fixation and convergence to near objects is beginning. When in supine position the baby follows dangling toy from side point beyond midline. Visually searches to locate sounds. And turns head to side when sound is made at level of ear.

3 MONTHS OLD Follows object to periphery about 180 degrees. Locates sounds by turning head to side and looking in same direction. And begins to have ability to coordinate stimuli from various sense organ Vocalization

1 MONTH OLD They cry to express displeasure. They make small throaty sound. And makes comfort sounds during feeding. 2 MONTHS OLD They vocalize distinct from crying. Crying becomes differentiated. They make coos sound. And they vocalize to familiar voices. 3 MONTHS OLD They sequels loud to show pleasure. They make babbles and they chuckles. They vocalize when someone smiles at them. And they have less crying during periods of wakefulness.

SOCIALIZATION

1 MONTH OLD They watches their parents face intently as they talk to them. 2 MONTHS OLD They already demonstrate social smile in response to various stimuli. 3 MONTHS OLD They display considerable interest in the surroundings. They cease crying when parents enter the room. They can already recognize familiar faces and objects such as feeding bottle. And shows awareness of strange situations. Age 4-7 Months From age 4-7 months, babies learn to coordinate their new perceptive abilities (including vision, touch, and hearing) and motor skills such as grasping, rolling over, sitting up, and may be even crawling. Babies now have more control over what they will or will not do, unlike earlier months in which they mainly reacted by reflex. Babies will explore toys by touching them and putting them in their mouth instead of just looking at them. They can also communicate better and will do more than simply cry when they are hungry or tired or when they want a change in activity or a different toy. By this time, babies have developed a strong attachment for their parents and they may show a preference for their primary caretakers. However, babies at this age usually smile and play with everyone they meet.

Once babies can lift up their heads, theyll push up using their arms and arch their back to lift up the chest. These movements help strengthen the upper body and are preparation for sitting up. They may also rock while on their stomachs, kick their legs, and swim with their arms. These movements are necessary for rolling over and crawling. By the end of this period, babies should be able to roll over from stomach to back and back to stomach and probably are able to sit without any support. By age 4 months, babies can easily bring toys to their mouth. They use their fingers and thumb in a clawlike grip to pick up objects. By age 6-8 months, they can transfer objects from hand to hand, turn them from side to side, and twist them upside down. Babies also discover their feet and toes during this stage. Babies range of vision is apparent as they concentrate and focus on objects and follow movements. Babies like increasingly complex patterns and shapes. They also like looking at themselves in a mirror. Babies continue to babble, but now they raise and lower their voice as if asking a question or making a statement. By the end of this period, most babies have reached the following milestones:

PHYSICAL DEVELOPMENT

4 MONTHS OLD Moro, tonic neck, and rotting reflexes disappear.

5 MONTHS OLD Beginning signs of tooth eruption. And their birth weight doubles. 6 MONTHS OLD Their growth weight may begin to decline. They weight gain 90-150 weekly for 6 months. Height gain 1.25cm monthly for 6 months. They may begin teething with eruption of 2 lower central incisors. They may chew and bite. 7 MONTHS O.LD The eruption of upper central incisors

GROSS MOTOR

4 MONTHS OLD Stands with support; sits propped on arms and lifts head 90 degrees and scans 180 degrees; rests on elbows; rolls tummy-to-side; uses two-handed embracing reach; accurately gathers dangled toy; explores clothing; uses mitten-like grasp.

5 MONTHS OLD its propped with pillows on floor or chair; stands, holding on for balance; rolls purposefully from tummy-to-back; rocks on tummy; assumes push-up position; wiggles forward; cranes neck forward to see; reaches one hand with good aim; transfers toys from hand to hand or mouth; begins block play. 6 MONTHS OLD Sits briefly by self; sits in high chair; stands briefly while leaning on furniture; rolls over both ways; digs in with toes and hands to move toward toy; reaches precisely; points at toys; manipulates blocks; uses whole hand to pick up small objects with thumb and fingers. 7 MONTHS OLD When in supine position they lift head off surface. When they are in a prone position

they bears weight on 1 hand. And they bears full weight on their feet. FINE MOTOR

4 MONTHS OLD They tries to reach object with hand but overshoot. They grasp object with both hand. They play rattle placed on their hand, shakes it but cant pick it up if dropped. Can carry object to mouth. 5 MONTHS OLD They are able to grasp object voluntarily. They use palmar grasp. Plays with toes. Takes object directly to mouth. And they holds 1 cube and regarding the 2nd one.

6 MONTHS OLD They resecure a dropped object. They drop 1 cube when another is given. Grasp and manipulates small objects. Holds bottle. Grasp feet and pulls to mouth. 7 MONTHS OLD

They transfer object from one hand to another. Has unidextrous approach and grasp. Holds 2 cubes momentarily. They bangs cubes on the table. They rakes at small objects.

SENSORY DEVELOPMENT

4 MONTHS OLD Baby was able to accommodate to near objects. Binocular vision is fairly well established. Can focus on a 1.25cm-block. Beginning eye-hand coordination.

5 MONTHS OLD They visually pursue dropped objects. They are able to sustain visual inspection of an object. And they can localize sound made below their ear.

6 MONTHS OLD they adjust posture to see objects. Prefers more complex visual stimuli. They can localize sounds made above ear. They will turn head to side, then look up and down. 7 MONTHS OLD they can fixate on very small objects. They respond to their own name. Localize sound by turning head in curving arch. They begin awareness of depth and space. They have rate preferences. VOCALIZATION

4 MONTHS OLD They make consonant sounds like n,k,g,p,b. They laugh loud. And their vocalization change according to their mood. 5 MONTHS OLD They squeals. They makes cooing vowel sounds interspersed with consonant sound.

6 MONTHS OLD They begin to imitate sounds. Vocalize to toys and mirror image. And they take pleasure in hearing their own sound. 7 MONTHS OLD

They produce vowel sound and chained syllables like dada, mama, papa. They can vocalize distinc vowel sounds. They take when other is talking.

SOCIALIZATION

4 MONTHS OLD Forms mental images of what to expect when given a cue; becomes aware that people and things have labels, such as cat or mommy or daddy. 5 MONTHS OLD Learns which sounds and gestures get a response; shows decision-making expressions during hand play; figures out objects and changes hand position to touch objects.

6 MONTHS OLD Shows more intentionality during play, such as trying to figure out how to pick up a third object with one already in each hand.

7 MONTHS OLD Increase fear to stranger; show sign of fretfulness when parents disappears. Imitates simple acts and noises. Tries to attracts attention by coughing. They plays pick-a-boo. Dislikes dressing and diaper change. Age 8-12 Months By age 8 months, most babies can sit up without support. They also figure out how to roll down to their stomachs and return to a sitting position again. Some babies are in constant motion; theyll arch their necks and look around while on their stomachs and grab at their feet or objects while on their backs. All this activity is preparing them for crawling, which is usually mastered between 7-10 months. Crawling is important for the development of integrated communication between the 2 sides of thebrain. Some babies never crawl but rather scoot on their bottoms or move on their stomachs, like an army crawl. Babies become increasingly more mobile during this stage; now is the time to childproof so baby can explore and discover without the possibility of injury. Baby gates are important to block off stairs or rooms that could be dangerous (such as bathrooms). After crawling is mastered, babies begin to pull themselves up to a standing position. They then begin to take some steps while holding on to something for support. This will change into

cruising around the furniture. As their balance improves, babies may gradually take a few steps without holding on. Many babies first steps are taken around 12 months, but earlier or later than this is completely normal. By the end of this stage, babies begin to use the pincer grasp, using the thumb and first or second finger to pick up small objects. As babies learn how to open fingers, they are able to drop and throw things. Babies also more thoroughly investigate objects by shaking them, banging them, and moving them from hand to hand. Babies are interested in objects with moving parts, such as wheels and things that open and close. They also like to poke their fingers through holes. Babies also show a lot of growth in their language development during this period. They begin to make recognizable syllables like ma or da, which eventually turn into mama or dada. They can also imitate speech sounds they hear others make. By age 12 months, many babies say at least one word (other than mama and dada) clearly. They understand the meaning of no and begin to follow simple commands. Babies communicate nonverbally by pointing, crawling, or gesturing toward desired objects. The can also initiate and play gesture games, such as peek-a-boo and pat-a-cake. Babies learn object permanence, the concept that an object still exists when taken out of their sight, during this stage. For example, if a toy is hidden under a blanket, babies will pick up the blanket and search for it. Babies also learn that objects have functions besides being just something to chew on or bang with (such as a hair brush or phone). Separation anxiety and stranger anxiety usually begin during this period and are a normal part of babies emotional development. Separation anxiety occurs when parents leave a babies sight, resulting in great distress with fussing and crying. Separation anxiety usually peaks between age 9-18 months and fades before their 2-year birthday. Stranger anxiety is a reaction of distress with an infant encounters a stranger. By the end of this period, most babies have reached the following milestones: PHYSICAL DEVELOPMENT

8 MONTHS OLD Begins to show regular pattern in bladder and bowel elimination. And parachute reflex appears. 9 MONTHS OLD Eruption of upper lateral incisor may begin. 10 MONTHS OLD

Labyrinth-righting reflex is strongest when infant is in prone position or supine position. And able to raise head. 11 MONTHS OLD Eruption of lower lateral incisor may begin. 12 MONTHS OLD The birth weight is tripled. The birth length is increased by 50%. Head and chest circumference is equal with a 46 cm. anterior fontanel is almost closed. Landau reflex is fading. Lumbar curves develops; lordosis evident during walking. GROSS MOTOR FINE MOTOR

8 MONTHS OLD Reads objects at will. Rings bell purposely. Returns two cubes regarding the 3rd one. And secures object by pulling on string. 9 MONTHS OLD Use thumb and index finger in cube pincer grasp. Preference for use of dominant hand now evident. And compares two cubes by bringing them together. 10 MONTHS OLD Crude of an object release beginning. And grasp bell by handle. 11 MONTHS OLD They explore object more toughly. Has an already neat pincer grasp. They drops object deliberately for it to be picked up. Puts one object after another into container. And able to manipulate object to remove it from tight-fitting enclosure. 12 MONTHS OLD Releases cube in cup. Attempts to build 2-blocks tower but fails. Tries to insert pellets into bottle but fails. Can turn pages in a book, many at a time.

REFERENCES: Adele Pillitteri (2005) Fifth Edition, Volume 2, Maternal & Child Health Nursing: Care of the Childbearing & Childrearing Family

Wong (2007) Nursing Care of Infants and Children

Hatfield, N (2008) 7th Edition, Broadribbs Introductory Pediatric Nursing

Potts, N., & Barbara, M. (2007) Second edition Pediatric Nursing: Caring for Children and their Families

Kozier (2007) 8th edition, Fundamentals of Nursing: Concepts, Process and Practice

Milestone of Infancy
In partial fulfillment of the requirements of NCM-101 RLE

School Nursing Rotation

Submitted to: Mrs. Ma. Paz Ta-asan, RN,MN Clinical Instructor

Submitted by: Publico, Loney II Samonte, Joyce Jemelle R. BSN-2D

August 27, 2011